Disasters: What you could have known

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DisastersWhat you could have knownWhat you
wished you would have knownWhat you can do now!

• Lou E. Romig MD, FAAP, FACEP
• Pediatric Emergency Medicine
• Miami Childrens Hospital
• Medical Director, FL5 DMAT

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Did we know about the possibilities of a Katrina
scenario before it happened?
FEMA Photo Library
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Medical Model
Disaster Preparedness and Mitigation
Preventive Medicine

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Do pediatricians have a role in preventive
medicine?

• Believe its worth the investment
• Practice it ourselves
• Teach our patients and their families
• Participate in preventive medicine efforts
• Advocate for institutionalization of preventive
  health measures

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Do pediatricians have a role in disaster
preparedness?

• Believe its worth the investment
• Practice it ourselves
• Teach our patients and their families
• Participate in disaster preparedness and response
  efforts
• Advocate for institutionalization of disaster
  preparedness and mitigation

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Culture of Preparedness Believe!

• Excrement occurs!
• Disasters dont happen to places.

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Lou Romig
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• Earthquake in Memphis?
• Hurricane in New York?
• Tsunami in Alaska?
• Terrorist bombing in Oklahoma City?
• Atlanta?

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Culture of Preparedness

• Disasters dont happen to places.
• Disasters happen to people.

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FEMA Photo Library
Lou Romig
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Culture of Preparedness

• Disasters dont happen to places.
• Disasters happen to people.
• Disasters can happen to us.

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• Disaster preparedness is a personal
  responsibility
• My family and friends
• My home
• My livelihood
• My patients
• My community

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Personal Preparedness

• Risk assessment
• Natural hazards
• Nonintentional man-made hazards
• Intentional man-made hazards
• Plan for all reasonable hazards

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Risk Assessment Natural

• Weather
• Geography
• Home
• Schools
• Office/Hospital
• Epidemiology
• Port of entry
• Travel destination

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Risk Assessment Man-made

• Industry
• Chemicals
• Explosives/Fires
• Transportation
• Hubs
• Through traffic

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Risk Assessment Man-made

• Seats of government/politics
• Symbolic institutions and icons
• Commerce and industrial centers
• Transportation centers
• Military bases
• Religious and cultural institutions
• Schools
• Medical facilities
• Mass gathering sites

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All Hazards Planning
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ADAPT to Environments
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FEMA Photo Library
Lou Romig
FL OEM Library
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STOCK your own resources
All photos Lou Romig
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Personal Planning

• Share your plans with family, friends and
  co-workers
• Know the plans at family members schools and
  workplaces
• Review and exercise your plans. Involve the kids!
• Learn from your own experiences and those of
  others

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Personal and Family Disaster Planning Resources

• www.aap.org/healthtopics/terrorism.cfm
• AAP Family Readiness Kit
• www.redcross.org
• www.ready.gov
• www.fema.gov
• www.fifionline.org/disaster_planning.htm
• www.nod.org (Emergency Preparedness)
• www.jumpstarttriage.com

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Plan to protect your livelihood

• Have disaster plans for your office and staff
• Have appropriate hazard and business interruption
  insurance
• Protect patient and business records. Make them
  transportable.
• Plan how to continue your practice if your office
  is not functional
• Make sure your patients know your plans

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• A Disaster Preparedness Plan for Pediatricians
• Scott Needle MD, FAAP
• Mississippi Chapter AAP
• www.aap.org/healthtopics/terrorism.cfm

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Teaching patients and families

• Disaster preparedness should be a part of
  anticipatory guidance.
• Physicians should assist families in disaster
  planning for children with special healthcare
  needs and other chronic illnesses.

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Teaching patients and families

• Remember that any acute medical need can be a
  disaster for a family.
• Use tools like the AAPs Emergency Information
  Form.
• www.aap.org/advocacy/emergprep.htm

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Start young!
www.ready.gov/kids
www.fema.gov/kids
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Participate Planning

• Local planning/training
• Schools/childcare facilities
• Shelters
• Hospitals
• Community Emergency Response Teams (CERTs)
• Local NGO programs
• Faith-based programs

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Participate Planning

• Regional/state planning
• Professional associations
• AAP, AMA
• Healthcare networks
• Public Health Departments
• State EMS for Children Programs

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Participate Response

• Become a part of the system before the disaster
  happens!

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Great volunteers

• Know the system in which they are enlisted to
  work
• Have their credentials established and verified
  before the disaster
• Understand liability issues
• Know how to live and work in austere conditions
• Bring their own supplies and support
• Have the support of their families and co-workers

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Nightmare on Sesame Street!
DHS
NRP
FEMA
JFO
ESF
EMAC
SNS
NIMS
USAR
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Federal Alphabet Soup

• US Citizen Corps
• Community Emergency Response Teams (CERTs)
• Medical Reserve Corps (MRCs)
• www.citizencorps.gov
• Volunteer Protection Act of 1997
• National Disaster Medical System (NDMS)
• Disaster Medical Assistance Teams (DMATs)
• International Medical-Surgical Response Teams
  (IMSuRTs)
• Covered by USERRA regulations and Federal Tort
  Claims Act

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Institutionalizing Preparedness
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Institutionalizing Preparedness

• Teach children about disaster preparedness
• Incorporate disaster preparedness into workplace
  policies and procedures
• Teach professions about pertinent aspects of
  disaster preparedness and response

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Institutionalizing Preparedness

• Disaster preparedness incentives
• Overcome financial obstacles to personal
  preparedness
• Study the tangible value of preparedness and
  mitigation
• Tackle liability issues

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Institutionalizing Preparedness

• Recognize the strengths and limits of generosity
  and use it responsibly
• Take the best advantage of volunteerism
• Build strong teams

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Review

• Turn knowledge into action
• Take disasters personally
• Its OK to be selfish
• Like injury and illness prevention and workplace
  safety measures, disaster preparedness should be
  a matter-of-fact part of our lives

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Review

• Recognize the tangible values of preaction
  instead of reaction
• Get on a team
• Play well together

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Thank you!
Lou Romig

• Presentation available at www.jumpstarttriage.com
• louromig_at_bellsouth.net