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Catastrophic Health Incident Response Planning. 2 Catastrophic Incident Response Community Fire Hospitals Public Administration Public Health Emergency.

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Presentation on theme: "Catastrophic Health Incident Response Planning. 2 Catastrophic Incident Response Community Fire Hospitals Public Administration Public Health Emergency."— Presentation transcript:

1 Catastrophic Health Incident Response Planning

2 2 Catastrophic Incident Response Community Fire Hospitals Public Administration Public Health Emergency Operations Public Works Citizen Volunteers Law Enforcement EMS HighImpactIncident

3 3 Catastrophic Incidents TIME (min) >120 EMS Approx. 20% of causalities PublicSafety Arrival Source: Davis, 2004 Upside down triage Bystanders transport 80% of casualties (11% of admits) EMS transports 20% of casualties (88% of admits) Self-evacuees % bypass public safety

4 4 Catastrophic Incidents TIME (min) >120 EMS Approx. 20% of causalities PublicSafety Arrival Source: Davis, 2004 Upside down triage Bystanders transport 80% of casualties (11% of admits) EMS transports 20% of casualties (88% of admits) Self-evacuees % bypass public safety GOAL - Protect The Hospitals

5 5 Psychological vs. Medical Footprint The size of the psychological footprint greatly exceeds medical footprint psychologicalfootprint medical footprint > 4:1 Not all victims should be evaluated in the emergency department !

6 6 Statewide Catastrophic Health Incident Response Plan (CHIRP) Chance favors the prepared mind. Louis Pasteur

7 7 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

8 8 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

9 9 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

10 10 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

11 11 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

12 12 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)

13 13 Concept of Operations Statewide and Federal Assets Regional Catastrophic Incident Response Plans Local/County Communications Risk/Public Information Special Needs Populations Volunteer Credentialing Patient Tracking Alternate Treatment Sites Training/Exercises Local/County Emergency Response Plans Enhances Coordinates

14 14 Concept of Operations Statewide Ambulance Response Plan Hospital Response Plan Public Health Response Plan Behavioral Health Response Plan Mass Fatality Response Plan Regional Catastrophic Incident Response Plans & Multi-Agency Coordinating Teams Local Communications Risk/Public Information Special Needs Populations Volunteer Credentialing Patient Tracking Alternate Treatment Sites Training/Exercises Local Emergency Response Plans

15 15 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

16 16 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

17 17 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

18 18 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

19 19 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)

20 20 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

21 Alternative Care Sites Plan Alternative Care Sites Plan Region 5 Domestic Security Taskforce Central Florida MMRS Central Florida UASI

22 22 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)

23 23 ACS Cache Locations ASPR Funded

24 24 MCI Cache Locations MCI DHS Funded 100 Pt Caches

25 25 MCI Cache Locations MCI UASI MCI UASI MCI 100 Pt Caches

26 26 All MCI Cache Locations MCI UASI MCI UASI MCI 250 Pt Cache

27 27 Hospital Cache Locations Hospital Hospital Hospital Hospital Hospital Hospital Hospital Hospital MMRS Funded Speedway Cruise ship Port Spaceport ThemeParks

28 28 County Cache Locations Region County County County County UASI Funded 100 Pt Caches & Enhance Regional 500 Pt Cache County

29 29 All Cache Locations UASI MCI UASI MCI UASI Region County County County County County Hospital Hospital Hospital Hospital Hospital Hospital Hospital MCI Region 5 MedicalSurgeStrategy Required Capacity Surge 500 Pt / Million Pop. Regional Population 3 million population3 million population 1500 Pts. 1 Regional Cache – 500 pt 5 County Caches – 100 pt 8 Hospital Caches – 100 pt 6 Sm MCI Caches – 100 pt 1 Lg MCI Cache – 250 pt Total Surge – 2,650 pt Total Surge – 2,650 pt Hospital

30 30 Alternate Care Site Cache Trailers

31 31

32 32 First Aid and Casualty Collection Points for Mass Gathering Events.

33 33 State Medical Response Team

34 34

35 35

36 36 ZUMBRO Air Inflatable Quad Tents Temps Cots Westcots carts, tables & chairs

37 37 State Medical Response Teams Florida has Three Mobile Field Hospitals and One Rapid Response Hospital

38 38 State Medical Response Team Set-up

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40 40

41 41

42 42 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

43 43 Questions? Discussion?

44 Federal Health and Medical Response Technological Disasters Terrorism Transportation Disasters Natural Disasters

45 45 National Disaster Medical Systems (NDMS) A federal asset whos major components are: Medical Response Patient Evacuation. Definitive Medical Care

46 46 National Disaster Medical Systems (NDMS) Purpose A Nationwide Medical Response System to: Supplement state and local medical resources during disasters or major emergencies to deliver definitive medical care to victims of a disaster Provide backup medical support to the DOD/VA medical care systems during an overseas conventional conflict.

47 47 National Disaster Medical Systems (NDMS) Managed by a VA or DOD Federal Coordinator (FCC). Can be activated by State (caution when doing this). Brings those like assets which mirror the state: DMATS, DMORT, and NVAT. Funded by HHS. Participating civilian hospitals are reimbursed.

48 48 Disaster Medical Assistance Teams (DMATs) A federal AMTS Designed to deliver medical care to victims of - and responders to - a domestic disaster Co-located with existing facility or stand alone

49 49 Partnerships The NDMS is an interagency partnership between the Department of Health and Human Services (HHS), the Department of Defense (DoD), Department of Homeland Security (HS) and the Department of Veterans Affairs (VA).

50 50 Importance of NDMS Improves Federal Mission Readiness – Ability to Mobilize and Deploy Medical Teams, Supplies, and Equipment – Ability to Provide Patient Evacuation System – Ability to Provide Definitive Medical Care Adds Value to America

51 51 Be Prepared for Anything


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