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GETTING DOCS into the DISASTER PREPAREDNESS LOOP Joanne Selkurt MD, FAAP

GETTING DOCS into the DISASTER PREPAREDNESS LOOP Joanne Selkurt MD, FAAP. Introduction. The Reality: September 11, 2001 “9 - 11”. Man-made Fires Explosive devices Firearms Structural collapse Transportation event Air, Rail, Roadway, Water

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GETTING DOCS into the DISASTER PREPAREDNESS LOOP Joanne Selkurt MD, FAAP

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  1. GETTING DOCS into theDISASTER PREPAREDNESS LOOP Joanne Selkurt MD, FAAP

  2. Introduction The Reality: September 11, 2001 “9 - 11”

  3. Man-made Fires Explosive devices Firearms Structural collapse Transportation event Air, Rail, Roadway, Water Industrial HAZMAT WMD – NBC events Etc… Natural Earthquake Landslides Avalanche Volcano Tornado Hurricanes, floods Fires Meteors Etc… “All-Hazards”

  4. Are We Prepared? • Is the US healthcare system prepared? • We appear to be… each Hospital, EMS agency, Law enforcement agency, Fire department,and Community has… … a disaster plan … properly documented drills … annual training documented • But...

  5. Are We Prepared? • KATRINA

  6. Are We Prepared? • Interagency communication failures! • Why do we all treat a cardiac arrest the same? • …because there is an agreed-upon approach.

  7. Are We Prepared? • Critical to healthcare preparedness • uniform • coordinated approach • mass casualty management from any cause • NEED: A nationally standardized training program

  8. Course Description BDLS • Didactic - 8 hours • Distance learning option • For healthcare providers • Physicians, Nurses, Paramedics, EMTs • Mid-level providers, Allied health, Public health • Provider status & course credit awarded • Course completion • Written examination passage • BDLS providers are eligible to take ADLS

  9. Overview & Concept DISASTER Paradigm Natural Disasters Explosive & Traumatic Nuclear & Radiological Biological Agents Chemical Agents Psychosocial Aspects Public Health System Examination Course evaluations BDLS Course Outline

  10. Course Description ADLS • 16 hour class (8-didactic, 8-practical) • Advanced practicum “hands on” course • Meets Hazmat Operations-level trainingrequirement (CFR 1910.120) • Must have completed BDLS course • Provider status & course credit awarded

  11. Day-One: Classroom & Interactive: DISASTER Paradigm Casualty Decontamination Legal Issues Media & Communications Community and Hospital Disaster Planning Community, State and Federal Resources Mass Fatality Management Day-Two: Skills Lab “hands on” MASS Triage Clinical Scenarios Human simulator use Disaster Skills Personal Protective Equip Decontamination ADLS Course Outline

  12. What is a “Disaster”? • Disaster- dis·as·ter n. • An occurrence causing widespread destruction and distress; a catastrophe. • A grave misfortune. • Informal- A total failure

  13. “Disaster” Definition • A disaster is present when need exceeds resources! • A response need that is greater than the response available!

  14. Mass Casualty Incident (MCI) • “Is this an MCI ?” • The first step in identifying an MCI is knowingyour own capabilities. • Any incident that exceeds the responder’s or receiving hospital’s capability to treat or transport is a Mass Casualty Incident

  15. D-I-S-A-S-T-E-R Paradigm

  16. D:Detection I: Incident Command S: Safety & Security A: Assess Hazards S: Support T: Triage & Treatment E: Evacuation R: Recovery

  17. D-I-S-A-S-T-E-R Paradigm Incident Command Incident Command System (ICS) • Born in Fire Service • Managing wildfires in early 1970’s • Interagency task force collaborative effort • Uniform structure • Clearly delineated roles/responsibilities • Clear chain of command/ communication

  18. Incident Command System “Commander” The Basics Unified Command Planning Logistics Operations Finance “Thinkers” “Getters” “Doers” “Payers”

  19. Incident Command SystemOperations

  20. D-I-S-A-S-T-E-R ParadigmAssess Hazards • Be Aware of Secondary Devices! • Bombs, Shrapnel devices, Incapacitating Devices, Multiple Snipers/Terrorists, Delay Devices

  21. D-I-S-A-S-T-E-R ParadigmAssess Hazards • Be Aware of Secondary Devices! • Bombs, Shrapnel devices, Incapacitating Devices, Multiple Snipers/Terrorists, Delay Devices

  22. D-I-S-A-S-T-E-R ParadigmSupport Unexpected Volunteers and Donations: • Positive intentions, often negative impact • Does your preparedness plan include them? • ICS, Identify needed skills and needed supplies • Negatives: • Time to sort large, poorly labeled goods • Storage space used • Unplanned personnel are a liability • At risk of injuries, require food, water and shelter

  23. Volunteers Need to Address… Licensure in state Credentialing for specific responder organization “Just-in-Time” Training Management:logistics, supervision, transportation, medical & other care needs Well-Meaning Volunteers Can… Overwhelm, Interfere, Confuse, Burden & Even Endanger themselves and others

  24. Best if a member of a recognized, organized response team that has been invited in • DON’T JUST SHOW UP !!

  25. M.A.S.S. Triage M – Move A – Assess S – Sort S – Send • M.A.S.S. Triageis a disaster triage system that utilizes US military triage categories with a proven means of handling large numbers of casualties in a mass casualty incident (MCI).

  26. “ID-me”! I – Immediate D – Delayed M - Minimal E – Expectant D - DEAD • “ID-me”! - a mnemonic for sorting patients during MCI triage. It is utilized effectively in the M.A.S.S. Triage model.

  27. I –Immediate D – Delayed M - Minimal E – Expectant D - DEAD M – Minimal D –Delayed I – Immediate E – Expectant D - Dead “ID-me”! - a mnemonic for sorting patients during MCI triage. It is utilized effectively in the M.A.S.S. Triage model.

  28. Tips for talking to children after a disaster • Provide opportunities to talk about what they are seeing on television and to ask ? • Don’t be afraid to admit you don’t know all the answers • Answer ? At a level the child can understand • Establish a family emergency plan (Sense of doing something is helpful) • Monitor children’s TV watching..don’t need to see event over & over) Watch with children • Help kids to understand there are no bad emotions • Try to not focus on blame • In addition to tragic things seen, also help kids focus on good things such as heroic actions, reuniting of families, assistance offered by people throughout the world

  29. For children closer to disaster • Disasters often reawaken a child’s fear of loss of own parents when parents are preoccupied with own fears … consider family counseling • Families may permit some regressive behavior weaning off by leaving bedroom door open, night lights, extra time with parents • Parents may have trouble leaving child after a disaster,,,may be able to use child’s problem as a way of asking for help themselves • Get the children into some sense of routine of school and play even if displaced • Teachers can help kids with art, and play activities, encouraging group discussions and presentations about the disaster

  30. For more information on children & disasters: • Child Health Alliance of Wisconsin (CHAW) www.chawisconsin.org ClickPrograms Click Trauma preparedness

  31. A A stuffed animal can help a lot

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