EMS/SMART

SMART History

In 1996, the SUNY at Buffalo School of Medicine, Department of Emergency Medicine, in cooperation with the Erie County Medical Center and the Erie County Department of Emergency Services created the Specialized Medical Assistance Response Team (SMART). SMART began with residents, EMS fellows and local EMS personnel augmenting the area’s emergency response system by providing on-scene medical control and the ability to provide advanced medical care not routinely done in the pre-hospital environment.

In October 2001, oversight of SMART moved from the Erie County Medical Center to the Erie County Department of Health while maintaining a continued close working relationship with the EM Residency and EMS Fellow programs.  Also at this time, the mission was expanded to include preparation and response for potential Bio-Terrorism threats, pandemic flu and emerging diseases, and other Public Health emergencies.  The roster of SMART members has continued to expand and includes over 400 volunteers from throughout the eight counties of Western New York in addition to Public Health and EMS officials.  Members come from multiple disciplines both in and out of the medical field, including:

• Medicine
• Nursing
• Public Health
• Veterinary Medicine
• Allied Health
• Mental Heath
• Law Enforcement
• EMS
• Fire Service
• HAZMAT
• Epidemiology
• Laboratory Sciences

This expansion has allowed residents a wide variety of training opportunities beyond the traditional EMS rotation; SMART’s involvement with multiple local and regional organizations gives residents in the program a unique opportunity to see firsthand the complexities often involved in pre-hospital care and disaster preparedness.

Through SMART, residents have an opportunity to gain training and experience in Tactical Medicine.  SMART works closely with SWAT from multiple area police departments.  These include the Buffalo Police Department, Erie County Sheriff’s Department, and the FBI.  Residents learn through didactic lecture and practical experience, including basic weapons training.  During the EMS rotation, residents respond to a variety of local SWAT missions with either attending faculty and/or County EMS personnel.  Further opportunities also exist through the EMS track of the EM Residency.

For incident response, the Specialized Medical Assistance Response Team utilizes three Ford Expeditions equipped with warning devices (lights & siren), communications equipment, a global positioning satellite navigation system, and all necessary advanced life support medical equipment (e.g., chest tubes, defibrillator, central IV lines, advanced airway management equipment, medications, etc.) A full complement of personal protective equipment (e.g., turnout gear, jumpsuits, body armor, etc.) is also stocked on the response vehicle for use by the team members. The primary SMART response consists of a minimum of one physician (EMS Fellow, EMS resident, or ED attending) and a representative from Erie County Department of Emergency Services, EMS Division.

Some typical SMART activities are to:

• Provide on-scene triage during prolonged or unusual incidents (e.g., disasters, MCI)
• Provide advanced/specialized patient care during unusual incidents (e.g., disasters, building collapse, patient entrapment, MCI, etc.)
• Provide on-scene medical direction during prolonged or unusual incidents (e.g., disaster, MCI)
• Serve as an additional component of the Erie County Disaster Response Team
• Provide specialized tactical emergency medical support to federal (i.e., FBI) and local S.W.A.T. teams during routine operations and training missions
• Provide medical direction, medical support and patient care assistance during community/civic events throughout Western New York (e.g., Rich Stadium events, festivals, etc.)
• Provide prehospital educational opportunities to the SUNY at Buffalo Emergency Medicine Residents
• Provide a means of conducting advanced prehospital care research

SMART can be activated during a disaster to establish a casualty collection point near the scene of a disaster or to establish a Point of Distribution to provide mass immunizations or post exposure prophylaxis after a public health emergency. For more information on the SMART expansion, please go to: http://www.wnysmart.org.

SMART is available for response 24 hours per day, 7 days per week. Requests for a response by SMART should be directed to Erie County MERS Control who is responsible for dispatching the SMART team via a digital paging system. All services rendered by SMART are provided to patients at no charge.