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Hospital Emergency Response Training (HERT) for Mass Casualty Incidents (MCI) Train-the-Trainer Course

Hospital Emergency Response Training (HERT) for Mass Casualty Incidents (MCI) Train-the-Trainer Course . Course Code: B461. HERT FOR MCI. Hospital Emergency Response Training (HERT) for Mass Casualty Incidents (MCI) Train-the-Trainer, B461 Course

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Hospital Emergency Response Training (HERT) for Mass Casualty Incidents (MCI) Train-the-Trainer Course

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  1. Hospital Emergency Response Training (HERT) for Mass Casualty Incidents (MCI) Train-the-Trainer Course Course Code: B461

  2. HERT FOR MCI • Hospital Emergency Response Training (HERT) for Mass Casualty Incidents (MCI) Train-the-Trainer, B461 Course • Resident Offering at Noble Training Center, Anniston, Alabama • 4.0 Days • Special offerings for hospital emergency departments, administration, and staff personnel • Prerequisites: • IS-195, Basic ICS • IS-346, An Orientation to Hazardous Materials for Medical Personnel B461 Course

  3. What HERT for MCI is Not? • Not a HazMat Course. Need additional training under: • OSHA’s Hazardous Waste Operations and Emergency Response, 29 CFR 1910.120, par (q), 1990 • OSHA 3152 Hospital and Community Emergency Response – What You Need to Know, 1997 • OSHA’s Best Practices for Hospital-Based First Receivers of Victims from Mass Casualty Incidents Involving Hazardous Substance Releases, 2004 • Department of Health and Human Services, CDC Recommendations for Civilian Communities Near Chemical Weapons Depots: Guidelines for Medical Preparedness, 1995 • USACHPPM, Technical Guide 275, PPE for Military MTF Personnel Handling Casualties from WMD and Terrorist Events, 2003 B461 Course

  4. What HERT for MCI is Not? (Cont’d) • Not a Hospital Emergency Incident Command System (HEICS) Course: • HERT stresses HEICS as a valuable tool for hospitals • Recognizes all Hospital Incident Management Systems (HIMS) • HERT emphasizes a hospital IMS during emergency response • HERT integrates its HIMS into all aspects of the course B461 Course

  5. What HERT for MCI is Not? (Cont’d) • Not a Weapons of Mass Destruction (WMD) Course: • HERT emphasizes the handling of patients contaminated with CBRNE agents • Recognizes attendee’s prior training and skills concerning these agents • Attendees should receive additional training on WMD Events from ODP B461 Course

  6. What HERT for MCI is Not? (Cont’d) • Not a National Incident Management System (NIMS) Course: • HERT emphasizes the use of an incident management system to comply with the NIMS • Recognizes attendee’s prior training in the NIMS • Has incorporated NIMS where it applies throughout the course • Participants wanting additional training should enroll in FEMA’s Online Courses in the NIMS: • IS 700 NIMS, An Introduction • IS 800 NRP, An Introduction B461 Course

  7. Unit One Course Introduction: Origin of the Incident Command System (ICS)

  8. Objectives • Review ICS as an incident management tool • List uses of ICS in emergency management • Describe the history of ICS • Discuss the evolution of HEICS • Define basic HEICS structure • Review ICS organizational chart B461 Course

  9. Objectives (cont'd) • Develop an initial organizational structure • List minimum staffing requirements • Prepare an incident briefing • Participate in a planning meeting • Develop incident objectives and an Incident Action Plan (IAP) • Identify appropriate uses of resources B461 Course

  10. What is ICS? • The model incident management tool for: • Command, control, and coordination of an emergency response • Providing a means to coordinate efforts of individual agencies • Allowing agencies to work toward a common goal for stabilizing an incident • Ensuring the protection of life, property, and the environment B461 Course

  11. When is ICS Used? • Hazardous materials incidents • Response to natural disasters • Fire and riot control • Incidents involving multiple casualties: • Weapons of Mass Destruction • Mass Casualty Events • Wide-area search and rescue missions B461 Course

  12. History of ICS • Developed in the 1970s in response to major wild land fires in Southern California • Allowed for collaboration to form the: • Firefighting Resources of Southern California Organized for Potential Emergencies, or FIRESCOPE B461 Course

  13. History of ICS (cont'd) • FIRESCOPE identified several recurring problems involving multi-agency responses, such as: • Nonstandard terminology • Lack of flexibility to expand or contract resources as required • Nonstandard and nonintegrated communications • Lack of consolidated action plans • Lack of designated facilities B461 Course

  14. History of ICS (cont'd) • Efforts to address these difficulties resulted in the development of an ICS model • Success of ICS has resulted directly from applying: • A command organizational structure • Key standardized management principles B461 Course

  15. NIIMS (existing): Incident Command System (ICS) Training Qualifications & Certification Publications Management Supporting Technology NIMS (new): Command & Incident Management Preparedness Resource Management Communications Information & Intelligence Management Science & Technology Management NIIMS versus NIMS B461 Course

  16. Hospital Emergency Incident Command System (HEICS) • Modeled after FIRESCOPE • Early work by the Northern California Hospital Council • California authorized a grant to Orange Country EMS for HEICS Project 91/92 • Major rewrite of HEICS documents: • Now provide the current HEICS Plan • HEICS considered a model for hospital incident management system B461 Course

  17. HEICS Attributes • HEICS attributes: • Command, control, coordination, and intelligence • Functional incident management system • A dependable chain-of-command • Improved communications through common language • Flexibility in section (component) activation • Prioritization of duties • Adaptable to HazMat, WMD, and MCI B461 Course

  18. HEICS Attributes (cont'd) • Organized documentation for improved financial recovery • Facilitates effective mutual aid with: • Other hospitals, and • Agencies B461 Course

  19. Basic HEICS Structure • Basic units of structure: • Incident Commander • Section Chiefs • Directors • Unit Leaders • Officers B461 Course

  20. ICS Organizational Chart • Represents lines of authority and communications • Command element (IC and staff) • Four functional sections: • Planning • Operations • Logistics, and • Finance/Administration B461 Course

  21. Incident Command Finance/ Planning Operations Logistics Administration Section Section Section Section ICS Organization B461 Course

  22. Incident Commander • Incident Commander (IC): • Defines the mission and ensures its completion • Has overall control of incident or emergency response • Can appoint a deputy commander B461 Course

  23. Command Staff Public Information Officer IncidentCommand Safety Officer Liaison Officer B461 Course

  24. Command Staff (cont'd) • Command Staff is: • Public Information Officer • Liaison Officer • Safety Officer • Officers can also have Assistants B461 Course

  25. Incident Command Planning Operations Logistics Finance/ Section Section Section Administration Section General Staff B461 Course

  26. Planning Section • Planning Section: • Determines and provides for the continuance of each response objective • Prompts and drives all Officers to develop: • Short-range action planning • Long-range action planning • Responsible for preparing the IAP B461 Course

  27. Planning Section Resource Unit Situation Unit Documentation Unit Demobilization Unit Planning Section (cont'd) B461 Course

  28. Operations Section • Operations Section: • Carries out the objectives to the best of the staff’s ability • Oversees and directs all response operations • Determines needs and requests additional resources B461 Course

  29. Operations Section Staging Area(s) Rescue Medical Multi-Casualty HazMat Group Branch Branch Branch Operations Section (cont'd) B461 Course

  30. Logistics Section • Logistics Section: • Provides a hospitable environment and materials for the overall objectives • Ensures service and support for responders B461 Course

  31. Logistics Section Service Branch Support Branch Supply Unit Ground Support Unit Food Unit Communications Unit Medical Unit Facilities Unit Logistics Section (cont'd) B461 Course

  32. Finance/Administration Section • Finance/Administration Section: • Provides funding for present objectives • Stresses facility-wide documentation to maximize: • Financial recovery, and • Reduction of future liability B461 Course

  33. Finance/Admin Section Cost Unit Time Unit Procurement Unit Compensation/Claims Unit Finance/Administration Section (cont'd) B461 Course

  34. Future of the ICS • Continues to expand throughout U.S.: • Law enforcement • Government agencies • Hospitals and HCF • Will be revisited to ensure: • It remains relevant to response agencies, and • Current with standardized ICS models • Must be adaptable to include an ICS/UC structure for HMI, MCI, and WMD events • Should incorporate NIMS as adopted on March 1, 2004 B461 Course

  35. Unit Two Hospital Incident Management System (HIMS)

  36. Objectives • Describe Hospital Incident Management System for: • Planned & unplanned events • Mass casualty incidents • HazMat incidents • CBRNE events • Describe transfer of command B461 Course

  37. HIMS – Operations Section Members • HIMS Operations Section could consist of: • Operations Section Chief • Group/Division Supervisors • CBRNE or HazMat Group • SHED or Cafeteria Division, etc. • Team Members • Triage and Treatment Unit Leaders • Triage and Treatment Team Members • Hospital Emergency Response Unit (HERU) • Team Members B461 Course

  38. Operations Section CBRNE Group SHED Division Cafeteria Division HIMS – Operations Section Organization B461 Course

  39. Medical Care Group/DivisionMembers • Medical Care Group/Division could consist of: • Medical Group/Division Supervisor: • Triage Unit Leader • Triage personnel • Treatment Unit Leader • Treatment Dispatcher Manager • Treatment Managers • Immediate, Delayed and Minor • Patient Transport Group Supervisor • Medical Communications Coordinator • Air/Ground Ambulance Coordinator B461 Course

  40. Medical Care Group/DivisionMembers (Cont’d) • Command from the top down • Staff from the bottom up: • Start with Team or Unit when possible • Staff up as span of control is exceeded • Maintain unity of command • Divisions are geographical: • North/South; East/West; 1st floor/2nd floor B461 Course

  41. Medical Care Group/DivisionMembers (Cont’d) • Groups are functional: • Security, medical care • CBRNE or HazMat • Groups can have Units: • Triage • Treatment • Hospital Emergency Response Unit (HERU) • Units may have Teams • Decontamination B461 Course

  42. Medical Care Group /Division Supervisor Medical Supply Coordinator Triage Unit Treatment Unit Leader Leader Treatment Dispatch Triage Personnel Manager Immediate Treatment Manager Morgue Manager Delayed Treatment Manager Minor Treatment Manager Medical Care Group/Division Organization B461 Course

  43. HazMat/CBRNE Unit Members • HazMat/CBRNE Unit Leader • Entry Team Leader • Hospital Site Access Control Leader • Safe Refuge Area Manager • Decontamination Team Leader • Technical Specialist • Assistant Hospital Safety Officer – HazMat B461 Course

  44. HazMat/CBRNE Unit Entry Hospital Access Control Safe Refuge Area Decontamination Technical Specialists HazMat/CBRNE Unit Organization B461 Course

  45. Hospital Emergency Response Unit* (HERU) • HERU Leader • Hospital Emergency Response Team (HERT) Leader • Initial Assessment & Triage • Immediate Treatment • Delayed Treatment • Minor Treatment *Unit can be replaced by a Team B461 Course

  46. HERU/HERT Leader Delayed Treatment Initial Assessment/ Triage Immediate Treatment Minor Treatment HERU/HERT Organization B461 Course

  47. Decon Team Members • Decontamination Team Leader • Initial Contact • Decon Triage* • Decon Site Access Control • Decon Set-up and Support *Patient/victim is continually triaged B461 Course

  48. Decon Team Leader Initial Contact Decon Triage Decon Site Decon Set Up/ Access Control Support Decon Team Organization B461 Course

  49. Scenario Objectives • Identify initial incident objectives • Incident priorities • Life Safety (staff and patients) • Incident Stability • Property preservation • Activate ICS • Fill positions as appropriate for the event • Key points: • Span of control (3 – 7) • Unity of command B461 Course

  50. Noble Hospital is planning their annual fundraiser: A two day Fish Fry Festival. Saturday and Sunday, Noon to 10 pm Menu: Fried catfish, Cole Slaw, Beans, Hush Puppies, Cornbread Ice Cream Cones Beer Soda Entertainment: 8 bands, 2 magician shows Vendors: 20 Arts & Craft booths Children’s Play area Scenario – Planned Event B461 Course

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