BIOTERRORISM PREPAREDNESS TRAINING

1. BIOTERRORISM PREPAREDNESS TRAINING SOCIAL WORKERS

2. Biological Agents of Highest Concern • Smallpox • Anthrax • Plague • Tularemia • Botulism • Viral Hemorrhagic Fevers

3. Types of Illnesses These Agents Can Cause • “Flu-like” illness (fever, sweats, nausea) • Cough and/or pneumonia • Headache, confusion • Skin ulcers (anthrax, tularemia, plague) • Rashes (smallpox, viral hemorrhagic fevers) • Paralysis (botulism)

4. Contagious Agents • Person-to-Person Transmission Smallpox Plague Pneumonia Some Viral Hemorrhagic Fevers (Ebola)

5. Antibiotics, Antitoxin, or Immunization • Antibiotics – Anthrax, Plague, Tularemia • Antitoxin – Botulism • Immunization – Smallpox, Anthrax, Some Viral Hemorrhagic Fevers

6. Decontamination – Category A Critical Agents • Exposed persons – showering/washing thoroughly with soap & water adequate for most; bleach not necessary • Facility & equipment – may not be necessary if contaminated with agents of short survival time; others may need bleach, sporacidal chemicals, incineration and/or sterilization in autoclave

7. Infection Control – Category A Critical Agents • Standard precautions – all cases • Airborne & contact precautions - smallpox, viral hemorrhagic fevers • Droplet precautions – pneumonic plague

8. Infection ControlStandard Precautions • Disposable, non-sterile gloves • Handwashing after glove removal • Disposable gown/apron, face-shield if splashing anticipated • Change protective gear between cases

9. Infection ControlContact Precautions • Standard precautions plus • Wear gloves & gown, change after contact with infectious material • Dedicate non-critical patient care items to single patient or disinfect between patients

10. Infection ControlAirborne Precautions • Airborne Precautions • Standard precautions plus • Patient in negative air pressure room • Wear respiratory protection (HEPA filter mask)

11. Infection ControlDroplet Precautions • Standard precautions plus • Wear mask when within 6 feet of patient

12. Quarantine vs. Isolation • Isolation: separation of a contagious person/group from other people to prevent spread of infection • Quarantine: restrictions of activities or limitations of freedom of movement of those presumed exposed to communicable disease to prevent contact with those who have not been exposed

13. Emergency Operations Planning – 4 Components • Preparedness – evaluate the risks/probabilities • Response – how to deal with risks/probabilities • Mitigation – how to minimize the effects or prevent reoccurrence of disaster • Recovery – what would be needed to restore unmet needs/how to do this

14. Incident Command System • System for organizing a response (based on the emergency operations plan) to an emergency after it occurs • Common goal of stabilizing the incident: protecting life, property and environment

15. Incident Command SystemDirected by Incident Commander 4 Basic Functions • Planning: determine what specifically needs to be done to handle the incident • Operations: directs all resources to carry out the plan • Logistics: provides the resources & all other services needed to support the plan • Finance/Administration: monitors costs related to managing the incident

16. Severity of Response Dependent Upon • Proximity to event (injured/bereaved) • Intensely exposed (first responders) • Displaced from home/work • Loss of property • Age (child/elderly) • Special Needs (developmentally disabled/blind/cognitively impaired/etc) • Culture

17. Severity of Response Dependent Upon Continued • History of: Previous trauma Mental illness Substance Abuse Chronic Illness

18. Early Intervention Goal #1 Safety: • Protect from further physical harm (remove from traumatic scene) • See to basic needs (food, shelter, clothing, sanitation, sleep, medical care) • Information dissemination

19. Early Intervention Goal #2 Function: • Support to return to normal function (reduce stressors/reminders) • Link to critical resources • Reunite and keep families together • Educate about responses to stressful or traumatic events

20. Early Intervention Goal #3 Action: • Support to return to productive activity • Redirect to constructive/helping tasks

21. CommunicationGeneral Guidelines • Tell the truth as it is known, when it is known • Explain what is being done to deal with the situation • Avoid withholding bad news or disturbing information • Be forthright about what is not known • Provide practical guidance • Messages should be simple & straightforward

22. Self-Care • Healthy lifestyle • Self-regulation • Positive coping skills (resilience) • Stress management • Education • Emergency Preparedness Practice

23. Preparedness Training • New Jersey State Division of Mental Health Training • New Jersey Department of Homeland Security • American Red Cross • FEMA Disaster Mental Health Training • NOVA (National Organization of Victims Advocacy) • International Critical Incident Stress Foundation (ICISF) • Religious organizations with disaster response groups • Professional organizations

24. Summary of Key Points • Most biological agents of concern produce initial non-specific or “flu-like” illness • Standard precautions should be used with all patients following bioterrorism incident • Reactions to a disaster will differ, but a structured response is necessary • Care providers need to practice self-care • Train for emergency preparedness