1. Code Green: PECC & EEC External Disaster Management Charles A. Murphy, M.D. Emergency Pediatric Group Children’s Healthcare of Atlanta November/December 2006

2. Code Green: Goals and Activities n Understand “Code Green” in Context of CHOA Emergency Preparedness n Identify and Understand ED Physician- Specific Roles and Responsibilities n Participate in “Table-Top” Exercise for “After-Hours” Event

3. Code Green and Emergency Preparedness n Systemwide Emergency Preparedness n Joint Commission (JCAHO) Expectations n n n n

4. Code Green and Emergency Preparedness n Systemwide Emergency Preparedness n Joint Commission (JCAHO) Expectations n External Disaster Variability and Constitution n Hospital Emergency Incident Command System (HEICS)

5. Code Green: ED Physician Roles n Look at Your Handout Now n Overview of Key Physician Roles

6. Code Green: ED Physician Roles n Participates in Decision for Code Green Activation n Provides On-line Medical Control for EMS n Dispositions Current EEC Patients n n n n

7. Code Green: ED Physician Roles n Participates in Decision for Code Green Activation n Provides On-line Medical Control for EMS n Dispositions Current EEC Patients n Works with Treatment Area Supervisor and Medical Care Director n Supervises and Coordinates All Physicians and Medical Care

8. Code Green: ED Physician Roles n Protects Integrity of Facility and Staff n Avoids Triage Role, With Exceptions n

9. Code Green: ED Physician Roles n Protects Integrity of Facility and Staff n Avoids Triage Role, With Exceptions n Acquires Physician Staff and Assigns Responsibilities –Attending Physicians –Fellows –Residents –Students

10. Code Green: “Table-Top” Exercise

11. n Chlorine Gas Release Scenario Mass Casualty Incident n All CHOA ED Facilities to Receive Influx of Exposed Patients n “Table-Top” Exercise for PECC and ECC Physicians

12. Code Green: “Table-Top” Exercise n Chlorine Gas Release Scenario –Sources of Exposure

13. Code Green: “Table-Top” Exercise n Chlorine Gas Release Scenario –Sources of Exposure –Range of Predominant Symptoms

14. Code Green: “Table-Top” Exercise n Chlorine Gas Release Scenario –Sources of Exposure –Range of Predominant Symptoms –Decontamination

15. Code Green: “Table-Top” Exercise n Chlorine Gas Release Scenario –Sources of Exposure –Range of Predominant Symptoms –Decontamination –Medical Management

16. Code Green: “Table-Top” Exercise n Setup for “After- Hours” Event n Number and Complexity of Expected Patients n Decontamination (PECC versus EEC) n Physician Call-Back Needed? n

17. Code Green: “Table-Top” Exercise n Setup for “After- Hours” Event n Number and Complexity of Expected Patients n Decontamination (PECC versus EEC) n Physician Call-Back Needed? n Treatment Areas: –RED--Immediate –YELLOW--Delayed –GREEN--Minor –BLACK--Expectant

18. Code Green: “Table-Top” Exercise n Exposed Adults Will Accompany Their Exposed Children n Contaminated Individuals May Attempt to “Crash” the Facility nn nn

19. Code Green: “Table-Top” Exercise n Exposed Adults Will Accompany Their Exposed Children n Contaminated Individuals May Attempt to “Crash” the Facility n Unauthorized Media Personnel May Attempt to “Crash” the Facility n Stay Alert for: –Co-morbid Medical Conditions –Psychological or Emotional Instability

20. Code Green: Summary n “Code Green” in Context of CHOA Emergency Preparedness n ED Physician-Specific Roles and Responsibilities n “Table-Top” Exercise in “After-Hours” Event Setting