It has become clear that one of the steps a local community must take to prepare for the medical response to a disaster or catastrophic mass casualty incident is the development of an Alternative Medical Treatment Site plan. Hospitals across Florida are extremely busy on a daily basis. In a disaster situation, hospitals become overwhelmed and it is essential that their resources remain available for treating critical patients. One method to achieve this is to open Alternative Medical Treatment Sites (AMTS) to handle "green tagged" or "minor" patients.

The Florida Department of Health and the Center for Disaster Risk Policy at Florida State University undertook a series of tabletop and drill format exercises to help enhance Florida's pre-hospitalization response capabilities through evaluating and strengthening the concept of AMTS.

Entitled "BETA Fish Exercise", the Florida counties of Leon, Martin and Orange were identified to test their AMTS plans VIA these exercises. Contained in this web site are the exercise documents which outlines how the series of exercises were developed, designed and facilitated. In addition, the various tools used to make this series of exercises both a learning opportunity and a capacity building initiative can be found within this web site.

In May 2008 the United States House of Representatives, Committee on Oversight and Government Reform released a report entitled Hospital Emergency Surge Capacity: Not Ready For The Predictable Surprise.

From the report's Executive Summary:

At the request of Chairman Henry, the majority staff of the Committee conducted a survey of Level I trauma centers in seven major cities in the United States to assess whether they have the capacity to respond to the level of casualties experienced in the Madrid Spain commuter trains attack that killed 177 instantly and injured more than 2,000.

The survey was conducted on Tuesday March 25 2008 at 4:30PM local time in each of the seven cities. The survey was designed to determine the real-time capacity of the emergency rooms at the Level I trauma centers to absorb a sudden influx from a mass casualty incident. 34 of the 41 Level I trauma centers in these cities participated in the survey.

The results of the survey show that none of the hospitals surveyed in the seven cities had sufficient emergency care capacity to respond to an attack generating the number of casualties that occurred in Madrid.

The entire report can be viewed by logging onto:

Support for your community to implement or strenghten an AMTS can be provided by the Center for Disaster Risk Policy at Florida State University. For additional information log onto: