Title: GETTING DOCS into the DISASTER PREPAREDNESS LOOP
1 GETTING DOCS into theDISASTER
PREPAREDNESS LOOP Joanne Selkurt MD, FAAP
2Introduction
- The Reality
- September 11, 2001
- 9 - 11
3All-Hazards
- Man-made
- Fires
- Explosive devices
- Firearms
- Structural collapse
- Transportation event
- Air, Rail, Roadway, Water
- Industrial HAZMAT
- WMD NBC events
- Etc
- Natural
- Earthquake
- Landslides
- Avalanche
- Volcano
- Tornado
- Hurricanes, floods
- Fires
- Meteors
- Etc
4Are We Prepared?
- Is the US healthcare system prepared?
- We appear to be each Hospital, EMS agency, Law
enforcement agency, Fire department, and
Community has - a disaster plan
- properly documented drills
- annual training documented
- But...
5Are We Prepared?
6Are We Prepared?
- Interagency communication failures!
- Why do we all treat a cardiac arrest the same?
- because there is an agreed-upon approach.
7Are We Prepared?
- Critical to healthcare preparedness
- uniform
- coordinated approach
- mass casualty management from any cause
- NEED A nationally standardized training program
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9Course Description
- BDLS
- Didactic - 8 hours
- Distance learning option
- For healthcare providers
- Physicians, Nurses, Paramedics, EMTs
- Mid-level providers, Allied health, Public health
- Provider status course credit awarded
- Course completion
- Written examination passage
- BDLS providers are eligible to take ADLS
10BDLS Course Outline
- Examination
- Course evaluations
- Overview Concept
- DISASTER Paradigm
- Natural Disasters
- Explosive Traumatic
- Nuclear Radiological
- Biological Agents
- Chemical Agents
- Psychosocial Aspects
- Public Health System
11Course Description
- ADLS
- 16 hour class (8-didactic, 8-practical)
- Advanced practicum hands on course
- Meets Hazmat Operations-level trainingrequirement
(CFR 1910.120) - Must have completed
- BDLS course
- Provider status course credit awarded
12ADLS Course Outline
- Day-Two
- Skills Lab hands on
- MASS Triage
- Clinical Scenarios
- Human simulator use
- Disaster Skills
- Personal Protective Equip
- Decontamination
- Day-One
- Classroom Interactive
- DISASTER Paradigm
- Casualty Decontamination
- Legal Issues
- Media Communications
- Community and Hospital Disaster Planning
- Community, State and Federal Resources
- Mass Fatality Management
13What is a Disaster?
- Disaster- disaster n.
- An occurrence causing widespread destruction and
distress a catastrophe. - A grave misfortune.
- Informal- A total failure
14Disaster Definition
- A disaster is present when need exceeds resources!
- A response need that is greater than the response
available!
15Mass Casualty Incident (MCI)
- Is this an MCI ?
- The first step in identifying an MCI is knowing
your own capabilities. - Any incident that exceeds the responders or
receiving hospitals capability to treat or
transport is a Mass Casualty Incident
16 17- D Detection
- I Incident Command
- S Safety Security
- A Assess Hazards
- S Support
- T Triage Treatment
- E Evacuation
- R Recovery
18D-I-S-A-S-T-E-R Paradigm Incident Command
- Incident Command System (ICS)
- Born in Fire Service
- Managing wildfires in early 1970s
- Interagency task force collaborative effort
- Uniform structure
- Clearly delineated roles/responsibilities
- Clear chain of command/ communication
19Incident Command System
Commander
Unified Command
Planning
Operations
Finance
Logistics
Thinkers
Getters
Doers
Payers
20Incident Command System Operations
21D-I-S-A-S-T-E-R ParadigmAssess Hazards
- Be Aware of Secondary Devices!
- Bombs, Shrapnel devices, Incapacitating Devices,
Multiple Snipers/Terrorists, Delay Devices
22D-I-S-A-S-T-E-R ParadigmAssess Hazards
- Be Aware of Secondary Devices!
- Bombs, Shrapnel devices, Incapacitating Devices,
Multiple Snipers/Terrorists, Delay Devices
23D-I-S-A-S-T-E-R ParadigmSupport
- Unexpected Volunteers and Donations
- Positive intentions, often negative impact
- Does your preparedness plan include them?
- ICS, Identify needed skills and needed supplies
- Negatives
- Time to sort large, poorly labeled goods
- Storage space used
- Unplanned personnel are a liability
- At risk of injuries, require food, water and
shelter
24 Volunteers
- Need to Address
- Licensure in state
- Credentialing for specific responder
organization - Just-in-Time Training
- Management logistics, supervision,
transportation, medical other care needs - Well-Meaning Volunteers Can Overwhelm,
Interfere, Confuse, Burden Even Endanger
themselves and others -
25- Best if a member of a recognized, organized
response team that has been invited in - DONT JUST SHOW UP !!
26M.A.S.S. Triage
- M Move
- A Assess
- S Sort
- S Send
- M.A.S.S. Triage is a disaster triage system that
utilizes US military triage categories with a
proven means of handling large numbers of
casualties in a mass casualty incident (MCI).
27ID-me!
- I Immediate
- D Delayed
- M - Minimal
- E Expectant
- D - DEAD
- ID-me! - a mnemonic for sorting patients
during MCI triage. It is utilized effectively in
the M.A.S.S. Triage model.
28ID-me! - a mnemonic for sorting patients
during MCI triage. It is utilized effectively in
the M.A.S.S. Triage model.
- M Minimal
- D Delayed
- I Immediate
- E Expectant
- D - Dead
- I Immediate
-
- D Delayed
-
- M - Minimal
-
- E Expectant
-
- D - DEAD
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32Tips for talking to children after a disaster
- Provide opportunities to talk about what they are
seeing on television and to ask ? - Dont be afraid to admit you dont know all the
answers - Answer ? At a level the child can understand
- Establish a family emergency plan (Sense of doing
something is helpful) - Monitor childrens TV watching..dont need to see
event over over) Watch with children - Help kids to understand there are no bad emotions
- Try to not focus on blame
- In addition to tragic things seen, also help kids
focus on good things such as heroic actions,
reuniting of families, assistance offered by
people throughout the world
33For children closer to disaster
- Disasters often reawaken a childs fear of loss
of own parents when parents are preoccupied with
own fears consider family counseling - Families may permit some regressive behavior
weaning off by leaving bedroom door open, night
lights, extra time with parents - Parents may have trouble leaving child after a
disaster,,,may be able to use childs problem as
a way of asking for help themselves - Get the children into some sense of routine of
school and play even if displaced - Teachers can help kids with art, and play
activities, encouraging group discussions and
presentations about the disaster
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35For more information on children disasters
- Child Health Alliance of Wisconsin (CHAW)
- www.chawisconsin.org
- Click Programs
- Click Trauma preparedness
-
36A
A stuffed animal can help a lot