The document discusses the IMPRESS project which aims to improve the preparedness and response capabilities of health services during crises. It does so by developing guidelines and tools to help with planning, increasing surge capacity, tracking hospital resources, and developing interoperable systems between response organizations. The project seeks to enhance coordination, information sharing, decision making, and interoperability among emergency medical services through common systems and training. It will test its tools and modules during a field exercise simulating a toxic chemical accident in Palermo, Italy.

1. IMproving Preparedness and Response of HEalth Services in major criseS
Ioannis Galatas, George Eftychidis, George Leventakis, Ilias Gkotsis
Center for Security Studies (KEMEA), Athens, Greece
FP7-SEC-2013.4.1-4.GA.608078

2. The Challenge
Current health emergency management systems
consist of
disconnected command & control operations
lacking of
appropriate coordination mechanisms
for the actions of their composing services
that will allow them to reform into
an effective, multi-faceted crisis response mechanism
SafeChania2015
FP7 - SEC-2013.4.1-4. GA. 608078

3. IMPRESS aims to advance the preparedness of emergency medical services
(health emergency operations centers, ambulance dispatch centers, hospitals
ED, first responders and volunteer communities etc) through:
 planning for all-hazards;
 increasing surge capacity;
 tracking the availability of beds and other hospital resources using
electronic systems;
 Monitoring health emergency operations and
 developing systems that are interoperable between the involved
response actors
The general objective
is to provide preparedness and response capabilities through guidelines and
tools applicable in disaster scenarios
Aims & objective
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4.  Re-balance the disproportion between response needs and health
system capacity, through proper mobilization of additional resources (material,
logistics and health personnel) and enhanced organization (e.g. e-triage,
interoperability of health services)
 Remediate the information deficit with rapid collection of relevant
data and exchange of adequate information
 Support decision making according to the impact of crisis and incident
type to the health status of the community
 Improve the response and preparedness level of HS based
on efficient planning, integral organization and comprehensive training, using
interoperable tools and systems
 Enhance interoperability within the same and among different EMS
organizations using common taxonomy and providing stakeholders in the emergency
response domain with a compatible operational framework
Objectives’ analysis
SafeChania2015
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5. Disasters’
Taxonomy
Response/
Ambulance
Injured Non-injured
ED Specialized Units Other Sections
First Responders
EOC
EU
Customized response
according to disaster type
Stakeholders
CIV-MIL
Incident
Command Zone
Resources
Concept & Stakeholders
Dis.Med. @ Incident Scene
1
2
Hospital ED
SafeChania2015
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6. LOGEVO (LOGistics EVOlution)
a suite enabling the use of
models for the logistics of
health care resources
WARSYS (WARehouse SYStem)
a database with real time
medical & logistics information
from available repositories
SICKEVO (SICK patients
physiological EVOlution forecast)
addressing physiologic trajectory
assessment and forecast
SORLOC (SOuRce LOCalization)
module for localizing likely
exposure in Chemical and
Radiological incidents and
contaminants spread in case of
epidemics
High level architecture
SafeChania2015
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7. Nuclear weapons
 Radiological dispersal devices (RDDs);
 Radiological emitting devices (REDs);
 Nuclear power plants’ accidents; R-waste depots
 Biological warfare agents (BWAs);
 Toxins;
 Pandemics
 Chemical warfare agents (CWAs);
 Toxic industrial chemicals (TICs)
CBRNE threats
 Low/high level explosives;
 IEDs
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8. CBRNE targets
Population density
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9. CBRNE targets
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10. Moments after a CRE incident
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11. Medical disaster response
CZ HHZ
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12. Medical CRE response
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13. CBRNE stress factors
CHEMICAL BIOLOGICAL RADIOLOGICAL
Difficult, time-consuming
identification
BA not perceivable Cannot be noticed
Genetic effects Specialized LABs Hard to control
Carcinogenic Incubation period Children – pregnant
Limitation of personal
freedom
Delayed effects
Hereditary defects
Carcinogenic
Affecting both
Citizens & Responders
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14. Urban canyons
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15. CBRNE
FP7 - SEC-2013.4.1-4. GA. 608078

16. PARAMETERS DISASTER CRE DISASTER
IMPACT Local Massive
ZONES HZCZ HZWZCZ
AREA OF
OPERATIONS
 Non-contaminated
 Non-lethal
 Contaminated
 Lethal
VICTIMS Save ALL Save NOT ALL
HOSPITALS Dedicated ALL hospitals/clinics
WORRIED-WELL None 1:5
AFTERMATH Restoration  Ghost city (R)
 Long lasting (C)
 Genetic/carcinogenic
Medical CRE response
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17. Contaminated plume
CBRNE
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18. Exercises/drills
Earthquake
Flooding
Tunnel explosion
Wildfire @
Palermo waste
dump
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19. CBRNEPalermo waste dump fire: July 29 – Aug 17, 2012
Day 1
Palermo District «Borgo»
160,000 inhabitants
504,000 m2
Day 2
Day 3
Day 4
Day 5
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20. - Bellolampo fire data will be used to validate IMPRESS emergency response modeling.
Toxic cloud dispersion simulation will be also validated against Bellolampo fire data
- For the IMPRESS scenario will be simulated sudden release of high concentrations of
toxic compounds from a tank fire developing on-board a ship moored in the Palermo
harbor
- The test area, supposed to be affected, is the Palermo District “Kalsa” sized 0.8 km2
which includes several institutional buildings such as the Marine Institute, the Harbor
Authority, and the Customs Office, the administrative offices of the University of
Palermo, a private hospital and a church
- The areas in the Warm zone are suitable for triage, evacuation and landing of
helicopters. The nearest hospital is 2 km away and is accessible directly through the
seafront boulevard.
Field test of IMPRESS against Chem Acc
SafeChania2015
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21. According to the planned test
- the fire developing on-board the ship shall produce a toxic cloud
- The cloud due to the wind blowing from NE will be spread over the Kalsa
district
- the IMPRESS modules will be activated
- at the Emergency Service,
- Emergency Department of local hospitals and
- at the National Health Service Operation center
for managing the public health aspects of the incident
- the Italian Civil protection Agency (PCI) shall coordinate the operations
System components
SafeChania2015
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22. The IMPRESS modules will be demonstrated/tested as follows:
SORLOC module is used to identify the distribution of potential patient flow, linked with
the distribution pattern of the toxic smoke cloud. Information will be shared with the
NHS and the ED departments of the relative hospitals
WARSYS is accessed by authorized users of the involved authorities (NHS and EMS) to
retrieve data concerning real time medical and logistics information.
SICKEVO shall provide physiological forecast of patients’ status evolution to the EMS and
to the ED of relevant hospitals in order to support relevant decisions
LOGEVO module will support at the NHS and EMS level the monitoring and logistics of
health care resources
INCIMAG shall be used to exchange information regarding the incident/situation, receive
data and develop the situational picture (victim health status resource availability ) and
receive prediction of the scenario evolution based on the taken decision (calls to
SICKEVO, LOGEVO,…,)
INCIMOB will provide field data collection and management support allowing the
insertion of patient data, exchanging and recording Triage data and displaying the actual
situational picture
IMPRESS components to be tested
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FP7 - SEC-2013.4.1-4. GA. 608078

23. Thank you for your attention!
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FP7 - SEC-2013.4.1-4. GA. 608078