Dr Shealy Emergency

Slide1: 

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

Slide2: 

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

IMAGINE …: 

IMAGINE …

Something very bad happens in your community .: 

Something very bad happens in your community .

There is a sudden calamity killing many people, : 

There is a sudden calamity killing many people,

There is a sudden calamity killing many people, but injuring many, many more.: 

There is a sudden calamity killing many people, but injuring many, many more.

IMAGINE …: 

IMAGINE …

Within a span of hours or days, people start becoming very sick, : 

Within a span of hours or days, people start becoming very sick,

Within a span of hours or days, people start becoming very sick, and begin to die, : 

Within a span of hours or days, people start becoming very sick, and begin to die,

Within a span of hours or days, people start becoming very sick, and begin to die, in increasing numbers.: 

Within a span of hours or days, people start becoming very sick, and begin to die, in increasing numbers.

IMAGINE …: 

IMAGINE …

Medical facilities and personnel are OVERWHELMED.: 

Medical facilities and personnel are OVERWHELMED.

TOO MANYCASUALTIES: 

TOO MANY CASUALTIES

TOO MANYREMAIN AT RISK: 

TOO MANY REMAIN AT RISK

TOO MANYWORRIED WELL: 

TOO MANY WORRIED WELL

NOT ENOUGHCAREGIVERS!: 

NOT ENOUGH CAREGIVERS!

DISASTER!: 

DISASTER!

Natural Disasters: 

Natural Disasters Weather Flood Hurricane Tornado Winter storm Geophysical Earthquake Tsunami Volcanic Eruptions

Man Made Disasters Unintentional: 

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

Man Made DisastersIntentional: 

Man Made Disasters Intentional Civil Disturbance War Terrorism

Types of Terrorism: 

Types of Terrorism Small Arms Explosive Incendiary Chemical Biological Radiation

Slide22: 

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

At some time during your professional career, you will experience a COMMUNITY HEALTH EMERGENCY!: 

At some time during your professional career, you will experience a COMMUNITY HEALTH EMERGENCY!

Threatens public health & safety: 

Threatens public health & safety

Threatens public health & safetyDisrupts essential services : 

Threatens public health & safety Disrupts essential services

Threatens public health & safetyDisrupts essential services May destroy infrastructure : 

Threatens public health & safety Disrupts essential services May destroy infrastructure

Threatens public health & safetyDisrupts essential services May destroy infrastructure Demands extraordinary measures: 

Threatens public health & safety Disrupts essential services May destroy infrastructure Demands extraordinary measures

Too many patients… : 

Too many patients…

Too many patients… coming too fast.: 

Too many patients… coming too fast.

Too many patients… coming too fast.Not enough clinicians.: 

Too many patients… coming too fast. Not enough clinicians.

Too many patients… coming too fast.Not enough clinicians.Not enough critical skills.: 

Too many patients… coming too fast. Not enough clinicians. Not enough critical skills.

Too many patients… coming too fast.Not enough clinicians.Not enough critical skills.Not enough resources.: 

Too many patients… coming too fast. Not enough clinicians. Not enough critical skills. Not enough resources.

Slide33: 

Every disaster is LOCAL!

Slide34: 

Every disaster is LOCAL! It’s OURS for 72 hours!

Slide35: 

Now IMAGINE that your ENTIRE REGION is in the same predicament. Today, we’re talking about the BIG ONE!

Slide36: 

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

Slide37: 

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

Everyone involved in acute medical care would be OVERWHELMED. Where would we get HELP!: 

Everyone involved in acute medical care would be OVERWHELMED. Where would we get HELP!

Slide39: 

A major disaster in a community disrupts everybody’s life. BUSINESS AS USUAL comes to a stop.

Will anybody show up for an elective procedure?: 

Will anybody show up for an elective procedure?

In a large scale disaster, health professionals who routinely provide elective services will be idled.: 

In a large scale disaster, health professionals who routinely provide elective services will be idled.

How do we tap this resource to relieve the critical shortage of acute care providers in a health emergency?: 

How do we tap this resource to relieve the critical shortage of acute care providers in a health emergency?

The Message to Allied Health Professionals:YOU are a FRONT-LINE DEFENDER of your community’s HEALTH and SAFETY! : 

The Message to Allied Health Professionals: YOU are a FRONT-LINE DEFENDER of your community’s HEALTH and SAFETY!

Slide44: 

Because YOU can step into the breach and help fill the gap!

Slide45: 

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

Slide46: 

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

Slide47: 

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

Slide48: 

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

Slide49: 

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 don’t do.

Slide50: 

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 don’t do. STANDARD OF CARE CHANGES because circumstances are grossly abnormal.

Slide51: 

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

Slide52: 

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!

Allied Health Professionals may have to THINK “OUTSIDE THE BOX” to meet their responsibility to the public in a disaster.: 

Allied Health Professionals may have to THINK “OUTSIDE THE BOX” to meet their responsibility to the public in a disaster.

Slide54: 

Health professionals often do not see how they can serve because they don’t really know what’s needed in a disaster.

Slide55: 

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

Slide56: 

“These are things I have been trained to do.” “These are things that need to be done.”

I can…: 

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

I can…: 

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

EXAMPLES: 

EXAMPLES Dentists Forensics Histories Allergies Contraindications Prescriptions Injections Simkovich

Slide60: 

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

Slide61: 

Medics Emergency Department Techs Hospital Techs Mass immunization clinics

Slide62: 

THERAPEUTIC MASSAGE revitalizes weary rescuers!

Job Requirements: 

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

Slide64: 

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

Slide65: 

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

Slide66: 

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.

Regardless of where you chose to volunteer, there are a few things EVERY disaster volunteer needs to know.: 

Regardless of where you chose to volunteer, there are a few things EVERY disaster volunteer needs to know.

Slide68: 

Gain an understanding of what a large scale disaster may be like.

Slide69: 

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

Slide70: 

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

Slide71: 

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

How do I fit in with existing systems for managing COMMUNITY HEALTH EMERGENCIES?: 

How do I fit in with existing systems for managing COMMUNITY HEALTH EMERGENCIES?

You will be a small part of a very large response.: 

You will be a small part of a very large response.

Slide74: 

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

A community’s success in a disaster will depend on EFFECTIVE RELATIONSHIPS across disciplines and between jurisdiction.: 

A community’s success in a disaster will depend on EFFECTIVE RELATIONSHIPS across disciplines and between jurisdiction.

A community’s success in a disaster will depend on EFFECTIVE RELATIONSHIPS across disciplines and between jurisdiction.These relationships must be formed IN ADVANCE.: 

A community’s success in a disaster will depend on EFFECTIVE RELATIONSHIPS across disciplines and between jurisdiction. These relationships must be formed IN ADVANCE.

Somebody will be in charge.: 

Somebody will be in charge.

Somebody will be in charge.It will not be you.: 

Somebody will be in charge. It will not be you.

National Incident Management System : 

National Incident Management System Common Structure Common Language Common Organization Interchangeability Interoperability

Incident Command System: 

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

Emergency Operations Center: 

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.

Family Plan: 

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

Family Plan: 

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

Family Plan: 

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

Preparing Your Workplace: 

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.

Preparing Yourself: 

Preparing Yourself Immunizations Go Bag Medical Kit

ImmunizationsRequired for deployment by NDMS: 

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

California DMAT Personal Equipment List: 

California DMAT Personal Equipment List http://www.armymars.net/ArmyMARS/EmergencyOps/Resources/DMAT/dmat-ca6-pers-equiplist.pdf

Laws Governing a Public Health Crisis: 

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

Mitigating Personal Risks: 

Mitigating Personal Risks How Am I Protected Against Civil Liability?

Principles of Triage: 

Principles of Triage A Different Paradigm for Delivering Care

Principles of Triage: 

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

Principles of Triage: 

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

Principles of Triage: 

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

Role in Public Information: 

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

SUMMARY: 

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

SUMMARY: 

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

SUMMARY: 

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

SUMMARY: 

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

QUESTIONS?: 

QUESTIONS?