Catastrophic Incident Response Annex

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Catastrophic Incident Response Annex
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Overview

• Introduction
• Overwhelming the system
• Implement CIRA
• Assumptions
• NDMS Actions
• Assumptions
• Capabilities
• FEMA Logistics
• Future

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Terms and Definitions

• CIS
• Catastrophic Incident Supplement
• Unclassified Version is a New Annex to NRP
• CIRAS
• Catastrophic Incident Response Annex Supplement
• For Official Use Only

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National Response Plan

• NRP
• Comprehensive plan for all types of incidents
• Annexes defined for specific events
• Will be used by all participants to manage an
  event
• Federal, State and Local
• Replaces Federal Response Plan

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Other Terms

• PFO
• Principal Federal Official
• HSOC
• Homeland Security Operations Center
• CIRES
• Catastrophic Incident Response Executive Schedule

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Catastrophic Event

• What do we really Mean?

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Events that would immediately overwhelm Local and
State Resources
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• 100,000 Casualties
• 100,000 Evacuees
• 100,000 Fatalities

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Catastrophic Incident Plan

• Secretary of DHS can Immediately implement
• When in doubt Deploy

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Accelerated provision of Federal support during
the first 48 hours
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Federal Assets deploy immediately to Federal
Mobilization sites
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Incident Management

• Local Incident Commander is still maintains
  control
• Federal Assets respond to assist and augment
  local resources that have been overwhelmed
• All responders will continue to follow basic
  principles of Incident Management Plan

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Assumptions

• Regarding the Catastrophic Event

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Assumptions

• Local / State Resources Overwhelmed
• Will need immediate Federal help
• Resources will need time to arrive

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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

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The CIS assumes

• Impacted community will need receive outside
  non-Federalized health care providers.
• All available Federal Medical Resources will be
  needed
• Will there be enough?

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Greatest Good for Greatest Number of Victims
with Available Resources
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National Disaster Medical System Actions

• Activate ALL Teams
• Mobilize in 4, 6, 12, 24 hours
• Closest teams go first
• Some assets will be held for second event

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NDMS Assumptions of Care

• Transportation routes are available to move NDMS
  assets
• Air and Ground Transport
• 24 hours post activation (D1)
• Teams will be setup at impact area
• Providing care within their region
• East, Central, West

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NDMS Assumptions of Care

• If an incident s in one region (East or West)
• 1/3 of NDMS Teams will be on site and providing
  care at D1.
• All other activated teams will arrive and
  initiate care at D2 to D3.

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NDMS Response Actions

• Alternate care facilities established 12 hours
• NDMS Teams first
• US Public Health Service
• CCRF next in resource
• Veterans Administration
• Mainly in Hospitals
• USPHS Additional Assets
• DOD

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What Will CIRP Bring to the Event?
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Capabilities

• Care Provided
• Outpatient Facility
• Treatment with Limited Holding Capacity
• Alternative Care Facility
• Augment Standard Med-Surg Ward
• Casualty Collection Center
• Similar to NDMS Reception Center

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CapabilitiesSingle Team 35 person- D 1

• Augment Standard Med-Surg Ward
• 50 Patients
• Casualty Collection Center
• 150 Patients
• Similar to NDMS Reception Center

• Care Provided
• Outpatient Facility
• 250 pts. Per day
• Treatment with Limited Holding Capacity
• Alternative Care Facility
• 160 pts. In patient /Out patient per day

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Capabilities 14 Teams D 1 (500 personnel)

• Augment Standard Med-Surg Wards
• 700 Patients
• Casualty Collection Centers
• 2100 Patients

• Care Provided
• Outpatient Facilities
• 2500 pts. Per day
• Treatment with Limited Holding Capacity
• Alternative Care Facilities
• 112 In patient
• 2250 Out patient per day

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Capabilities Entire NDMS System - Day 3
(1100 Personnel)

• Augment Standard Med-Surg Wards
• 1400 Patients
• Casualty Collection Centers
• 4200 Patients

• Care Provided
• Outpatient Facilities
• 5000 pts. Per day
• Treatment with Limited Holding Capacity
• Alternative Care Facilities
• 224 In patient
• 4500 Out patient per day

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FEMA Logistics

• Prepackaged and staged patient unit trailers
• Multi function packages
• Care for 150 Persons each
• Alternate Care Facility Trailer
• 150 patients each

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Future

• 500 Bed Field Hospital
• Surgical Capablility
• ICU Capability
• Isolation Capability
• 2 planned delivery in 2005
• 2006 expansion of equipment and training

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Future

• Improved Deployability of 31 NDMS Response Teams
• NDMS Standardized Basic Load for Response Teams
• Provision of Transport Vehicles for Equipment
  Cache
• Improved Training of Personnel

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Work in Progress

• Develop a Medical Professional Surge Capacity
  Plan
• Rapidly provide additional Medical Personnel.
• Medical Professionals that can be identified and
  credentialed Pre-Incident and rapidly Federalized
  and Transported to assist.
• Goal is 20,000 nationwide

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Acronyms

• JOC
• Joint Operation Center
• JIC
• Joint Information Center
• FCO
• Federal Coordinating Officer

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Acronyms

• ERT-N
• National Emergency Response Team
• PFO
• Principal Federal Officer
• SFLEO
• Senior Federal Law Enforcement Official

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Acronyms

• DRC
• Disaster Recovery Centers
• IMT
• Incident Management Teams