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Model State EMS Disaster Response Plan


April, 2002

TABLE OF CONTENTS

Acknowledgements

Forward

1.0 Purpose

2.0 Applicability

2.1 Disaster LEAD Hospitals

2.2 State Government Departments and Agencies

2.3 Public Service Organizations

2.4 Federal Government Departments and Agencies

3.0 Concept of Operations

3.1 State Emergency Operations Plan Integration

3.2 Authority for Direction and Control

3.3 Direction and Control Points

3.4 Response Actions

4.0 Organization and Assignment of Responsibilities

4.1 State Department of Public Health

4.2 Disaster LEAD Hospital

4.3 Resource, Associate and Participating Hospital

4.4 EMS Providers

4.5 State Emergency Management Agency

4.6 National Pharmaceutical Stockpile

4.7 American Red Cross

4.8 Blood Centers

4.9 State Police

4.10 Medical Examiners/Coroners

4.11 State Department of Central Management Services

4.12 State Department of Transportation

4.12 State Department of Veterans Affairs

4.14 State National Guard

4.15 Salvation Army

4.16 State Poison Center

4.17 Mutual Aid Box Alarm System

5.0 Plan Development and Maintenance

6.0 Authorities and References

Attachments

Attachment 1 State Operations Headquarters and Notifications Office

Attachment 2 Public Information

Attachment 3 Disaster LEAD Hospital Requirements/Locations

Attachment 4 Resource Availability Report Forms

Attachment 5 State Emergency Medical Response Staff

Attachment 6 Communications

Attachment 7 Medical Management Site

Attachment 8 Transportation

Attachment 9 Good Samaritan Immunity

Attachment 10 National Disaster Medical System

Attachment 11 National Pharmaceutical Stockpile Program

Attachment 12 Hospital Medical Bags

Abbreviations/Acronyms

Terms and Definitions

Confidential Emergency Contact Information

Acknowledgements

The NASEMSD would like to thank Leslie-Stein Spencer, State EMS Director for Illinois for her invaluable expertise and assistance in the preparation of this document. This plan is based upon the Illinois Emergency Response Plan.

OVERVIEW

The world experiences hundreds of natural and man-made disasters every year. They kill and injure scores of persons and cause tens of thousands to seek emergency care and shelter. Disaster planning is the means for anticipating these events and preparing for the situations that result. Its purpose is not to reduce the likelihood of disaster because, by definition, disaster is an uncontrollable event. Rather, disaster planning seeks to enable rescuers to respond effectively and efficiently regardless of disruption. The need for disaster planning and its related emergency medical response in a catastrophic event became more evident than ever with the recent terrorist attack on the World Trade Center and Pentagon, as well as, earthquakes which occurred in Loma Prieta, California (1989), Northridge, California (1994), and Kobe, Japan (1995).

This document constitutes the State's Emergency Medical Disaster Plan. It addresses medical preparedness, response and recovery in the event of an emergency medical situation within the state of ___________. The Emergency Medical Disaster Plan is not meant to take the place of the National Disaster Medical System (NDMS), which is the federal government s nationwide system to provide capabilities for treating a large number of casualties injured in a major domestic disaster or conflict overseas. The overall goal of the State Plan, is to assist emergency medical services personnel and health care facilities in working together in a collaborative way in situations where local resources are overwhelmed.

Various efforts were undertaken in the planning process, such as conducting meetings with disaster lead hospitals, public and not-for-profit organizations, and private organizations. These individuals/organizations have participated in the planning process and agree to their respective responsibilities as assigned in this plan in the event of an emergency.

This document is in compliance with the Emergency Medical Services Systems Act and the State Emergency Operations Plan.

ABBREVIATIONS/ACRONYMS

AERO - State Division of Aeronautics

ARC - American Red Cross

ARES - Amateur Radio Emergency Services

CDC - Centers for Disease Control and Prevention (Atlanta, Georgia)

CEO - Chief Executive Officer

CISM - Critical Incident Stress Management

CME - Continuing Medical Education

CMS - Central Management Services

CSU - Clearing-Staging Units

DMAT - Disaster Medical Assistance Team

DMS - Disaster Management System

DMORT Disaster Mortuary Services Team

DOD - Department of Defense (U.S.)

DOJ - Department of Justice (U.S.)

DOT - Department of Transportation

DPH - Department of Public Health

DVA - State Department of Veterans Affairs

DWI - Disaster Welfare Inquiry Service

ED - Emergency Department

EMA - State Emergency Management Agency

EMS - Emergency Medical Services

EMSMD Emergency Medical Services Medical Director

EOC - Emergency Operations Center

EOP - State Emergency Operations Plan

ESF - Emergency Support Function

FAA - Federal Aviation Administration

FEMA - Federal Emergency Management Agency

HF - High Frequency

HHS - United States Department of Health and Human Services

IC - Incident Commander

ICS - Incident Command System

JCAHO - Joint Commission on Accreditation of Healthcare Organizations

JPIC - Joint Public Information Center

MABAS Mutual Aid Box Alarm System

MD - Medical Doctor

MERC - Medical Emergency Radio Communications

MERT - Mobile Emergency Response Team

NDMS - National Disaster Medical System

NG - State National Guard

OHNO - Operations Headquarters (Department Operations Center)

OSC - Federal On-Scene Coordinator

PC - Poison Center

REACH - Radio Emergency Assistance Channel

RN - Registered Nurse

SEMSVs Specialized Emergency Medical Services Vehicles

SFDA - State Funeral Directors Association

SP - State Police

USPHS - United States Public Health Service

VA - Department of Veterans Affairs

VIP - Very Important Person

TERMS AND DEFINITIONS

Ambulance Service Providers - Individuals, groups of individuals, corporations, partnerships, associates, trusts, joint venturers, units of local government, or other public or private ownership entities that own and operate a business or service using one or more ambulances or EMS vehicles to transport emergency patients.

Disaster LEAD - Public Health EMS regions used for the medical disaster plan, with each region having a designated hospital serving as the LEAD Hospital.

Emergency Medical Services Medical Director - The physician, appointed by the local resource hospital and approved by the Department of Public Health, who has the responsibility and authority for total management of the EMS system.

Helicopter Accommodations - The availability of either a helipad or another site (not specifically designated as a helipad) where a helicopter could land safely.

Department Operations Center (DOC) - This is the DPH command post set up specifically upon activation of the Emergency Medical Disaster Plan. DOC will be based in ______________ depending on what area of the state is affected by the disaster. DOC personnel will be in direct contact with the activated emergency operations center (EOC) in ____________. All communication to and from the activated LEAD hospital(s) will be from DOC.

MERT - Mobile Emergency Response Team consists of four four-person groups serving _______________. If a mass casualty incident (MCI) occurs and a medical response team is needed, the on-call MERT will be activated.

In-Patient Bed Availability - Number of unoccupied beds covered by staff within a hospital, broken down into non-monitored beds and monitored beds.

Incident Command System - A standardized organizational structure used to command, control and coordinate the use of resources and personnel that have responded to the scene of an emergency.

Local Government Official - The official of the community who is charged with authority to implement and administer laws, ordinances and regulations for the community.

MABAS (Mutual Aid Box Alarm System) - MABAS is an agreement among fire departments in the majority of counties to provide immediate extra manpower and equipment, systematic response of teams of personnel, access to specialized equipment that could not be justified for any single department, contractual responsibilities and liabilities, and broad area coverage.

Negative -Air-Pressure Room - A room equipped with a ventilation system that prevents air from the room from leaking out or circulating in other parts of the facility.

Phase I - This phase of the plan instructs the disaster LEADs to assess broad areas for disaster resources in their given region.

Phase II - This phase of the plan instructs the disaster LEAD to assess specific capabilities in its region.

Specialized Emergency Medical Services Vehicles (SEMSV) - Vehicles that are not ambulances that transport the sick or injured by means of air, water or ground. These vehicles include watercraft, aircraft and special purpose ground transport vehicles not intended for use on public roads.

CONFIDENTIAL EMERGENCY CONTACT INFORMATION

Department Operations Center:

State Emergency Operations Center:

State Department of Public Health Duty Officer:

Disaster LEAD Hospitals:

Poison Center:

State Poison Center:

State Network of Critical Incident Stress Management Teams:

State Department of Public Health Regional Offices:

EMERGENCY MEDICAL DISASTER PLAN

1.0 Purpose

The overall goal of the State EMS Disaster Response Plan is to assist emergency medical services personnel and health care facilities in working together in a collaborative way and to provide support in situations where local resources are overwhelmed.

2.0 Applicability

2.1 This plan applies to the disaster LEAD hospitals and to the resource, associate and participating hospitals and emergency medical services (EMS) providers within each region that may be called upon to provide or assist in emergency medical care when local resources are overwhelmed. The disaster LEAD hospitals are--

2.2 This plan is applicable to those state departments and agencies that may be called upon to provide or support emergency medical assistance when local resources are overwhelmed. These departments and agencies and organizations may include, but are not limited to--

Department of Central Management Services (CMS)

Department of Public Health (DPH)

State Department of Transportation (IDOT)

State Emergency Management Agency (SEMA)

State National Guard (ING)

State Police (ISP)

State Department of Veterans Affairs (IDVA)

2.3 This plan applies to those local or public service organizations and associations that may be called upon to provide or support emergency medical assistance when local resources are overwhelmed. The public service organizations may include, but are not limited to--

American Red Cross (ARC)

State Poison Center (IPC)

State Funeral Directors Association (ISFDA)

Salvation Army

Mutual Aid Box Alarm System (MABAS)

College of Emergency Physicians (CEP)

State Hospital & Health Association (IHHS)

2.4 This plan is applicable to those federal government departments and agencies that may be called upon to provide or support emergency medical assistance when state and local resources are overwhelmed. These departments and agencies may include, but are not limited to—

Center for Disease Control and Prevention (CDC)

Federal Emergency Management Agency (FEMA)

United States Department of Health and Human Services (DHHS)

United States Public Health Service (USPHS)

National Disaster Medical System (NDMS)

3.0 Concept of Operations

This section describes the direction of tasked organizations: the command structure, specifying who will be in charge during emergency medical operations; the authorities of, and limitations on, key response personnel; how medical response organizations will be notified when it is necessary to respond; the means used to obtain, analyze and disseminate information; the relationship between the control points; and the provisions made to coordinate and communicate among all the jurisdictions and agencies that may be involved in the emergency medical response.

3.1 State Emergency Operations Plan Integration

3.1.1 Each organization that is called upon to provide or support the rendering of emergency medical assistance will exercise direction and control of its staff and resources. In order to meet the public needs that could be generated by an incident, it is essential that the responding organizations coordinate their efforts within an overall direction and control system.

3.1.2 Response to an emergency medical incident in State will be coordinated and conducted utilizing the State Disaster Management System (IDMS). This component of the State Emergency Operations Plan provides a mechanism for identifying organizational roles and responsibilities of responding organizations, and also establishes a structure for information exchange and coordination among responding organizations.

3.2 Authority for Direction and Control

3.2.1 Within State, the overall authority for direction and control of the response to an emergency medical incident rests with the governor. The governor is assisted in the exercise of direction and control activities by his/her staff and in the coordination of response activities by SEMA. The State Emergency Operations Center (EOC) is the strategic direction and control point for State response to an emergency medical incident.

3.2.2 The overall authority for direction and control of DPH s resources to respond to an emergency medical incident is the director of the agency. The line of succession at DPH goes from the director to the ______________. The director is assisted in the coordination of emergency medical response activities by the Chief / Director of the Division of Emergency Medical Services.

3.2.3 The overall authority for coordinating the resources of the disaster LEAD hospital(s) that respond to an emergency medical incident is the EMS medical director (MD).

3.3 Direction and Control Points

During an emergency medical incident, overall medical direction and control as well as coordination of input from all responding organizations will be accomplished through the staffing and operation of the following direction and control points.

3.3.1 State Operations Headquarters and Notification Office (DOC)

3.3.1.1 The DOC, located within the _____________, serves as the strategic coordination center for emergency medical operations and will communicate with the site(s) and disaster LEAD hospital(s) (Attachment 1).

3.3.1.2

The DOC is responsible for notifying the disaster LEAD hospital(s) of the request for medical assistance. The DOC may also contact the largest provider in the disaster LEAD region or MABAS and request assistance.

3.3.1.3

The issuance of press releases and the coordination of media calls regarding the state medical response operation will be the responsibility of the Governor s Press Office, coordinated through the state EOC (Attachment 2).

3.3.1.4

The DOC is the designated point of contact for coordination and providing updates on the status of emergency medical operations with the following organizations:

State EOC

Disaster LEAD hospitals

Governor ‘s Press Office

USPHS

3.3.2 Disaster LEAD Hospital

3.3.2.1

The disaster LEAD hospital (Attachment 3) is the lead hospital in a specific region responsible for coordinating disaster medical response upon the activation of the Emergency Medical Disaster Plan by the DOC.

3.3.2.2

The disaster LEAD hospital will serve as the primary point of contact for communication and coordination of disaster response activities with all hospital(s) and EMS provider(s).

3.3.2.3

The disaster LEAD hospital is the designated point of contact for coordination, receipt of inputs and providing updates on the status of disaster medical response to the following organizations:

$ DOC

$ Hospitals and EMS providers

$ Hospital public information

3.3.3 Field Incident Command Components

3.3.3.1 EOC Command and Control

Overall direction and control of the county response to the needs generated by an emergency medical incident will be exercised and maintained through the local EOC, when available. The incident commander assigned to the situation will provide status reports to and request additional resources from the local EOC.

3.4 Response Actions

3.4.1 Emergency Medical Disaster Plan Activation

3.4.1.1

The local government official of the affected area notifies the state EOC communications center or EMA that local resources have been overwhelmed as a result of an emergency situation and may request the activation of the Emergency Medical Disaster Plan.

3.4.1.2

The state EOC communications center will obtain, from the local official, his/her name and contact information and notify the DPH duty officer.

3.4.1.3

The DPH duty officer will contact the local government official and obtain the information listed on the Medical Incident Report Form (Attachment 4) and report this information to the director of Public Health, or his designee.

3.4.1.4

The DPH duty officer may contact the director of Public Health, or his designee, and request the activation of the Emergency Medical Disaster Plan, based on the magnitude of an incident, in lieu of a request by a local government official.

3.4.1.5

The director of Public Health, or his designee, will determine whether the Emergency Medical Disaster Plan will be activated. If activated, the director of Public Health, or his designee, upon consultation with the chief of the Division of EMS and HS, will designate the disaster LEAD hospital(s) and declare the situation a phase I or phase II emergency medical disaster.

3.4.1.6

The DPH duty officer will notify the appropriate DPH regional EMS coordinator(s), upon consultation with the chief of the Division of EMS and HS, to report to the disaster LEAD hospital(s). The DPH regional EMS coordinator will notify the DOC when they are operational at the disaster LEAD hospital.

3.4.2 DOC Activation and Staffing

3.4.2.1

Upon activation of the Emergency Medical Disaster Plan, the director of Public Health, or his designee, will report to the DOC in Springfield or Chicago.

3.4.2.2

The director of Public Health, or his designee, will contact appropriate support staff to report to the DOC. The selection of the DOC staff will be based on the type and magnitude of the disaster (Attachment 5).

3.4.2.3

The chief of the Division of EMS and HS will notify the DPH duty officer of the designation of a phase I or phase II emergency medical disaster and which DOC(s) will be activated.

3.4.2.4

The chief of the Division of EMS and HS will notify the DPH duty officer when the DOC(s) is operational and what communication protocol should be utilized to transmit verbal and written correspondence (Attachment 6).

3.4.3 Phase I Emergency Medical Disaster

3.4.3.1

The chief of the Division of EMS and HS, after activating the plan, will notify the appropriate disaster LEAD hospital(s) of the phase I emergency medical disaster and provide the information contained on the Medical Incident Report Form (Attachment 4).

3.4.3.2

The disaster LEAD hospital will contact the local resource hospital(s) within the region and request the initiation of the disaster contact list, specifying phase I. Information received by the disaster LEAD hospital from the local resource hospital(s) will be recorded on the Provider Worksheet and the Phase I Disaster LEAD Worksheet (Attachment 4).

3.4.3.3

The initial phase I call from the DOC to the disaster LEAD hospital(s) is to determine the resource availability within the region. Resource, associate and participating hospital(s) and EMS provider(s) should not send personnel, equipment or supplies to a disaster site until a request is received by the disaster LEAD hospital from the DOC.

3.4.3.4

The disaster LEAD hospital will contact the participating hospital(s) and non MABAS EMS provider(s) within the region to elicit information on resource availability. Information received by the disaster LEAD hospital from the participating hospital(s) and EMS provider(s) will be recorded on the Provider Worksheet and the Phase I Disaster LEAD Worksheet (Attachment 4).

3.4.3.5

The local resource hospital(s) will initiate the notification tree in its respective system, and specify phase I. This resource information will then be reported back to the disaster LEAD hospital.

3.4.3.6

The disaster LEAD hospital will provide verbal and telefacsimile (fax) notification of resource availability for all resource, associate and participating hospital(s) and EMS provider(s) within the disaster LEAD to the DOC.

3.4.4 Phase II Emergency Medical Disaster

3.4.4.1

The chief of the Division of EMS and HS, after activating the plan, will notify the appropriate disaster LEAD hospital(s) of the phase II emergency medical disaster.

3.4.4.2

The disaster LEAD hospital will contact the local resource hospital(s) within the region, after notification by the DOC, and request the initiation of the disaster contact list, specifying phase II.

3.4.4.3

The disaster LEAD hospital will contact the participating hospital(s) to elicit information on resource availability. Information received by the disaster LEAD hospital from the local resource hospital(s) will be recorded on the Provider Worksheet and the Phase II Disaster LEAD Worksheet (Attachment 4).

3.4.4.4

The local resource hospital(s) will initiate the notification tree in its respective system, and specify phase II. This resource information will then be reported back to the disaster LEAD hospital. Information received by the disaster LEAD hospital from the local resource hospital(s) will be recorded on the Provider Worksheet and the Phase II Disaster LEAD Worksheet (Attachment 4).

3.4.4.5

The disaster LEAD hospital will provide verbal and telefacsimile (fax) notification of resource availability for all resource, associate and participating hospital(s) within the disaster LEAD to the DOC.

3.4.5. Assessment and Deployment of Resources to Disaster Site

3.4.5.1

Upon receipt of the resource information from the disaster LEAD hospital(s), the chief, Division of EMS and HS will assess the capabilities and determine if any additional disaster LEAD hospital(s) should be activated.

3.4.5.2

State Mobile Emergency Response Team (MERT) will be activated by DOC when a request has been made from the disaster site for medical assistance.

3.4.5.3

Additional personnel and equipment resources will be allocated by the DOC based on availability. The DOC will instruct the disaster LEAD hospital(s) to notify the appropriate resource, associate and participating hospital(s) of the need for equipment and supplies and non MABAS EMS provider(s) of their deployment.

3.4.5.4

Specific instructions will be provided by the DOC to the disaster LEAD hospital(s). These instructions will include--

$ Location for deployment

Designated emergency transportation routes

Site security information

Disaster site weather conditions

3.4.5.5

Personnel, equipment and supplies from resource, associate and

participating hospital(s) and non MABAS EMS provider(s) will be deployed to the specified site by the disaster LEAD hospital. Personnel deployed to the disaster will report to the incident commander (IC) (Attachment 7).

3.4.5.6

Personnel designated by DOC and deployed by the disaster LEAD hospital to perform medical operations will be covered from liability by state good samaritan immunity laws (Attachment 9) and the EMS Act.

3.4.5.7

The State Mobile Emergency Response Team (MERT) is a state sponsored voluntary medical team that will respond to and assist with emergency medical treatment at mass casualty incidents, including, but not limited to chemical, biological and radiological incidents, when activated by the DOC. This team will consist of a physician, a nurse, an EMT and other allied health professionals who will respond and become integrated into the local incident command system and report to the incident commander. Once activated, the MERT will respond to an actual scene or to the local health care facility, based upon the request received, to assist with the triage and treatment of patients.

The MERT will have three teams strategically located throughout the state to correspond with the structure of the State Interagency Response Teams (SIRT). An additional team will be part of the MMRS in Chicago. The State State Police will be responsible for transporting the medical supplies to the disaster site.

Hospitals will be asked to maintain disaster bags (Attachment 12) for utilization as needed.

3.4.6 Activation of Critical Incident Stress Management Team

3.4.6.1

Following a critical incident, it is not unusual for emergency care providers to experience strong physical and emotional reactions to the events they have seen, heard and participated in. These reactions may cause emergency care workers to perform in a less than optimal manner following the incident.

3.4.6.2

The network of critical incident stress management (CISM) teams provides a simple yet effective method to help emergency workers trying to cope with these stressful experiences. CISM promotes the continuation of productive careers while building healthy stress management behaviors.

3.4.6.3

The CISM team is composed of emergency service and mental health professionals who volunteer their time, energy and resources. Team members receive special training and participate in regular continuing education sessions.

3.4.6.4

The local resource hospital will contact the appropriate CISM team(s) within its EMS system to request services, upon request of the DOC or the IC.

3.4.7 Activation of National Medical Disaster System

3.4.7.1

In the event of a major disaster, the governor may request federal assistance under the authority of the Disaster Relief Act of 1988, PL100-707, as amended.

3.4.7.2

The U. S. president may make a declaration of a major disaster or an emergency. The presidential declaration triggers a series of federal responses coordinated by FEMA. These may include the activation of NDMS, when appropriate (Attachment 10).

3.4.7.3

The assistant secretary for health within DHHS may also activate NDMS upon the request of the director of Public Health in situations not involving a presidential declaration, under authority provided by the Public Health Service Act.

3.4.7.4

In the event of a national security emergency, the secretary of defense has authority to activate the system.

.

3.4.8 Reimbursement of Disaster Related Expenses

3.4.8.1

Expenditures incurred by MERT, the resource, associate and participating hospital(s), and EMS provider(s) as a result of activation by the DOC willbe submitted to SEMA for reimbursement under the State Disaster Relief Fund.

3.4.8.2

MERT, the resource, associate and participating hospital(s), and EMS provider(s) will be responsible for gathering and maintaining documentation of expenses according to applicable state and local regulations.

3.4.8.3

The disaster LEAD hospital(s) will be responsible for providing all reimbursement documentation of the hospitals and EMS providers to the DOC for verification and subsequent submission to SEMA.

4.0 Organization and Assignment of Responsibilities

This section describes the specific direction and control responsibilities that are assigned to the tasked organizations. The organization and assignment of responsibilities listed in this section are in accordance with the State Emergency Operations Plan.

4.1 State Department of Public Health (DPH)

DPH is designated in the State Emergency Operations Plan as the primary agency for health and medical services. This responsibility requires the Department to be the point-of-contact for public health and medical services response to a disaster to ensure the assistance provided is accomplished in a coordinated manner when local resources within the state are overwhelmed.

4.1.1 Director of Public Health

4.1.1.1

Activates and closes the DOC, when appropriate.

4.1.2 Chief/Director Division of Emergency Medical Services

4.1.2.1

Provides technical assistance to the director and will assist with the assessment of the resource needs of the local government.

4.1.2.2

Provides overall coordination of the emergency medical response.

4.1.2.3

Determines resource availability and coordinates with MERT and the disaster LEAD hospital to send personnel and equipment to a disaster site.

4.1.2.4

Provides overall direction and control of the emergency medical response in the absence of the director.

4.1.2.5

Approves the issuance of CME credit and/or recognition to responding EMS personnel for their participation and assistance at the disaster site.

4.1.3 DPH Duty Officer

4.1.3.1

Serves as the Department s 24-hour liaison to the state EOC during disaster operations.

4.1.3.2

Initiates requests for assistance in state EOC with other state agencies and departments and not-for-profit organizations.

4.1.3.3

Point-of-contact for the initial request for emergency medical assistance by the local government official or notification of a disaster operation from the state EOC communications center.

4.1.3.4

Updates the DOC on the status of the state disaster response and recovery operations.

4.1.4 DPH Regional EMS Coordinator

4.1.4.1

Provides technical assistance to the disaster LEAD hospital.

4.1.4.2

Serves as medical liaison for the DOC.

4.1.4.3

Serves as communication liaison with the disaster LEAD hospital.

4.1.5 State Public Information officer

4.1.5.1

Serves as point-of-contact for all health and medical information requests from the media.

4.1.5.2

Issues press releases as appropriate on the status of the emergency medical response.

4.1.5.3

Coordinates the issuance of press releases with the Governor s Press Office, hospitals, local government officials and neighboring states to ensure consistent information is reported to the general public.

4.1.5.4

Provides updates on media requests to the JPIC.

4.2 Disaster LEAD Hospital

4.2.1 A hospital designated as a level I or II trauma center is a local resource hospital and is designated pursuant to state law.

4.2.2 The disaster LEAD hospital is the lead hospital in a specific region responsible for coordinating disaster medical response upon the activation of the Emergency Medical Disaster Plan by the DOC.

4.2.3 The disaster LEAD hospital will serve as the primary point of contact for communication and coordination of disaster response activities with all hospitals and EMS providers.

4.2.4 When the disaster LEAD hospital(s) is/are notified by the DOC that the Emergency Medical Disaster Plan has been activated for its region, it will initiate the notification telephone tree in its respective region and specify phase I or phase II. This information will then be reported back to the DOC.

4.2.5 The disaster LEAD hospital will assess blood availability throughout the region. If massive quantities of blood and blood products are needed, hospitals may be requested to provide blood and/or blood products for use at or near the scene.

4.3 Hospitals

4.3.1 Local Resource Hospitals

4.3.1.1

The local resource hospital(s) has/have the authority and responsibility for its EMS systems as outlined in the DPH-approved EMS system program plans. The local resource hospital, through the EMSMD, assumes responsibility for the entire program, including clinical aspects and operations.

4.3.1.2

When the local resource hospital(s) is notified by the disaster LEAD hospital that the disaster plan has been activated, it will initiate the notification telephone tree in its respective system, and specify phase I or phase II. This information will then be reported back to the LEAD hospital.

4.3.2 Alternate Healthcare Facilities

4.3.2.1

Alternate healthcare facilities function within a given area, may assist in staging or receiving patients, supplies or personnel as required by the LEAD Hospital.

4.4 EMS Providers

4.4.1 All ambulance providers and SEMSV providers participating in an EMS system sign a letter of commitment that outlines their responsibilities in providing emergency care and transportation of the sick and injured.

4.4.2 Providers may be asked to participate voluntarily in disaster responses that occur outside their system(s) and are not part of pre-existing mutual aid agreements.

4.5 State Emergency Management Agency (SEMA)

SEMA is the state agency responsible for the coordination of disaster-related activities of state government agencies and certain volunteer organizations. This coordination includes the pre-emergency functions of mitigation and preparedness as well as response and recovery actions.

Response to an emergency medical incident in State will be coordinated and conducted utilizing the State Disaster Management System (IDMS). This component of the State Emergency Operations Plan provides a mechanism for identifying organizational roles and responsibilities of responding organizations, and also establishes a structure for information exchange and coordination among responding organizations.

4.5.1 Coordination of State Emergency Operations Center

4.5.1.1

The state EOC, located within the SEMA offices in __________, serves as the strategic coordination point for the overall response to an emergency medical incident.

4.5.1.2

The state EOC communications center is the designated primary 24-hour point-of-contact to be used by the local government official for the initial notification of an emergency medical incident. The state EOC is responsible for notifying the DPH duty officer of a request from the local government official.

4.5.1.3

The state EOC communications center is responsible for notifying representatives of those state agencies designated to report to the state EOC. DOC requests for state assets to support the provision of emergency medical care will be forwarded through the DPH duty officer assigned to the state EOC.

4.5.1.4

The state EOC is the designated point-of-contact for coordination and for providing updates on the status of State overall emergency operations to the following organizations:

Federal on-scene coordinator (OSC)

Other federal agencies

DOC

JPIC

4.5.2 Development of State Emergency Operations Plan

4.5.2.1

SEMA is responsible for coordinating the development and maintenance of the State Emergency Operations Plan.

4.5.2.2

The purpose of the State Emergency Operations Plan is to provide operational guidance for State response and recovery actions to prevent or minimize injury to people and damage to property resulting from emergencies or disasters of natural or manmade origin. It incorporates applicable provisions of the federal and regional response plans.

4.5.3 Coordination of State Disaster Management System (IDMS)

4.5.3.1

SEMA is responsible for coordinating state operations personnel to ensure needs of the requesting agency or department are met. SEMA provides for the management and coordination of all dedicated state assets, disaster intelligence, disaster recovery operations, and on-site local, state and federal agencies.

4.5.4 Coordination of Resource Support

4.5.4.1

SEMA will coordinate resource support for the state response. This response will require the cooperative effort of all state agencies.

4.6 National Pharmaceutical Stockpile

In the event of a bioterrorist incident or when additional equipment, supplies and/or drugs are needed, the director of Public Health, as delegated by the governor, will request the NP stockpile from CDC (Attachment 11).

4.7 American Red Cross (ARC)

Following notification and verification of a disaster, the local ARC will identify appropriate staff and volunteers to respond to the disaster. Initial response will be through the closest ARC unit. Time permitting, radio equipped Red Cross workers will be dispatched to the scene and to each receiving hospital. One (1) worker may report to the command post to act as the liaison between the scene and the chapter. This facilitates the gathering of information for the ARC Disaster Welfare Inquiry Service (DWI). Once at the scene, the Red Cross volunteers and/or staff will report to the IC.

4.7.1 Central Registration Point for Victims

4.7.1.1

The ARC serves as a central registration point for victims when possible. All information obtained will be held in the strictest confidence; no confidential information will be released to the media.

4.7.1.2

An ARC disaster health services representative, if available, will be assigned to each receiving hospital to obtain the following information from victims:

$ Name

Age

Gender

Address

Contact phone number

Diagnosis and condition

4.7.1.3

The disaster health services representative will also assist members of victims' families who are at the hospital. To collect the above information, the ARC worker should have access to a hospital representative authorized to release medical information and to a telephone removed from the press area to transmit confidential information to a central number maintained by the ARC chapter.

4.7.1.4

Information is gathered not only from hospitals, but from morgues, ARC shelters and other registration centers. There will be a moratorium on releasing information for a minimum of 24 hours. Each hospital should refer inquiries about victims to the local chapter of the ARC. A phone number for inquiries will be announced.

4.7.2 Provision of Emergency Services and Supplies

4.7.2.1

The ARC may provide emergency food, shelter, clothing, medical supplies and other services deemed necessary for victims and rescuers. They will also assist in tracking blood supplies and provide finances to obtain blood and blood products.

4.8 Blood Centers

4.8.1 The State hospital licensing rules require hospitals to maintain a minimum blood supply for emergency situations, or to be able to obtain blood quickly from community blood banks or institutions or have an up-to-date list of donors and equipment necessary to obtain the blood. Hospitals that depend on outside blood banks must have an agreement governing the procurement, transfer and availability of blood.

4.8.2 The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requires hospitals to have established procedures for obtaining a supply of blood and blood components at all times. For emergencies, JCAHO requires the hospital to maintain at least a minimum supply of blood, or have arrangements to obtain blood quickly from community blood sources or maintain an up-to-date list of available donors and provide the equipment and personnel to obtain the donor blood.

4.9 State Police (SP)

4.9.1 Security and Traffic and Crowd Control

4.9.1.1

A primary responsibility of the ISP during disaster response activities is to provide for security, traffic and crowd control, protection of very important persons (VIPs) and other functions of local and state law enforcement agencies.

4.9.1.2

The SP will be responsible for transporting MERT’s medical supplies to the disaster site.

4.9.2 Disaster Site Access

4.9.2.1

Upon notification, the ISP will facilitate/coordinate MERT getting to and from the disaster site. They will open any roadblock that may hinder a team or supplies from getting to the site. The ISP officers will be assigned to direct traffic and ensure an orderly process to and from the disaster site.

4.9.2.2

Traffic and access control in the disaster area is essential. Only official and necessary traffic will be allowed into the impacted area. The ISP and SEMA have available disaster tag kits to assist in this process.

4.10 Medical Examiners/Coroners

In the event of a major emergency or disaster, a large number of fatalities may occur. The primary responsibility for emergency mortuary services rests with medical examiners and coroners. The medical examiner or coroner of the area is in charge of the death scene and establishing the emergency morgue.

4.10.1 State Funeral Director s Association (ISFDA)

4.10.1.1

If a disaster inflicts a large number of fatalities, exceeding the medical examiner s or coroner’s response capabilities, the ISFDA will be notified by the state EOC.

4.10.1.2

The SFDA will be responsible for the following services:

Victim identification

Tagging and placing the deceased in body bags

Transportation of the deceased

Establishment of an emergency morgue

Providing refrigeration units

Dealing with body remains and personal effects

Family assistance

4.10.2 Activation of Disaster Mortuary Services Team

4.10.2.1

The ISFDA will request activation of NDMS Disaster Mortuary Services Team (DMORTs) if additional resources are necessary.

4.11 State Department of Central Management Services (CMS)

4.11.1 Provision of Goods and Services

4.11.1.1

CMS will be responsible for coordinating the purchase of or contract for the following goods and services:

Commodities

Medical equipment/supplies and drugs

Office supplies

Telecommunication equipment

Computers and software

Vehicles and vehicle repair vendors

4.11.2 Procurement of Real Property and Use of Commercial Vendors

4.11.2.1

CMS will coordinate the use of real property under its ownership or lease agreement and the acquisition of additional leased property as necessary. This coordination will also include the use of excess state property and donation of federal surplus property and the disposal of state owned durable goods considered excess at the end of the disaster response and recovery efforts.

4.11.2.2

The procurement of items not available through state sources from commercial vendors or suppliers will be the responsibility of CMS.

4.12 State Department of Transportation (IDOT)

4.12.1 Division of Highways

4.12.1.1

IDOT, Division of Highways, will be responsible for providing information on structural integrity of roads and highways.

4.12.1.2

IDOT, Division of Highways, will update the state EOC about roads that are no longer passable and will provide information to the ISP on alternate routes to the disaster site. The state EOC will forward IDOT, Division of Highways, information to the DOC.

4.12.2 Division of Aeronautics (AERO)

4.12.2.1

IDOT s, AERO will be responsible for the organizational structures and procedures for the use of aviation support to major emergency and disaster situations in State.

4.12.2.2

The aviation support structure will address coordination of response and allocation of resources, staging, logistics, intelligence, reporting and communications for disaster air support.

4.12.2.3

AERO will brief EOC on the status of air operations, including current missions, available aircraft by type, locations of staging areas and proposed priorities for aviation support.

4.12.2.4

AERO will be available to transport essential personnel to assist with transportation of MERT, medical equipment and/or medical supplies.

4.13 State Department of Veterans Affairs (IDVA)

4.13.1 IDVA will provide available medical support to assist emergency medical operations. Such services may include medical treatment and the utilization of medical centers and vehicles.

4.13.2 IDVA will provide available medical supplies for distribution to medical care locations being operated for disaster victims.

4.14 State National Guard (NG)

4.14.1 Activation of NG

4.14.1.1

All requests for NG support must be made to SEMA through the state EOC.

4.14.1.2

SEMA determines if the NG is the best state resource for the emergency response and makes a recommendation to the governor. Only the governor can order the NG to active duty. At that time, the NG assets become available to SEMA for response missions as required.

4.14.2 Medical Response Capabilities

4.14.2.1

The ING will assist emergency medical response operations by providing a limited number of medical personnel to assist with triage and basic first aid at medical management site(s). The ING medical personnel will report to the IC to receive their mission.

4.14.2.2

The ING will also provide the following services, equipment and supplies to support emergency medical response operations at medical management site(s):

Distribute medical supplies (air/land)

Evacuate casualties (air/land)

Procure medical supplies

Airlift personnel and material into disaster area

Provide essential equipment to assist with the establishment of a medical management site e.g., ambulances, tents, cots, lights, generators, water, etc.

4.15 Salvation Army

The Salvation Army emergency disaster services team will provide food, clothing, shelter and other basic necessities for survival during an emergency situation upon request. Crisis counseling capability is also available for those individuals who struggle to come to terms with the unusually trying situation.

4.16 State Poison Center (IPC)

4.16.1 State residents or hospitals may call the IPC 24-hours a day, 365 days a year. The IPC is staffed by toxicology trained pharmacists, nurses, physicians and other paramedical professionals to assist with statewide disasters.

4.16.2 The IPC will be available for consultation and/or drug related questions.

4.17 Mutual Aid Box Alarm System (MABAS)

4.17.1 MABAS is a consortium of municipalities, fire districts and EMS providers who have committed to an organization for the purpose of providing emergency service assistance. MABAS is a programmed sequential response through a series of running cards.

4.17.2 The goal of MABAS is to establish a standard, statewide mutual aid plan for fire, EMS, hazardous materials, mitigation and specialized rescue through a recognized system that will effectively support existing plans. MABAS has been recognized as an existing system that provides a 24-hour mechanism to mobilize emergency response and EMS resources to any given location within the state during a time of need through coordination with SEMA and DPH/EMS. DPH/EMS is supportive of the efforts of MABAS in their efforts to facilitate a statewide mutual aid system utilizing the MABAS system.

4.17.3 Once the MABAS dispatch center is notified by DPH/EMS through the State Operations Headquarters and Notification Office (DOC) of a request for additional resources from the stricken community or region s incident command, the MABAS dispatch center will make balanced requests for response of MABAS Divisions to fill the assignment without significantly depleting any single MABAS Division or geographic area.

4.17.4 To date, MABAS assets include fire engines, ladder trucks, heavy rescue squads, ambulances and hazardous material teams. MABAS also is capable of providing a consortium of special teams and equipment including: water tankers, underwater rescue and recovery, specialized rescue (above/below grade and building collapse), and task force disaster response capabilities.

4.17.5 A MABAS objective is to be recognized as a mechanism to mobilize mass resources in a swift and coordinated manner with various state agencies during statewide disaster plan activation and to be integrated into the system as a resource available to the local command system.

5.0 Plan Development and Maintenance

5.1 The entire Emergency Medical Disaster Plan will be reviewed and revised annually by the Division of EMS and HS.

5.2 The Division of EMS and HS will meet as needed with the agencies and organizations listed in the Emergency Medical Disaster Plan to review their roles and responsibilities and to revise as needed.

5.3 The Division of EMS and HS will produce and distribute changes to holders of controlled copies of the State Emergency Operations Plan. Holders of non-controlled copies will receive changes only upon written request.

6.0 Authorities and References

6.1 State Emergency Operations Plan

6.2 Federal Response Plan (April 1992)

6.3 Emergency Medical Services Systems Act

Attachment 1

DOC

This section contains the location of the State Department of Public Health, DOC in _______________.

Location of DOC

Attachment 2

PUBLIC INFORMATION

This section describes the means, organization and process by which emergency medical response and recovery information and instructions will be provided to the general public throughout the disaster.

DOC Medical Public Information

The chief of the Division of Communications will report to DOC upon the activation of the Emergency Medical Disaster Plan. It will be his/her responsibility to answer all questions from the media and to issue press releases. Hospitals involved in the emergency medical response operations may have their public information staff call DPH s Public Information Officer to get updated emergency response information to ensure a coordinated message is provided to the media and public. Based on the magnitude of the disaster, more than one information center may be established by the Public Information Officer to handle the anticipated large volume of public and media inquiries and rumor control issues. He/she will utilize the governor s office as the main coordination and release site during the disaster response period.

Senior Coordinating Group Establishment

During a major, large-scale disaster involving many state agencies, a senior coordinating group may be established. This group will include the senior public affairs representatives from the Governor s Press Office and each responding agency. The senior coordinating group will include lead public information officers from the involved state agencies and organizations.

Attachment 3

DISASTER LEAD HOSPITAL REQUIREMENTS/LOCATIONS

Following is a listing of the minimum guidelines for a hospital to be designated as a disaster LEAD by DPH. The attachment also provides the address of each designated disaster LEAD hospital and a graphical representation of its region.

Requirements for a Disaster LEAD Hospital

The director of Public Health will designate a disaster LEAD hospital for each EMS region in State. To be named a disaster LEAD hospital by the director of Public Health, a hospital must meet the following minimum criteria:

Designated local resource hospital

Designated level I or level II trauma center

Maintain an established disaster plan

Commit one advanced life support (ALS) provider to be dispatched at the scene, if necessary

Maintain an established two-way communication system to participating and associate hospitals

Maintain a fax machine accessible to emergency department staff 24-hours a day

Location of Disaster LEAD Hospitals

Attachment 4

RESOURCE AVAILABILITY REPORT FORMS

This section contains a sample of the forms that will be utilized by disaster LEAD hospitals to support direction and control information management. The information contained on the forms will support the DOC s assessment of the resource availability at disaster LEAD hospitals.

Attachment 5

STATE EMERGENCY MEDICAL OPERATIONS STAFF

This section contains the staff positions that may be activated by the director of Public Health, or his designee, to support the state emergency medical response at the DOC and the state EOC, and in the field, based on the type and magnitude of the disaster.

State Emergency Medical Operations Staff

The director of Public Health, or his designee, will determine an operational staffing level. This determination will be based on the initial status of the emergency situation provided by the DPH duty officer. Any subsequent staffing changes will be made by the director of Public Health, or his/her designee, as appropriate.

Minimal Operational Staffing Level

The following is the minimum DPH staff required to support the medical response to an emergency situation. Other staff will be required to assist with the medical response at the direction of the director of Public Health, or designee. Based on the type and magnitude of the emergency situation, DPH staff with technical expertise may be added to the minimal operations staffing level.

DOC

Director of Public Health

Assistant Director and Deputy Directors

Chief/Director, Division of EMS

Chief, Division of Communications

Clerical Support Staff

Building Security Officer

State EOC

Duty Officer

Disaster LEAD Hospital or DOC

Regional EMS Coordinator

Full Operational Staffing Level

The following is the full DPH staff required to support the medical response to an emergency situation. Other staff may assist with the medical response at the direction and discretion of the director of Public Health, or designee. Based on the type and magnitude of the emergency situation, DPH staff with technical expertise may be added to the full operations staffing level.

DOC

Director of Public Health

Assistant Director

Chief/Director, Division of EMS

Public Information Officer

Chief, Division of Infectious Diseases

Chief, Division of Environmental Health

Bureau of Long-Term Care, Division of Long-Term Care Field Operations

Division of Information Technology

Clerical Support Staff

Building Security Officer

Deputy Director, Office of Finance and Administration

Deputy Director, Office of Health Care Regulation

Deputy Director, Office of Health Protection

Local Health Department Liaison

State EOC

Duty Officer

Division of Environmental Health, Duty Officer

Disaster LEAD Hospital or DOC

Regional EMS Coordinator

Regional Health Office/State Forward Command Post

Regional Health Officer

Attachment 6

COMMUNICATIONS

This section focuses on the communications systems upon which DPH, DOC and the medical community will rely during an emergency response. The total communications system is discussed in detail and procedures for its use are outlined.

Need for Alternate Communication System

Public telephone companies report their networks will rapidly become overloaded during a catastrophic disaster. Additionally, widespread electrical outages may occur and switching centers may become inoperable. The restoration of essential public channels has been designated as a priority by the telephone companies. However, it is unknown when this essential telephone service will be restored. Because of the uncertainty that surrounds the availability of critical telephone service, the DOC and disaster LEAD hospital(s) may need to be self-sufficient and rely on other communication networks until telecommunication access is restored.

Telecommunications support for a significant disaster will be provided by SEMA and other state departments, agencies and organizations. As the primary agency, SEMA will coordinate the telecommunications assets of state agencies, departments and other organizations during disaster operations. This coordination can include the following:

Designating specific control frequencies and/or communications systems for use by agencies and organizations during disaster operations.

Restricting access to specific control frequencies during disaster operations.

Designating procedures for transferring information during disaster operations using the state telecommunications system.

If public telephone networks become overloaded during a catastrophic disaster, the DOC will utilize high frequency (HF) radio as the secondary telecommunications network to communicate basic medical command and control information to the disaster LEAD hospitals. The disaster LEAD hospitals will be responsible for utilizing the Medical Emergency Radio Communications of State (MERCI) system, various amateur radio organizations or other communications networks to transmit basic medical command and control information within their EMS systems.

HF Radio Communications Network

The DOC will utilize HF radio as the secondary telecommunications network to communicate basic medical command and control information with the disaster LEAD hospitals. The advantage of the HF radio system is its long-distance capabilities and its ability to function during a technological disaster. The HF system may be used in the event of a failure of other statewide radio systems that use telephone lines to connect to a system of radio towers. As a result of Y2K preparedness, SEMA purchased 10 HF radios to provide a secondary telecommunications network between DPH and the disaster LEAD hospitals. An HF radio site was established on-site or in the community for each disaster LEAD hospital and DOC.

Medical Emergency Radio Communications of State

The basis of the State medical communications system is the MERCI system. This system is a basic ambulance-to-hospital system and operates in the VHF band (155.340MHz, 155.160MHz, 155.400MHz, 155.280MHz and 155.220MHz) with voice-only, and in the UHF band (463.000/468.000MHz) with voice and biomedical telemetry on eight paired channels designated MEDS 1 through 8. All hospitals providing emergency care are required to have the ambulance-to- hospital channel. A hospital-to-hospital communications channel operates on 155.280MHz but, as State rules and regulations do not require this channel, its current status cannot be confirmed. Channel 155.220MHz is designated as a dispatch channel, 155.160MHz is the primary ambulance- to-hospital channel in the Edwardsville/Collinsville/Belleville area and 155.400MHz is used in the northeast corner of the state (north of Evanston) to protect the 155.340MHz channel in adjacent states. The balance of the state operates on 155.340MHz.

Approximately 2,000 State EMS providers use the MERCI ambulance-to-hospital system. Among these providers are ambulances, rescue units, nuclear response teams and various EMS coordinating agencies. Because access to the MERCI system cannot be selectively limited, it cannot easily be configured to provide the multi-agency command and control communications necessary in mass casualty disaster situations.

Radio Amateur Civil Emergency Service/Amateur Radio Emergency Services

In view of the anticipated overload of the MERCI system due to lack of an enforceable control mechanism and the limited availability of a common statewide public safety coordination channel, disaster LEAD hospitals may be required to initiate discussions with amateur radio organizations to support basic command and control communications during mass-casualty disasters. Due to the variety of operating channels and services available through amateur radio, and the fact that most these radio operators are skilled electronic technicians, their services can be readily configured to accommodate most local and regional radio communications needs. Another advantage of the amateur radio system is its long-distance capabilities, which may be used in the event of a failure of other statewide radio systems that use telephone lines to connect to a system of radio towers. In the long term, many amateur radio operators can accommodate transmission of fax, data and phone patch transmissions until commercial services are restored. As access to the amateur radio channels is restricted, the MERCI system is less likely to overload.

Attachment 7

MEDICAL MANAGEMENT SITE

This section deals with the actions that will be taken by the medical responders deployed to the staging area by the disaster LEAD hospital or by DOC. These actions include assistance with the triage of casualties, which should already be established by local authorities, and at the treatment/stabilization area and holding/counseling site, based on the magnitude of the disaster.

When notified by local authorities that medical assistance is needed at the disaster site, the Chief/Director, Division of EMS, will notify the on-call MERT. MERT will be deployed to the disaster site and report to the incident commander. The MERT members will assist with the triage and treatment of casualties.

ATTACHMENT 12

HOSPITAL MEDICAL BAGS

MINIMUM RECOMMENDED EQUIPMENT FOR DISASTER BAGS

(Two disaster bags minimum per medical team)

Intravenous Supplies/Drugs

8 1cc pre-filled Tubex Epinephrine 1:1000

4 1cc pre-filled Tubex Epinephrine 1:10,000

4 Pre-filled 50% Dextrose, 50cc

4 Naloxone (Narcan) 0.8 mg preload

6 Atropine Sulfate 1mg/10cc preload

4 Lidocaine 100mg/5cc preload

4 Regular drip IV tubing taped to I.V. solution containers

4 ea. Angiocaths (#22, 20, 18, 16, and 14)

4 ea. Jam Shidi Intraosseous needles (15)

4 Bags .9 normal saline, 1000cc each

5 TB syringes

5 Assorted syringes with needles

2 Disposable pressure infusers

Airway Equipment

2 Bulb syringe (may be used for suction)

2 ea. Oropharyngeal airways, adult (large, medium and small) and pediatric (child and infant)

2 Bag/valve/mask system, adult

2 Bag/valve/mask system, pediatric

1 NU-TRAKE cricothyrotomy device or equivalent

2 ea. #10 or #14 angiocath with 3.0 or 3.5 ET tube adapter

5 Adult non-rebreather masks

5 Pediatric non-rebreather masks

1 ea. Endotracheal tubes (sizes 3.0, 3.5, 4.0, 4.5, 5.0, and 5.5)

2 ea. Endotracheal tubes (sizes 6.0, 6.5, 7.0, 7.5, 8.0 and 8.5)

1 Endotracheal tube stylette

1 Laryngoscope handle

2 Batteries for laryngoscope handle

3 Laryngoscope blade bulbs (one for each blade)

1 ea. Straight or curved laryngoscope blades #3 and #4

1 ea. Straight pediatric laryngoscopte blades

#1 or #2

Dressings

3 Large ABD dressings

4 Eye shields

3 4" Ace bandage

3 6" Ace bandage

6 4" Rolls Kling

6 Kerlex

4 Rolls wet-proof tape, assorted sizes

4 bx. 4x4 sterile gauze pads (multi-use or single use)

1 bx. Medium size Vaseline gauze dressings

1 bx. Bandaids

Immobilization Equipment

2 Arm splints

2 Leg splints

2 ea. Arm slings (small, medium and large)

2 ea. Cervical collars (small, medium, large, and pediatric or equivalent)

2 ea. Arm boards (pediatric and adult)

Personal Protection Equipment

4 Paper isolation gowns

4 Protective face masks

4 Pair protective eye wear

1 ea. Box of non-sterile gloves (medium and large)

1 ea. Pair sterile gloves (sizes 6.5, 7.5 and 8.0)

Miscellaneous Supplies

1 ea. Sphygmomanometer and cuff (adult and child)

1 Stethoscope

1 bx. Box alcohol preps

4 Rubber tourniquets/IV starter kits

1 Large trauma scissors

5 Cold packs

5 Warm packs

20 Disaster Tags

5 Black markers or pens for Disaster Tags

1 Flashlight with batteries

2 Blankets

4 Sheets

2 Irrigating fluid (NS/water), 1 liter size

1 Sharps disposal system

2 Large red plastic hazardous waste bags

Attachment 8

TRANSPORTATION

This section describes the modes of transportation available to move medical resources and casualties to and from the disaster area and the procedure for their use during an emergency situation.

Use of Local Modes of Transportation

During emergency situations, if available, local modes of transportation will be utilized for the deployment of medical resources to the disaster site. The disaster LEAD hospital will advise the hospital(s) and EMS provider(s) where to send these resources upon activation by the DOC.

If transportation is not available for deployment of resources to the disaster site, the disaster LEAD hospital will initiate a request for the utilization of state transportation support through the DOC to the state EOC. The state EOC will recommend or provide a mode of transportation for the deployment of these resources.

When medical resources arrive at the disaster site, transportation requests will be initiated through the local incident command system (ICS). The DOC will verify all medical transportation requests originated by the local ICS to ensure coordination with the implementation of the Emergency Medical Disaster Plan.

State Ground Transportation Support

Immediately following a major emergency, SEMA and support agencies will take immediate action to identify, mobilize and deploy ground transportation resources. The state EOC will coordinate directly with IDOT officials to provide the assistance requested by state and local governments. Under a presidential declaration of a major disaster or emergency, DPH may coordinate with its federal counterparts when federal ground transportation assets are required.

State Aviation Support

During an emergency situation, IDOT s, AERO will send staff to the state EOC to serve as the air operations manager. It will be the responsibility of IDOT to coordinate and allocate resources, staging, logistics, intelligence, reporting and communications for disaster air support. Specifically, the primary responsibilities of the air operations manager as follows:

• Identify all aviation assets already committed to the response.

• Identify aviation assets available, but not yet committed.

• As necessary, identify and establish a forward staging area, and the associated logistical support necessary for operations.

• Brief state EOC on the status of air operations, including current missions, available aircraft by type, locations of staging areas and proposed priorities for aviation support.

• Respond to requests for aviation support from the state EOC.

Aeronautical resources for the medical response to emergency situations will come from a wide variety of both governmental and private sector sources. Under a presidential declaration of a major disaster or emergency, DPH may coordinate with its federal counterparts when federal aeronautical assets are required.

Attachment 9

GOOD SAMARITAN IMMUNITY

This section deals with the liability issue when resources of the disaster LEAD region are deployed by the DOC for emergency medical response operations. This section is applicable to the hospital(s) and EMS provider(s) who deploy personnel, MERT equipment and supplies upon the request of the DOC.

EMS Field Personnel Immunity

Civil Immunity for Persons Certified in CPR

Firefighter and Law Enforcement Officer Immunity

Physician and Nurse Immunity

Out-of-State Medical Assistance Immunity

Attachment 10

NATIONAL DISASTER MEDICAL SYSTEM

This section describes the policies and procedures for mobilizing and managing health and medical services under NDMS.

U.S. Department of Health and Human Services/United States Public Health Service

The United States government will provide coordinated assistance to supplement state and local resources in response to public health and medical care needs following a significant natural disaster or man-made event. Assistance provided under Emergency Support Function #8 - Health and Medical Services is directed by HHS through its executive agent, the assistant secretary for health, who heads the U.S. Public Health Service (USPHS). Resources will be furnished when state and local resources are overwhelmed and medical and/or public health assistance is requested from the federal government.

United States Public Health Service

The USPHS, in its primary agency role for Emergency Support Function #8 - Health and Medical Services, directs the provision of federal government provided health and medical assistance to fulfill the requirements identified by the affected state and/or local authorities. Included in Emergency Support Function #8 - Health and Medical Services is the overall public health response; the triage, treatment and transportation of victims of the disaster; and the evacuation of patients from the disaster area, as needed, into a network of military services, veterans affairs and pre-enrolled non-federal hospitals located in the major metropolitan areas of the United States.

National Disaster Medical System Overview

The National Disaster Medical System a cooperative effort of the federal, state and local government, and the private sector. It includes disaster medical assistance teams (DMATs) and clearing-staging units (CSUs) at the disaster site or receiving location, a medical evacuation system, and more than 100,000 precommitted non-federal acute care hospital beds in more than 1,500 hospitals throughout the country. NDMS does not replace state and local disaster planning efforts; rather it supplements and assists where state and local medical resources are overwhelmed and federal assistance is required.

The purpose of the NDMS is to have a single system designed to care for large numbers of casualties, either from a domestic disaster or overseas war. The premise of the NDMS is that no single city or state can be fully prepared for such catastrophic events. Although many of the nation s cities have adequate health resources, those resources would be overwhelmed by a sudden surge of disaster injuries proportional to the population. The health resources of most states would similarly be overtaxed. NDMS provides "mutual aid" to all parts of the nation and is able to handle the large numbers of patients that might result from a catastrophic incident.

NDMS is designed to fulfill three (3) system objectives:

To provide medical assistance to a disaster area in the form of DMATs and CSUs, and medical supplies and equipment;

To evacuate patients who cannot be cared for locally to designated locations throughout the United States; and

To provide hospitalization in a national network of medical care facilities that have agreed to accept patients.

Federal/State Integration of NDMS

Upon system activation, the NDMS operation support center will become operational and coordinate federal health and medical responses to the disaster. The operations support center includes representatives of HHS/USPHS, DOD, FEMA, VA, ARC and other federal and private agencies concerned with medical services and medical logistics. The operations center will work in cooperation with the federal catastrophic disaster response group, state emergency medical authorities and the federal coordinating officer responsible for overall management of federal response to the disaster. In State, the federal coordinating center is located at ________________________.

Attachment 11

NATIONAL PHARMACEUTICAL STOCKPILE PROGRAM

The purpose of the National Pharmaceutical Stockpile Program (NPSP) is to help minimize human suffering and loss of life due to terrorist attacks. The potential for terrorist attacks with chemical and biological weapons on the civilian population of the United States is considered by experts to be an increasingly real threat. The NPSP is designed to ensure the rapid deployment of life-saving pharmaceuticals, vaccines, medical supplies and equipment that public health and medical providers could use to treat and assist victims of a terrorist attack. The success of the NPSP will depend on elements of the state and local emergency response and public health infrastructure that will be on the "front lines" of any terrorist attack so that the stockpile program may be integrated into the foundation of the local response to terrorism.

The NPSP is a two-tiered response comprising of a 12-hour push package and a vendor-managed inventory (VMI) package. Once the NPSP is activated, technical advisers (for example, pharmacists, public health experts and emergency response specialists) will arrive ahead of the push packages to coordinate closely with the incident command structure within the state EOC. These technical advisers will maintain continuous contact with the CDC s NPSP operations center while the hand-off of the push package will be conducted in accordance with a state s medical disaster plan.

The 12-hour push package is ready for deployment to reach a designated airfield within 12 hours of federal activation. The push packages are pre-configured for rapid identification and ease of distribution. The VMI package will be shipped to arrive within 24- and 36-hour periods. The VMI packages consist of pharmaceuticals and supplies that are delivered from one or more manufacturer sources. The VMI will be tailored to provide specific material depending on the suspected or confirmed agent.

The 12-hour push package occupies 124 cargo containers and requires 5,000 square feet of ground/floor space for proper staging and management. Each push package can provide prophylactic treatment for 830,000 people for three (3) days or 350,000 for seven (7) days. Each push package can provide therapeutic treatment for 14,000 people for three (3) days or 6,000 people for seven (7) days. The push package is designed to be followed by VMI.

The state and local planning considerations will include distribution of the material from the designated airport to the scene or health care facilities, storage and handling of the materials, treatment protocols, and interagency communications utilizing the existing incident command system.

In order to activate this system, ____________________________________________________________.

State Department of Public Health

MEDICAL INCIDENT REPORT FORM

DPH Duty Officer Date/Time

Caller Information

Name

Title

Community/Municipality

Contact Information

Incident Commander Information

Name

Title

Contact Information

Staging Area

Address of incident _____________________________________________________________________

Type/Nature of Disaster(s)

Hazardous Material Involvement Yes No Type

Status of Local Medical Response Operations

Area(s) Affected (Include Location of Disaster Site(s), etc.)

Approximate Number of Casualties

Resources Needed (Specify Approximate Number of Each)

Medical Team (MERT)

Ambulances

Medical Supplies (Type)

TO BE COMPLETED BY THE DPH DUTY OFFICER AND KEPT FOR DPH RECORDS