Personal Protective equipment

1
Personal Protective equipment

• Given the preeminent need to protect HCW, highest
  level of protection available should be used
• Fit tested N 95 mask, gowns, and gloves
• Positive Air Purifying Respirators (PAPR) for
  high risk aerosol generating procedures
• Assume 4 changes of masks and gown/12 hr shift
• Glove changes between each patient.
• Calculate needs for HCW involved in direct
  patient care.
• Include essential visitors.

2
Critical Shortage of Hospital Workers

• High absenteeism of all hospital staff due to
  illness, family responsibilities, or fear of
  contagion.
• Mutual aid agreements of limited use in pandemic
  affecting all hospitals
• Deployable federal medical assets unlikely to be
  available.
• Many demands on available volunteers

3
Key Preparedness tasks cannot be Accomplished by
Hospitals Individually

• Regional resource allocation, patient
  redistribution through utilization of alternate
  care sites.
• Effective recruitment, training, credentialing
  and deployment of volunteer health and hospital
  workers
• Scientific, ethical, legal framework for
  decisions regarding the allocation of limited
  healthcare resources and standards of care.

4
Demand for Care Will Exceed Capacity

• In severe pandemic traditional hospital care for
  all who need it will be impossible.
• Hospital care will have to be reorganized through
  rationing and altered standards of care
• Hospitals will need to defer non-urgent services
• There is no nationally sanctioned scientific,
  ethical, and legal framework for the optimal
  allocation of scarce resources.
• Transparency, Fairness, and consistency are
  critical to public acceptance.

5
Regional Hospital Planning Response Groups
Essential Function

• Standardize planning preparedness
• Expand the role of hospitals in traditional EOCs
• Enable sharing of assets, staff, patients
• Share situational awareness in disasters
• Coordinate surge supersurge processes

6
Regional Hospital Planning Response Groups
Essential Function

• Advisory body to public health elected
  officials on medical issues.
• Communicate with public and media
• Community-wide approach to ethical political
  challenges (ie Altered standards of care)
• Establish systems for recruiting coordinating
  volunteers

7
Allocation of limited healthcare resources to do
the greatest good for the greatest number

• Prioritize services that can de deferred, for how
  long, and with what consequences
• Alternative care plan for patients who will be
  deferred.
• Create process for refining and updating
• Track deferred patients
• Plan for the graceful alteration of patient care.

8
Federal Role in Pandemic Response

• Any Municipality that fails to prepare with the
  idea that somehow the federal government will be
  able to rescue them will be tragically wrong.
• Preparedness needs to be Global in all
  Communities.