Michael Nostradamus

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Michael Nostradamus French
Physician During the Great Plague Circa
1549 We Must Learn From Lessons Of the
Past!
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Flu Ward 1918 We
May Find Ourselves Only Able To Treat Symptoms
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Flu 1968 to 1969 Last Documented
Pandemic
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Professor Ian Tan Royal University Of Beijing
Dr. Tom Buckley University Hospital Hong Kong
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• Is the Sense of Urgency Real, or is this all
  Being
• Blown out of Proportion ?
• Fear Mongering
• Never will happen here
• Our medical care is better than the rest of the
• world
• These are the Real Questions!

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March 10, 2005 Tropical Disease
Hospital Hanoi
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• Why Involve Respiratory Care Practitioners?
• We work in most areas of the hospital
• We know the technology health of the
  organization
• We know how to function in a crisis
• We have contacts with medical device vendors
• We know how to how to adapt equipment
• at a moments notice
• Pandemic Influenza is mainly various stages of
• ARDS

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March 1, 2007 World Health Organization
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Unit for Infectious, Deadly Illness
Opens Country's Largest Medical Unit for Deadly
Infectious Diseases Opens in Nebraska March 07,
2005
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Bush Order Allows Isolation of Those with Bird
Flu Fri Apr 1, 446 PM ET Health -
Reuters WASHINGTON (Reuters) - President Bush
issued a directive on Friday allowing authorities
to detain or isolate any passenger suspected of
having avian flu when arriving in the United
States aboard an international flight.
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Quarantine Program

• 1970s
• Smallpox eradicated less fear of infectious
  disease
• Smaller stations closed
• Oversee refugee screening
• 1980s
• Mass migration emergencies
• Health information for international travel
• Distribute emergency immunobiologics
• 1990s
• Cholera, Plague, Ebola
• Refugee arrivals

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U.S. Quarantine Program

• DHEW 1953
• 52 seaports
• 41 airports
• 17 border stations
• 33 territory stations
• 41 U.S. consulates
• 50 maritime vessels
• 600 employees

• DHHS 2004
• 8 airports
• 70 employees

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CDC Quarantine Stations
Seattle
Anchorage
Minneapolis
Boston
Detroit
New York
Newark
Chicago
San Francisco
Washington DC
Los Angeles
San Diego
Atlanta
El Paso
Houston
Miami
Honolulu
San Juan
Operational Stations (18)
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• The Federal Government will not be
• able to help you. This could be the
• equivalent to 5000 Katrinas all at once.
• Every State, city, hospital and home must
• plan on saving yourself.
• Michael Leavitt HHS Secretary Boston January 12,
• 2006

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• Where to Begin with Pandemic Planning
• Should Hospitals Begin to Stockpile Essential
  Medical Supplies Now?
• This could lead to immediate
• shortages throughout the world
• If we do not increase our inventory
• we could find ourselves short of
• essential supplies and drugs

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Sample Proposal Develop a task force that
would review the specific details that would
allow for 1000 patients to receive oxygen and
simple mask CPAP during an out break of a severe
respiratory compromising Infection. This would
include all disciplines that would have
responsibilities for treating this patient
population.
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Simple Mask CPAP
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Health Care Worker Protection Lessons Learned
From SARS

• Must Be Taken Extremely Seriously
• We Must Protect Not Only Ourselves But
• Also our Families And Communities
• Fit Testing For All Clinicians Including
• Physicians

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Wear Purified Air Powered Respirator with N-95
During Open Airway Procedures
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• Managing Patient Surge For Months At A Time
• Cancel All Elective Surgeries, Prioritize
• Admissions (Develop Strict Admission
• Criteria)
• Ensure Adequate Clinical Staffing
• Ration Medical Supplies

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Flu Ward 2007 ???
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As I walked out of my office door immediately
after sending a telegram to Washington explaining
that I felt we should move the Fleet out to sea
for its protection, I watched the first Bomb
make a direct hit on the Arizona. Dear God, I
wish I had called Washington last week when this
first came to my mind! Admiral Chester Nimitz
Pearl Harbor Hi 0745 December 7, 1941
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