MODULE 3: Algorithm and MedicationScreening Form

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MODULE 3 Algorithm and Medication/Screening Form
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CRI Medication Center Form

• Simplified form that anyone can use to
  determine what medication to dispense.

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Medication Forms

• Forms will be available in English and Spanish
• Non-English speaking residents will be encouraged
  to bring a translator with them, or a designate
  someone to pick up their meds as translation
  services may not be available at all PODs in
  every language

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Medication Forms

• Critical elements
• Name of each person receiving medications
• All 3 questions must be answered
• Zip code of household(s)

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Medication Forms

• Given to each household representative upon entry
  
• Forms are typically filled out while standing in
  line
• Planners consider asking local businesses to
  donate clipboards/pens
• Place a drop bin for pens clipboards at
  screening point for runner to retrieve and place
  back at entry
• If no clipboards available, improvise!

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Medication Forms

• Even if a screener or dispenser is handed a form
  in another language, the algorithm will be the
  same
• The form will be presented at a queue stop
  where the person will be directed to the
  appropriate line
• People may still need help filling out the
  formsconsider assigning someone to help those
  standing in line.

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Medication Forms

• NCR Counties person takes form home with them
  after receiving medications
• Baltimore Metro Counties The form is retained by
  health department for data capture at a later
  hour. (Persons name is written on the bottle if
  they are receiving a medication different from
  the others in the house)

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Medication Dispensing

• There will be two medications in large supply
• Ciprofloxacin (a.k.a Cipro)
• Doxycycline (a.k.a. Doxy)
• Doxycycline is the preferred prophylaxis
  medication for exposure to aerosolized Anthrax.
  Ciprofloxacin will work effectively as wellmost
  people tolerate Doxy better.

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Medication Dispensing

• Drug of choicemajority of people will get
  Doxycycline UNLESS
• Pregnant or breastfeeding
• Under 9 years of age (UNDER REVIEW)
• Allergic to Doxycycline (hives, swelling, severe
  trouble breathing)

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Medication Dispensing

• If someone who is appropriate for Ciprofloxacin
  (pregnant, breast feeding, under 9 years of age
  UNDER REVIEW) is ALLERGIC to Cipro.
• They will be given Doxycycline as an alternative.
  Per the CDC guidance, the risks of Anthrax
  outweigh the risks of side-effects.

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Medication Dispensing

• If someone is allergic to both Cipro and Doxy,
  there is a POSSIBILITY of a third option
• Amoxicillin is an IND Investigative New Drug
  for Anthrax prophylaxis. A very limited amount
  may be available for those who absolutely cannot
  take Doxy or Cipro.

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Algorithm
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Yes
No
No
Smith, Tony
Smith, Barbara
Yes
Yes
No
No
Yes
No
Smith, Tony Jr.
Smith, Mary
No
No
No
Jones, Cynthia
Yes
Yes
No
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Yes
No
No
Smith, Tony
Smith, Barbara
Yes
Yes
No
No
Yes
No
Smith, Tony Jr.
Smith, Mary
No
No
No
Jones, Cynthia
Yes
Yes
No
21211
16
Yes
No
No
Smith, Tony
Smith, Barbara
Yes
Yes
No
No
Yes
No
Smith, Tony Jr.
Smith, Mary
No
No
No
Jones, Cynthia
Yes
Yes
No
1
3
1
21211
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Screening Two different approaches

• Approach 1 Specialized queues screen at choke
  point
• Fast-track Doxy only dispensed
• General Dispensing Cipro Doxy
• Peds Needs Children, multiple allergies to
  meds, special needs, etc.

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Screening

• Quick review of form
• Circle appropriate medication
• Send to the appropriate line queue
• Doxy Only Fast-tracked to Doxy Only Lines
• Doxy Cipro (no other) to General Dispensing
  Doxy Cipro Lines
• If they have an other response checked at
  allsend to Special Needs Line

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Screening Two different approaches

• Approach 2 More queues, screen at dispensing
  table
• Everyone stops at the line choke point and
  shows that they have filled out their form. They
  are directed to the first available dispensing
  station where their form is screened, medications
  picked, and the medications information are put
  in a bag.

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Practical Drill Lets put it to the test!