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Calaveras County

Alternate Care Site Plan

Site Set-up Teams/ Bin Lists

&

Transport/ Delivery Task List

Prepared by: Douglas Buchanan

Emergency Preparedness Consultant

www.DisasterDoug.com

(Revised: 01/17/11)

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Table of Contents

A. ACS Setup Team A (Red Team): Peds, Nursing, Pharmacy, Isolation................................. page 3

B. ACS Setup Team B (White Team): Womens, Mens Units……………………………………………… page 4

C. ACS Setup Team C (Blue Team): Laboratory, Supply, Radiology Areas ………………………… page 5

D. ACS Supply Team D: Bedding / Pt. Supplies …………………………………………………….……………. page 6

E. ACS Supply Team E: Nursing Unit ………………………..………………………………………….……………. page 7

F. ACS Supply Team F: Pharmacy Unit ………………………..……………………………………….……………. page 9

G. ACS Supply Team G: Laboratory Unit ……………………………………………………………………………. page 11

H. ACS Supply Team H: Supply Unit ……………..……………………………………………………………………. page 12

I. ACS Supply Team I: Radiology Unit ……………………..………………………………………………………. page 15

J. ACS Transportation & Delivery Task List ………………………………………………………………………. Page 16

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ACS Setup Team A (Red Team): Peds, Nursing, Pharm., Iso

Personnel Quantity Needed Quantity On Hand 4

Team Leader: Unit Equipment/Supplies Needs Quantity Needed Quantity On Hand Unit Signage

• Isolation • Pediatrics • Nurse’s Station • Pharmacy Station

1 ea 1 ea 1 ea 1 ea

Unit Specific Diagrams • Isolation • Pediatrics • Nurse’s Station • Pharmacy Station

4 ea 4 ea 4 ea 4 ea

J.A.S. 4 Beds (or cots) 10 Partitions 10 Side Tables/TV Trays 10 IV Poles 10 Painters Tape 2 Rolls Rope

• 4’ • 7’

2 ea

Measuring Tape 1 Tables 6 Chairs 10 Hand Washing Stations 2 Refrigerator (nurse unit / pharm unit) 2 Trash Can 2 Biohazard Waste Disposal 1 Soiled Linen Bin 2 Isolation Cart 1

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ACS Setup Team B (White Team): Womens / Mens



• Women • Men

1 ea 1 ea

Unit Specific Diagrams • Women • Men

1

J.A.S. 4 Beds 40 Partitions 6 Side Tables/TV Trays 40 IV Poles 40 Painters Tape 2 Rolls Rope

• 100’ • 20’

2 ea

Hand Washing Stations 1 Trash Cans 4 Biohazard Waste Disposal 2 Soiled Linen Bin 4

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ACS Setup Team C (Blue Team): Lab, Supply, Radiology



• Radiology • Supplies • Laboratory

1 ea 1 ea 1 ea

Unit Specific Diagrams • Radiology • Supplies • Laboratory

1

J.A.S. 4 Partitions 8 Supply Shelving Units 6 Painters Tape 2 Rolls Rope

• 4’ • 7’

2 ea

Tables 8 Chairs 4 Hand Washing Stations 1 Clean Linen Cart 1 Refrigerator (lab unit) Trash Cans 2

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ACS Setup Team D: Bedding/Pt Supplies Team Leader:

Personnel Quantity Needed Quantity On Hand Setup: Iso, Peds 2

Setup: Mens 2

Setup: Womens 2

Team Leader 1

Unit Equipment/Supplies Needs Quantity Needed Quantity On Hand J.A.S 7 Diagrams

• Bedding set-up/supplies diagram 7

Bedding (Linen) • Fitted Sheets • Flat Sheets • Blankets • Pillow Cases • Pillows • Gowns • Socks

50 ea 50 ea 50 ea 50 ea 50 ea 50 ea 50 ea

Pt Supplies/Toiletry Kits • Water Cup/Pitcher/Bottled Water • Basin • Toiletries

o Toothbrush o Toothpaste o Comb/Hairbrush

• Urinals & Caddies (mens) • Bed Caddies • Belongings Bags • Call Light/Bells • Bedside Trash Bag

50 ea 50 ea

50 ea 50 ea 50 ea

20 ea 50 ea 50 ea 50 ea

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ACS Setup Team E: Nursing Station


Unit Equipment Needs Quantity Needed Quantity On Hand Shredder Box 1

Chart Rack 1

Trash Can 2

Computer 1

Printer/Copier 1

Crash Cart 1

Unit Supplies Quantity Needed Quantity On Hand Non-Medical Supplies Unit Signage 1

Facility Diagram 2

Unit Specific Diagram 2

Bands • Allergy • I.D. • DNR

100 ea 100 ea 100 ea

Writing Utensils • Black Pens • Red Pens • Black Sharpies • Highlighters • Dry Erase Pens

1 Box ea 1 Box ea 1 Box ea 1 Box ea 1 Box ea

Miscellaneous Supplies • Stapler • Staples • 5 Whole Punch • 3 Whole Punch • Tape • Paper Clips • “Sign Here” Stickers • Sticky Notes • Printer Paper

2

2 Boxes 1 1 2

1 box 1 pack 1 pack

5 Reams

Forms • J.A.S.

2

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• Patient Medical History • Consent Forms • Physician Referral Forms • Assessment Forms • Patient Treatment Forms • Discharge Forms

o Instructions o Medications o Follow-Up

• Supply Request Slips • I & O Forms • Vitals Forms • ….

100 100 20 100 100 100

20 100 100

Charts 50 Chart Dividers 50 sets Trash Bags 4 Box of Tissue 2 Paper Towels Roll Hand Sanitizer 2 Spray Bottle of Sanitizer 2 Dry Erase Boards 2 Medical Supplies Box of Gloves 2 Blood Pressure Cuffs

• Adult • Child

5 2

Stethoscopes 10 Thermometers (Oral) 4 Thermometers (Tempanic) 2 Thermometer Covers 4 boxes

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ACS Setup Team F: Pharmacy Unit


Unit Equipment Needs Quantity Needed Quantity On Hand Medication Cart 2

Sharps Container 2

Unit Supplies Quantity Needed Quantity On Hand Non-Medical Supplies Facility Diagram 1

Unit Specific Diagram 1

Writing Utensils • Black Pens • Red Pens • Black Sharpies • Highlighters

1 Box Ea 1 Box Ea 1 Box Ea 1 Box Ea

Miscellaneous Supplies • Stapler • Staples • Tape • Paper Clips • Sticky Notes • Labels

1 ea

1 box 2

1 box 2 pads 1 box

Forms • J.A.S. • Blank M.A.R.’s • Supply Request Slips

1

100 20

Unit Supplies Quantity Needed Quantity On Hand Trash Bags 2 Box of Tissue 1 Paper Towels 1 roll Hand Sanitizer 1 bottle Spray Bottle of Sanitizer 1 bottle Medical Supplies Medication Cart Supplies Syringes

• 3ml

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• 10ml • Insulin • TB

Needles • 18g • 21g • 23g • 25g • Filter Needle

NS Flushes • 3ml • 10ml

Alcohol Pads Sterile Caps IV Claves Pill Cutter Pill Crusher Medicine Cups 2x2 Gauze Band Aids Plastic Baggies IV Labels Blood Pressure Cuffs

• Adult • Child

IV Fluids • NS • ½ NS • D5 ½ NS • D5 • LR

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ACS Setup Team G: Laboratory


Unit Equipment/Supplies Needs Quantity Needed Quantity On Hand J.A.S 2 Unit Specific Diagram 1 ea Sharps Container 1 Paper Towels 1 roll Hand Sanitizer 1 bottle Spray Bottle Sanitizer 1 bottle Hemoccult Supplies

• Applicator Sticks • Testing Solution • Hemoccult Test Board

HcG Testing • Droppers • Urine Specimen Cups • Testing Board

Accu Check • Lancets • Alcohol Pads • Cotton Balls • Strips • Testing Solution • Accu Check Machine

Urine Dip Stick • Strips • Machine

Writing Utensils • Black Pens • Red Pens

1 box ea 1 box ea

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ACS Setup Team H: Supply Unit


Unit Supplies Quantity Needed Quantity On Hand J.A.S. 2 Unit Specific Diagram 1 Linen

• Towels • Washcloths • Fitted Sheets • Flat Sheets • Blankets • Pillow Cases • Gowns • Pants • Socks • Pillows

25ea

Toiletries • Toothpaste • Toothbrush • Comb • Hairbrush • Shampoo • Soap • Deodorant • Denture Cups • Denture Paste/Cleaners • Mouthwash

25ea

Urinals 25 Bed Pans 25 Hats (urine) 25 Bedside Commodes 5 Straight Catheters 15

Unit Supplies Quantity Needed Quantity On Hand Foley Catheters 25 Specimen Cups 25 Adult Diapers (Attends) 10

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Child Diapers 10ea Gloves

• Small • Medium • Large

1 box ea

Sterile Gloves • 7 • 7.5 • 8 • …

1 box ea

Isolation Gowns 10 Disposable Stethoscopes IV Tubing

• Primary • Secondary • Blood

IV Start Kits IV Needles

• 18g • 20g • 22g

Chloraprep Alcohol Pads Tape

• Plastic Tape o ½” o 1”

• Paper Tape o ½” o 1”

Lubricant Trash Bags Biohazard Waste Bags Bedside Trash Bags Suction Equipment

• Portable Suction • Yaunker • Tubing

House Cleaning Supplies Housekeeping Cart 1

Unit Supplies Quantity Needed Quantity On Hand Oxygen Equipment

• Nasal Cannula • Non-Rebreather

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• Bag-Valve Mask Dressings

• 2x2 • 4x4 • Abd Pad • Drain Sponges • Tegaderm • Mepilex • Kerlix • Ace Bandages • Cotton Tip Applicators • Didaksol • Sterile Water • Hydrogen Peroxide • … • …

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ACS Setup Team I: Radiology Unit


Unit Equipment Needs Quantity Needed Quantity On Hand J.A.S 1 Unit Specific Diagram 1 Facility Diagram 1 Lead Drapes ? Paper Towels Hand Sanitizer Spray Bottle Sanitizer Writing Utensils

• Black Pens • Red Pens

1 box ea

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Transportation / Delivery Task List

Both the loading and unloading priorities for the ACS equipment and supplies are essential for effective

and timely mobilization and demobilization of this facility. The following diagrams and task lists are

provided to assist the personnel assigned to this task.

A. Loading Priorities

Items should be loaded in the following order to allow for systematic unloading at the ACS

Equipment/Supply staging areas. Depending on the size of transport vehicle, multiple transport

priorities could be loaded in a single vehicle (i.e. Bins H, I, G, F, & E could all be loaded together).

1. Load Bins H, I, and G (last drop-off point)

2. Load Bins F & E (second drop-off point)

3. Load Bins D & A,B,C (first drop-off point)

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B. Delivery / Drop-Off Priorities

Delivery and drop-off of the ACS equipment and supplies should occur in the following order at

their respective staging areas:

1. First Delivery / Drop-off Priority: Bin A,B,C & Bin D

-Unload the ABC Bin (tables, chairs, partitions) and Bin D at the center of the building,

between the sets of doors

-Unload Bin D (Bedding / Pt Supplies) at the center of the building, between the sets of

doors.

2. Second Delivery / Drop-off Priority: Bin E & Bin F

-Unload Bin E (Nursing) & Bin F (Pharmacy) at the southwest corner of the gym.

3. Third Delivery / Drop-off Priority: Bin G, Bin I, & Bin H

-Unload Bin G (Lab), Bin I (Radiology), and Bin H (Supply) at the northwest corner of the

gym.

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C. Equipment/Supply Staging Areas

1. Individually labeled sheets or signs to designate staging areas for specific

equipment/supplies should be placed on the ground (preferably under the overhang on

the cement walkway) prior to off-loading, using the following diagram. The first

equipment and supplies to be unloaded outside the gym, are from Block ABC (tables,

chairs, shelving, etc.), followed by Block D (bedding / pt. supplies).

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