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Introduction
The Reality:
9 - 11
All-Hazards
Man-made Fires Explosive devices Firearms Structural collapse Transportation event
Air, Rail, Roadway, Water
Natural Earthquake Landslides Avalanche Volcano Tornado Hurricanes, floods Fires Meteors Etc
Are We Prepared?
Is the US healthcare system prepared? We appear to be each Hospital, EMS agency, Law enforcement agency, Fire department, and Community has
a disaster plan properly documented drills annual training documented
But...
Are We Prepared?
KATRINA
Are We Prepared?
Interagency communication failures!
Why do we all treat a cardiac arrest the same? because there is an agreed-upon approach.
Are We Prepared?
Critical to healthcare preparedness
uniform coordinated approach mass casualty management from any cause
Course Description
BDLS
Didactic - 8 hours Distance learning option For healthcare providers Physicians, Nurses, Paramedics, EMTs Mid-level providers, Allied health, Public health Provider status & course credit awarded Course completion Written examination passage BDLS providers are eligible to take ADLS
Overview & Concept DISASTER Paradigm Natural Disasters Explosive & Traumatic Nuclear & Radiological Biological Agents Chemical Agents Psychosocial Aspects Public Health System
Course Description
ADLS
16 hour class (8-didactic, 8-practical) Advanced practicum hands on course Meets Hazmat Operations-level training requirement (CFR 1910.120) Must have completed BDLS course Provider status & course credit awarded
Day-Two: Skills Lab hands on MASS Triage Clinical Scenarios Human simulator use Disaster Skills Personal Protective Equip Decontamination
What is a Disaster?
Disaster- disaster n. a. An occurrence causing widespread destruction and distress; a catastrophe. b. A grave misfortune. c. Informal- A total failure
Disaster Definition
A disaster is present when need exceeds resources!
Disaster = Need > Resources A response need that is greater than the response available!
D-I-S-A-S-T-E-R Paradigm
D: Detection I: Incident Command S: Safety & Security A: Assess Hazards S: Support T: Triage & Treatment E: Evacuation R: Recovery
Commander
Unified Command
Planning
Logistics
Operations
Finance
EMS Operations
Medical Direction
Fire Operations
LE Operations
Public Health
Communications
Surveillance
Immunization Clinics
Triage
Treatment
Transportation
Extrication/Rescue
Staging
Negatives:
Time to sort large, poorly labeled goods Storage space used Unplanned personnel are a liability At risk of injuries, require food, water and shelter
Need to Address
Volunteers
Licensure in state Credentialing for specific responder organization Just-in-Time Training Management: logistics, supervision, transportation,
medical & other care needs
Best if a member of a recognized, organized response team that has been invited in DONT JUST SHOW UP !!
M.A.S.S. Triage
M Move A Assess S Sort S Send
M.A.S.S. Triage is a disaster triage system that utilizes US military triage categories with a proven means of handling large numbers of casualties in a mass casualty incident (MCI).
ID-me!
I Immediate D Delayed M - Minimal E Expectant D - DEAD
ID-me!
- a mnemonic for sorting patients during MCI triage. It is utilized effectively in the M.A.S.S. Triage model.
Tips for talking to children after a disaster Provide opportunities to talk about what they are seeing on
television and to ask ? Dont be afraid to admit you dont know all the answers Answer ? At a level the child can understand Establish a family emergency plan (Sense of doing something is helpful) Monitor childrens TV watching..dont need to see event over & over) Watch with children Help kids to understand there are no bad emotions Try to not focus on blame In addition to tragic things seen, also help kids focus on good things such as heroic actions, reuniting of families, assistance offered by people throughout the world