Alternate Care Site Presentation FEPA

Report
Catastrophic Health Incident
Response Planning
Catastrophic Incident Response
Community
Emergency Operations
EMS
Law
Enforcement
Hospitals
Fire
High
Impact
Incident
Public
Administration
Public Works
Citizen
Volunteers
Public Health
2
Catastrophic Incidents
TIME (min)
0
15
30
45
60
90
>120
Self-evacuee’s
50 - 80% bypass
public safety
Public
Safety
Arrival
“Upside down triage”
EMS
Bystanders transport 80% of
casualties (11% of admits)
Approx. 20%
of causalities
EMS transports 20% of
casualties (88% of admits)
Source: Davis, 2004
3
Catastrophic Incidents
TIME (min)
0
15
30
45
60
90
>120
Self-evacuee’s
50 - 80% bypass
public safety
Public
Safety
Arrival
“Upside down triage”
EMS
Bystanders transport 80% of
casualties (11% of admits)
Approx. 20%
of causalities
EMS transports 20% of
casualties (88% of admits)
GOAL - Protect The Hospitals
Source: Davis, 2004
4
Psychological vs. Medical
“Footprint”
The size of the
psychological
“footprint”
greatly exceeds
medical
“footprint”
!
“Not all victims should be
evaluated in the
emergency department”
psychological
“footprint”
> 4:1
medical
“footprint”
5
Statewide Catastrophic
Health Incident Response
Plan (CHIRP)
“Chance favors the prepared mind.”
Louis Pasteur
6
CHIRP Scope
A catastrophic incident may result from:
natural events (hurricanes, floods, etc.)
large-scale accidents such as a plane crash
manmade/terrorism events
Size of incident is not the determining
factor, capacity and capability to respond
is most important factor
7
CHIRP Provisions
Provides for:
Incident response strategy
• Preparedness, prevention, response, recovery
Roles and responsibilities
Coordination of regional response
Alternate Care Sites
• Expansion of medical care capacity and capability
8
Statewide CHIRP
All hazards plan utilizing principles from;
National Response Framework (NRF)
National Incident Management System (NIMS)
National Preparedness Guidance (NPG)
Incorporate plans and resource from
regional:
Law enforcement, emergency management,
EMS, fire/rescue, hospitals, and public health
9
Statewide CHIRP
Concept of operations
Develop, exercise and maintain regional
catastrophic response plans which support
local plans, and draw on regional, state, and
federal assets
Catastrophic Incident Response Plans
reside at the regional level
10
Regional CHIRP Provisions
Incident management
priorities
Protect, restore critical
infrastructure, resources
Conduct law enforcement
operations
Protect property, mitigate
impacts
Facilitate recovery
Source: FEMA Photo Library
11
Operational Goals
Provide chain of command
Attend to all victims
Minimize injury/illness, damage/loss of property
& records
Provide maximum safety
Integrate with community emergency plans
Maintain and restore normal services
Provide supportive action
All operational goals are built into the Emergency Operations Plan (EOP)
12
Concept of Operations
Statewide and Federal Assets
Coordinates
Regional
Catastrophic Incident Response Plans
Enhances
Local/County
Communications
Risk/Public Information
Special Needs Populations
Volunteer Credentialing
Patient Tracking
Alternate Treatment Sites
Training/Exercises
Local/County
Emergency
Response Plans
13
Concept of Operations
Statewide
Regional
Local
Ambulance Hospital
Response Response
Plan
Plan
Public
Health
Response
Plan
Behavioral
Health
Response
Plan
Mass
Fatality
Response
Plan
Catastrophic Incident Response Plans
& Multi-Agency Coordinating Teams
Communications
Risk/Public Information
Special Needs Populations
Volunteer Credentialing
Patient Tracking
Alternate Treatment Sites
Training/Exercises
Local Emergency
Response Plans
14
Planning Targets
Rural Areas
Minimum 100 total casualties
per incident
Smaller Urban Areas
Minimum 250 total casualties
per incident
Major Urban Areas
500 casualties per million
population
15
Planning Assumptions
CHIRP will knit together existing plans, not
replace them.
Agency Mass Casualty Plans
• Fire Departments and EMS Agencies
• Hospitals
• Law Enforcement Agencies
Field Operations Guide (FOG)
Medical Examiner Disaster Plans
MMRS Regional MCI Plans
16
Assumptions
Triage / Treatment
Basic Principles of Disaster Medicine must
apply
Level of care will be less than day to day
medicine as we know it
Standards
Will see and care for larger patient / staff
ratios
17
Regional Catastrophic Health
Incident Response Plan
Components
Prehospital (MCI) Response Plan
Alternate Medical Treatment Site Plan
Hospital Response Plan
Mass Fatality Plan (FEMORS)
Lab Surge Capacity Plan
Healthcare Professional Surge Capacity
Plan
Disaster Behavioral Health Plan
18
Injury Severity
10 percent immediate deaths
Of those surviving:
20 percent emergent (severe
multi-system injuries)
30 percent urgent (able to defer
definitive treatment once
stabilized)
50 percent mild or moderate
(the “walking wounded’)
1
2
3
4
19
Practical Options
Expand via
Mobile facilities-expand in place or deploy to
incident site
Convert existing buildings to temporary hospitals
Use of shuttered hospitals [closed,
obsolete,mothballed, bankrupt, etc.]
Add beds to existing facilities
Build temporary facilities
Develop protocols addressing emergency
standard of care procedures
20
Alternative Care Sites Plan
Region 5 Domestic Security Taskforce
Central Florida MMRS
Central Florida UASI
Funding Sources
State Homeland Security Grants (DHS)
Centers for Disease Control Grants (CDC)
DHHS – ASPR Grants (ASPR)
Urban Area Security Initiative Grants (UASI)
Metropolitan Medical Response System Grants
(MMRS)
22
ACS Cache Locations
1
2
3
4
5
ASPR Funded
6
7
23
MCI Cache Locations
MCI
MCI
DHS Funded
MCI
MCI
100 Pt Caches
24
MCI Cache Locations
MCI
UASI
MCI
100 Pt Caches
MCI
MCI
UASI
25
All MCI Cache Locations
MCI
UASI
250 Pt Cache
MCI
UASI
MCI
UASI
MCI
26
Hospital Cache Locations
Hospital
Speedway
Hospital
Spaceport
Hospital
Hospital
Hospital
Hospital
Theme
Cruise ship Port
Hospital
Parks
Hospital
MMRS Funded
27
County Cache Locations
County
County
County
County
Region
UASI Funded
100 Pt Caches
&
Enhance
Regional
500 Pt Cache
County
28
All Cache Locations
1 Regional Cache – 500 pt
County MCI
5 County Caches – 100 pt
Hospital
Region 5
Medical
Surge
Strategy
Required Capacity Surge
UASI
8 Hospital Caches – 100 pt
MCI
County
UASI
Hospital County
6 Sm MCI Caches – 100 pt
County Region Hospital
Hospital
Hospital Hospital
1 Lg MCI Cache –
250 pt
Hospital MCI
UASI
HospitalTotal
Surge – 2,650 pt
County
MCI
500 Pt / Million Pop.
Regional Population
≈3 million population
1500 Pts.
29
Alternate Care Site Cache Trailers
30
31
First Aid and Casualty Collection Points for Mass Gathering Events.
32
State
Medical
Response
Team
33
34
35
ZUMBRO
Air Inflatable
Quad Tents
Temps Cots
Westcots
carts, tables & chairs
36
State Medical Response Teams
37
Florida has Three Mobile Field Hospitals and One Rapid Response Hospital
State Medical Response Team
Set-up
38
Leveraging Our Assets
Pandemic Influenza Caches
Points of Dispensing Caches
Special Needs Shelter Caches
Mass Casualty Caches
Local and Regional AMTS Caches
State Medical Response Team Cache
42
43
Federal Health and
Medical Response
Natural Disasters
Transportation Disasters
Terrorism
Technological Disasters

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