february 25, 202020surge%20trainin… · why use the incident command system? burt schmitz msdh...
TRANSCRIPT
Oxford Conference Center102 Ed Perry BlvdOxford, MS 38655
Enhance your medical surge response capabilities.
Registration Starts: 8:30 A.M.Training: 9:00 A.M. - 4:30 P.M.
February 25, 2020
Healthcare Medical Surge
Burt SchmitzMSDH Emergency Planner
Objectives
• Define Medical Surge Capacity and Capabilities
o Identify Triggers
• Utilization of NIMS
• Identify Planning Assumptions
• Identify Appropriate Actions that will Improve Preparedness
• Benefits of surge management planning
Medical Surge
Medical Surge is the ability to provide adequate medical evaluation and care during events that exceed the limits of the normal medical infrastructure of an affected community.
Definition of Capacity and Capability
• Medical surge capacity refers to the ability to evaluate and care for a markedly increased volume of patients—one that challenges or exceeds normal operating capacity.
• Medical surge capability refers to the ability to manage patients requiring unusual or very specialized medical evaluation and care.
Why do we need medical surge training ?
• All potential situations demanding a surge response are unique. Incident specific surge plans should be included in your emergency operations plan to ensure preparedness.
• A high degree of internal self-sufficiency and self reliance is important in any surge event.
Why use the Incident Command System?
Burt SchmitzMSDH Emergency Planner
National Incident Management System
(NIMS)
• A consistent nationwide approach for all levels of government to work effectively and efficiently together to prepare for and respond to domestic incidents
• Core set of concepts, principles and terminology for incident command and multi-agency coordination
Homeland Security Presidential Directive 5
• Requires all Federal Departments and Agencies to adopt the NIMS and the NRP
• Requires state and local NIMS compliance as a condition for Federal preparedness assistance
NIMS Key Concepts
• Framework for interoperability and compatibility
• Flexibilityo Consistent, flexible, and adjustable national framework
o Applicable regardless of incident cause, size, location, or complexity.
• Standardizationo Standard organizational structures
o Key to interoperability
Key Components of ICS
ComprehensiveResource
Management
Pre-designatedIncidentFacilities
UnifiedCommandStructure
IncidentActionPlan
ManageableSpan-of-Control
Common Terminology
Modular organization
ICS Command and General Staff Titles
Incident Commander
Operations Section Chief
Planning Section Chief
Logistics Section Chief
Finance/Adm Section Chief
Safety Officer
Public Information
Officer
Liaison Officer
Command Staff:The Command Staff
provides Information,Safety, and Liaison services for the entire organization.
General Staff:The General Staff are assigned
functional authority for Operations, Planning,
Logistics, and Finance/Administration.
Training: Who needs to take what?
• IS-700 NIMS: An Introductiono All personnel with a direct role in emergency preparedness, incident
management, or response
• IS-800 NRP: An Introductiono All Federal, state, territorial, tribal, and local emergency managers or
personnel whose primary responsibility is emergency management
• ICS-100: Introduction to ICSo All Federal, State, territorial, tribal, local, private sector and non-
governmental personnel at the entry level, first line supervisor level, middle management level, and command and general staff level of emergency management operations
• ICS-200: Basic ICSo All Federal, State, territorial, tribal, local, private sector and non-
governmental personnel at the first line supervisor level, middle management level, and command and general staff level of emergency management operations
Use of NIMS for Resource Management
• Identifying and Typing Resources
• Certifying and Credentialing Personnel
• Inventorying Resources
• Identifying Resource Requirements
• Ordering and Acquiring Resources
• Mobilizing Resources
• Tracking and Reporting Resources
• Recovering Resources
• Communications
• Reimbursement
ICS Training
• The Emergency Management Institute (EMI) has several ICS-100 and ICS-200 level courses that can be taken online as interactive Web-courses. These course materials may also be downloaded and used in a group or classroom setting. Answer sheets may be obtained from the Emergency Management Institute by calling the EMI Independent Study Office at 301-447-1256. To complete the courses or download the course materials go to http://training.fema.gov/emiweb/IS/crslist.asp
ICS Training• ICS 100, 200, 300, and 400 level training equivalencies can
be met by following the guidance outlined in the NIMS National Standard Curriculum Training Development Guidance (October 2005).
• It is not necessary that the training requirements be met through a federal source. ICS training developed by state, local, and tribal agencies and private training vendors can “qualify” as NIMS compliant training if the training meets or exceeds the ICS objectives outlined in the NIMS National Standard Curriculum Training Development Guidance (October, 2005) and is adopted for use by the sponsoring training organization (i.e. State Emergency Management Agency, State Fire Training Academy, etc.).
NIMS Training GuidelinesEntry Level First Responders & Disaster Workers
Audience• Emergency Medical Service
Personnel
• Firefighters
• Healthcare Facility Staff
• Law Enforcement Personnel
• Public Health Personnel
• Public Works/Utility Personnel
• Skilled Support Personnel
• Other emergency management response, support, volunteers' personnel at all levels
Required Training
• FEMA IS-700: NIMS, An Introduction
• ICS-100: Introduction to ICS or equivalent
NIMS Training GuidelinesFirst Line Supervisors
Audience
• First line supervisors, single resource leaders, field supervisors, and other emergency management & response personnel that require a higher level of ICS/NIMS Training
Required Training
• FEMA IS-700: NIMS, An Introduction
• ICS-100: Introduction to ICS or equivalent
• ICS-200: Basic ICS or equivalent
NIMS Training GuidelinesMiddle Management
Audience
• Middle management including strike team leaders, task force leaders, division/group supervisors, branch directors, and multi-agency coordination system/emergency operations center staff.
Required Training• FEMA IS-700: NIMS, An Introduction• FEMA IS-800: NRP, An Introduction• ICS-100: Introduction to ICS or
equivalent• ICS-200: Basic ICS or equivalent• ICS-300: Intermediate ICS or
equivalent
NIMS Training GuidelinesCommand & General Staff
Audience
• Command and general staff, select department heads with multi-agency coordination system responsibilities, area commanders, emergency managers, and multi-agency coordination system/EOC managers.
Required Training
• FEMA IS-700: NIMS, An Introduction
• FEMA IS-800: NRP, An Introduction
• ICS-100: Introduction to ICS or equivalent
• ICS-200: Basic ICS or equivalent
• ICS-300: Intermediate ICS or equivalent
• ICS-400: Advanced ICS or equivalent
Interaction with Community Response Organizations
• Identify Roles and Responsibilities
• Common Terminology
• Resource Management
• Patient Tracking
• Communications
• Joint Exercises/Training
Resources you can use!
• Training Opportunities
• Forms
• Position Specific Job Aids
• HICS NHICS
• ASPR TRACIE
• NIMS Implementation Guide
• EMA / Healthcare Coalitions / LEPCs
Communications /MEHC / EEIs
Lillie BaileyMSDH Healthcare Coalition Coordinator
Communications: MEHCThe Mississippi Emergency Support Function 8 Healthcare Coalition
Mission StatementThe mission of the Mississippi Emergency Support Function 8 Healthcare Coalition (MEHC) is to reduce the burden of illness, injury, and loss of life in the event of an emergency or disaster through coordination and communication regarding emergency preparedness, mitigation, response, and recovery.
Communication is a vital part of any response!!
The MEHC helps to provide a two-way communication process for creating and sustaining a common operational picture
for all MEHC partners and their stakeholders.
Knowledge Center Incident management software
Helps to build a common operating picture during a critical event in order to save lives
and mitigate risk. Incident management technology platform that is a mission-ready. Provides wide visibility and interoperability from a comprehensive, integrated platform
with a single-sign-on.
• Access and share real-time bed data
• Save time and improve decision making
• Enhance patient care coordination
• Better utilize staffing resources
• Standard ICS/HICS forms
• SitReps and IAPs
• AARs, HSEEPs, Joint Commission 6 Critical Element Evaluations
• MS Point of Contact for KC Users – Jamie Wilson
Communications: KC
Essential Elements of InformationExamples of EEIs include, but are not limited to:
• Healthcare facility information• Healthcare facility operational status • Healthcare facility security status • Healthcare facility staffing availability • Emergency Department status • Bed availability• Location and medical needs of every home-bound
patient in an affected area • Availability of respirators and/or powered medical
supplies • Alternate means of power • Vehicles for patient movement • Identified health issues • Inventory of available counter measures • Strategic National Stockpile • Morgue operations
The need to have accurate information in
a timely manner is critical in making decisions during
disaster response.
Communications: EEI
Surge Capacity The ability to expand care capabilities in response to prolonged demand
• Potential patients' beds
• Transportation
• Available space for:o Triage
o Incident Command / EOC
o Patient Management
o Volunteer Management
o Vaccinations
o Decontamination
o Medications, supplies and equipment
o Security
o Traffic flow
Lillie Bailey
Supply Chain
Christy HooverMSDH Emergency Planner
Developing and Maintaining Resources
• What is needed?
• Food, Water, Fuel, Critical Supplies (medical, laboratory), Medication, Oxygen/Medical Gas, Transportation, Others
• What can you not do without?
Developing and Maintaining Relationships
• Who do you need relationships with?
• Emergency Management, Fire Department, Law Enforcement
• Think outside of the boxo Neighboring Facilities & Transport Agencies
(Church vans, tour buses, school buses, etc.)
o Medical/Urgent Care Clinics
o Home Health/Hospice Agencies
o Local businesses (Wal-Mart, Dollar General, Walgreens, etc.)
o Places of Worship
o Community Centers
o Electric & Water Companies/Cooperatives
Supply Chain Integrity
• Definition of Integrity
o The condition of being unified, unimpaired, or sound in construction.
• Definition of Resilience
o The capability to recover quickly from difficulties; toughness.
Supply Chain Resilience
Supply chain resilience is the ability of a network, or portion of a network, to continue moving goods and services even when important elements of the network are no longer operating. For example, the continued flow of water, food, and fuel while the electric power grid is not operational.
Supply Chain Resilience Guide
Supply Chain Integrity
Issues• Equipment/Power Failure(s)/Communication Loss
• Loss of Facility Capability
• Staff Shortages
• Loss of Supplies
• What happens when your first supplier is unavailable?
• Shortage due to compromised/contaminated supplieso Saline
o Drug shortages/recalls
o Flu Vaccine
Supply Chain Integrity
• Developing and Maintaining Supply Chain Integrity
• Prioritizing supplies/resources
• Do you have a 72-hour supply?
• Complex Emergencies – what if you run out sooner
than expected?
• Backup plano Orders of Succession
What is EMS?
Alisa WilliamsMississippi Director of EMS
Steven JonesState EMS Director of Education and Certification
Introduction
The EMS system is constantly evolving.
• Originally, the primary role was transportation.
• Today it provides advanced medical care. © Mark C. Ide
Introduction cont…
The public’s perception is based on:
• TV and articles
• Treatment of theirloved ones
The History of EMS
1485’s• First use of an ambulance
• Transport only
1926’s• Service started similar to
present day
1800’s• First use of ambulance/
attendant to care for injuries on site
1940’s• EMS turned over to fire
and police departments
• No standards set
The 20th Century and Modern Technology
EMS made major strides after WWII.
• Bringing hospital to field gave patients a better chance for survival
• Korean War
o First use of a helicopter
o M*A*S*H units
The 20th Century and Modern Technology
• 1965: “The White Paper” releasedo “The White Paper” findings outlined 10 critical points for EMS
system
Led to National Highway Safety Act
Created US Department of Transportation
• 1968o Training standards implemented
o 9-1-1 created
The 20th Century and Modern Technology
• 1969o First true paramedic
program
o Standards for ambulance design and equipment
• 1970so NREMT began Courtesy of Eugene L. Nagel and the Miami Fire Department
The 20th Century and Modern Technology
• 1970s (cont’d)
o 1971: Emergency Care and Transportation of the Sick and Injured published by the AAOS
o 1973: Emergency Medical Services System Act
o 1974: Mississippi Emergency Medical Services System Act
o 1977: First National Standard Curriculum for Paramedics developed by US DOT
The 20th Century and Modern Technology
• 1980s/1990so Number of trained personnel grew
o NHTSA developed 10 system elements to help sustain EMS system
o Responsibility for EMS transferred to the states
o Major legislative initiatives
Licensure, Certification, and Registration
• Certification examination:
o Ensures all health care providers have the same basic level of knowledge and skill.
• Licensure:
o How states control who practices
o Also known as certification or credentialing
o Unlawful to practice without licensure
Levels of Education
EMS system functions from a federal to local level
• Federal: National EMS Scope of Practice Model
• State: Licensure
• Local: Medical director decides day-to-day limits
Emergency Medical Responder (EMR)
• Formerly “first responder”
• Requirements vary by state
• Should be able to:
o Recognize seriousness of condition.
o Provide basic care.
o Relay information.
© Matt Dunham/AP Photosages
EMT
• Primary provider level in many EMS systems
• EMT certification precedes paramedic education
• Most populous level in the system
© A
man
da H
erro
n, T
he Ja
ckso
n Su
n/AP
Pho
tos
Advanced EMT (AEMT)
• Formerly EMT-I
• Initially developed in 1985
o Major revision in 1999
• Trained in:
o More advanced pathophysiology
o Some advanced procedures
• Highest level to be nationally certifiedo 1999: Major revisions to curriculum
greatly increased level of training and skills
• Even if independently licensed, you must:o Function under guidance of
physicians.
o Be affiliated with a paramedic-level service.
Paramedic
Lillie Bailey
Medical Direction
• Paramedics carry out advanced skillso Must take direction from medical directors
• Medical directors may perform many roles:o Educate and train
o Recommend new personnel or equipment
o Develop protocols, guidelines, and quality improvement programs
Roles of the medical director (cont’d):
• Provide input for patient care
• Interface between EMS and other agencies
• Advocate for EMS
• Serve as “medical conscience”
Medical Direction
Medical DirectionMedical directors also provide online and off-line medical control.
Online• Provides immediate and
specific patient care resources
• Allows for continuous quality improvement
• Can render on-scene assistance
Offline• Allows for the
development of:
o Protocols or guidelines
o Standing orders
o Procedures
o Training
Evidence-Based Practice
• Care should focus on procedures that have proven useful in improving patient outcomes.
o Evidence-based practice has a growing role in EMS.
• Mississippi utilizes this model.
• Research determines the effectiveness of treatment.
o Can help identify which procedures, medications, and treatments do and do not work
• What is EMS in Mississippi?
By the Numbers
EMS Personnel
• MFR – 15
• EMT – 2,063
• AEMT – 15
• Paramedics – 1,679
• Critical Care - 32
By the Numbers
EMS Services
• Air - 33
• ALS - 46
• BLS - 5
• Invalid - 1
By the Numbers
EMS by county• Rural Area
o 1-2 ambulances
• Urban Areao 15-20 ambulances
911: Send an Ambulance!What to do in Med Surge situation?
• Call local ambulance service and advise of situation.• Local service may have limited resources even with
mutual aid.
Steps to ask for more resources• EMS or Facility contact
EMA Director• EMA will contact MEMA• MEMA will contact
State EMS to obtain and deploy additional resources.
What we do to help• Coordinating resources• Assisting with evacuation of facility on request.
• Ambulance corps were developed during World Wars I and II to transport and rapidly care for soldiers.
• Helicopters were used to rapidly remove soldiers from the battlefield during the Korean and Vietnam Wars.
SUMMARY
• In 1966 the National Academy of Science and the National Research Council released “The White Paper” outlining 10 points.
o The National Highway Safety Act and the US Department of Transportation were created as a result.
• EMS Personnel must be licensed (also known as certification or credentialing) before performing any functions.
SUMMARY
• Standards for prehospital emergency care, and the people who provide it, are regulated under state law by a state office of EMS.
• There are four levels of training: emergency medical responder, emergency medical technician, advanced emergency medical technician, and paramedic.
SUMMARY
• A physician medical director authorizes EMS providers to provide care in the field through off-line or online medical direction.
o Standing orders or protocols
• Some of the primary ems responsibilities include preparation, response, scene management, patient assessment and care, management and disposition, patient transfer and report, documentation, and return to service.
SUMMARY
Triage
Alisa WilliamsMississippi Director of EMS
Steven JonesState EMS Director of Education and Certification
What is Triage?
• French verb trier
• To sieve / to sort
• Medically:
o The process of applying medical priority based on needs, available resources, and situation
o Assign priority when resources limited
o Someone has to go last
What is a Mass Casualty Incident?
• A MCI is any incident in which emergency medical services resources, such as personnel and equipment, are overwhelmed by the number and severity of casualties.
What is a Disaster?
Needs > Resources = Disaster
When the need for resources is (or is anticipated to be) greater than the
resources available, you have a disaster.
Situation
Day-to-day emergencies• The greatest good for each
individual patient
Disasters/Mass Casualty• The greatest good for the
greatest number of potential survivors
Available Resources
Do we have enough?• Medical supplies &
equipment
• Trained medical personnel
• Transportation
• Beds available at definitive care centers
Needs
• Lifesaving interventions
• Casualties greater than available resources
• Scene hazards (austere environments)
• Incident command
• Communication
• Multi-jurisdictional/multi-agency response
General Principles of Mass Casualty Triage
• Separate-those requiring minimal or no treatment and get them to safety
• Treat first-those most seriously injured who have a reasonable possibility of survival
• Treat last-those who have the lease severe illnesses or injuries or are very unlikely to survive
General Concepts of Mass Casualty Triage
Mass Casualty Triage• Systematic method
• Organization of casualties
• Begins on the scene
• Continues throughout incident until the last patient treated at hospital
Mass Casualty Triage Decision Making Encompasses:
• Presence of life-, limb, or vision threatening condition
• Available lifesaving interventions
• Availability of transportation assets
Triage toolsIntended use:
• Hospital vs. Pre-hospital
• Day-to-day vs. MCI
• Trauma vs. Other
• Adult vs. Child
Types:• Tags
• Tape
• Tarps
• Flags
What’s Unique About Disaster Triage?
Needs > available resources
• Number of patients
• Life Saving Interventions (LSI)
• Spinal immobilization
• Extended extrication
• Entrapment
• Specialized rescue
S-A-L-T Triage
• New National Standard
• Evidenced Based
• A non-proprietary free system, was developed from available research, widely accepted best practices of existing mass triage systems, and consensus opinion from the workgroup.
AND it looks like this…
And this…..
And this.
S-A-L-T TriageSort – Assess – Life Saving Interventions –
Treatment/Transport
• Simple
• Easy to remember
• Groups large numbers of patients together quickly (15 seconds vs. 60 seconds with START)
• Applies rapid life-saving interventions early
85
SALT/MCI General Principles
• Move as quickly as possible
• Begin transports of red patients as soon as feasible
• REMEMBER: don’t neglect other MCI processes (Command, Communication, etc.)
SALT Triage Methodology
• Global Sorting
• Individual Assessment
• Life Saving Interventions
o Control major hemorrhage
o Open airway (if child, consider 2 rescue breaths)
o Chest decompression
o Auto-injector antidotes
• Treatment / Transport
SALT Mass Casualty Triage
Step 1 – Sort:Global Sorting
WalkAssess 3rd
Wave/Purposeful MovementAssess 2nd
Still/Obvious Life ThreatAssess 1st
Step 2 – Assess:Individual Assessment
LSI*– Control major hemorrhage– Open airway (if child,
consider 2 rescue breaths)– Chest decompression– Autoinjector antidotes
Breathing
– Obeys commands or makes purposeful movement?
– Has peripheral pulse?– Not in respiratory distress?– Major hemorrhage in control?
Minor injuries only?
MinimalDelayed
Yes
No
All YesYes
DeadNo
Likely to survivegiven current resources
No
Expectant
ImmediateYes
No*LSI: Lifesaving Interventions
SALT TriageStep 1: Global Sorting
Global SortingIf you can walk, get up and go to _____ = Assess 3rd
If you cannot walk, wave your arm or leg = Assess 2nd
If not compliant with either, possible life threat = Assess 1st
Rapidly identify most at-risk by sorting into groups!
Limitations: Many… hearing, language, fear, injured family…
L S I *– Control major hemorrhage– Open airway (if child,
consider 2 rescue breaths)– Chest decompression– Autoinjector antidotes
Breathing?
– Obeys commands or makes purposeful movement?
– Has peripheral pulse?– Not in respiratory distress?– Major hemorrhage in control?
Minor injuries only?
Minimal
Delayed
Yes
No
Yes
DeadNo
Likely to survivegiven current
resources?
No
Expectant
ImmediateNo
*LSI = lifesaving interventions
AllYes
SALT TriageStep 2: Individual Assessment
Yes
Individual Assessment What can I do?
Lifesaving interventionsControl major hemorrhage
Open airway
Decompress chest
Autoinjector antidotes
Casualties overwhelm available resources
Goal of disaster triage: Do the greatest good for the greatest number of
potential survivors
IMMEDIATE DELAYED MINIMAL DEADEXPECTANTI D M E
Individual Assessment Triage Category Assignment
Response to interventionsBreathing?
Responds to commands?
Peripheral pulse?
Respiratory distress?
Bleeding stopped?
Individual Assessment Triage Category Assignment
ImmediateRequires immediate care for a good probability of survival
DelayedRequires care that can be safely delayed without affecting probability of survival
MinimalSick or injured but expected to survive with or without care
ExpectantAlive, but with little or no chance of survival given current available resources
Dead A fatality with no intrinsic respiratory drive
IMMEDIATE
Highest priority of casualties to receive care• Immediate, life-threatening conditions
• Require immediate management in order to survive
• Response to lifesaving interventions:
o Any NO answer + resources are available
DELAYED
Require prompt medical attention for survival
• Condition can tolerate a short delay in treatment
• Expected to survive despite that short delay
• Response to lifesaving interventions: o All YES answers + does need access to additional or definitive
health care
MINIMAL
• Minor injuries or illnesses
• Expected to survive even if medical treatment not received
• Response to lifesaving interventions:
o All YES answers + does NOT need access to additional or definitive health care
EXPECTANT
Casualties with low probability of survival
• Not expected to survive given available medical resources
• Response to lifesaving interventions:
o Any NO answer + resources are NOT available
DEAD
Casualties with complete absence of life• Not breathing after basic airway-opening maneuvers, including two
rescue breaths if a child
• Attempt basic life-sustaining efforts only if sufficient personnel available
• It is important to NOT move dead casualties, unless the remains are blocking access to live casualties
Do NOT relocate the disaster to the hospital!!
Triage Tag CharacteristicsTwo Sided Basic Components:
• Tear off sections
• Main Body
o Patient information
o Patient vital signs
o Patient treatments
o Special Fields
o Triage aides
• Tracking Number
TRANSPORT, TRANSPORT, TRANSPORT
1st EMS transport unit(s) arrives on sceneSets up Triage & Treatment
Subsequent EMS transport unit(s)load and go!
Move – Move – Move those RED patients
Patient Tracking
In a rapidly evolving incident, critical Red Tag patients may bypass Treatment Area and be
taken directly to Transport.
AMBUS
AMBUS is a mass casualty transport system for hurricanes and other disasters
• No-Notice (Permanent): A permanently installed AmbuBus Kit that allows a mass transit vehicle to be converted into a turnkey mass casualty transport system for earthquakes and other no-notice disasters.
• On-Demand (Temporary): A temporarily installed AmbuBus Kit that allows for the use of an everyday vehicle to be converted on-demand into a mass casualty transport system for hurricanes and other disasters.
AMBUS
Mississippi Ambulance Bus (AmBus)Mass Evacuation Transport Program
Mississippi MEDCOM
Mississippi MEDCOM
Mississippi MED-COM is designed to function as a service to the emergency response agencies, hospitals and first responders of Mississippi. The communications center is located on the campus of the University of Mississippi Medical Center and serves many functions.
Mississippi MEDCOM
• Provides a point of contact for referring providers statewide to facilitate timely acceptance of their critical patients. Mississippi MED-COM also assist hospitals in arranging out-of-state transport of burn patients to burn centers
• Acts as the access point to Medical Control physicians for those EMS agencies that have Medical Control through UMMC.
Mississippi MEDCOMMED-COM Communications:• Averages 6,000 calls for assistance a month and provides a
single point of contact for almost 1,000 emergency transfers into the University of Mississippi Medical center and other tertiary care facilities in Mississippi and neighboring states.
• Strategically placed emergency direct dial phones across the state in hospitals and dispatch centers for use with day-to-day operations as well as for disaster support situations.
• Monitors radio frequencies for fire departments and law enforcement agencies in the regional area around University of Mississippi Medical Center. This enables the first responders to have ready access to UMHC's AirCare 1,2,3 and 4
Recovery Planning
Lillie BaileyMSDH Healthcare Coalition Coordinator
Recovery Planning
Picking up the pieces
Recovery planning piece is as essential as planning for the response
• Safely continue care provided to the community
• Help in maintaining financial viability
• Caring and retaining staff
Lillie Bailey
Checklist Ideas for Recovery Planning:
• Access
• Buildings
• Communications(Internal & External)
• Dialysis
• Dietary
• Electrical Systems
• Emergency Department
• Equipment/Supplies
• Facility Maintenance
• Infection Control
Checklist Ideas for Recovery Planning:
• Medical Records/IT
• Laboratory
• Management Staff
• Morgue
• Sterile Procedures Support Systems
• Surgical Services
• Vendors
• Waste Management
• Water Systems
Lessons Learned
Coronavirus 2019-nCoV
MSDH Interim Guidance for Assessing a Person Under Investigation (as of 1/31/2020)
• Identify
• Isolate
• Call
