Development of the ASPR TRACIE No- Notice Incident Fact Sheets & Recommendations for Use

Transcription

1 Development of the ASPR TRACIE No- Notice Incident Fact Sheets & Recommendations for Use Melissa Harvey Dr. John Hick Dr. Rick Hunt June 19, 2018

2 ASPR Visit to Las Vegas ASPR representatives visited with staff from Sunrise and University Hospitals on December 13-15, Purpose: Improve ASPR s understanding of the response, what went well, and what other communities from across the country would benefit from knowing. Discussions were a mix of general sharing of big issues or action the healthcare system could do to prepare for future incidents to structured questions from ASPR. 2

3 Sharing Lessons Learned ASPR TRACIE Webinar: Healthcare Response to a No- Notice Incident: Las Vegas on March 28, 2018 No-Notice Incident Tip Sheets ASPR TRACIE Exchange Issue 7: Providing healthcare after mass casualty incidents (Release end of June 2018) ASPR TRACIE Mass Violence Resource Page (asprtracie.hhs.gov/mass-violence) 3

4 ASPR TRACIE No-Notice Incidents Tip Sheets ASPR TRACIE developed a series of tip sheets (9) for hospitals and other healthcare facilities to consider when planning for no-notice incidents in their area. The tip sheets are based on discussions with healthcare personnel who were involved in the response to the October 2017 mass shooting in Las Vegas and supplemented with information from other recent no-notice incidents. Each tip sheet focuses on a priority response activity. While there is great variance in the scope of and healthcare needs resulting from no-notice incidents, these activities were identified as likely to require attention. 4

5 Community Response and Media Management No-notice incidents are often followed by an overwhelming response from the community, including the media. While generally wellintentioned, these efforts may complicate healthcare facility operations. Tip Sheet Contents: Security Implications Volunteers Media Affairs Donations 5

6 EMS Considerations Tip Sheet Contents: Pre-Event Considerations Initial Response Issues EMS Support for Hospitals Other Considerations 6

7 Expanding Traditional Roles As part of their no-notice incident planning, healthcare facilities should consider arranging for specialty providers to assume non-traditional roles to help address the surge in patients. In some cases, specialists may be available to meet their traditional roles as well as supplement other critical activities. Describes the non-traditional role some anesthesiologists assumed following the October 2017 mass shooting in Las Vegas. It also lists possible non-traditional roles other providers (e.g., pediatric) can assume in similar incidents. 7

8 Family Assistance Considerations for family assistance centers to include: Establish a process even if there is no information to give. Ensure interpreter services are available. Telephone support as part of surge planning. Provide on-side mental health support. Items to provide family members and friends that may arrive from the incident for support (e.g. phone chargers, clothing) Plan for longer-term family and patient assistance. 8

9 Fatality Management Lessons learned from Sunrise Hospital are provided: Designated the endoscopy suite as a temporary morgue Arranged decedents in rooms in the order of their arrival Recorded sex, approximate age, hair color, and eye color on a blank sheet of paper located with each victim Photographed each victim Collected descriptions and photographs from family members Cleaned stretcher, replaced bedding, and covered with a clean sheet once identified Tip Sheet Contents: Mortuary response Considerations for when responders are affected Forensic considerations 9

10 Hospital Triage, Intake, and Throughput Tip Sheet Contents: Prepare for large volumes of self-referred patients Conduct initial triage and intake / tagging / registration Review your trauma alias process for patients who arrive without identification Stage personnel and resources to manage initial treatment needs Initiate rapid discharge of existing patients, as appropriate Establish a process for disaster patient flow one way! Partner with hospital incident command to expand capacity Be prepared for existing ED patients to depart 10

11 Non-Trauma Center Considerations During the initial response to a large-scale, no-notice incident, all healthcare facilities should be prepared for unusual patient distribution patterns, misinformation, and challenging communications. Patient Arrival Patient Management Surgical Services Communications and Information Sharing Transfer coordination 11

12 Trauma Surgery Adaptations and Lessons Healthcare facilities should be prepared to conduct initial triage of patients at their door and continue to assess and reprioritize patients as the incident evolves. Plan for clear decision making on patient prioritization Secondary triage Consider zoning patients by injury type Plan for services to support trauma surgery Know how other spaces will be used Plan for the next shift 12

13 Trauma System Considerations Tip Sheet Contents: Community-wide Patient Distribution Considerations Resource Considerations Surgical Services 13

14 Additional Mass Violence Resource Examples Exchange Issue 3: Preparing for and Responding to No-Notice Events Post-Mass Shooting Programs and Resources Overview Tips for Retaining and Caring for Staff after a Disaster Explosives and Mass Shooting Topic Collection 14

15 Questions/Comments asprtracie.hhs.gov TRACIE 15