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FIFA World Cup Disaster Preparedness

FIFA World Cup Disaster Preparedness. NY Institute For All Hazard Preparedness Department of Emergency Medicine SUNY Downstate Medical Center Brooklyn, NY, USA. 1. Disclosures. Project funded by the Provincial Government of the Western Cape, South Africa. 2. Long Distance Table Top.

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FIFA World Cup Disaster Preparedness

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  1. FIFA World CupDisaster Preparedness NY Institute For All Hazard Preparedness Department of Emergency Medicine SUNY Downstate Medical Center Brooklyn, NY, USA 1

  2. Disclosures • Project funded by the Provincial Government of the Western Cape, South Africa 2

  3. Long Distance Table Top • Gather information electronically • Feasible? • Effective? • Reliable? • Remotely? • Simulate a likely scenario • Adaptable to any place/situation • Identify weaknesses/strengths • Develop an improvement plan 3

  4. Our Program • Internet based • Test preparedness • Send, Receive, Respond and Evaluate • Weekly “scenarios” • 10 weeks • Results • Analysis 5

  5. Our Program • Time sensitive questions • 1 week • Numerical • Tables • Text responses 6

  6. What’s Unique? • Real Time data collection • Immediate Feedback • Help • Follow up • Scalable 7

  7. Hospitals Involved • Milnerton Mediclinic Hospital • Vincent Pallotti Hospital • Netcare Blaauwberg Hospital • Netcare N1 City Hospital • New Somerset Hospital • Groote Schuur Hospital • Tygerberg Hospital • Christian Barnard • Melomed Hospital 8

  8. Scenario • Soccer game • Fight in stands • Harare, Zimbabwe • Local security responds • Police respond • Tear gas • Mass exodus • Injuries/deaths • Patients evacuated • Present to ED 9

  9. Topics Tested • Patient care capacity (surge) • Communications • Equipment • Major incident plan (EOP) • Hazard vulnerability analysis • Public relations/media • Safety, security and supplies 10

  10. Patient Care Capacity • How many? • Specialty care • ICU, burn, vent unit, OT, recovery room • How sick? • Doctors • Nurses • Support staff • Triage space • Evaluation space 11

  11. Surge Capacity • What can be found? • Borrowed? • Who can be sent away? • Call in staff? • Other help? • Bordering towns • Govt. • International 12

  12. Communications • Phones? • Lines go down • Cell towers out • Walkie talkies • Runners • Ham radios • How to? • Notify facilities • Notify staff 13

  13. Equipment • How long will you last? • Back up generators • Working? • Stretchers • Vents • Oxygen tanks • PPE 14

  14. Major Incident Plan • Written document • Known location • Can be followed • Patient tracking • Additionally • Mass fatalities • Evidence collection • Staff mental health 15

  15. Public Relations/Media Integration • Public wants to know • Their right? • Media will try to get into hospital • Curb hysteria 16

  16. Safety, Security and Supplies • Hospital security organized • Lock down • Supply lines • Pharmacy stocks • Antidotes • Food stocks 17

  17. Hazard Vulnerability Analysis • Human events • Natural events • Technological events • Decontamination • Before transportation • Tents • Showers • HAZMAT suits • Radiation detectors • Labs level 18

  18. RESULTS 19

  19. Analysis of LDTT Capabilities • 163 questions • 1500 data points 20

  20. Data Interpretation • Positive response = hospital able to provide service or equipment • Negative response = hospital unable to provide service, equipment or unknown • Hard numbers (eg. patient beds, equipment available, staff availability) 21

  21. Overview by Category 22

  22. Communications • Staff Notification • Updated and tested • Call Down List • Staff Notification results varied across the board with 57% positive response rate 23

  23. Communications • Communications • Walkie talkies, runners • Communications showed 67% positive response rate • Scored well on low-tech comms (runners and short wave radio) • Low scores on internet comms and walkie talkies 24

  24. Equipment • Emergency Power • Generators and essential service availability • Logistics and Facilities • Back-up power • Fuel availability • Facility Readiness • HAZMAT training 25

  25. Equipment Results 26

  26. Hazard Vulnerability AnalysisResults • 4 OUT OF 9 HOSPITALS SUBMITED 27

  27. Major Incident Plan (M.I.P) • Preparedness • Surge • Mitigation • Response • Transport • Integration of services • Recovery • Outpatient follow-up 28

  28. M.I.P Results • Areas of strength: • Surge staffing • Scheduling of non-emergent surgery • Preprinted ED charts • Rapid disposition of ED patients • Critical areas of weakness: • Mental health and clergy • Surge planning 29

  29. Public Information, Media Relations • Public Information • All hospitals have Public Information Officer (PIO) • Staff know where to refer media inquiries • 4 hospitals have media facility off-site 30

  30. Risk Management • Mass Fatalities Management • 2/9 hospitals registered low or no preparation for mass fatalities management • Only 3 hospitals have plans to handle a Chemical, Biological, Radiological, Nuclear, Explosive (CBRNE) event 31

  31. Surge Capacity • Other Hospital Capacities • Patient Triage • Patient Tracking 32

  32. Surge Capacity 33

  33. Hospital Capacities 34

  34. Triage 35

  35. Patient Tracking • 8 of 9 hospitals are able to provide and track care for unknown/unidentified patients • 7 of 9 hospitals have a method for casualty tracking • 5 of 9 hospitals have a back-up casualty tracking system 36

  36. Patient Care Capacity Results 37

  37. Safety, Supplies, Security • Patient Decon • Laboratory Services • Pharmacy Services • Biological Agent Readiness • Syndromic Surveillance • Hospital Safety and Security 38

  38. Safety, Supplies, Security 39

  39. Safety, Supplies, Security Results • Patient Decontamination • 44% had plans to handle weapons found on patients undergoing decon • 33% had plans for handling pediatric patients and male/female privacy • 0% had trained decon team 40

  40. Safety, Supplies, Security Results • Laboratory Services • 100% have protocol on reporting suspicious isolates to health department • 8 of 9 have 24hr Lab availability 41

  41. Safety, Supplies, Security Results • Pharmacy Services • 100% report having the following drugs available in appropriate amounts • Epinephrine, beta-agonist, dopamine, silvadine, steroids, morphine, demerol, aspirin 42

  42. Safety, Supplies, Security Results • Safety and Security • 100% have full time security force • 8 of 9 have entrances that can be controlled and monitored • 7 of 9 have a plan for crowd control and crowd communication • 7 of 9 can perform a lock-down within minutes 43

  43. Thank YouBonnie Arquilla DO Lee Wallis MD, Wayne Smith MD, Mark Silverberg MD, Brian Gillett MD Walter Valesky MD John Adeline, Patricia Roblin MS, 44

  44. Questions?

  45. Dedicated to Edward R.Arquilla MD, PHd1922-2010 47

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