危机应对医疗方案

DisasterResponseAndRespiratoryCareObjectivesUnderstandtheuniversalcharacteristicsofdisastersandthecomponentsofanallhazardsapproachtodisastermanagementinvolvinghealthcarepractitioners.DemonstrateunderstandingoftheroleofRespiratoryTherapistsindisasterresponseandemergencymanagement;and,describetheroleofRespiratoryTherapistsasvolunteersfordisasterresponse.ObjectivesExplainthevariouslevelsofequipmentandsupportRespiratoryTherapistswillutilizeinrespondingtomasscasualtyincidentsanddisasters.DiscusstheimplicationofPandemicInfluenzaasitrelatestoplanningandresponsecapabilityandcapacity.DescribetheimpactofBioterrorismandman-madedisasterstohealthcaresystems,providers,anddisasterpreparednessplans.What’sTheFuss?HowDoWeRespondToThis…SoWeDon’tFeelLikeThis…DisasterCharacteristicsIncreaseddeath,injury,illnessthatcan’tbemanagedCoordinationpublic,government,andprivateorganizationsEqualtriagedistributionNotificationoffamilyEvacuation/ShelteringofevacueesDisasterCharacteristicsMediaattentionHeightenedsecurity;crimesceneImmediateandlongtermemotionalsupportSignificantpropertydamageImpactofDisastersInthepast20years“Althoughtheyearlydeathtotalsfromdisasterdeclinedbyapproximately30%,thenumberofpeopleaffectedbydisasterincreased59%”(AARCTimes.2006.p.8)ConsequenceManagementTheobjectiveofconsequencemanagementis:ProvidesupportSavelivesRelievesufferingMitigatefurtherharmPreparednessCyclePlanTrainHealthsystemswillbepreparedthroughacontinuouscycleofplanning,equipping,trainingandexercising.P.E.T.E.PlanPublicHealthPreparednessStrategicPlanEquipVentilators,PPE,Pharmaceuticals,etc…TrainOSHA,DHS,OtherExerciseLocal,Regional,Statewide,Interstate,NationalSurgeCapacityCountyHealthDepartmentsPre-hospitalOutpatientServicesHospitalsPharmaciesLaboratoriesMortuaryServicesPublicHealthResponseHealthCareSystemDomesticSecurityRegionsRegion1Region2Region3Region4Region5Region6Region7IntegratedPlansFederalNationalResponseFramework(NRF)SupportedbyNationalIncidentManagementSystem(NIMS)andtheNationalDisasterMedicalSystem(NDMS)ComprehensiveEmergencyManagementPlan(CEMP)ProvidesguidanceIntegratedandcoordinatedresponseEmergencySupportFunctions(ESF-8)FollowsNRFIntegratedPlansStateFloridaDepartmentofHealthBomb,Blast,Burn(B3)Biological(B4)PandemicInfluenzaPublicHealthandMedicalPreparednessStrategicPlan2007-2010CountyCEMPPlansHospitalCEMPPlansGoalofSurgeThinkingMaximizesurvivalforallplayers!Minimizemorbidity!Maximizeresourceutilization!Willrequirenewthinking!NaturalDisastersNaturalDisastersTornadoesForestFiresFloodsBlizzardsCyclones/TyphoonHurricanesHeatwaveTsunamiVolcanicEruptionEarthquakesMudslidesLimnicEruptionDraught/FamineHailNaturalDisasters-FloridaHurricanesTornadoesForestFiresFloodingFreezingSinkholesDroughtHeatwaveHailNaturalDisasters-Florida2004July31toDecember39Hurricanes;5TropicalStormsCharley,Frances,Jeanne,Ivan2005June8toJanuary615Hurricanes;12TropicalStormsKatrina,RitaCost–2004HurricaneSeasonFlorida’shospitalsincurred$163.2millioninunexpectedcostsExpensesrelatedtofacilitymodificationstoreducedamagefromfuturestormswouldexceed$48millionAveragehospitalimpactofmorethan$1millionTotalimpactonhospitals$200millionLessonsLearnedPreparationFacilityPlanningPower,MedicalGases,Water,Etc.FloodzoneMaterialResourcesCommunicationRedundancyContingencyplansIncidentCommand!LessonsLearnedWorkforceissuesAdequatestaffHospitalPlanningIncidentCommandEducation/TrainingSpecialNeedsBehaviorHealthPatient&EmployeeLessonsLearnedHospitalSecurityFacilitysupportProtectivemeasuresPatientSafetyMutualAidPublicandprivatepartnersMedivacMan-MadeDisastersUnintentional/AccidentalEngineeringFailuresBridges,Buildings,DamsTransportationPlanes,Trains,Automobiles,ShippingEnvironmentalOilspills,pollution,wasterunoffExplosionsMinedisastersIndustrialaccidentsWarFireTerrorismPokingskunksisdangerous!TerrorismThegoalsofterroristsareto:Createconfusion,fear,chaos,andmistrust.Breakdownthephysicalandpoliticalinfrastructure.Intimidate,subjugate,andweakenauthority.HOWWILLOURENEMIESFIGHTUS?UNCLASSIFIEDChemicalBiologicalRadiologicalNuclearEnergetics/ExplosivesAWeaponofMassDestructionisadeviceormaterialspecificallydesignedtoproducecasualtiesorterror.CBRNEincidentsmayresultfromindustrialaccidents,actsofwar,oractsofterrorism.ChemicalAgentsMustardgasSarinPhosgeneCyanideChlorineChemicalAgentsIndustrialChemicalsChokingAgentsBloodAgentsWarfareAgentsBlisterAgentsNerveAgentsRoutesofexposureInhalation,skincontact,ingestion,injectionEffectdependsondoseLargerdose:earlierandmoresevereeffectsEffectsmaybeimmediateordelayedIndividualsusceptibilityvariesAge,chronicillness,medicationsExposureToChemicalsBiologicalAgents:Undetectablebyhumansenses+Prolongedincubationperiod+Limitedsurveillancecapability=UnrecognizedexposureBio-threatsBiologicalagentsmaybe:BacteriaVirusesToxinsTheyarenaturallyoccurringand/orcanbebioengineeredasWeaponsofMassDestruction.RoutesofTransmissionAbsorption:Skinandmucusme