1. Identify the necessary components of an emergencyoperations plan.2. Discuss how triage in a disaster differs from triage inan emergency.3. Develop a plan of care for a patient experiencing short-term or long-term psychological effects after a disaster.4. Evaluate the different levels of personal protection anddecontamination procedures that may be necessaryduring an event involving mass casualties or weaponsof mass destruction.
5. Describe isolation precautions necessary forbioterrorism agents.6. Identify the differences among the various chemicalagents used in terrorist events, their effects, andthe decontamination and treatment procedures thatare necessary.7. Determine the injuries associated with varyinglevels of radiation or chemical exposure and theassociated decontamination processes.
1. LEVEL I: Local emergency response personnel andorganizations can contain and effectively manage thedisaster and its aftermath.2. LEVEL II: Regional efforts and aid from surroundingcommunities are sufficient to manage the effects ofthe disaster.3. LEVEL III: Local and regional assets areoverwhelmed; statewide or federal assistance isrequired. Control centers, and other local volunteerorganizations.
• The Incident Command System (ICS) is amanagement tool for organizing personnel, facilities,equipment, and communication for any emergencysituation.• Under this structure, one person is designated asincident commander. This person must becontinuously informed of all activities and informedabout any deviation from the established plan.
1. ACTIVATION RESPONSE: The EOP activation responseof a health care facility should define where, how, andwhen the response is initiated.2. INTERNAL / EXTERNAL COMMUNICATION PLAN:Communication is critical for all parties involved, includingcommunication to and from the pre-hospital arena3. PLAN FOR COORDINATED PATIENT CARE: A responseis planned for coordinated patient care into and out of thefacility, including transfers to other facilities.
4. SECURITY PLANS: A coordinated security plan involvingfacility and community agencies is key to the control of anotherwise chaotic situation.5. IDENTIFICATION OF EXTERNAL RESOURCES:External resources are identified, including local, state,and federal resources and information about how toactivate these resources.6. PEOPLE MANAGEMENT AND TRAFFIC FLOW:“People management” includes strategies to manage thepatients, the public, the media, and personnel.
7. DATA MANAGEMENT STRATEGY: A data managementplan for every aspect of the disaster will save time at everystep.8. DEACTIVATION RESPONSE: Deactivation of theresponse is as important as activation; resources shouldnot be overused.9. POST-INCIDENT RESPONSE: Often facilities seeincreased volumes of patients up to 3 months after anincident.
10. PLAN FOR PRACTICE DRILLS: Practice drills thatinclude community participation allow for troubleshootingany issues before a real-life incident occurs.11. ANTICIPATED RESOURCES: Food and water must beavailable for staff, families, and others who may be at thefacility for an extended period.12. MASS CASUALTY INCIDENT PLANNING: MCI planningincludes such issues as mass fatality and morguereadiness.
13. EDUCATIONAL PLAN FOR ALL OF THE ABOVE: Astrong educational plan for all personnel regarding eachstep of the plan allows for improved readiness andadditional input for fine-tuning of the EOP.
The following are some general principles of awareness thatshould raise suspicion:1. Beware of an unusual increase in the number of peopleseeking care for fever or respiratory or gastrointestinalcomplaints.2. Take note of an unusual illness for the time of year.Clusters of patients from a single location should raisesuspicion.3. Clusters can be from a specific geographical location,such as a city, or from a single sporting or entertainmentevent.
The following are some general principles of awareness thatshould raise suspicion:4. A large number of rapidly fatal cases should raisesuspicion, especially when death occurs within 72 hoursafter hospital admission.5. Any increase in disease incidence in a normally healthypopulation should also raise suspicion. These casesshould be reported to the state health department