2003 Statewide Medical and Health Disaster Exercise

1
The 2004 Disaster Exercise Overview
Cheryl Starling, RN, BSHS, Health Program
Manager, Emergency Medical Services Authority
2
2004 Statewide Medical and Health Disaster
Exercise
Cheryl Starling, RN Disaster Medical
Specialist California EMS Authority
3
Exercise History

• This is the 6th annual exercise!
• Past Exercises
• 1999 Y2K
• 2000 Earthquake, chemical spill, train
  derailment, tsunami
• 2001 Chemical (terrorism)
• 2002 Radiological (terrorism)
• 2003 Plague (terrorism)
• 2004 Botulinum (terrorism)

4
Exercise Development

• Exercise Planning Committee
• Members from
• Public and Private Organizations
• Planning begins in January
• Scenario is developed and refined
• Exercise Contact for each OA identified
• Guidebook is created and released in July

5
Exercise Day

• November 18, 2004
• 800 am until 1200 pm

6
Exercise Guidebook

• Written to guide participants
• Reporting participation
• Intent to Participate
• OA Intent to Participate
• Exercise Participant Evaluation Forms
• Hospital facility
• Other healthcare provider/facility
• Ambulance
• ACS
• Public Health

7
Exercise Guidebook

• Reference Materials
• Tips for hospitals
• Glossary
• FAQs about Botulinum
• OA Exercise Contacts

8
Exercise Contacts

• Each OA appoints an Exercise Contact
• Role of the OA Exercise Contact
• Coordinate the exercise for the OA
• Bring agencies and participants together for
  planning and preparations
• Act as liaison between OA and region
• Act as problem solver before and during exercise
• Orchestrate the hotwash (debriefing)

9
Exercise Objectives

• Exercise Objectives for participants
• Hospitals
• Ancillary Healthcare Facilities
• Ambulance
• ACS
• OA Emergency Operations Center
• Local Public Health
• State Agencies
• Add your own objectives!

10
2004 Exercise

• The Annual Jubilee is November 17, 2004
• At 500 am, cases begin presenting to the ED
• Sudden onset of dizziness
• Blurred vision
• Slurred speech
• Difficulty swallowing
• Nausea

11
2004 Exercise

• Suspected Clostridium botulinum
• Patients begin arriving with symptoms
• Issues are
• management and allocation of
• scarce resources!

12
2004 Exercise

• Healthcare system overwhelmed with critical
  patients and a lack of resources including
• Healthcare personnel
• Equipment
• Supplies
• Bed capacityespecially ICU

13
2004 Exercise

• The scenario spurs you into action
• A number of patients are presenting to the local
  community clinics wanting to see the doctor with
  complaints of dizziness, weakness and facial
  drooping. There are several patients that
  require immediate care at the clinic and 9-1-1 is
  called to transfer them immediately to the ED.
  Unfortunately, EMS is overtaxed with calls, and
  cannot get to the clinics immediately.
• What communication mechanism does the clinic have
  with the acute care hospital to alert them of
  incoming patients?
• What internal procedure(s) or plan(s) should the
  clinic activate in this situation?
• What other resources does the clinic require for
  the patient until EMS can arrive to transport the
  patients to the acute care hospital?
• How does the clinic communicate with local public
  health to notify them of the patients and to
  receive assistance?

14
2004 Exercise

• Participants will exercise
• Policy and procedure for communicating to health
  departments and healthcare providers
• Management of scarce resources
• Cooperation with public and private community
  organizations
• Collaboration with inter-agency PIOs to
  coordinate risk communication

15
The Exercise Cycle

• Planning
• Preparation
• Execution
• Post exercise activities

16
2004 Exercise

• Certificate of Participation
• Issued when exercise evaluation form completed
  and
• returned to EMSA

17
2004 Exercise

• Developing the After Action Report
• Informal debriefing or hotwash
• Immediately post-exercise
• What worked?
• What did not work?
• Improvements to be made?
• Document critique!

18
After Action Reporting

• A written record of your exercise!
• Report should address
• The objectives were met/not met
• Achievements
• Areas to improve
• Strategies for the future
• Outlines the ACTION PLAN
• For plan revision and additions
• For future exercises and activities
• Documentation for accreditation agencies!

19
After Action Reporting

• Share the information!

Internally Board of Directors CEO Disaster
Committee Safety Committee Staff
Externally Fire EMS Community Emergency Planners
20

• Follow up is the
• Test of success!

21
Follow Up Actions

• From Soup to Nuts!
• Purchase new equipment
• Provide more training
• Revise existing policy
• Create new policies
• Over haul the entire disaster plan ?
• Implement HEICS ?
• Have another exercise

22
Exercise Guidebook

• Download from the
• EMSA website at
• www.emsa.ca.gov/dms2/hospambex.asp

23
The End !
24
Contact Information
Cheryl Starling, RN Disaster Medical
Specialist CA EMS Authority 916-322-4336
cheryl.starling_at_emsa.ca.gov