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FIELD TREATMENT SITES

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FIELD TREATMENT SITES Another PIECE of the PUZZLE Presented by: Doug Buchanan www.DisasterDoug.com – PowerPoint PPT presentation

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Title: FIELD TREATMENT SITES


1
FIELD TREATMENT SITES
  • Another PIECE of the PUZZLE

Presented by Doug Buchanan www.DisasterDoug.com
2
OBJECTIVES
  • After this course, you should be able to answer

1- WHAT?
  • What Are They?Identify several resources
    available to help augment current Treatment
    Facilities

2- WHY?
  • Why Do We Need Them?Describe the purpose and
    function of a Field Treatment Site.

3- WHO?
  • Who Decides When We Need to Activate an
    FTS?Describe the Decision Process for Activation
    of an FTS.

4- HOW?
  • How Do We Activate an FTS?Outline the Activation
    and Set-up Process for an FTS.

5- WHERE?
  • Where Do We Get the Equipment/Supplies ?Describe
    the Logistics and Support Process for an FTS.

6- WHEN?
  • What Happens at the End of 3 Days?
  • List the options for Demobilization of an FTS.

3
What is an EMS Field Treatment Site?
How does this relate to other facility types?
  • An EMS Field Treatment Site is a temporary
    facility, designed to provide Triage and
    Treatment of patients awaiting transportation,
    for up to 72 hours.

4
Dont We Already Have Options?.. like
  • Mobile Field Hospitals
  • The California EMS Authority currently has three
    200-bed Mobile Field Hospitals available for
    deployment.
  • Alternate care sites
  • Many Operational Areas have already developed
    plans for establishing Alternate Care Sites as
    part of the local Medical Surge plan.

5
YES.
  • Local and State Government agencies currently
    have Assets and Plans to help augment Treatment
    locations during a Medical Surge.
  • However most of these plans require a minimum of
    72 hours to fully activate.
  • An EMS FTS is designed to use Paramedics, EMTs,
    and EMRs to provide care up to 72 hours.

6
Field Treatment Sites
  • Filling in the Gap.
  • Establishing an EMS Field Treatment Site to fill
    in the gap between the onset of a local Medical
    Surge event, and the time it takes to activate a
    Mobile Field Hospital or an Alternate Care Site
    is one possible scenario (i.e. Medical Surge).
  • Another reason why an EMS Field Treatment Site
    may be activated is that Transportation of
    patients to definitive care is not possible, due
    to
  • Unavailable Transportation Routes
  • Unavailable Transport Resources

7
TEST YOUR KNOWLEDGE
  • Lets examine what weve learned so far
  • Scenario A bridge on the local highway had
    partially collapsed during a mud slide earlier
    today. At 6pm, a 50 passenger bus and several
    automobiles didnt notice the problem until it
    was too late. This highway is the primary route
    to local hospitals. Taking alternate routes
    could take hours. You now have 58 patients, and
    the weather forecast is calling for freezing
    temperatures tonight. You anticipate that
    getting adequate transport resources here could
    take until morning. You decide to
  1. Request a Mobile Field Hospital
  2. Request an Alternate Care Site
  3. Request a Field Treatment Site

8
TEST YOUR KNOWLEDGE
  • Lets examine what weve learned so far
  • If you answered C. Request a Field Treatment
    Site, youre correct.
  • Our problem is not places to send our patients,
    it is that the transportation routes are
    significantly affected, and transport resources
    are significantly delayed.
  • Requesting an FTS should allow us to getpatients
    out of the environment, andprovide facilities to
    maintain patients overnight.

9
Deciding to Activate
  • Requests for FTS Activation come to the MHOAC
    from a local Incident Commander or the OA EOC.
  • An Incident Commander may decide to contact the
    MHOAC to request an FTS Activation when it
    appears that patients will have to be cared for
    greater than 12 hours on scene.
  • T he OA EOC may elect to activate an FTS due to a
    Healthcare Surge event.
  • The MHOAC may use the FTS Decision Checklist and
    tools found in the FTS Planning Guide to
  • Evaluate Resource Options
  • Determine number, type, and locations of FTSs
  • Sign an FTS Activation Order
  • Appoint an FTS Activation Team Leader
  • FTS Activation Team Leader oversees the
    Activation and set-up of the FTS.

10
FTS Decision Checklist
  • Designed for use by the MHOAC
  • A Medical / Health Technical Advisory Committee
    may be convened to help assess the available
    alternatives or Medical Surge strategies, prior
    to FTS activation.

11
Assessment Factors
  • To assist the MHOAC or the EOC MH Branch in
    evaluating the need for an FTS, many factors
    should be considered. This tool is available in
    the FTS Planning Guide.

12
FTS Options
  • Considering what is available.
  • Pre-Surveyed Facility
  •  If the County has a pre-designated FTS within
    the area , this location should be considered
    first. A list of Pre-designated sites can be
    found in the Appendix of the FTS Planning Guide.
  •  
  • Non-Surveyed Facility
  •  If no pre-designated sites in the target area
    are available, other non-surveyed facilities
    should be considered, such as halls, community
    centers, etc.
  •  
  • Non-Fixed Site
  •  If there are no targetable facilities within the
    area, an FTS will need to be identified and
    established in close proximity to the incident,
    which may require assets such as tents, portable
    water / sanitation, and generators, etc.

13
FTS Activation Order
  • After Identifying the Site
  • This is the first part of the form, designed to
    be used by the MHOAC or Med/Health Branch
    Director at the EOC.

14
FTS Activation Order
  • After Identifying the Site
  • The second portion of the FTS Activation Order is
    designed to list the Team Leader, appointed by
    the MHOAC or Med/Health Branch Director of the
    EOC.

15
Decision to Demobilize or Transition
  • Thinking ahead
  • The MHOAC or MH Branch needs to consider when,
    and how the FTS might be demobilized. Planning
    must begin as early as possible to ensure a
    smooth transition. The options for consideration
    may be
  • Maintain the FTS until all patients are
    disbursed, then demobilize the site.
  • Utilize the FTS for initial care and treatment,
    then transition the care of patients to an FTS or
    ACS at different location.
  • Utilize the FTS for initial care and treatment,
    then transition the FTS into an ACS at the same
    location.

16
Decision to Demobilize or Transition
  • Thinking ahead
  • The following graphic provides examples of
    transitioning an on-scene Treatment Area to an
    FTS and transitioning an FTS into an ACS for
    longer term care.

17
Decision to Demobilize or Transition
  • Once an FTS is Activated

18
Activating an EMS Field Treatment Site
  • FTS Activation Team Leader Checklist
  • Once the decision has been made to activate a
    Field Treatment Site (FTS), and an FTS Activation
    Team Leader has been assigned, the team leader is
    responsible to
  • Assign the Activation Team staff,
  • Secure the selected FTS location,
  • Acquire the necessary resources to staff and
    equip the site, and
  • Set-up the site.

19
Activation Team Leader Checklist
  • This tool from the FTS Planning Guide is meant to
    assist the FTS Activation Team Leader.
  • Additional supporting tools are listed in the
    column to the right.

20
FTS ACTIVATION TEAM
  • Planning Tool
  • This tool is intended to give the FTS Activation
    Team leader an overview of the tasks and
    responsibilities involved in the FTS activation
    process, and shows how these tasks may be
    assigned to various Section Chiefs and Unit
    Leaders.
  • Team Leader (Command and Control) 
  • Logistics Section Chief
  • Facility Procurement Unit (Select and Secure a
    Site) 
  • Staffing Unit (Establish Initial Operational
    Period Staffing)
  • Equipment / Supply Unit (Order of Equipment and
    Supplies)
  • Communications Unit (Establish Communication
    Systems)
  • Operations Section Chief
  • Staging Manager (Receive and inventory incoming
    equipment / supplies)
  • Site Set-up Unit (Site Set-up)
  • Security Unit (Establish Site Security Plan)

21
FTS Activation Org Chart
  • Example of how the Activation Team may be
    organized.
  • This chart utilizes Smart Art which is feature in
    PowerPoint 2007. If you wish to make charts like
    this and dont have PPT 2007, we have provided
    the graphical elements to help you build this
    yourself.
  • Here is the description of the chart. You may
    change or delete this text as you wish.

FTS logistics will by managed by, or in
cooperation with, the OA EOC
22
Job Action Sheets
  • The right tool for the right job.
  • Job Action Sheets are included in the FTS
    Planning Guide for each position on the FTS
    Activation Team.
  • In addition to the Job Action Sheets, the
    supporting tools, such as the ICS Forms, can be
    found in the Attachments section.

23
FTS Equipment / Supplies Tool
  • And Recommended Quantities for a 50 patient FTS

24
FTS Equipment / Supplies Tool
  • How do we use this form?

PHD 50 PHD 150 PHD 200 OES 100 OES 200
  • Example Available in Local Cache?This is
    designed to be filled out in advance, based upon
    known local assets.

25
FTS Equipment / Supplies Tool
  • How do we use this?

PHD 50 PHD 150 PHD 200 OES 100 OES 200
30 90 30 6 20
  • Example Select for OrderingThis is designed to
    be filled out to reflect the actual need during
    an incident (e.g. if your incident requires care
    for only 30 patients, the column should reflect
    that.)

26
FTS Equipment / Supplies Tool
  • How do we use this?

PHD 50 PHD 150 PHD 200 OES 100 OES 200
30 90 30 6 20
10 0 0 2 2
20 90 30 4 18
  • Example Have Need These columns are designed
    to indicated what items we already HAVE, versus
    what we still NEED (e.g. We have 10 cots, 2
    Tables, 2 Chairs we need everything else).

27
FTS Equipment / Supplies Tool
  • How do we use this?

PHD 50 PHD 150 PHD 200 OES 100 OES 200
30 90 30 6 20
10 0 0 2 2
20 90 30 4 18
20 90 30 4 18
  • Example Requested Order FilledThe last two
    columns are meant to help us track what has been
    requested, and if an order has been filled.

28
FTS Layout
  • Sample Layout of a Field Treatment Site

29
TEST YOUR KNOWLEDGE
  • Lets examine what weve learned so far
  • Scenario You have been assigned as an FTS
    Activation Team Leader, and are tasked with
    activating this facility for 50 patients.
    Besides patient cots, bedding, and food, what
    additional items might need to be considered?
  1. Portable toilets.
  2. Storage area for medical supplies.
  3. Nothing.

30
TEST YOUR KNOWLEDGE
  • Lets examine what weve learned so far
  • If you answered C. Nothing, you might need to
    restart this lesson.
  • If you answered A. Portable toilets, you have
    begun thinking like an FTS Activation Team
    Leader.
  • Caring for 50 people will likely require more
    than one toilet. You might also consider
    additional handwash stations.A good rule of
    thumb is 20/1

31
FTS Operations
  • The FTS Organization Chart is largely modeled
    after the current FIRESCOPE MCI organization
    chart.

32
FTS Operations
  • Job Action Sheets, Forms, other Tools
  • Job Action Sheets are included in the FTS
    Planning Guide for each position in the FTS
    organization.
  • In addition to the Job Action Sheets, the
    supporting tools, such as the ICS Forms and FTS
    Report Forms can be found in the Attachments
    section.

33
FTS Tools
  • Several forms have been developed to assist the
    personnel with FTS operations, including the
  • FTS Report Form
  • FTS Staffing Roster
  • FTS Time Sheet
  • FTS Patient Record

34
FTS Site Surveys/Diagrams
  • Developed through HPP Grant Funding
  • Most Operational Areas in California have had the
    opportunity to conduct FTS Assessments on local
    target facilities.
  • The FTS Assessment allows us to identify in
    advance what services or features already exist
    at a target facility, and what will likely need
    to be brought in to make a facility functional as
    an FTS.
  • In addition to the county specific FTS Surveys
    and Site Diagrams, a generic FTS Diagram has been
    included in the Appendix of the FTS Planning
    Guide that demonstrates an FTS set-up at or near
    the site of an incident, using Tents, Cots, etc.

35
Field Treatment Sites
  • Another piece of the puzzle.

You have completed the FTS Overview. -Thank you.
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