Emergency Management Working Group 13 January 2014

1. Emergency Management Working Group13 January 2014 Please remember to silence your cell phone.

2. Agenda • Medical Reserve Core • Updates • Redbook Update • Flu Surveillance • Inclement Weather • Evacuation Exercise Overview • Overview of Emergency Preparedness Cache • Year in Review

3. Medical Reserve Corp

4. Red Book Update • Redesigned for 2013 • -Clean, refined interface. • -Large, easy to read font. • -Restructured hazard identification. • -Maps, Contacts, and Documents Tabs

5. Red Book Update • Quick Reference Sheet • -Replaces the Emergency Response Sheet. • -Brightly colored with larger front. • -Only contains guidance for life-threatening situations. • -All other hazards can be found in the Emergency Action Plan.

6. Red Book Update • Emergency Action Plan • -Combines the former EP&R Guide and Area-Specific Plan into one streamlined document. • -Supporting documentation is now linked with its appropriate hazard. • -Portrait page orientation. • -One page/section for each individual hazard.

7. Flu Surveillance • Weekly Report • -UVA-HS sentinel site reporting initiated in 2009. • -Currently six sites are monitoring ILI/Influenza activity and are providing weekly frequencies. • -Information compiled in a standardized two page report. • Overall summary • Annual trend comparison • Sentinel site breakdown • Laboratory data • CDC/VDH – National/Regional activity

8. Winter Weather • Revised Communications • -Updated Inclement Weather Hotline • -Winter Preparedness Sheets • Predictions • -Cooler, dry first half of winter. • -Milder, wetter second half. • -Total snow: 15”

9. Overview of Emergency Preparedness Cache Emergency Management Equipment Caches

10. Overview of Emergency Preparedness Cache Emergency Department Cache (Rm 44 & Decon Room) • Negative Pressure Room Inserts • Decon Chem Suits, Gloves, Boots, • Masks, PAPR • Don and Doff Kits • Disposable Coveralls • Scene Tape • Light Sticks • Flashlights • Cotton Towels, Face Cloths, • J&J Baby Shampoo

11. Overview of Emergency Preparedness Cache Nursing Supervisor’s Office: 1st Floor in SRO Office • 800 MHz Radio • 8 Radios with external Mics

12. Overview of Emergency Preparedness Cache Medical Center Dining Conference Room 1 Closet (First Floor) • Phones • Office Supplies • Printer • Tripod stands • “Butcher” Paper Pads and markers • Medsleds • Command Vests

13. Overview of Emergency Preparedness Cache Medical Center 2M Storage Room • Positive Air Purifying Respirators (PAPR) • Internal use • Positive Air Purifying Respirators (PAPR) • External Use • Decon Chemical Suits • Oxygen Manifolds: 50 psi systems • Oxygen and Air Extension Hoses • Extra PAPR Cartridges (FR57), HEPA Cartridges • Decon Hot Water Heater less Propane Cylinder • Extra Suction Machine parts • Crank Flashlights • Oxygen Regulators for traditional cylinders • Glow Sticks and Dots

14. Overview of Emergency Preparedness Cache Medical Center 2nd Floor Link • Push Pack for Power Outages • HT 50 Ventilators: 8 Units • Addition units Stored in: • PACU • Medic 5 Ambulances • Transitional Care Hospital (TCH) • LSLC Simulation Center • Suction Machines • Respiratory Treatment Cart

15. Overview of Emergency Preparedness Cache Medical Center 4 East Link • Regular MedSleds • Bariatric MedSleds • Regular MedSled • with Infant insert • Regular MedSled • with Toddler insert • Neonatal Baskets

16. Overview of Emergency Preparedness Cache Medical Center Chempack (Main Pharmacy 0 Level) • Mark 1 Auto Injectors (Atropine and Pralidoxime) • Atropine Auto Injectors • Pralidoxime Auto Injectors • Diazepam Auto Injectors • Multi-Dose Atropine, Pralidoxime • and Diazepam vials

17. Overview of Emergency Preparedness Cache 11th Street Parking Garage“A” Level Cage • Backboards • Resupply units for Vaccination Station • Batteries for Breath Easy PAPR Non-Rechargeable • PAPR Hoods, Chem Suits, Gloves, Boots for Training

18. Overview of Emergency Preparedness Cache 1222 Jefferson Park Ave (4th & 5th Floor) • Radios • 900 MHZ: 12 Units • Motorola: Low Band, Walkie-Talkie (in use at Northridge Medical Office Building) • Gamma Detectors: 2 Units • Computers for Hospital Command Center

19. Overview of Emergency Preparedness Cache Hazmat (Decon) 70 • Box Truck parked in the 11th Street Parking Garage, A Level (Unlabeled) • Houses Decon Tent • Hot Water Heater • Decon PAPRs • Suits, Boots, Gloves • Cleaning Material • Traffic Cones, Barrier Tape, etc.

20. Overview of Emergency Preparedness Cache Stoney Ridge Facility: Off Avon Street Extended • MERC 8 System-8 Body ”Portable Morgue” • MERC 4 System- Main Morgue • PAPR Head Covers & Hoods • ½ Face Respirators • Small, Med, Large • P100 Filters • Hand wash Stations

21. Overview of Emergency Preparedness Cache VHHA-North West Region Employee Health • 5000 person Vaccination Station • 500 person Vaccination Bag Special Event Medical Management (SEMM) • Stabilize and Treat in Place • (STiP) Tent System Augusta Health • Fatality Management Trailer

22. Overview of EVAC 2013 After Action Review (AAR)“EVAC 2013”Emergency Management Work GroupJanuary 13, 2014Thank you all for your participation!!!

23. http://www.youtube.com/watch?v=N0aiLbrnlFc

24. Exercise Demographics Command and Control = 18 Controllers = 27 Evaluators = 29 Volunteer Patients = 81 Observers = 6 Bucket Brigade=42 Safety Officers = 18 Collection Point = 4 Total Exercise Participants = 225

25. Actual Unit Patients Triaged Green (Ambulatory) = 192 patients Yellow (Sled/Stretcher) = 192 patients Red (Shelter in Place) = 27 patients Total Patients Triaged = 411 patients Evacuation Times for our Volunteer Patients Ambulatory Patients: 6 to 40 min / average 13 min Sled Patients: 8 to 47 min / average 23 min

26. Survey Results 95 Responses How prepared do you feel to Evacuate patients in the future? 1 Not Prepared 5 Very Prepared 3 Neutral

27. Survey Results 95 Responses How comfortable do you feel using the Med Sleds after the exercise? 1 Not Comfortable 5 Very Comfortable 3 Neutral

28. Survey Results Do you feel comfortable triaging patients (ambulatory, Med Sled, shelter in place) for evacuation?

29. Areas to Sustain • Hands on training prior to the exercise was critical to my comfort • Staff seemed to really want the opportunity to participate & practice • Sleds worked the way they were supposed to work • Lots of enthusiasm for learning • “X” strapping for shorter patients worked well • Great team work! • No one was injured • Sledding patients down worked well when we got the hang of it • More drills, more often! • Great to have the FBF involved in this drill, as they will be called if this really happened

30. Areas to Improve • Communication • Need a different plan for getting ambulatory patients down • Nurses on my unit seemed totally unfamiliar with Med Sleds • Flow—need a plan to move people in the stairwell based on condition • Gloves, water, headlights, radios if this was for real • Second person on each landing to help move patients • Hook configuration & a marked spot on the railing for placement • Relief teams for stairwell team • Triage training for units • More practice on a regular basis-keeping hook slack out of the rope, hook placement, patients rolling inside of the sled because straps were not tight

31. Planning • Next level of evacuation plan • Special needs patients • Collection Point • Altered care//transport out • Table Tops to exercise//refine new plans • Training • Ongoing Med Sled training • Education regarding the plan • Annual full scale evacuation exercise • Questions & Discussion….. Next Steps