Medical sheltering during a flood evacuation

Transcription

1 Broome County Health Department March 19, 2014

2 Outline Background Weather Flood photos Concept of operations Organization Clinical issues A community-wide response

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4 Weather Flood photos over 11 inches of rain fell between 7 and 8 September 2011 Susquehanna and Chenango river levels were generally more than 11 feet above their flood stages 30,000 people were displaced from their homes

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11 Initial timeline, 7 September hr: assemble personnel and gear 1600 hr: mandatory evacuations begin 1800 hr: BCHD arrives at shelters as they open

12 Initial timeline, 7 September hr: assemble personnel and gear 1600 hr: mandatory evacuations begin 1800 hr: BCHD arrives at shelters as they open two primary shelters Binghamton University: 850 evacuees by 1930 hr. Johnson City High School: 403 evacuees by 1930 hr.

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14 Concept of operations Organization Clinical issues A community-wide response Concept of operations who comes to a congregate shelter? people functioning in their communities and at home, but... now put into a new environment bathroom now over 200 feet away home care interrupted emotional stress Don t just transport the disaster to the hospital

15 Concept of operations Organization Clinical issues A community-wide response Binghamton University general population in the Events Center (ARC) special medical needs in the West Gym (BCHD)

16 Concept of operations Organization Clinical issues A community-wide response Binghamton University general population in the Events Center (ARC) special medical needs in the West Gym (BCHD) placement decisions oxygen or CPAP/BiPAP electrically powered supportive equipment type 1 diabetes and unable to self-manage severe limitations in self-care, mobility, and ADLs

17 Concept of operations Organization Clinical issues A community-wide response Binghamton University general population in the Events Center (ARC) special medical needs in the West Gym (BCHD) placement decisions oxygen or CPAP/BiPAP electrically powered supportive equipment type 1 diabetes and unable to self-manage severe limitations in self-care, mobility, and ADLs staffing 2 attending physicians 4 residents nurses/students 1 pharmacist and 1 pharmacy tech 1 respiratory therapist EH and logistics several social workers and psychologists

18 Concept of operations Organization Clinical issues A community-wide response Johnson City High School a unified evacuee population

19 Concept of operations Organization Clinical issues A community-wide response Johnson City High School a unified evacuee population staffing at least one physician several nurses EH and logistics

20 Concept of operations Organization Clinical issues A community-wide response Clinical issues and Our main activities obtaining and assisting with medications obesity and immobility respiratory issues emotional support and mental illness assessing decompensations of chronic illness small outbreak of diarrhea

21 Concept of operations Organization Clinical issues A community-wide response Transports out nature of complaint count chest pain 10 altered consciousness 9 musculoskeletal injury 8 fall 6 abdominal pain 5 general malaise 5 respiratory 3 gastrointestinal 2 neurological 3 emotional 1 head injury 1 hypotension 1 pregnancy-related 1 upper respiratory 1

22 Concept of operations Organization Clinical issues A community-wide response Census Day of BU JCHS operation general medical general medical

23 Concept of operations Organization Clinical issues A community-wide response A little help from our friends Binghamton University incident command team facilities food service Decker School of Nursing Harpur s Ferry Ambulance Service police about 6000 student, faculty, and staff volunteers Johnson City School District school nurses custodial staff food service

24 Concept of operations Organization Clinical issues A community-wide response A little help from our friends UHS family practice residents attending physicians nurses pharmacists respiratory therapists home care Lourdes Hospital attending physicians nurses pharmacists SUNY Upstate Clinical Campus medical students

25 Concept of operations Organization Clinical issues A community-wide response A little help from our friends other county agencies Mental Health Social Services Security CASA animal response team countless churches, volunteer agencies, local businesses, and individuals non-local agencies Medical Reserve Corps Fire Department of New York New York National Guard SUNY Cortland Campus Rescue SUNY Oneonta Emergency Squad

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35 Surprises obesity dialysis and other ongoing medical treatments shelter became a discharge destination for hospitals laundry rebounds to shelter law enforcement issues federal capabilities: DMAT versus FMS

36 What worked well network of community relationships the physical plant support from the medical (in broadest sense) community ICS information technology

37 What didn t work so well the general population vs special needs dichotomy administrative status of spontaneous helpers record-keeping more bathrooms

38 Lessons learned cultivate your personal relationships with other agencies good chronic disease control is good disaster preparation get there firstest with the mostest trust the incident command system plan for a mainly local operation for first 3 5 days know your neighborhoods prepare for obesity

39 Increase our capabilities Informal goal is to be completely self-sufficient for the first 8 hours of sheltering operations acquired much equipment medication jump kit from either hospital pharmacy

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46 Do what you can, where you are, with what you ve got.