Download Disaster Mitigation - UMass Medical School

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PDLS :
Disaster Planning and
Organization
Learning Objectives
 Steps of disaster planning
 Concepts in management planning and
interventions
Steps of Disaster Planning
 Planning
 Resource assessment
 Risk and hazard analysis
Risk and Hazard Analysis
 Assessment of threats to the locality
-
Geographic
Building
Population cluster
 Children groups
-
Day care or schools
Summer camps
Field trips
Risk and Hazard Analysis
Environmental Hazards
 Weather
-
Winter storms
Hurricanes
 Geographic
-
Earthquakes
Flood plains
Risk and Hazard Analysis
Man-made Hazards
 Chemicals
- Production, storage and transport
 Biologic hazards
 Terrorism
Transportation Hazards
 Materials
 Mass transit centers
Resource Assessment
 Local resources
- EMS
- Police
- Fire department
 Volunteers
- Boy Scouts
- Rotary, Shriners
 Children’s advocacy groups
Resource Assessment
 National
-
Red Cross
FEMA
DMAT
Department of Defense
 Agencies and unions
-
AMA
ENA
www.fema.gov/areyouready
Resource Needs
 Personnel
-
Pediatric specialists (if available)
 Equipment
 Supplies: water, food, blankets
 Shelter
 Suppliers with contact source
-
Back-up suppliers and contact sources
Resource Needs
 Communications
-
Equipment and personnel
Telephone company/cell phones often overload
Ham radio / alternative methods
Resource Needs
 Transportation
-
Roads
Vehicles, public and private
 Maintaining access for emergency vehicles
often problematic
Planning is a Dynamic Process
 Plan before, during and after
 Contingency planning
 Continued revising
Plan Ahead
 Resource assessment
-
Be realistic about resources not already
committed to the disaster
-
Know local limits
When and how to call for outside resources
-
Scale of response
Medication and Immunization stockpiles
Pediatric specific!
Plan Ahead
 Children with special needs
- Medications
- Psychological/emotional
Support/coping mechanisms
- Specialized equipment
Ventilators, suctioning equipment, wheelchairs
 Displaced Children
Plan Ahead
 Discuss with groups /
individuals
-
Schools, daycare centers,
pediatrician offices
-
Identify problems
Find options
Keep updated on
response abilities
Resources and personnel
Vary by incident
Plan Ahead
 Involve all potential
participants
-
Don’t overlook potential
resources
-
Avoid improper
assumptions
 Regular planning meetings
-
Risks of area
Unforeseen events
Planning Exercises
 Look for deficiencies
 Single components vs. multi-group
-
Moulage useful but complex
Inter-group cooperation
Planning after Exercise
 Debriefing after exercise
-
Share information
Improve plan
Ensure dissemination of changes to plans
 Honest not defensive feedback from all
During the Disaster
 Constant revision of plan
-
New risks and resources
Loss of resources
 Flexibility
-
Alternate uses of resources
Alternate ways of transporting patient to
resources or resources to patient
History of ICS
 1970s
 Review of catastrophic wildfires
 Inadequate management:
- Lack of accountability
- Poor communication
- Lack of systematic planning process
- Overloaded Incident Commanders
- No method to integrate interagency
requirements
History of ICS
 Fire
 Other agencies
 HICS
February 2003: HSPD-5
 President Bush
 In response to Sept 11th
WTC attacks
 Called for a National
Incident Management
System (NIMS)
 Improve coordination of
federal, state, local and
private industry
responders
 Preparedness
March 2004: NIMS
 Developed and administered by Secretary of
DHS
 The Incident Command System is a key
feature of The National Incident Management
System
 Prior to this: no standards for domestic
incident response applicable to all levels of
government and emergency response
agencies
Incident Command System
Incident
Commander
Command
Staff
Planning
Logistics
Finance
Operations
Incident Command System
 Identified central commander with limited
scope of control
-
leave chain of command for smaller groups
intact
 Unified command
 Modular system
 Expand as needed
ICS for Hospitals and Healthcare Systems
 Benefits of adopting ICS:
- Greater efficiency
- Better coordination
- More effective communication
 Comply with Joint Commission Standards
 Meet NIMS requirements: $$$
 HICS
Hospital Incident Command
System
 Ensure preparedness within and around
 48 hour supply pediatric equipment & meds
 Pediatric specific disaster risk assessment
- School district, EMS, day cares, mental health
facilities
 Develop resources and training for biologic,
chemical and radiological terrorism
 Designation of pediatric trauma, burn,
hyperbaric and critical care centers
Medical control - Decisions
for children
 Disaster interventions differ from everyday
- less information
- more victims
- different priorities
 Stress for responders
 “Greatest good to greatest number”
- may not be optimal care for each person
 Triage/treatment protocols for children
will help providers
Documentation
 Need to provide permanent record
 Transfer of information from field to base
hospital
 Limit information
-
will lose some details
Documentation problems
 Data loss / inaccuracies
 Patient limitations - unable to obtain / convey
accurate information
 Multicopy permanent record
 Deterioration of record
 Identifying the nameless victim
Documentation uses
 To track patient movements
 To reunite families
 Epidemiological studies
 Evaluation and post disaster critique
 Long term sequelae and resupply
Security
 “Situational awareness”
 Concerned/interested parties
 Contamination
 Proper identification
 Evidence
 Perimeter preservation
Conclusion
 Planning
-
pediatric specific concerns
risk / hazard analysis
resource assessment
planning is a dynamic process
 Incident Command System
©
PDLS :
Train the Trainers
Learning Objectives
At the end of this lecture participants
will be able to:
 Make logistical arrangements for
conducting the program
 Deliver an effective presentation
 Use principles of adult learning
Preparing for a Course
 Identify an audience by level of training and
experience
 Select a proper facility
 Obtain appropriate audiovisual equipment
 Identify faculty with effective presentation skills:
- Lecture
- Skills station teaching
- Simulation drill instruction
Principles of Adult Learning:
 Establish the need to know
 Past experiences both positive and
negative influence the adult learner
 Adults learn best when information is
practical and useful
 A non-judgmental, non-threatening
environment supports learning
Principles of Adult Learning
 Learning depends on motivation
 Learning is based on the capacity to learn
 Education must be meaningful
Adult Learning (cont)
 Active participation increases learning
 Learning must be experience based
 Goals must be clearly set
 Feedback is required
Facilities
 Lecture Hall/Auditorium
 Physical Plant
- Table Top Exercises
- Group discussions
 Personnel
- Support staff, mock patients
 Logistics
- Certificates & record keeping
Audiovisual Equipment
 Equipment failure – Be prepared
 Contingency plans
 Communications
Presentation Skills: Lecture
 Tell them what you are going to say
 Say it
 Tell them what you said
Presentation Skills:
Skills Station Teaching
 Conceptualization:
- Describe when, how, precautions and
considerations
 Visualization:
- Instructor demonstration of the technique
 Verbalization:
- Student to describe steps of the technique
Presentation Skills:
Skills Station Teaching
 Practice:
- Student to perform skill with correction and
reinforcement from instructor
 Skills mastery
Presentation Skills: Group
Discussion
 Establish the goals of the discussion
 Facilitate discussion
 Provide closure
Presentation Skills: Minitalks
 Participant Preparation:
- 5 minute presentation by participants
- Videotape or verbal feedback
 Critique by class, instructor and self
Presentation Skills:
Case Studies as a Teaching Tool
 Review of Cases
 Group Discussion
 Problem Students:
- Lack of preparation
- Lack of participation
- Aggressive or defensive behavior
©
PDLS :
Train the Trainers
Thank you!