Situation Manual (SitMan)

Transcription

1 Situation Manual (SitMan) 285 Minutes Situation Manual Tabletop Exercise 1 Disaster Resistant Communities Group

2 Treacherous Transport Exercise Play No Image During this exercise it will be important to remember and comply with the following statements: The objectives of this exercise include: 1. Test hospital decontamination (decon) procedures in response to a hazardous materials incident. 2. Test hospital coordination during a scenario requiring evacuation and / or Emergency Department (ED) diversion. 3. Evaluate communication with first responders, other health care agencies and internal staff. 4. Evaluate MOUs and agreements in place for community resources. 5. Evaluate hospital security and access control related to a hazardous materials incident. It is important NOT to jump ahead in the exercise scenario. In other words, don t focus on what might happen, focus on the Common Operating Picture that is presented during the exercise to make informed decisions. In any exercise a number of assumptions and artificialities may be necessary to complete play in the time allotted. During this exercise, the following apply: 1. The scenario is plausible, and events occur as they are presented. 2. There is no hidden agenda, nor any trick questions. Thoroughly review all scenario information and injects as they are presented during the exercise. Identify one person be responsible for controlling the computer and inputting responses to the exercise injects. If you need assistance anytime during the exercise, please call the Help Desk at: Phone Number Account Number # Identification Number - 1 # 20 Minutes Situation Manual Tabletop Exercise 2 Disaster Resistant Communities Group

3 Treacherous Transport Scenario # 001 All Image of Overturned Tanker Truck It is a warm summer day in June with low humidity and a mild breeze out of the west. At 4:30PM, as rush hour is beginning, a tractor-trailer carrying hazardous materials is cut off by a mini-van driven by a distracted teenager, who was carrying his three younger siblings. The tractor-trailer hits the mini-van and swerves into a ditch, tipping on its side and releasing its contents. 10 Minutes Situation Manual Tabletop Exercise 3 Disaster Resistant Communities Group

4 Treacherous Transport Inject # 002 All Image of Hazardous Materials Icon All of the passengers in the mini-van are injured in the crash, with the tractor trailer driver suffering significant injuries. Several people have stopped their cars to provide assistance to those injured in the accident. As the chemical release continues to grow, all of the people in the immediate vicinity become overwhelmed by the fumes. Briefly describe what the immediate concerns would be given this scenario. Based on your agency s role in responding to this event, what information would you want to know? Situation Manual Tabletop Exercise 4 Disaster Resistant Communities Group

5 Treacherous Transport Inject # 003 All Image of Respiratory Distress First responders arrive on scene and identify six patients with various injuries from the crash and additional respiratory problems from breathing in the fumes being released from the damaged tractor-trailer. Evacuation is initiated for the area immediately around the scene. Identify the agencies that would likely be notified for this event. Briefly describe how the first responders will identify the chemical being released. Situation Manual Tabletop Exercise 5 Disaster Resistant Communities Group

6 Treacherous Transport Inject # 004 All Image of Patient in Emergency Room During the initial response to the accident, a motorist who stopped to help was mildly exposed to the chemical fumes. He immediately left the scene when he realized hazardous materials were involved. Minutes later he began to experience symptoms including burning in his nose and mouth and difficulty breathing. The motorist arrived at the hospital and reported his symptoms, but did not initially mention the hazardous materials. At this point in the event, is the hospital likely to know an accident happened? Yes No Describe how the hospital will learn of the incident and will prepare for receiving contaminated patients. Typically, how long after an incident is the hospital notified? Describe the procedures for monitoring the Emergency Department (ED) for possibly contaminated self-reporting patients. Briefly describe the procedures for limiting access the hospital. Is there a formal written policy for the above describe procedures? Yes No Identify the individual(s) that determine when the procedures for monitoring the ED would be activated. 20 Minutes Situation Manual Tabletop Exercise 6 Disaster Resistant Communities Group

7 Treacherous Transport Inject # 005 All Image of Decontamination Process Briefly describe how decontamination is performed for this type of event. (Explain if gross decon is performed in the field with technical decon performed at the hospital or are other methods employed.) Does the hospital have adequate training, staff and resources to undertake decontamination? Yes No If the above answer is yes. List the resources that are available at the hospital. If the above answer is no. Briefly describe how the hospital will coordinate decon with external resources. Does the hospital have formal agreements with community resources, such as the fire department, to provide decon support? Yes No Situation Manual Tabletop Exercise 7 Disaster Resistant Communities Group

8 Treacherous Transport Inject # 006 Southeast Image of Hospital Decontamination How will the hospital know the chemical to which the patients were exposed? Describe the process the hospital will use to determine adequate decon and treatment for the chemical involved. Describe how EMS will ensure their vehicles are not contaminated by the chemical. The chemical has been identified as Fenthion. Situation Manual Tabletop Exercise 8 Disaster Resistant Communities Group

9 Treacherous Transport Inject # 006 Central Image of Hospital Decontamination How will the hospital know the chemical to which the patients were exposed? Describe the process the hospital will use to determine adequate decon and treatment for the chemical involved. Describe how EMS will ensure their vehicles are not contaminated by the chemical. The chemical has been identified as SmartChoice 5G Insecticide. Situation Manual Tabletop Exercise 9 Disaster Resistant Communities Group

10 Treacherous Transport Inject # 006 TriCounty Image of Hospital Decontamination How will the hospital know the chemical to which the patients were exposed? Describe the process the hospital will use to determine adequate decon and treatment for the chemical involved. Describe how EMS will ensure their vehicles are not contaminated by the chemical. The tractor-trailer was carrying two chemicals identified as FE-1A Acidizing Composition and VICON NF BREAKER. Situation Manual Tabletop Exercise 10 Disaster Resistant Communities Group

11 Treacherous Transport Scenario # 007 All Image of EMS / Hospital EMS begins to arrive with patients from the scene. The following patients are transported by EMS to the ED: Patient 1 Driver: 18 year old male, lacerations to face and arms, respiratory distress from chemical exposure. Patient 2 Passenger: 14 year old female, unconscious, head trauma, chemical burns to arms and torso. Patient 3 Passenger: 8 year old female, chemical burns to face and eyes. Patient 4 Passenger: 10 year old male, respiratory distress from chemical exposure, broken right arm. Patient 5 Truck Driver: 43 year old male, unconscious, neck injury and respiratory distress from chemical exposure. Patient 6 Assisting Motorist: 35 year old female, complaining of burning eyes, nose and mouth from breathing in chemical. 10 Minutes Situation Manual Tabletop Exercise 11 Disaster Resistant Communities Group

12 Treacherous Transport Inject # 008 All Image of Busy Emergency Department Additional motorists in the area of the crash begin to self-report to the ED with complaints of burning eyes, nose and mouth. The ED begins to reach capacity. Is the Hospital Command Center (HCC) activated at this point? Yes No Describe how and when the HCC would be activated. Identify the trigger points for activation of the HCC. Are the trigger points defined in a formal plan? Yes No Briefly describe how the HCC staff will be notified upon the activation of the HCC. Briefly describe any changes in the staff notification procedure if the event occurred overnight or on a weekend. 20 Minutes Situation Manual Tabletop Exercise 12 Disaster Resistant Communities Group

13 Treacherous Transport Inject # 009 All Image of Hospital Incident Command System List and briefly describe the positions that would be activated within the HCC and identify by name the individual that would be assigned to each position. (Example: Logistics Section Chief John Harper) Situation Manual Tabletop Exercise 13 Disaster Resistant Communities Group

14 Treacherous Transport Inject # 010 All Image of Security Hospital security reports to the HCC that members of the public are gathering near the ED entrance and are creating a disturbance. One man in particular is agitated complaining that is 18-month old daughter was in the car when he drove near the accident scene. While she is not exhibiting any symptoms, he insists she is seen by a doctor immediately. Security officers would like to know if additional support can be dispatched to the ED entrance to assist. Identify and briefly describe what additional resources can be used to help security. Situation Manual Tabletop Exercise 14 Disaster Resistant Communities Group

15 Treacherous Transport Inject # 011 All Image of Sick Nurse A nurse within the ED begins to exhibit symptoms similar to those of the patients who were exposed to the chemical on scene. Briefly describe the concerns associated with this new development. Briefly describe the actions that will be undertaken to determine if the ED has been contaminated. Describe how this event will be communicated to the HCC and external support agencies. Situation Manual Tabletop Exercise 15 Disaster Resistant Communities Group

16 Treacherous Transport Inject # 012 All Image of Contaminated ED It has been confirmed that the ED is contaminated. Prepare a list of all external agencies that should be notified about the contamination of the ED. Briefly describe how communications will occur with the above listed external agencies. Briefly explain how the need for partial or full evacuation of the ED will be determined. Describe the process for notifying EMS of the need to divert patients to other hospitals. Situation Manual Tabletop Exercise 16 Disaster Resistant Communities Group

17 Treacherous Transport Inject # 013 All Image of ED Evacuation The HCC has determined the best course of action is to evacuate the ED. Briefly describe the evacuation plan for the ED. Identify the location to which patients and staff will be relocated. Due to contamination of the ED, describe what treatment or decon will the patients and staff receive. Describe what external resources, if any, will be needed to assist with decon, patient movement, transportation and / or staffing. Situation Manual Tabletop Exercise 17 Disaster Resistant Communities Group

18 Treacherous Transport Inject # 014 All Image of Closed ED There are additional patients self-reporting to the hospital complaining of symptoms similar to others exposed to the chemical. With the ED closed, how will these patients be received, triaged, treated and / or transported? Situation Manual Tabletop Exercise 18 Disaster Resistant Communities Group

19 Treacherous Transport Inject # 015 All Image of Doc In The Box 911 Dispatch receives a call from an Urgent Care Clinic in the area. Three people have arrived at the facility with symptoms of respiratory distress. The patients mentioned the accident and the hazardous material spill. The Urgent Care Clinic does not have the capability to decon these patients and is looking for support. Briefly describe the best course of action to care for these patients. Briefly describe the ongoing communications that occur between healthcare agencies during this event. Situation Manual Tabletop Exercise 19 Disaster Resistant Communities Group

20 Treacherous Transport Inject # 016 Southeast Image of Ambulance EMS has patients, not involved in the chemical release, to transport to a hospital. Briefly describe how these patients will be managed. Identify the location(s) to which these patients will be transported. Treacherous Transport Inject # 016 Central Image of Ambulance EMS has patients, not involved in the chemical release, to transport to a hospital. Briefly describe how these patients will be managed. Identify the location(s) to which these patients will be transported. Situation Manual Tabletop Exercise 20 Disaster Resistant Communities Group

21 Treacherous Transport Inject # 016 TriCounty Image of Ambulance EMS has a patient to transport from Daggett County. EMS calls the hospital en route only to find out that the ED is on divert. The patient has extensive injuries including lacerations and neck pain from falling through a plate glass window. Briefly describe how this patient will be treated and where he will be transported. Situation Manual Tabletop Exercise 21 Disaster Resistant Communities Group

22 Treacherous Transport Inject # 017 All Image of Normal Operations As the response wraps up on scene and patients are being treated and sent home, what actions should be considered for returning to normal operations? When the ED goes off diversion, how will this information be communicated to EMS and other hospitals? Briefly describe how hospitals can improve communication between one another during an event such as this. Briefly describe the kind of debrief or after action, if any, that would be performed by the hospital following an event such as this. Situation Manual Tabletop Exercise 22 Disaster Resistant Communities Group

23 Treacherous Transport Inject # 018 All Image of MOU Based on the today s exercise scenario, list all Memoranda of Understanding (MOUs) or Memoranda of Agreement (MOAs) that the hospital currently has in place. When listing the MOU / MOA identify the: Resource. Agency the MOU / MOA is with. If the MOU / MOA is a formal written document or informal agreement. The date the MOU / MOA was last reviewed. (Example: Wheelchair Accessible Bus ABC School District Formal Reviewed 12/2011) Identify and describe any gaps in resources that an MOU / MOA may help alleviate based on today s exercise scenario. Situation Manual Tabletop Exercise 23 Disaster Resistant Communities Group