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1 Application of Incident Action Plan & Forms: Chemical Attack Hospital Incident Command System This material has been developed for training purposes;

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Presentation on theme: "1 Application of Incident Action Plan & Forms: Chemical Attack Hospital Incident Command System This material has been developed for training purposes;"— Presentation transcript:

1 1 Application of Incident Action Plan & Forms: Chemical Attack Hospital Incident Command System This material has been developed for training purposes; do not share, distribute, transmit or reproduce without prior written consent of California Hospital Association This course was developed by the CHA Hospital Preparedness Program with grant funds provided by the U.S. Department of Health & Human Services Assistant Secretary for Preparedness & Response Hospital Preparedness Program and awarded by the California Department of Public Health. No part of this course or its materials shall be copied or utilized for monetary gain.

2 2 Demonstrate the Incident Action Planning Process Demonstrate the use of HICS Forms Implement the use of the Incident Response Guides Objectives

3 3 Scenario Based Implementation Discuss and rehearse practical implementation of the Incident Action Planning process utilizing HICS forms and the Incident Response Guides Utilize a “Table Top” learning process

4 4 Incident Action Planning 1.Assess the Situation 2.Set the Operational Period 3.Determine Safety Priorities & Establish Control Objectives 4.Determine Operational Period Objectives 5.Determine Strategies & Tactics 6.Determine Needed Resources 7.Issue Assignments 8.Implement Actions 9.Reassess & Adjust Plans

5 5 Scenario The Universal Adversary terrorist group releases Sarin into the ventilation systems of three large commercial office buildings. Within minutes, people develop runny nose, watery eyes, coughing, chest tightness, blurred vision, drooling and sweating. Some develop severe muscle twitching, confusion, nausea and vomiting. Many have died. People are self evacuating the building and there are numerous fall/crush injuries. EMS has initiated triage and performing decontamination outside of the buildings.

6 6 Based on the symptoms, EMS requests large quantities of nerve agent antidotes to be brought to the scene. Hazmat confirms Sarin is the causative agent. Your hospital is the closest hospital about 2 miles from the scene. Many victims self evacuate and drive to your hospital. EMS also begins transporting the most critical victims to your facility with a short ETA. It is unknown if the victims have been fully decontaminated. Scenario

7 7 Time: 0830 Weather: Clear, 68º F, no winds

8 8 Within 15 minutes large numbers of contaminated and worried well are presenting to the hospital for care. Number of victims expected to arrive: Unknown Is this an incident? What are your first actions? Who is in charge? First Actions

9 9 Use HICS form 214: Operational Log Complete HICS form 201: Incident Briefing Event History and Current Actions Summary Begin form 202: Incident Objectives Weather/environmental implications for period Step 1: Assess the Situation Incident Action Planning

10 10 Which Positions to Activate ?

11 11 Immediate Time Period

12 12 The Incident Commander names the incident If the incident is a community-based incident, the appropriate jurisdiction will name the incident (e.g., county, city, EMS) The incident name should be documented on all forms Naming the Incident

13 13 HICS form 202: Incident Objectives Operational Period Date/Time Incident Commander sets the Operational Period Based on number of simultaneous activities How quickly the situation is changing An Operational Period breaks the incident down into manageable timeframes Step 2: Set the Operational Period Incident Action Planning

14 14 Identify Command & Control Objectives (these are the overarching objectives that will last throughout the whole response) HICS form 202: Incident Objectives Step 3: Determine Safety Priorities & Control Objectives Incident Action Planning

15 15 Utilize the Incident Response Guide Chemical Attack: Identify, triage, isolate and treat contaminated/ exposed patients Safely admit a large number of contaminated/exposed patients while protecting your staff and facility Accurately track patients through the healthcare system Assure safety and security of the facility Control Objectives

16 16 It has been 30 minutes since the event: Approximately 40 ambulatory self-transported victims have arrived at the hospital claiming to be in the vicinity of the release. Hospital decontamination set up is complete and decontamination has been started. EMS reports they have approximately 50 victims in moderate to severe distress. Field decontamination is in process. There are unknown numbers minor exposed/contaminated. EMS is ready to transport 4 critical victims. Scenario Update # 1

17 17 Assess the Safety issues What hazards exist and what precautions need to be taken Potential contamination of the facility, activate limited access Ensure safety of staff receiving victims, appropriate PPE Potential of hospital to be overwhelmed by incoming victims, insure security response Complete form 261 – Incident Action Plan Safety Analysis Side Note: Safety Officer Tasks

18 18 Prepare a statement for the media Prepare a statement for the staff, patients and visitors (e.g., situation, status, safety precautions, next update time) The statements need approval from the Incident Commander Coordinate consistent messaging with the Joint Information Center (JIC) Side Note: Public Information Officer Tasks

19 19 Who or what entity operates as the county contact/MHOAC, and how do you make contact? Who else should be notified of the situation? Who should be notified of hospital status? Bed status? Decontamination capability? How? Who is the source of government resources in your local plan? (e.g., Fire department, local EMS Department Operations Center (DOC), PHD DOC, County/City Emergency Operations Center) Key contacts should be determined prior to the incident Side Note: Liaison Officer

20 20 Utilize HICS forms Form Operational Log Side Note: Documenting your Actions

21 21 Document on HICS 204 – Branch Assignment List They are based on the Control Objectives These are based on what is desired to be achieved by the Section in that operational period Objectives need to be SMART (Simple, Measurable, Achievable, Realistic, Time Sensitive & Task Oriented) Incident Action Planning Step 4: Determine Operational Period Objectives

22 22 A common problem during exercises is that Sections/Branches don’t develop their objectives promptly Report top 3 objectives Operational Period Objectives

23 23 Strategies & tactics are how your Section/Branch is going to achieve the objectives What actions do you need to take? Use your facility response plans and Incident Response Guides Record strategies & tactics on form 204 – Branch Assignment List Incident Action Planning Step 5: Determine Strategies & Tactics

24 24 Does additional space need to be activated? What personnel resources do you need? What equipment and/or supplies/ pharmaceuticals do you need? What resources do you need in the patient collection/decontamination area? What communication devices do you need? Document resource activities: Resources assigned (form 204) Resource requests (form 213) Actions taken to utilize & obtain resources (form 214) Step 6: Determine Needed Resources Incident Action Planning

25 25 Who will be assigned to the units? Fill in the assignments on form 204 – Branch Assignment List Are there other branches that need activated? Step 7: Issue Assignments Incident Action Planning

26 26 For the first Operational Period the Incident Action Plan should be done within minutes What makes up the Incident Action Plan? Form Incident Briefing Form Incident Objectives Form Incident Assignments Form Branch Assignments Form Incident Action Plan Safety Analysis The Planning Section compiles the forms to create the Incident Action Plans Incident Action Planning

27 27 Put your activities / plans into action What are some of these activities? Step 8: Implement Actions Incident Action Planning

28 28 It is now 1000 – 1.5 hrs into the incident The hospital has received 60 additional ambulatory self-transported victims, 4 in severe distress and 10 in moderate distress Decontamination of victims continues EMS has transported 2 critical victims to your hospital What are your major concerns? Scenario Update #2

29 29 Towards the end of the operational period, you will need to evaluate status Repeat steps 1-8 Update the forms Evaluate and/or update your Operational Period Objectives This creates your Incident Action Plan (game plan) for the next operational period Step 9: Reassess & Adjust Plans Incident Action Planning

30 30 It is now 4 hours into the incident All victims have been transported Hospital decontamination is completed and there is a large volume of victim belongings and grey water collection Universal Adversary has claimed responsibility and states a secondary device is in place What issues should be considered? Scenario Update #3

31 31 What are things we need to remember to do? Share information Recovery / Restoration After Action Report Corrective Actions Plan How are we doing?

32 32 Questions?

33 33 developed by the California Hospital Association’s Hospital Preparedness Program Application of Incident Action Plan & Forms: Chemical Attack This material has been developed for training purposes; do not share, distribute, transmit or reproduce without prior written consent of California Hospital Association This course was developed by the CHA Hospital Preparedness Program with grant funds provided by the U.S. Department of Health & Human Services Assistant Secretary for Preparedness & Response Hospital Preparedness Program and awarded by the California Department of Public Health. No part of this course or its materials shall be copied or utilized for monetary gain.


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