MEDICAL PLANNING MAJOR EVENTS

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1 NATIONAL DISASTER LIFE SUPPORT EDUCATIONAL CONSORTIUM ANNUAL MEETING MEDICAL PLANNING MAJOR EVENTS Cynthia Davidson Louisiana Region 1 Hospital Designated Regional Coordinator

2 EMERGENCY MANAGEMENT 1970 s and 1980 s Low priority at hospitals, except for fire Internal and local evacuation Joint Commission requirements Limited planning and training on evacuation 1990 s more interest due to increased exposure to global terrorism Still very little attention to external evacuation - CBRNE SIP Stay in Place plan for hurricanes

3 BIOTERRORISM GRANT TO HOSPITALS 2002 Communications Incident Management Surge capacity Decontamination Prophylaxis Isolation Training and education Drills 3

4 NATURAL DISASTERS Not mentioned under Grant to hospitals Emphasis on terrorism No requirements for evacuation

5 LOUISIANA ESF 8 PUBLIC HEALTH AND MEDICAL SERVICES Designated Regional Coordinator System 5

6 ESF 8 PERSONNEL Louisiana Department of Health and Hospitals State Medical Officer Executive Director for Emergency Preparedness Office of Public Health 6

7 LOUISIANA REGIONS

8 ESF 8 PERSONNEL Regional Designated Regional Coordinators Public Health Emergency Response Coordinators 8

9 DESIGNATED REGION COORDINATOR RESPONSIBILITIES To assist hospitals to meet the goals of the HHS Grant to Hospitals through planning, training and drills To be the coordinator for the Region s inpatient facilities during an emergency in which hospitals are tasked to respond. To facilitate the identification of a medical evacuation queue during a declared state of emergency. To support the patient transfer/evacuation process during a declared state of emergency

10 LOUISIANA HOSPITAL CLASSIFICATIONS Based on hospital capabilities Designated Regional Hospitals (DRH) Larger acute care facilities with emergency room capabilities and multiple specialty services Serve voluntarily Provide additional capacity and resources in initial emergency response Trauma Center, Children s Hospital, 4 major non- evacuating hospital Tier 1 Emergency department capabilities 24/7 Tier 2 No emergency room capabilities Single serve nature Psychiatric, rehab, long term acute care, specialty

11 REGION 1 ESF 8 COALITION Hospitals EMS Nursing Homes Hospice Home Health Mass Fatality Public Health

12 REGION 1 ESF 8 COALITION Orleans and Plaquemines Parish Health Departments New Orleans Chapter of the American Red Cross The Blood Bank ESF 8 Liaisons from Jefferson, Orleans, Plaquemines and St. Bernard Parishes Offices of Homeland Security and Emergency Preparedness Salvation Army SPCA

13 Bitmap Image

14 Tulane CHARITY HOSPITAL VA Before

15 Tulane CHARITY HOSPITAL VA After

16 University Hospital

17

18

19 EVACUATING PATIENTS AT MEMORIAL

20 CHALMETTE MEDICAL CENTER

21 THODIST HOSPITAL

22 HOSPITALS POST KATRINA Prior to storm 16 acute care hospitals in Metropolitan area After storm - Only 5 hospitals still able to function Orleans Parish Jefferson Parish Touro West Jefferson Childrens East Jefferson Ochsner During the next week - Touro and Children's close.

23 [Hospitals] Hospital Name Licensed Beds Pre-K Staffed Beds December 2005 beds Mar-07 Parish Chalmette General Saint Bernard Children's Orleans Lindy Boggs Orleans MCLNO Orleans Memorial (Ochsner) Orleans Methodist Orleans Touro Orleans Tulane HCA Med Center Orleans VA Orleans Orleans Parish Totals East Jefferson Jefferson Kenner Regional (Ochsner) Jefferson Tulane HCA Lakeside Jefferson Meadowcrest (Ochsner) Jefferson Ochsner Jefferson West Jefferson Jefferson Jefferson Parish Totals Jefferson

24

25 Aero- Medical Evacuation Process (Under the National Ambulance Contract NDMS) Local Hospital Submits Patient Movement Request (PMR) PMR MSN JPATS Ambulances located at hospitals pick up patients according to scheduled Aircraft missions Designated Regional Coordinator (DRC) AE Liaison Ambulances dispatched to APOE/AMP to load patients on waiting aircraft PMR PMR PMR JPATS MSN JPATS LA State EOC Joint Patient Assessment Tracking System (JPATS) FEMA (AMR) Incident Support Team APOE/AMP MSN JPATS FEMA (AMR) HHS/FEMA (AMR) HHS/FEMA (AMR) MSN JPATS FEMA (AMR) Field Assessment Teams MSN JPATS Mission (MSN) Details (Msn #, Time, Loc, Etc) JPATS Normally Within miles Of APOD NDMS Hospital APOD/FCC 25

26 Gustav

27

28 REGIONAL COORDINATION CENTER Governor s Office of Homeland Security and Emergency Preparedness Department of Health and Hospitals Department of Children and Family Services Louisiana National Guard

29 ESF 8 RESPONSE Hurricanes Katrina and Rita Gustav and Ike Isaac H1N1 Pandemic BP Oil Spill Chemical spills Water Outage White Powder Events 29

30 EVENTS NEW ORLEANS Sugar Bowl 100,000 Mardi Gras 1 million Jazzfest 435,000 Essence Festival 550,000 Bayou Classic 100,000 2 or more festivals monthly averaging 20,000 50,000 attendance Large conventions Superbowl 150,000

31 ALL HAZARDS PLANNING Multiple Casualty Incident (MCI) Plan Surge Plan HazMat Plan Mass Prophylaxis Plan Mass Fatality Plan Evacuation Plans Communications Plan

32 MCI Alert System HIC EMS routing system MCI patient tracking Numbers Board Tracking Officer

33 SURGE CAPACITY Personnel Equipment and Supplies Medical/surgical beds ICU beds Beds external to the hospital Medical Office Building Western Shelter Tents Crisis Standards of Care 33

34 HAZMAT PLAN C- BRNE Chemical Train derailment Pesticides and fertilizer Biological White powder event Radiological/Nuclear Nuclear Power Plant 34

35 MASS PROPHYLAXIS Cities Readiness Initiative A Federal effort designed to increase bioterrorism preparedness in large cities Pharmaceutical cache Mass Prophylaxis training Open and Closed POD Plans ChemPack Nerve agent antidotes placed in secure containers by the Federal government 3 sites Atropine Diazepam Pralidoxime Mark 1 Kits

36 MASS FATALITY DRC Surge Capacity in Morgues Refrigerated trucks Surge Capacity in hospitals

37 EVACUATION Superdome Morial Convention Center Port French Quarter

38 COMMUNICATIONS 700 MHz Radio Cell Phones Internet Web based programs ESF 8 Portal EMSTAT At Risk Patient Registry

39 HVA, HSEEP AND HICS Hazard Vulnerability Assessment Homeland Security Exercise and Evaluation Plrogram HICS Part of every Exercise IAP Evacuation

40 SPECIAL EVENTS PLANNING Sugar Bowl, Jazzfest, Essence Festival and other yearly events 3 months Mardi Gras 6 months Superbowl 1year

41 ONE YEAR OUT Attend Superbowl in current venue Obtain Medical Operations Plan and distribute Convene Initial Planning Meeting

42 NINE TO THREE MONTHS OUT Review by all agencies of the After Action Review and Improvement Plan from Region 1 previous Superbowl Development of the Health and Medical Plan (ExPlan) Training Special Event Contingency Planning (FEMA) Sports and Special Events Incident Management MGT- 404 (FEMA) Review of Hospital Plans and the interface with the event] Tabletop

43 THREE MONTHS OUT TO SUPERBOWL Biowatch Early warning air sampling system Bioterrorism agents BioWatch Actionable Result (BAR) Threat Assessment Homeland Security FBI Louisiana State Police New Orleans Police Department

44 THREE MONTHS OUT TO SUPERBOWL Governor s Office of Homeland Security and Emergency P reparedness Operations Plan Final review of plans Incident Action Plan

45 SUPERBOWL 2013 Mardi Gras 2 week event Family Gras Friday through Sunday Mardi Gras Wednesday through Tuesday Superbowl on Sunday of Family Gras Family Gras Friday through Sunday Superbowl Wednesday through Monday Mardi Gras Wednesday through Tuesday THREE WEEKS OF INCIDENT COMMAND

46 PREPAREDNESS TAKES PRACTICE Cynthia Davidson Louisiana Region 1 Hospital ADRC

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