Transcript Alternate Care Site Presentation FEPA
Catastrophic Health Incident Response Planning
Catastrophic Incident Response Community
Emergency Operations EMS Law Enforcement Public Works Citizen Volunteers High Impact Incident Hospitals Fire Public Administration Public Health 2
Catastrophic Incidents
TIME (min) 0 15 30 45 60
Self evacuee’s 50 - 80% bypass public safety Public Safety Arrival
90 >120
EMS Approx. 20% of causalities “Upside down triage”
Bystanders transport 80% of casualties (11% of admits) EMS transports 20% of casualties (88% of admits)
Source: Davis, 2004
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Catastrophic Incidents
TIME (min) 0 15 30 45 60
Self evacuee’s 50 - 80% bypass public safety Public Safety Arrival
90 >120
EMS Approx. 20% of causalities “Upside down triage”
Bystanders transport 80% of casualties (11% of admits) EMS transports 20% of casualties (88% of admits)
GOAL - Protect The Hospitals
Source: Davis, 2004
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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”
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Statewide Catastrophic Health Incident Response Plan (CHIRP)
“Chance favors the prepared mind.” Louis Pasteur
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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
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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
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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)
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Concept of Operations
Statewide and Federal Assets Coordinates Regional Enhances 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 13
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 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
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MCI Cache Locations
MCI MCI MCI MCI DHS Funded 100 Pt Caches
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MCI Cache Locations
MCI UASI MCI MCI UASI MCI 100 Pt Caches
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All MCI Cache Locations
MCI UASI MCI UASI UASI MCI 250 Pt Cache MCI
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Hospital Cache Locations
Hospital Speedway Hospital Theme Parks Hospital Spaceport Hospital Hospital Hospital Cruise ship Port Hospital MMRS Funded
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County Cache Locations
County County County County Region UASI Funded 100 Pt Caches & Enhance Regional 500 Pt Cache County
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Region 5 Medical Surge Strategy
All Cache Locations
1 Regional Cache – 500 pt County MCI 5 County Caches – 100 pt Hospital UASI MCI County UASI 8 Hospital Caches – 100 pt County Hospital Hospital Region Hospital County Hospital 6 Sm MCI Caches – 100 pt Hospital 1 Lg MCI Cache – 250 pt Hospital MCI UASI Hospital Total Surge – 2,650 pt County MCI Required Capacity Surge 500 Pt / Million Pop.
Regional Population ≈3 million population 1500 Pts.
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Alternate Care Site Cache Trailers 30
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First Aid and Casualty Collection Points for Mass Gathering Events.
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State Medical Response Team 33
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ZUMBRO Air Inflatable Quad Tents Temps Cots Westcots carts, tables & chairs
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State Medical Response Teams
37 Florida has Three Mobile Field Hospitals and One Rapid Response Hospital
State Medical Response Team Set-up
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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
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Federal Health and Medical Response
Natural Disasters Transportation Disasters Terrorism Technological Disasters