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Disaster Preparedness The University of Texas at Austin School of Nursing

2009 Integrated Medical, Public Health, Preparedness and Response Training

Dallas, Texas
April 6-7, 2009

  1. First time to be integrated. Plans to have it international…(Yesky)
    • ESF 8- has 17 responsibilities: concept of operations (should be finalized July 09): public health, medical, cross cutting (patient evacuation, patient care, mass fatality, victim identification, vet medicine
    • ESF 6
  2. Beale: NDMS was founded 25 years ago in Austin, Texas in response to the cold war. To prepare the civilian workforce to care for returning soldiers. Has evolved since then as the medical arm for FEMA, now HHS
  3. ESR VHP
  4. Medical Reserve Corps - now 170,000 members, public health common theme
  5. New mission – patient advocacy teams to take patient back to facility of origin, processing care on trains.
  6. New Term: “National Response Framework” (versus National Response Plan)
  7. “side bar” communication
  8. What does “At risk population” mean? – functional approach is best versus using groups like children, pregnant and elders
  9. Geriatrics and disasters
    • Increased risk? Yes! Immunosuppressed, altered presentation, may exacerbate or mimic CBRN. Over 65 years: 52% report disability, 37% severe disability. 27% community dwellers difficulty ADLs, burden caregivers, co-morbidities.
    • Acute issues: trauma, exposure, infection
    • Chronic
    • Mitigation – threats includes mobility, cognition, community vulnerability, facility hazard
    • Preparation – geriatric health professionals, SWIFT triage system, tracking system, separate shelter/arena (quieter) coordinated evacuation plan,
    • Response – integrated plans, SWIFT triage after START, languishing in silence, attend only those who complain. Don’t
      1. Depend on same symptoms
      2. Depend on lack of symptoms
      3. Forget beta adrenergic and pro cholinergic agents
      4. Forget depression, delirium
    • Recovery – debrief teams and operation, periodically survey potential shelters
    • Need disaster geriatrics – research and publications.
  10. Pediatrics
    • Disaster of one: larger head, lower center of gravity, large area evaporative loss, veins tiny, dosages are in kilograms, introsseous (sternal, tibial); 20% of ACLS meds not labeled for kids
  11. Medical Needs Shelter – (if feds were to come in and take over
    • Scalable size capacity---all hazard, 250 beds, scalable by 50’s 72 hours of supplies per 250 beds FMS: e.g. will provide bariatric mattresses, quarantine, infection control
    • Criteria: requires level of care/resources beyond shelter but not hospital.
  12. Applied Public Health Teams – new from USPHS
    • Post disaster needs out strips local public health capacity
    • Staff of local PHC may be victims themselves, evacuate themselves.
    • Now USPH officers, augmentable, subject matter experts
    • “Public health department in a box” – pre-configured, deployable teams, rapid deployed force; helps coordinate, immunize, “help” with local efforts
      1. Epidemiology and surveillance
      2. Environmental services – health statistics, food and safety inspection
      3. Preventive services – work, health education, shelters
  13. Resiliency versus Fear (Building community resiliency)
    • CARD – Collaborative Agencies Responding to Disasters (Ana Marie Jones)
    • What would ESL clients have in their go bag? Phrase book, phone number of embassy, contact person who could speak both languages)
    • Reaching out – culturally isolated (religion, sobriety, isolated for whatever reason)
    • Islam teaches “Faithful are protected by God” (what does this mean for disaster preparedness?) (They do not need to prepare: God’s will)
    • Actions:  “evacuate, prepare a kit, get treatment, drop/cover/hide. Go to our website.”
    • Now say it to low income, Spanish speakers, veteran, frail elders, blind/visually impaired
    • Embrace “couch potato” preparednes
    • We need to empower diverse communities. Think of them, not us.
      1. Teaching – zip lock bags (audience, EMT (irrigation, hot pack, chest wound, gloves), vs elders (medications) vs kids (toys, snacks, gold fish)
      2. ICS of one (fire stove)
      3. “Bill Gates option”

By Marilyn Pattillo