Calaveras County Alternate Care Site Plan. Set-up Diagrams REVISED: 06/24/11

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Calaveras County Alternate Care Site Plan Set-up Diagrams REVISED: 06/24/11 Prepared by: Douglas Buchanan Emergency Preparedness Consultant www.disasterdoug.com

Table of Contents Diagram 1: ACS Overview page 3 Diagram 2: Medical Bed Setup for Teams A-C page 4 Diagram3: Team A: Pediatrics, Pharmacy, Peds/Iso Nursing, Isolation page 5 Diagram 4: Team B: Womens / Mens Patient Areas page 6 Diagram 5: Team C: Lab/Diagnostics Area, Supply Area, Radiology Area page 7 Diagram 6: Team D1: Bedding / Patient Supplies (Peds/Isolation) page 8 Diagram 7: Team D2: Bedding / Patient Supplies (Mens) page 9 Diagram 8: Team D3: Bedding / Patient Supplies (Womens) page 10 Diagram 9: Team E: Nursing page 11 Diagram 10: Team F: Pharmacy Units Peds/Iso Nursing page 12 Diagram 11: Team G: Laboratory/Diagnostics Unit page 13 Diagram 12: Team H: Supply Unit page 14 Diagram 13: Team I: Radiology Unit page 15 Diagram 14: Staging 1 page 16 Diagram 15: Staging 2 page 17 Diagram 16: Staging 3 page 18 Diagram 15: Alternate ACS Layout (65-bed) page 19 Calaveras County ACS Plan - Diagrams Page 2 of 19 Revised: 6/24/11

Diagram 1: ACS Overview Diagram 1 depicts an overview of the ACS, including: 50 beds (or cots), divided into four groupings, spaced 4 apart with aisle ways of 7 o Womens, o Mens, o Pediatrics, o Isolation Laboratory / Diagnostics Area (15 x 35 ) with tables/chairs and shelving Supply / Storage Area (15 x 39 ) with shelving Radiology Area (15 x 35 ) with tables/chairs Two Nurses Stations, one for Peds/Iso Nursing located near Pharmacy, the other in the center of the gym for the Mens/Womens Nursing Pharmacy Area with 2 tables and chairs, a pharmacy prep unit, a pharmacy dispensing unit, and four med carts 4 Handwashing Stations (2 single, 2 double), and 1 4-person Hand Sanitizer station in the Nurses Station. 6 partitions placed to separate patient groupings For alternate (surge) diagram (for 65 patients) see Diagram 16. Calaveras County ACS Plan - Diagrams Page 3 of 19 Revised: 6/24/11

Diagram 2: Medical Bed Setup for Teams A & B Calaveras County ACS Plan - Diagrams Page 4 of 19 Revised: 6/24/11

Diagram 3: Team A: Pediatrics, Pharmacy, Peds/Iso Nursing, & Isolation Team A will begin at the southeast corner of the gymnasium: 1. Place the five Isolation beds a. First bed, 4 from outside wall (head against bleachers) b. Measure 4 between beds c. Place two partitions 4 from last bed d. Place the 1-person Hand-washing against Partition 2. Arrange the Pharmacy Unit & Peds/Iso Nursing Station a. Place the first table and chair, 7 from Isolation partition against bleachers b. Measure 14 and place second table and chair c. Measure 4 from Pharmacy tables, and place two tables and chair for Peds / Iso Nursing Station (at the Electrical Hub). 3. Place the five Pediatric beds a. Measure 7 from pharmacy table and place first bed b. Measure 5 between beds 4. Place Partitions a. Place five Isolation partitions 7 from beds b. Place second set of five partitions 7 from, and parallel with, the first set of partitions c. Place four partitions 7 from Pediatric beds d. Place second set of five partitions 7 from, and parallel with, the first set of partitions Calaveras County ACS Plan - Diagrams Page 5 of 19 Revised: 6/24/11

Diagram 4: Team B: Womens / Mens Patient Areas Team B will begin 4 from the Starting Point Partition (southeast corner of Men s Unit), 7 from the east wall. 1. Place the Men s beds a. First bed, 7 from outside wall, and 11 from Radiology partitions (see Team B Starting Place) b. Measure 4 between beds c. Place beds head to foot d. Leave a 7 aisle way between rows e. Place HW Station, centered on east wall f. Place row of four partitions 4 from foot of beds 2. Set-up Nurses Station a. Measure 7 from center Mens beds and place one table w/chairs b. Measure 5 and place Handwash station c. Measure 5 and place second table w/chairs d. Measure 7 from Men, place two parallel partitions e. Measure 9, place two parallel partitions- north & south of HW f. Measure 9, place two parallel partitions 3. Place the Women s beds a. First bed, 7 from partitions and Nurses Station table b. Measure 4 between beds c. Leave a 7 aisle way between rows d. Place HW station, centered on west wall e. Place row of four partitions 4 from foot of beds Calaveras County ACS Plan - Diagrams Page 6 of 19 Revised: 6/24/11

Diagram 5: Team C: Lab/Diagnostics Area, Supply Area, Radiology Area Team C will begin in from the bleachers in the northeast corner: 1. Mark Team B Starting Place a. Measure 15 from the bleachers, and 7 from the outside wall; place an X on the floor, using painters tape 2. Set up Radiology Area a. At 15 from the bleachers, place two 16 partitions parallel to bleachers, leaving a 3 entry space b. Place tables and chairs vertically at 32.5 from the east wall 3. Set up Supply Area a. Place shelving units: Three units placed parallel to Radiology tables Measure 5 between rows of shelving units Place remaining shelving units, leaving 5 aisle ways Last row of shelving units should be at 39 from Radiology Unit 4. Set up the Lab / Diagnostics Area a. Place two tables vertically against west wall b. Place two tables horizontally at back wall against bleachers, and two chairs 5. Place Partitions a. Place two 16 partitions, 15 from bleachers, leaving a 3 entry way between partitions 6. Place Handwash Station a. Place two-person hand-washing station outside the Lab unit, against partition Calaveras County ACS Plan - Diagrams Page 7 of 19 Revised: 6/24/11

Diagram 6: Team D1: Bedding / Patient Supplies (Peds/Isolation) 1. Begin by placing the fitted sheet over the mattress. 2. Next, place a flat sheet, followed by a blanket, tucking in the foot and sides. 3. Slip a pillow case over the pillow. 4. Open the hook & loop tabs on the disposable caddy, and wrap over the side rail; and fill with patient toiletries (toothbrush, toothpaste, etc.); and bottle of water. 5. Place Patient Belongings Bin and call-bell at each bed. 6. Place Trash cans: Isolation against partition, Nurses Station at end of table, and Pediatrics against partition. 7. Place Biohazard waste cans in Isolation and Peds near trash cans. 8. Place Soiled Linen bins in Isolation and Peds in far corners, against partitions 9. Place Isolation Cart in Isolation area against partitions, near Nurses Station, 10. Place Pharmacy Prep Unit against bleachers, between tables, & Pharm Dispense Unit at Nursing table 11. Place two Med Carts at ends of Pharmacy tables, & two against Isolation partition. 12. Place Crash Cart against bleachers, at the Pharmacy Unit table. 13. Place refrigerator at end of Nursing tables, next to trash can. Calaveras County ACS Plan - Diagrams Page 8 of 19 Revised: 6/24/11

Diagram 7: Team D2: Bedding / Patient Supplies (Mens) 1. Begin by placing the fitted sheet over the mattress. 2. Next, place a flat sheet, followed by a blanket, tucking in the foot and sides. 3. Slip a pillow case over the pillow. 4. Open the hook & loop tabs on the disposable caddy, and wrap over the side rail; and fill with patient toiletries (toothbrush, toothpaste, etc.; and bottle of water.) 5. Place Patient Belongings bin and call-bell at each bed. 6. Place Trash cans next to HW station on east wall, and against center partitions in Nurses Station 7. Place Biohazard waste can next to HW station on east wall 8. Place Soiled Linen can at north partition 9. Place Chart Rack against trash can at the center/south partition in Nurses Station. Calaveras County ACS Plan - Diagrams Page 9 of 19 Revised: 6/24/11

Diagram 8: Team D3: Bedding / Patient Supplies (Womens) 1. Begin by placing the fitted sheet over the mattress (or cot). 2. Next, place a flat sheet, followed by a blanket, tucking in the foot and sides. 3. Slip a pillow case over the pillow. 4. Open the hook & loop tabs on the disposable caddy, and wrap over the side rail; and fill with patient toiletries (toothbrush, toothpaste, etc.; and bottle of water.) 5. Place Patient Belongings bin and call-bell at each bed. 6. Place Trash can on either side of the HW station. 7. Place one Biohazard waste can next to HW station, and one against each center partition in Nurses Station. 8. Place Soiled Linen can at south partition. Calaveras County ACS Plan - Diagrams Page 10 of 19 Revised: 6/24/11

Diagram 9: Team E: Nursing Units 1. Nursing Unit: a. Start by placing Medical supplies, Bands, and Forms from Team E Bin on the Diagram table 10: Team located F: Pharmacy on the Women s (west) side of the Nurses Station. b. On the table near the Mens (east) side, place the Tissue, Writing Utensils, Sanitizer, and Misc. Supplies. c. Place the paper towels at the Hand Sanitizer station. d. Place the paper shredder and trash bags next to the north Trash can. e. Finally, place the Charts and Dividers at the Chart Rack. Calaveras County ACS Plan - Diagrams Page 11 of 19 Revised: 6/24/11

Diagram 10: Team F: Pharmacy Unit Peds/Iso Nursing BLEACHERS Team F 1. On the northwest table near Pediatrics, place the: tissue, sanitizer, and paper towels. 2. On the Peds/Iso Nursing tables, place the: trash bags, misc. supplies, and writing utensils. 3. Place the Med-cart supplies and Sharps Container on each Med Cart. Calaveras County ACS Plan - Diagrams Page 12 of 19 Revised: 6/24/11

Diagram 11: Team G: Laboratory/Diagnostics Unit Team G: 1. On the table, next to the refrigerator, place the: Sanitizer, Paper Towels, and Sharps Container. 2. On the adjacent table, place the writing utensils. 3. On the corner table, place the four bins with the: Hemoccult, Accu-Check, HcG, and Urine Dipstick testing supplies. Calaveras County ACS Plan - Diagrams Page 13 of 19 Revised: 6/24/11

Diagram 12: Team H: Supply Unit Team H: 1. Start with placing supplies on the three shelving units against Radiology Unit with items from the Toiletries, Bathroom Supplies, and Dressings bins. 2. Next place supplies on the three center shelving units with items from the PPE, Respiratory, and I.V. supply bins. 3. Next, place supplies on the first two carts against the Lab Unit with items from the Linen and Housekeeping supply bins. 4. Finally, place the Miscellaneous Supplies on the southwest corner shelving unit. Calaveras County ACS Plan - Diagrams Page 14 of 19 Revised: 6/24/11

Diagram 13: Team I: Radiology Unit Team I: 1. On the corner table in the southwest corner of the Radiology Unit, place the: Sanitizer bottle, paper towels, and writing utensils 2. On the second table located inside the partition, place the lead drapes. Calaveras County ACS Plan - Diagrams Page 15 of 19 Revised: 6/24/11

Diagram 14: Staging 1 Staging areas for the ACS Equipment & Supplies have been identified on the east side of the Flock Gym, under the covered eating area. Equipment and supply staging has been designated in three waves. 1. The first wave of Staging is designed for delivery of the major equipment to the east side of the gymnasium. (Blocks A, B, & C: Tables, Chairs, Cots/Beds, etc.). 2. Signage should be set-up to assist the unloading and staging personnel. 3. The Staging Manager will direct overall unloading and staging activities. 4. Staging Assistants should be strategically placed to help direct staff during the unloading and staging process. Calaveras County ACS Plan - Diagrams Page 16 of 19 Revised: 6/24/11

Diagram 15: Staging 2 1. The second wave of Staging is designed for delivery of additional ACS equipment and supplies (Blocks D-I) for set-up of each ACS unit. 2. Signage should be updated to reflect the Team equipment/supply areas. 3. The Staging Manager will direct overall unloading and staging activities. 4. Staging Assistants should be strategically placed to help direct staff during the unloading and staging process. Calaveras County ACS Plan - Diagrams Page 17 of 19 Revised: 6/24/11

Diagram 16: Staging 3 1. The third wave of staging is located in the ancillary classrooms to the west of the gym for ICP / Communications, and the Additional Storage. 2. Signage should be clearly placed and visible to assist the unloading and staging personnel. 3. The Staging Manager will direct overall unloading and staging activities. 4. Staging Assistants should be strategically placed to help direct staff during the unloading and staging process. Calaveras County ACS Plan - Diagrams Page 18 of 19 Revised: 6/24/11

Diagram 17: Alternate ACS Layout (65-bed) Calaveras County ACS Plan - Diagrams Page 19 of 19 Revised: 6/24/11