New York City Department of Health and Mental Hygiene Role in Preparedness and Response GNYHA Roundtable: Being Prepared to Respond to Terrorist

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1 New York City Department of Health and Mental Hygiene Role in Preparedness and Response GNYHA Roundtable: Being Prepared to Respond to Terrorist Attacks Tuesday, November 24, 2015

2 DOHMH Initial Actions in Response to a Mass Casualty Event Hold initial Incident Command System (ICS) meeting to determine if ICS and Departmental Emergency Operations Center will activate Initial response objectives: Surveillance and Epidemiology for incident-related injuries, illnesses, and deaths Environmental monitoring as necessary Make public health recommendations for NYC residents, healthcare workers and first responders and support public messaging Activate mental health surveillance to prioritize deployment of mental health resources Support healthcare facilities in managing surge Support radiological monitoring efforts Deploy DOHMH reps to city EOC and other multi-agency coordination centers Provide mental health resources to activated service centers, including activation of Medical Reserve Corps volunteers

3 DOHMH Initial Actions in Response to a Mass Casualty Event Hold initial Incident Command System (ICS) meeting to determine if ICS and Departmental Emergency Operations Center will activate Initial response objectives: Surveillance and Epidemiology for incident-related injuries, illnesses, and deaths Environmental monitoring as necessary Make public health recommendations for NYC residents, healthcare workers and first responders and support public messaging Activate mental health surveillance to prioritize deployment of mental health resources Support healthcare facilities in managing surge Support radiological monitoring efforts Deploy DOHMH reps to city EOC and other multi-agency coordination centers Provide mental health resources to activated service centers, including activation of Medical Reserve Corps volunteers

4 DOHMH Preparedness Programs Hospital Preparedness Program (HPP) Assistant Secretary for Preparedness and Response, HHS Public Health Emergency Preparedness Program (PHEP) Centers for Disease Control and Prevention, HHS

5 PHEP and HPP Capabilities Public Health Preparedness Capabilities Healthcare Preparedness Capabilities 1. Community Preparedness 1. Healthcare System Preparedness 2. Community Recovery 2. Healthcare System Recovery 3. Emergency Operations Coordination 3. Emergency Operations Coordination 4. Emergency Public Info & Warning 5. Fatality Management 5. Fatality Management 6. Information Sharing 6. Information Sharing 7. Mass Care 8. Medical Countermeasure Dispensing 9. Medical Materiel Management & Distribution 10.Medical Surge 11.Non-Pharmaceutical Interventions 12.Public Health Labs 13.PH Surveillance & Epi Investigation 14.Responder Safety and Health 15.Volunteer Management 10. Medical Surge 14. Responder Safety and Health 15. Volunteer Management

6 Support for Coordinated Planning NYC Burn Surge Response Protocol NYC Pediatric Disaster Plan

7 NYC Burn Surge Response Protocol Developed jointly with NYC EM, FDNY, and hospitals Completed in 2011 Addresses coordination of secondary transport of patients with severe burn injuries

8 NYC Burn Protocol Key Points FDNY activates protocol by declaring burn mass casualty incident based on operational needs and local burn resource availability Tiered Burn Disaster Receiving Hospitals (BDRH) Tier 1: NYS-designated burn centers (4) Tier 2: NYS-designated trauma (12) Tier 3: Hospitals not designated trauma center (12) DOHMH provided burn carts to Tier 2 and Tier 3 BDRHs Cart is stocked with supplies needed to stabilize patients with burn injury Up to 10 patients for 3 to 5 days

9 Phase 1 NYC Burn Protocol Phases FDNY triages at the scene and transports patients to BDRHs ESF-8 activated FDNY, DOHMH, and NYS DOH request the following: Phase 2 Hospitals suspend routine interfacility transfers of burn patients to Burn Centers Burn Centers suspend acceptance of patients that do not include FDNY notification Burn patients arriving at non-bdrhs are transported to BDRHs Burn patients in Tier 2 and Tier 3 BDRHs are transferred to Burn Centers for definitive care Burn Logistics Coordination Center (BLCC) assigns available burn bed and transport asset BLCC needs a prioritized list of patients for transport; Virtual Burn Consultation Center (VBCC) provides prioritization

10 NYC Burn Protocol Next Steps VBCC exercise and workgroups Identify interim methods of patient prioritization to support BLCC Update and restock BDRH burn carts Develop sustainable training plan for BDRHs Develop periodic assessment for preparedness of BDRHs

11 Draft NYC Pediatric Disaster Plan Currently in development with Pediatric Disaster Coalition, NYC EM, and FDNY Presented to hospitals August 2015 Pediatric Disaster Coalition has worked with hospitals to increase PICU surge capacity

12 Draft NYC Pediatric Disaster Plan Key Points FDNY activates Pediatric Disaster Plan after determining that there is a mass casualty event with potential for escalation Hospitals tiered as Pediatric Disaster Receiving Hospitals (PDRH) based on availability of pediatric services Tier 1: Committed to pediatric subspecialty care Tier 2: Committed to general pediatric care

13 Draft NYC Pediatric Disaster Plan Phases Phase 1: PDRH activation and primary transport FDNY activates plan and transports patients to PDRHs FDNY asks that hospitals suspend routine inter-facility transfers to PDRHs Pediatric Intensivist Response Team (PIRT) activated Phase 2: Patient prioritization and inter-facility transfer Pediatric patients at hospitals unable to provide appropriate services are prioritized by PIRT physician PIRT physician provides prioritized list to FDNY FDNY assigns resources for transport

14 Draft NYC Pediatric Disaster Plan Next Steps Hospitals will be asked to confirm their understanding and acceptance of their role as a Tier 1 or Tier 2 PDRH City agencies endorse plan and incorporate into procedures and protocols

15 Thank You! Contact information: Celia Quinn, MD, MPH