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WHAT'S ALL THIS ABOUT

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Process medical records. Identify pills. Suggest alternative drugs for prescription refills ... Store necessary supplies. Decide what each family member should do. ... – PowerPoint PPT presentation

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Title: WHAT'S ALL THIS ABOUT


1
  • WHAT'S ALL THIS ABOUT
  • EMERGENCY PREPAREDNESS?
  • Ralph M. Shealy, M.D.
  • South Carolina Area Health Education Consortium
  • Disaster Preparedness Response Training Network
  • Commission on Accreditation of Allied Health
    Education Programs
  • Orlando, Florida
  • January 26, 2007

2
  • Funded by a grant from
  • Health Resources Services Administration
  • U.S. Department of Health and Human Services

3
IMAGINE …
4
Something very bad happens in your community .
5
There is a sudden calamity killing many people,

6
There is a sudden calamity killing many people,
but injuring many, many more.
7
IMAGINE …
8
Within a span of hours or days, people start
becoming very sick,
9
Within a span of hours or days, people start
becoming very sick, and begin to die,
10
Within a span of hours or days, people start
becoming very sick, and begin to die, in
increasing numbers.
11
IMAGINE …
12
Medical facilities and personnel are OVERWHELMED.
13
TOO MANY CASUALTIES
14
TOO MANY REMAIN AT RISK
15
TOO MANY WORRIED WELL
16
NOT ENOUGH CAREGIVERS!
17
DISASTER!
18
Natural Disasters
  • Weather
  • Flood
  • Hurricane
  • Tornado
  • Winter storm
  • Geophysical
  • Earthquake
  • Tsunami
  • Volcanic Eruptions

19
Man Made Disasters Unintentional
  • Structural Collapse
  • Transportation Accident
  • Hazardous Material Spill
  • Industrial Accident
  • Explosion

20
Man Made Disasters Intentional
  • Civil Disturbance
  • War
  • Terrorism

21
Types of Terrorism
  • Small Arms
  • Explosive
  • Incendiary
  • Chemical
  • Biological
  • Radiation

22
  • Natural
  • Weather
  • Flood
  • Hurricane
  • Tornado
  • Winter storm
  • Geophysical
  • Earthquake
  • Tidal wave
  • Volcanic Eruption
  • TAXONOMY of
  • CATASTROPHE
  • Man-made
  • Unintentional
  • Structural Collapse
  • Transportation Accident
  • Hazardous Material Spill
  • Industrial Accident
  • Explosion
  • Intentional
  • Crime
  • Civil disturbance
  • War
  • Terrorism
  • Small arms
  • Explosive
  • Incendiary
  • Chemical
  • Biological
  • Radiation

23
At some time during your professional career, you
will experience a COMMUNITY HEALTH EMERGENCY!
24
Threatens public health safety
25
Threatens public health safety Disrupts
essential services
26
Threatens public health safety Disrupts
essential services May destroy infrastructure
27
Threatens public health safety Disrupts
essential services May destroy infrastructure
Demands extraordinary measures
28
Too many patients…
29
Too many patients… coming too fast.
30
Too many patients… coming too fast. Not
enough clinicians.
31
Too many patients… coming too fast. Not
enough clinicians. Not enough critical skills.
32
Too many patients… coming too fast. Not
enough clinicians. Not enough critical
skills. Not enough resources.
33
  • Every disaster is LOCAL!

34
  • Every disaster is LOCAL!
  • Its OURS for 72 hours!

35
  • Now IMAGINE
  • that your ENTIRE REGION
  • is in the same predicament.
  • Today, were talking about
  • the BIG ONE!

36
  • On 911, there were massive
  • fatalities
  • and FEW SURVIVORS.
  • Imagine a thousand critical
  • BURNS and CRUSH INJURIES!

37
  • During KATRINA
  • there was massive DAMAGE
  • but few INJURIES.
  • Suppose the CASUALTIES
  • had been proportionate
  • to the DAMAGE.

38
Everyone involved in acute medical care would be
OVERWHELMED. Where would we get HELP!
39
  • A major disaster in a community disrupts
    everybodys life.
  • BUSINESS AS USUAL comes to a stop.

40
Will anybody show up for an elective procedure?
41
In a large scale disaster, health professionals
who routinely provide elective services will
be idled.
42
How do we tap this resource to relieve the
critical shortage of acute care providers in a
health emergency?
43
The Message to Allied Health Professionals YOU
are a FRONT-LINE DEFENDER of your communitys
HEALTH and SAFETY!
44
  • Because YOU can
  • step into the breach and help fill the gap!

45
  • Health professionals
  • have much more knowledge
  • than is used in daily practice.

46
  • Health professionals
  • have many more skills
  • than are used in daily practice.

47
  • ALL of your abilities will be needed in a
    disaster, because

48
  • ALL of your abilities will be needed in a
    disaster, because
  • EXTRAORDINARY MEASURES are required to resolve
    the crisis.

49
  • ALL of your abilities will be needed in a
    disaster, because
  • EXTRAORDINARY MEASURES are required to resolve
    the crisis.
  • SCOPE OF PRACTICE CHANGES
  • Health Professionals need to do things that they
    ordinarily dont do.

50
  • ALL of your abilities will be needed in a
    disaster, because
  • EXTRAORDINARY MEASURES are required to resolve
    the crisis.
  • SCOPE OF PRACTICE CHANGES
  • Health Professionals need to do things that they
    ordinarily dont do.
  • STANDARD OF CARE CHANGES because circumstances
    are grossly abnormal.

51
  • In a community health emergency
  • HEALTH PROFESSIONALS
  • may have to play
  • UNACCUSTOMED ROLES
  • in UNFAMILIAR SURROUNDINGS

52
  • In a community health emergency
  • HEALTH PROFESSIONALS
  • may have to play
  • UNACCUSTOMED ROLES
  • in UNFAMILIAR SURROUNDINGS
  • BECAUSE THERE IS
  • NO ONE ELSE TO DO IT!

53
Allied Health Professionals may have to THINK
OUTSIDE THE BOX to meet their responsibility
to the public in a disaster.
54
  • Health professionals
  • often do not see
  • how they can serve
  • because they dont really know
  • whats needed in a disaster.

55
  • A creative collaboration between
  • health professionals
  • and disaster experts
  • is often needed
  • to define an optimum role
  • for disaster service.

56
  • These are things
  • I have been trained to do.
  • These are things
  • that need to be done.

57
I can…
  • Take a medical history
  • Give an injection
  • Provide patient education
  • Lend emotional support
  • Identify allergies
  • Identify contraindications
  • Communicate with relatives

58
I can…
  • Process medical records
  • Identify pills
  • Suggest alternative drugs for prescription
    refills
  • Staff shelters
  • Purify water
  • Defuse tensions

59
EXAMPLES
  • Dentists
  • Forensics
  • Histories
  • Allergies
  • Contraindications
  • Prescriptions
  • Injections
  • Simkovich

60
  • Pharmacists
  • Manage Strategic National Stockpile
  • Mass immunization and treatment clinics
  • Recommend alternative script renewals

61
  • Medics
  • Emergency Department Techs
  • Hospital Techs
  • Mass immunization clinics

62
  • THERAPEUTIC MASSAGE revitalizes weary rescuers!

63
Job Requirements
  • REASONABLE INTELLIGENCE
  • HIGHLY MOTIVATED
  • CAN FOLLOW INSTRUCTIONS
  • CAN BE A TEAM PLAYER

64
  • There will be a CRITICAL need for professional
    volunteers
  • during a widespread
  • infectious disease OUTBREAK!

65
  • Health Departments has insufficient staff to
    operate mass clinics
  • that would be required to control
  • a widespread outbreak
  • of dangerous communicable disease.

66
  • Using protocols and
  • backed by public health experts,
  • many health professionals possess
  • skills required to staff a
  • mass immunization clinic or a pharmaceutical
    dispensing center.

67
Regardless of where you chose to volunteer, there
are a few things EVERY disaster volunteer needs
to know.
68
  • Gain an understanding
  • of what a large scale disaster
  • may be like.

69
  • Disasters destroy infrastructure.
  • Health Professionals
  • need to be able to perform
  • their critical skills
  • WITH MINIMAL DEPENDANCE
  • ON TECHNOLOGY.

70
  • Untrained and unorganized free-lance
    volunteers, regardless of good intentions, create
    avoidable problems during a disaster.

71
  • DISASTER VOLUNTEERS
  • Become EFFECTIVE more quickly
  • if they have already SIGNED UP and undergone
    BASIC TRAINING.

72
How do I fit in with existing systems for
managing COMMUNITY HEALTH EMERGENCIES?
73
You will be a small part of a very large response.
74
  • Community Health Professionals
  • Public Health
  • Hospitals
  • Emergency Management
  • Law Enforcement
  • Fire Service
  • EMS
  • Rescue
  • Public Works
  • Business and Industry
  • Local, State and Federal Government
  • Military

75
A communitys success in a disaster will depend
on EFFECTIVE RELATIONSHIPS across disciplines and
between jurisdiction.
76
A communitys success in a disaster will depend
on EFFECTIVE RELATIONSHIPS across disciplines and
between jurisdiction. These relationships must be
formed IN ADVANCE.
77
Somebody will be in charge.
78
Somebody will be in charge. It will not be you.
79
National Incident Management System
  • Common Structure
  • Common Language
  • Common Organization
  • Interchangeability
  • Interoperability

80
Incident Command System
  • Incident Commander or Joint Command
  • Operations
  • Logistics
  • Planning
  • Administration and Finance

81
Emergency Operations Center
  • Every county has a secure site where county
    government, community leaders, and key decision
    makers gather during a crisis to make and
    implement critical decisions when a crisis
    threatens the community.

82
Family Plan
  • In order to be able to take care of others
    during a crisis, you first need to know that your
    own family is safe and secure

83
Family Plan
  • Learn what disasters are most likely.
  • Consider where each family member might be when
    disaster strikes.

84
Family Plan
  • Store necessary supplies.
  • Decide what each family member should do.
  • Anticipate failure of communications.

85
Preparing Your Workplace
  • How will you secure your offices?
  • How will you communicate with staff?
  • Make and discuss Practice Disaster Plan with
    staff in advance.

86
Preparing Yourself
  • Immunizations
  • Go Bag
  • Medical Kit

87
Immunizations Required for deployment by NDMS
  • Hepatitis A
  • Hepatitis B
  • Influenza Annual
  • MMR (measles, mumps, rubella)
  • Polio (IPV)
  • Tetanus-diphtheria (Td) 
  • Varicella (chickenpox)
  • Pneumococcal polysaccharide (PPV) vaccine
  • Small Pox

88
California DMAT Personal Equipment List
  • http//www.armymars.net/ArmyMARS/EmergencyOps/Res
    ources/DMAT/dmat-ca6-pers-equiplist.pdf

89
Laws Governing a Public Health Crisis
  • Emergency Health Powers Act
  • HIPPA
  • OSHA

90
Mitigating Personal Risks
  • How Am I Protected Against Civil Liability?

91
Principles of Triage
  • A Different Paradigm for Delivering Care

92
Principles of Triage
  • Focuses on the welfare of a population, rather
    than the welfare of an individual

93
Principles of Triage
  • Allocation of resources is prioritized to enhance
    the overall survival of the population

94
Principles of Triage
  • In a large scale disaster,
  • allocation of scarce resources
  • among the sick and injured
  • may lead to
  • profound ethical emotional dilemmas.

95
Role in Public Information
  • Health Professionals are
  • opinion leaders
  • who define the situation
  • for their neighbors Demonstrate reassurance and
    resolve.

96
SUMMARY
  • We currently do not have the
  • capability to respond to a large scale disaster
    with massive casualties.
  • PANDEMIC INFLUENZA?

97
SUMMARY
  • Allied Health Professionals
  • will be desperately needed
  • to support
  • overwhelmed clinicians.

98
SUMMARY
  • Some BASIC TRAINING
  • is necessary
  • to prepare them
  • for this role.

99
SUMMARY
  • Although there may be some variation in
    curriculum
  • among the various professions,
  • there is a core of information
  • that everyone should know.

100
QUESTIONS?
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