ASSESSING A FACILITY FOR POTENTIAL BIOLOGICAL ATTACK

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ASSESSING A FACILITY FOR POTENTIAL BIOLOGICAL
ATTACK

• Through the Eyes of Facility Managers
• Presented at the NJHA February 15, 2005

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BIOLOGICAL ATTACK PREP

• Todays Presentation is to
• Help prepare for TopOff3 -An International
  Emergency Preparedness Drill
• One of a series of presentations
• Designed primarily for Facility Managers

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BIOLOGICAL ATTACK PREP

• Drill activities include the following areas
• Connecticut
• New Jersey
• Washington D.C.
• United Kingdom
• Canada

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BIOLOGICAL ATTACK PREP

• Institution Participation
• Determined by each institution/agency
• Anything from 1 to 5 days
• Anything from tabletop exercise to full Command
  Center activation

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BIOLOGICAL ATTACK PREP

• What systems or areas may be affected?
• HVAC
• Medical Air
• Domestic Water
• Oxygen
• Emergency Room
• Operating Rooms
• Isolation Rooms

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BIOLOGICAL ATTACK PREP

• HVAC System Pre-Attack
• Locate all outside fresh air intakes
• Look at vulnerability at each location
• Secure/limit access to each location
• Verify proper operation of dampers
• Can you override minimum outside air completely?
• Can you make your Emergency Room negative?

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BIOLOGICAL ATTACK PREP

• HVAC Systems Post-Attack (Potential Actions)
• Close down outside air dampers and operate on
  100 recirculation
• Shut down air handlers completely
• Shut off patient room PTAC/Through-the-Wall units
• Isolate your ER from remainder of facility
• Convert ER to negative pressure

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BIOLOGICAL ATTACK PREP

• Medical Air System Pre-Attack
• Identify location of air intake(s)
• Secure/minimize access to location of air
  intake(s)
• Identify, tag and chart location of shut-down
  controls
• Can you take supply air from inside the building?
• Do you have equipment to back-feed medical air
  within a specific area?

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BIOLOGICAL ATTACK PREP

• Medical Air System Post-Attack (Potential
  Action)
• Shut down pumps
• Take supply air from clean HVAC source (if
  possible)
• If system contaminated leave pumps off
• Bleed down system
• Make provisions to back-feed specific areas

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BIOLOGICAL ATTACK PREP

• Domestic Water System Pre-Attack
• Locate, identify and list all major water supply
  points and control valves
• Identify outside areas where foreign matter may
  be introduced
• Identify inside areas where foreign matter may be
  introduced
• Isolate/secure these areas through best possible
  means

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BIOLOGICAL ATTACK PREP

• Domestic Water System Pre-Attack (Contd)
• Identify and list booster pump shut-down
  locations
• If you have wells, are they secure and is access
  controlled?
• Verify back-up supply of water

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BIOLOGICAL ATTACK PREP

• Domestic Water System Post-Attack (Potential
  Actions)
• Close off valves on all incoming feeds
• Shut down booster pumps
• If contaminated tag all outlets as Non-Potable
• Shut off well pumps
• Activate/Transport back-up supply

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BIOLOGICAL ATTACK PREP

• Oxygen System Pre-Attack
• Locate, identify and list main control valves
• Identify outside areas where foreign matter may
  be introduced into the system
• Identify inside areas where foreign matter may be
  introduced into the system
• Secure/isolate these areas through the best
  possible means

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BIOLOGICAL ATTACK PREP

• Oxygen System Pre-Attack (Contd)
• Determine if you have equipment to back-feed
  critical areas and locate this equipment
• Pre-plan the installation of the equipment

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BIOLOGICAL ATTACK PREP

• Oxygen System Post-Attack (Potential Actions)
• Shut off main supply valve(s)
• Bleed pressure off system
• Deliver back-up supply
• Set up back-feed equipment

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BIOLOGICAL ATTACK PREP

• Other Areas/Items to Take Into Consideration
• Emergency Room
• Operating Room
• Isolation Rooms
• Surge Capacity
• Re-Supply of Critical Supplies

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BIOLOGICAL ATTACK PREP

• Emergency Room
• If HVAC system is not dedicated, how do you
  isolate it from the remainder of the facility
• If you go negative in the ER is the exhaust
  filtered
• In the event of a total shutdown, do you have
  portable coolers/heaters to maintain temperature
  control and circulation
• Have you pre-planned installation of this
  equipment

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BIOLOGICAL ATTACK PREP

• Emergency Room (Contd)
• If you decontaminate are you prepared to pump out
  your holding tank and properly handle the
  effluent?

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BIOLOGICAL ATTACK PREP

• Operating Room
• If you shut HVAC down, what do you do about
  positive pressure
• How do you maintain air circulation
• Do you have portable coolers/heaters that can be
  temporarily installed
• Have you pre-planned installation/changes
• Do you shut your ORs totally down

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BIOLOGICAL ATTACK PREP

• Isolation Rooms
• If you shut the HVAC down what do you do about
  Negative Pressure
• What about air circulation
• Do you have portable units that can provide
  temporary negative pressure
• Have you pre-planned the installation/changes

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BIOLOGICAL ATTACK PREP

• Surge Capacity What is Your Involvement
• Do you have to open rooms and equip them
• Who knows where the equipment is
• Do any utilities need checked out
• Have you pre-planned these activities

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BIOLOGICAL ATTACK PREP

• Re-Supply of Critical Supplies
• If vendor employees are incapacitated what are
  your alternatives
• If vehicular travel is drastically curtailed what
  are your alternatives
• Do you have rationing plans

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BIOLOGICAL ATTACK PREP

• Do you have this document?
• If not obtain a copy from the NJHA
• If you do look at it and do some preliminary
  assessment

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BIOLOGICAL ATTACK PREP

• Wrap-Up
• Nothing discussed today is absolute
• Each facility and situation is unique
• Look at the operational aspects of your systems
• Use common sense
• Be prepared do an evaluation in advance of an
  event
• Work with Infection Control and Safety

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BIOLOGICAL ATTACK PREP

• Comments
• Questions