Highlights of the important domains that Infection preventionist should cover and be involved during emergency crisis.

1. ROLE OF INFECTION
CONTROL DURING
EMERGENCY CRISIS
Dr. Moustapha Ramadan

2. INTRO- QUESTIONS
 Scope ? ( Hospital Vs Community )
Participation ? ( Action and leading Vs Reaction and
conservative)
Level of involvement ?

3. EMERGENCY CRISIS
Intentional
Event
Infectious
Non
infectious
Natural occurring
incident
Infectious Non infectious

4. IP DOMAINS DURING CRISIS
MANAGEMENT
KNOWLEDGE OF DISASTERS AND EMERGENCY MANAGEMENT
ASSESSING READINESS AND EMERGENCY MANAGEMENT PLANS
INFECTION PREVENTION COVERAGE
DISASTER RESPONSE AND RECOVERY
HEALTHCARE POLICY DEVELOPMENT
SURVEILLANCE
PATIENT MANAGEMENT
INFRASTRUCURE/ LAYOUT ISSUES
TRAINING AND ORIENTATION

5. KNOWLEDGE OF DISASTERS AND
EMERGENCY MANAGEMENT
Natural disaster Vs Infectious disease disaster
Potential consequences of various types of disasters
Infection Prevention Strategies
Emergency management principles ( Mitigation /
Preparedness / Response / Recovery)
Prioritizing limited resources

6. ASSESSING EMERGENCY PLANS
PREPARDNESS
 Involvement at personal, facility and community
level.
 Identify IP roles and responsibilities.
Alternative care sites / Shelters .
Volunteers.
Input for decision making.

7. ASSESSING EMERGENCY PLANS
PREPARDNESS
Components of an emergency management plan that
require IP input
Infection prevention
coverage around the clock
Prioritization for limited
supplies
Facility assessment/
hazard vulnerability
assessment
Screening and triage
protocols
Participation in drills Isolation surge capacity
Communications alerts and
reporting
Outbreak investigation
coordination
Safe patient specimen Environmental

8. ASSESSING EMERGENCY PLANS
PREPARDNESS
IP resources needed for controlling infectious disease
spread
Hand hygiene products PPE
Waste bags and containers Disinfectants
Wound management spp Syndromic surveillance spp
Body fluid management
spp
Environmental controls
Forms ( triage) Education materials/
signage

9. INFECTION PREVENTION
COVERAGE
Infection prevention coverage around the clock.
Hospitals / alternative care sites / shelters.
Hierarchy and communication.
Infection prevention designee.

10. DISASTER RESPONSE AND
RECOVERY
Level of involvement depends on the type and scope
of event.
Implementation and monitoring of infection
prevention interventions.
Reporting events, communication and coordination.
Internal Vs External
Health authorities and staff Vs Community members
Application of emergency protocols Vs Changes in mid disaster
response.

11. HEALTHCARE POLICY
DEVELOPMENT
Create or reform healthcare policy and practices.
Surveillance and screening
Cohort cases
Prioritization plans for limited supplies ( HH / PPE)
Post exposure management
Occupational health and Preventive medicine.

12. SURVEILLANCE
 Syndromic surveillance / Monitor surveillance
Health facilities/ Alternative care sites/ Shelters …
Levels/ data and indicators

13. SURVEILLANCE
 Develop surveillance
program/ indicators
Program evaluation
Data collection and
reporting
Communication and
coordination
Train data collectors and
reporters
Screening

14. SURVEILLANCE

15. PATIENT MANAGEMENT
Screening/ Triage Patient Placement/ Cohort
Isolation Quarantine
Patient transport Patient Decontamination
Shortage of supplies Specimens handling
Discharge management Postmortem care

16. PATIENT MANAGEMENT

17. PATIENT MANAGEMENT

18. INFRASTRUCURE/ LAYOUT ISSUES
Airborne isolation rooms.
Environmental decontamination.
Reprocessing of patient care equipment.
Closure and reopening of room / facility.
Pet management.

19. TRAINING AND ORIENTATION
Hospital based Vs alternative site and shelters
Day to day activities Vs disaster situations.
 Regular Topics Vs emergency preparedness
domains.
Target groups ( HCWs Vs Community based groups)
Hands out and training materials.

20. TRAINING AND ORIENTATION
Screening /
triaging
Patient
decontamination
Isolation
procedures
Hand hygiene PPE Respiratory
etiquette
Specimen
handling
Waste
management
Postmortem care
Cleaning /
Disinfection of
toys in shelter
Cot or sleeping
area
configuration in
shelters

21. TRAINING AND ORIENTATION
Volunteers Firefighters
Shelter workers Transportation
services
College students Political leaders
Morgue Veterinarians

22. GAPS?
Community settings lack infection prevention guidance.
Nonhospital-based healthcare workers receives the least
infection prevention education.
Surge capacity as it relates to infection prevention issues
(such as negative-pressure room/area) is lacking.
Public health professionals' knowledge about infection
prevention.
General public requires more education about the
potential infectious disease implications of disasters and
strategies they can implement to help prevent the spread
of infection.

23. TAKE HOME MESSAGE
Mass casualty incidents pose a risk of infection
transmission, specially if the event is an infectious
disease disaster.
IP input is needed when developing facility and
community emergency management plans.

24. REFERENCES / FURTHER READING
APIC- State of the art report: The role of infection preventionist in
emergency management.
APIC Infection Prevention and Control for Shelters during disasters
https://www.cdc.gov/disasters/infectioncontrol.html