Objectives

1
Objectives

• Provide a History of the Chempack Program
• Provide an Overview of the Metro Region
  Activation Plan
  
• Educate Personnel the Activation Procedures

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Thank YOU! For developing the Metro Chempack
Plan

• MMRS ChemPack Team Membership
• Major Allen Autry 55th Civil Support Team
  Chris Kummer HCMC EMS and WMRCC
  
• Ginny Baresch MDH SNS Coordinator Jeff
  Lanenberg Allina EMS/ Bloomington FD
  
• Mary Burfeind Metro Hospital Compact/RHRC Mark
  Lappe HCMC EP/Security and Metro RHRC
  
• Dave Burke MAC Fire Department Denzil Mellors
  Fairview System
  
• Tim Butler St. Paul Fire/EMS EM Kevin
  Miller Dakota County EMS
  
• Jeff Czyson North Memorial Ambulance Penny
  Mills North Memorial Medical Center
  
• Sheri Fox Regions Hospital Jon
  Muller Lakeview EMS
  
• Dave Gammell Regions EMS and EMRCC Sharon
  Richmond Fairview Ridges
  
• Doug Gesme HCMC EMS Kristi Rollwagen
  Minneapolis Fire
  
• Kent Griffith Regions EMS Ulie Seal
  Minneapolis Fire/Bloomington Fire
  
• Katherine Grimm HealthEast System Lance Ross
  Metro Region EMS, MESB
  
• Kris Herold HealthEast Medical Transportation
  Kevin Sell MDH/HCMC Pharmacist
  
• John Hick, MD HCMC and MDH-OEP
• Sue Jacobson St. Paul Fire Department
• Scott Tomek Woodbury Public Safety and Lakeview
  EMS
  
• Tom Ward HCMC EMS
• Special thanks to Kevin Sell, Dr. John Hick and
  Lance Ross for their dedication and leadership on
  the guidelines and procedures for local
  implementation of this plan.

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• Division of Strategic National Stockpile
• (DSNS) Program Mission
• Deliver critical medical assets
• to the site of a national
• significance

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What types of items are in the DSNS Push Package?
Oral Antibiotics
IV Supplies
Nerve Agent Antidotes
Airway Supplies
Pediatric Supplies
Med/Surg Supplies
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What is different about Chempacks?

• DSNS Program has a 12-hour response time, too
  long in the event of a nerve agent attack
  
• Some state and local governments dont have any
  nerve agent antidote stocks
  
• Hospitals carry limited supplies of treatments
  for nerve agent exposures
  
• Nerve agent antidotes have variable shelf lives
  (are not an easily sustainable resource)

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Chempack Project Mission

• Implement a nationwide project for the forward
  placement of nerve agent antidotes. To provide
  state and local governments a sustainable
  resource that increases their capability to
  respond quickly to nerve agent event.
• State participation in the CHEMPACK Project is
  voluntary

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Why?

• Due to the availability of chemical weapons,
  terrorist organizations may be able to obtain and
  deploy chemical weapons to create a weapon of
  mass destruction (WMD) Event. These chemicals
  are commonly referred to as choking, blister,
  blood and nerve agents.

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Why?

• Agricultural accidents, mishandling of
  insecticides, or other accidents involving
  organophosphate or carbamate pesticides could
  also result in releases that threaten human
  health.

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Where?
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For Real!

• Saddam Hussein used sarin against Kurdish
  villagers in 1988 and against Iranian fighters
  during the Iraq-Iran War (1980-1988).
  
• The Japanese terrorist cult, Aum Shinrikyo, used
  sarin to kill seven people and injure 144 in the
  1994 Matsumoto, Nagano Prefecture, attack.
  
• The same cult used sarin to kill 11 people and
  injure more than 5,500 in the 1995 Tokyo subway
  system attack.

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What are nerve agents?

• Nerve agents are extremely toxic
  organophosphate-type chemicals including
  
• GA (tabun), GB (sarin), GD (soman), GF
  (cyclosarin), and VX,
  
• They attack the nervous system and interfere with
  chemicals that control nerves, muscles, and
  glands.
  
• They are odorless and invisible and can be
  inhaled, absorbed through the skin, or swallowed.

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Symptoms that might be seen in a Nerve Agent
Poisoning
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Casualty Assumptions

• 30 will have a mild exposure
• 40 will have a moderate exposure
• 30 will have a severe exposure
• May overwhelm pre-hospital and hospital health
  care system

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What is a Chempack!
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Standard Containers

• The CHEMPACK Project provides two types of
  containers
  
• Emergency Medical Service (EMS) Container
• Designed for emergency responders material
  packaged mostly in auto-injectors.
  
• Treats up to 454 patients
• Hospital Container Designed for hospital
  dispensing, with multiuse vials, for precision
  dosing and long term care.
  
• Treats up to 1000 patients

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CHEMPACK CONTENTS
Mark I, Kit Nerve Agent Antidote Kit
Diazepam Auto-Injector
ATROPINE, PRALIDOXIME, AND DIAZEPAM MULTI-DOSE
VIALS
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Great How Do I Request a Chempack?
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If Agency PSAP has Chempack/s they can Send th
eirs and then
Contact MRCCs
Process for an Agency to Request Chempacks 2/2006
Agency PSAP

• Determines
• Signs/Symptoms of victims
• Treatment supplies limited
• Deployment of Chempack is appropriate.
• Requests Chempack/s to be deployed to scene

First Responder Agency ie LE, Fire, EMS or I
C/EMS Branch Dir.
Response to Scene
Incident
Responding Agency can request Chempack/s throu
gh their PSAP or MRCC. If PSAP is contacted
they need to contact MRCC to activate the EMS C
hempack plan.
MRCCs
Agency PSAP

• Responding Chempack Agency
• Contacts requesting PSAP or IC/EMS Brh Dir. for
  incident information

Utilizes appropriate communications to alert/act
ivate
EMS Chempack Plan
Responding EMS Chempack/s
All CHEMPACK agencies to standby and monitor

designated TG/Freq. for instructions
Requests FASTEST/CLOSEST CHEMPACK/s, relays d
ispatch info

MDO
Contacts MDO of activation of their Chempack/s
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What you need to know
Bad Day! HELP!!!
Dispatch Or PSAP
Incident
IC or EMS Branch Command
Chempack Agencies
MRCCs
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• Medical
• Resource
• Control
• Center

East Metro
West Metro
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Who Are You Going To Call?

• EMRCC 651-254-2990
• Washington County
• White Bear Lake
• Ramsey County
• Ramsey
• Maplewood
• St. Paul
• Eagan
• Burnsville
• Apple Valley
• Lakeville
• Dakota County
• Cottage Grove

• WMRCC 612-347-5710
• Anoka
• Brooklyn Center
• Hennepin County
• Minneapolis
• Mpls/St. Paul Airport
• St. Louis Park
• Minnetonka
• U of M
• Hopkins
• Edina
• Eden Prairie
• Richfield
• Bloomington
• Carver County
• Scott County

You can also use the Intersystem talkgroup
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MRCCs

• MRCC operators can complete phone-to-phone,
  phone-to-radio and radio-to-radio patches between
  paramedics and physicians at all hospitals
  statewide as well as Western WI.
• Monitor the status and is in contact with Metro
  Area Emergency Departments, and notifies EMS
  agencies when hospitals are temporarily closed to
  ambulances due to high volume.
• Disaster Major Incident EMS Communication/Coordi
  nation point, medical resource access,
  coordination of mass casualties
  
• Monitor Minnesota's Statewide EMS (National EMS)
  frequency, ready to assist ambulance crews from
  anywhere in the state or region.
  
• Local coordination of the National Disaster
  Medical System (NDMS), specifically involved in
  hospital surge capacity and the Metropolitan
  Medical Response System (MMRS).

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MRCCs Continued

• Metro Region Critical Incident Stress Management
  (CISM) Team answering point.(WMRCC)
  
• Minnesota EMS Honor Guard answering point.
  (WMRCC)
  
• MRCCs will serve as back-ups for each other as
  requested
  
• 24/7 EMS System Information resource.
• Serves as the online radio liaison between EMS
  ambulance crews and destination hospitals.
  
• MRCC can provide medical control communications
  to ambulance services and pre-hospital emergency
  care providers
  
• MRCC staff can provide ambulance personnel with a
  single contact point for relaying patient
  information.
  

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How Will They Be Deployed?

• PSAPs with ChemPacks can deploy their packs
  immediately (SPF)
  
• Agencies/PSAPs without Chempacks can contact MRCC
  (east or west) to find the location and contact
  information of the nearest ChemPack
  
• MRCC will contact closest/fastest ChemPack and
  have them respond to staging.
  

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Notification

• The MRCCs will be responsible for notification
  and coordination of each EMS ChemPack host agency
  when the assets are requested.

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