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Emergency Preparedness Study Guide

by: Jordan Wawrzyniak

Emergency Preparedness Study Guide H455

Marketplace > H455 > Emergency Preparedness Study Guide
Jordan Wawrzyniak
GPA 3.75
Natural Disaster and Emergency Preparedness
Professor Vandeventer

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About this Document

Notes on Community and Hospital Preparedness methods and protocols in times of a disaster or emergency
Natural Disaster and Emergency Preparedness
Professor Vandeventer
Study Guide
emergency, Study Guide, hospital, disaster, community, Planning, Mass prophylaxis
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This 10 page Study Guide was uploaded by Jordan Wawrzyniak on Monday January 26, 2015. The Study Guide belongs to H455 at a university taught by Professor Vandeventer in Fall. Since its upload, it has received 244 views.


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Date Created: 01/26/15
H455 Study Guide Exam 2 Pandemic in uenza In uenza types precautionsisolation A pandemic occurs when a novel or new in uenza type virus emerges and begins to spread easily though the human population In uenza A viruses have the potential to cause pandemics It is estimated that a pandemic will last 68 weeks 0 Types 0 Type A lnfects humans and animals 0 Birds are the most natural hosts Viruses are divided into subtypes based on their surface proteins 0 Haemagglutinin HA 15 known types 0 Neuraminidase NA 9 known types Most severe 0 Type B lnfects humans only Less severe 0 Type C Mostly asymptomatic infection Precautions 0 State and local responsibilities Develop state and local plans Assist healthcare facilities conduct exercises Develop communications for timely dissemination of information between hospitals and public health Address legal issues Education for staff Patient triage Facility access plan Occupational Health plan for employees when ill Vaccine and antiviral prophylaxix plan Surge Bed Capacity Mutual Aid Agreements Stockpile of supplies Postmortem Plan 0 Hospital responsibilities Develop planning and decision making structures for responding to pan u Develop written plans Surveillance Communications education Vaccinesmass prophy clinic Surge capacity 0 Supply chain Mortuary issues 0 Infection Control Measures Vaccination chemoprophylaxis hand hygiene universal precautionsbody substance isolation standard precautions Droplet Precautions gown glove N95 mask vs surgical mass N95 mask if aerosol generating procedures intubation bronch suction resp tx 0 Isolation Restriction of ill visitors healthy visitors healthcare workers 0 Visitor guidelines during an outbreak 0 Screen for signssymptoms of in uenza prior to entry o If exposed must wear a mask 0 Limit visitors 0 Instruct visitors on hand hygiene practices Altered standards of care May need to be implemented during an event A shift to providing care and allocation of scarce equipment supplies and personnel in a way that saves the largest number of lives Mitigation 3 steps strategies Preparedness Response and Recovery Mitigation 3 steps and strategies 0 1 Hazard identi cation identify every possible emergency events that could occur in the community make a list of the disasters 0 natural hurricanes tornadoes ood etc technological disrupts public service utility failure gassteamfuel transportation trainssubway human intentional and unintentional acts civil distrubances hostage bomb threats VIP situations chemical spills biologicalradiological threats 0 2 Hazard Vulnerability Analysis HVA Identify direct and indirect effects hazards may have on the hosptal Based on probability and magnitude of hazards Resource allocations hospital39s capacity such as of beds ventilators decon suits training staff For pro tability consider geography weather variations demographics endemicseasonal patterns businesses landmarks high pro le events For magnitude consider human property and business impact 0 3 Emergency Operations Plan EOP a written document that describes how a hospital will quotbehavequot during an event brings all hospital services together to focus on onethe incident 4 key issues in plan 0 1 Life Safety 0 2 Property Protection 0 3 Continuity of Operations 0 4 Environmental protection 0 Strategies Aterthe hazard modify the hazard involves eliminating or reducing the frequency of occurrence 0 Ex Stabilize stream banks to prevent continued erosion to prevent ooding Avertthe hazard redirecting the impact away from a vulnerable location by using structural devices or land treatment 0 Ex Build dams to prevent ooding Adaptto the hazard modify structures and alter designs of structures 0 Ex Building standards to withstand high winds earthquakes etc Avoid the hazard keep people away from the hazard area or limit development in risk area 0 Ex Don t allow business or residential building in ood areas Preparedness Phase 2 0 Activities actions training planning done to increase response to identi ed hazards in the community 0 Incident Command Incident Command System ICS 5 management sectors for ICS Command responsibilities are designed to develop direct and maintain a viable organization and to coordinate with other entities Highest authority lies with the incident commander Operations identi es the doers in the organization where the real work is done operations carries out the directions of the command center 0 Planning provides past present and future information abou the incident O O 0 Logistics identi es and obtains all personnel equipment supplies and services needed for the incident 0 Finance staff responsible for nancial management and accountability of the incident lncident command provides an authority structure and job descriptions designed for hospitals lnteragency coordination Hospitals must work seamlessly with local govt of cials emergency managers law enforcement rerescue EMS public health and others 0 Mutual aid agreements must be obtained with other facilities Preparedness is all about PLANNING Being ready to react promptly and effectively in the event of an emergency Having a plan of action before event occurs Utilize HVA to prioritize planning What bad things can happen How likely are they to occur How bad could they be Risk Assessment what39s in your community How vulnerable are People aged children nonEnglish speaking individuals disabilities Institution schools hospitals prison group homes Property vital facilities 0 Transportation systems hospitals utilities dams residences stores and warehouses businessgovt farm crops malls schools prisons universities Once you39ve identi ed the risks conduct an inventory of your resources Local Private Sector Nearby citydistrict Statement govt Equipment people generators shelters dump trucks rescue vehicles search and rescue teams HAM operators community facilities etc Response Phase 3 when you implement your ICS O Mobilization of resources to meet the needs of the community in response to an event Response begins with recognition 1St priority in a terrorism attack is to secure the hospital and to protect personnel patients and visitors Establish sites for victim reception and identi cation The Incident Commander performs all major ICS command and staff responsibilities unless the ICS functions are delegated and assigned O Command staff it may be necessary for the Incident commander to designate a Command Staff who 0 Provide Info and safety services for the entire org 0 Report directly to the Incident Commander Operations Section Directs and coordinates all incident tactical operations o Is typically one of the 1St organizations to be assigned to the incident Expands from the bottom up Has the most incident resources May have Staging Areas and special organizations Branches 0 Established if the of Divisions or Groups exceeds the span of control 0 Have functional or geographical responsibility for major parts of incident operations 0 Identi ed by roman numerals or functional name 0 Managed by a branch director Planning Section Maintains resources status and situation status prepares the incident action plan develops alternative strategies prepares the demobilization plan provides a primary location for Technical Specialists assigned to an incident Logistics Section Responsible for o Communicatins 0 Medical Support to incident personnel 0 Supplies and facilities ground support FinanceAdministration Section 0 Contract negotiation and monitoring Timekeeping Cost analysis 0 Compensation for injury or damage to property See slides for hospital response detais Response ef cient disaster response depends an organized and prepared govt preplanning and practice are key to successfully dealing with a disaster must be effective communication among community39s policy makers and all response agencies Recovery 0 Returning the community to its preevent statuscondition o Shortterm Restoration of vital services and facilities to minimum stands of operation and safety Ex sheltering feeding life comforting efforts 0 Longterm May continue for months or years Community returns to preemergency conditions Ex debris clearance contamination control disaster unemployment assistance temporary housing and facility restoration HVA Identi es potential threats risk and emergencies Formal assessment Allhazards approach planning for any type of emergency Plan to target your resources where the risk is greatest Not if but quotwhenquot a disaster happens mentality is necessary Compile a list of potential hazards can do a risk assessment for any issue ex Infection control safety etc Purpose of HVA o A prioritization process that result in a risk assessment for quotall hazards o The tool includes consideration of multiple factors 0 The focus is on organization planning and resources andor the determine that no action may be required This is an organization decision Process 0 Identify potential hazards 0 Determine the likelihood of occurrence 0 Severity factor if the event occurs what is the impact on the community lives lost 0 Gap analysis determine incidents the community is not prepared 0 Determine probability What are the chances the event will occur Consider geography weather variations demographics endemicseasonal patterns businesses landmarks high pro le events 0 Determine severity What impact will the event have on the community Consider human property and business impact 0 Gap analysis What are the highest risk events What are the issues associated with the events Are you prepared for these events What additional preparedness activities do you need to do for these events H Community Community 0 A social group of any size whose members reside in a speci c locality share government and often have a common cultural and historical heritage Functional community associations are required by groups of people living together within a speci c geographical area Structural community types of interconnectedness that individuals choose to make with one another such as through social organizations Key stakeholders in the community 0 Public safety and security public works bridges damns transportation schoolscollegesuniversities housing agencies health care providers private industry etc 0 These stakeholders must collaborate and quotde ne the communityquot for the purposes of emergency management and planning 0 Collaboration ensures that the scope of services provided and the populations served by each entity are well understood Geographical factors 0 Communities are de ned as village town county parish 0 Geography is signi cant in access to essential services however essential services such as re EMS law enforcement schools utilities etc do not necessarily conform to the same geopolitical bounda es Planning strategies 0 Build the team on existing relationships 0 There are natural linkages that already exist in a community re law enforcement public health hospital EMS etc Planning partners who should be at the quothospitalquot table 0 Director of ED Administration Infection Control Plant Operations Community Relations Ambulatory Care EMS Home Health Planning partners what outside partners should be at the table 0 Local health department EMA Fire department EMS and Others such as Red crossHome CareRural Health ClinicCitizen Corplocal govtetc Emergency Support Functions 0 ESF 1 transportation ESF 2 Communication ESF 3 Public Works and Engineering ESF 4 Fire ghting ESF 5 Emergency Management ESF 6 Mass Care Housing and Human Services ESF 7 Resource ESF 8 Public Health and Medical Services ESF 9 Urban Search and Rescue ESF 10 Oil and Hazardous Materials ESF 11 Agriculture and Natural Resources ESF 12 Energy ESF 13 Public Safety and Security ESF 14 LongTerm Community Recovery and Mitigation ESF 15 External Affairs Develop the Integrated Plan OOOOOOOOOOOOOO o The plan should be designed to meet the needs of the community based on its HVA must be realistic small vs large community plans very different and is a living document and must be routinely updated 0 Plan should include direction and control communication warning emergency public info education mass care health and medical services resource management Mass Prophylaxis Certain public health situations may necessitate prophylaxis to a large number of people in a short time frame to prevent transmission of illness Some examples of when phrophy is needed 0 Measles smallpox pandemic in uenza u bacterial meningitis in a crowded setting case of hepatitus A in a food handler bioterrorism event Mass prophy requires collaboration and communication among several entities to provide rapid effective intervention Phase 1 Deciding to provide mass prophy 0 Has the agent been con rmed o Is there a potential for further exposure 0 Are pharmaceuticals available Phase 2 Conducting a mass prophy clinic 0 Planning a clinic 0 Conducting a clinic 1 Form clinic team 2 Transport pharmaceuticals and supplies 3 Distribute info sheets 4 Set up clinic layout 5 Maintain security 6 Distribute clinic info 7 Maintain communication 8 Monitor pharmaceutical supply Phase Three Resolving the Crisis 0 Compile total expenditures Maintain active surveillance Keep media informed Assess Success and challenges of the clinic Document the event 0000 Syndromic Surveillance Goals 0 1 Monitoring symptoms in a population early detection of disease outbreaks o 2 Timely public health response Types 0 PHESS Public Health Emergency Surveillance System a system for gathering data and alerting communities Statewide infrastructure electronically transfers and analyses hospital and other health care data for 0 Near realtime continual syndromic surveillance for o The early detection of 1 Disease outbreaks 2 Other public health emergencies 3 Terrorism 0 ESSENCE Electronic Surveillance System for Early Noti cation of Communitybased Epidemics a tool for analyzing data for unusual events How it works 0 1 ED patient chief complaints and basic demographic information captured amp sent to Regenstrief Institute IUSM Indianapolis 0 2 Regenstrief processes batches and sends data to lSDH every three hours 0 3 lSDH ESSENCE server codes chief complaints for key syndromes and runs outbreak detection algorithms 0 4 ESSENCE output monitored by lSDH for signi cant changes in case volume or syndrome clusters by area and timeframe 8 Prede ned Syndromes Botulismlike fever gastrointestinal GI Hemorrhagic illness HI Neurological Rash Respiratory ShockComa Syndromes are de ned by chief complaints 0 GI abdominal pain nausea vomiting diarrhea 0 HI feverchills plus acute blood abnormalities 0 Other 0 About 70 of ED cases do not fall into any syndrome 0 Data on these cases is in ESSENCE for custom que es 0 These cases include trauma injuries and other complaints Advantages Leverages data already collected for routine care Timely data are made available to facilities local and state authorities with no additional provider effort 0 May reassure public in highpro le incidents Adaptable to other ED and PH planning uses Customized ESSENCE Use 0 Users can de ne their own quotsyndromesquot and save speci c queries to run anytime Examples asthmarelated symptoms injuries burnsfallsetc heatrelated ED visits o HIPPA protectionpatient privacy is maintained on all PHESS and ESSENCE servers NlMslncident Command System positions and responsibilities Incident Command provides an authority structure and job descriptions designed for hospitals 0 Incident command system ICS o 5 management sectors for ICS Command responsibilities are designed to develop direct and maintain a viable organization and to coordinate with other entities Highest authority lies with the incident commander Operations identi es the doers in the organization Where the real work is done Operations carries out the directions of the command sector Planning provides past present and future information about the incident Logistics identi es and obtains all personnel equipment supplies and services needed for the incident Finance staff responsible for nancial management and accountability of the incident


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