PDLS © : Disaster Planning and Organization

Learning Objectives Steps of disaster planning Steps of disaster planning Concepts in management planning and interventions Concepts in management planning and interventions

Steps of Disaster Planning Planning Planning Resource assessment Resource assessment Risk and hazard analysis Risk and hazard analysis

Risk and Hazard Analysis Assessment of threats to the locality Assessment of threats to the locality - Geographic - Building - Population cluster Children groups Children groups - Day care or schools - Summer camps - Field trips

Risk and Hazard Analysis Environmental Hazards Weather Weather - Winter storms - Hurricanes Geographic Geographic - Earthquakes - Flood plains

Risk and Hazard Analysis Man-made Hazards Chemicals Chemicals - Production, storage and transport Biologic hazards Biologic hazards Terrorism Terrorism Transportation Hazards Materials Materials Mass transit centers Mass transit centers

Resource Assessment Local resources Local resources - EMS - Police - Fire department Volunteers Volunteers - Boy Scouts - Rotary, Shriners Children’s advocacy groups Children’s advocacy groups

Resource Assessment National National - Red Cross - FEMA - Department of Defense Agencies and unions Agencies and unions - AMA - ENA

Resource Needs Personnel Personnel - Pediatric specialists (if available) Equipment Equipment Supplies: water, food, blankets Supplies: water, food, blankets Shelter Shelter Suppliers with contact source Suppliers with contact source - Back-up suppliers and contact sources

Resource Needs Communications Communications - Equipment and personnel - Telephone company/cell phones often overload - Ham radio / alternative methods

Resource Needs Transportation Transportation - Roads - Vehicles, public and private Maintaining access for emergency vehicles often problematic Maintaining access for emergency vehicles often problematic

Planning is a Dynamic Process Plan before, during and after Plan before, during and after Contingency planning Contingency planning Continued revising Continued revising

Plan Ahead Resource assessment Resource assessment - Be realistic about resources not already committed to the disaster - Know local limits When and how to call for outside resources - Scale of response

Plan Ahead Discuss with groups / individuals Discuss with groups / individuals - Identify problems - Find options - Keep updated on response abilities Resources and personnel Vary by incident

Plan Ahead Involve all potential participants Involve all potential participants - Don’t overlook potential resources - Avoid improper assumptions Regular planning meetings Regular planning meetings - Risks of area - Unforeseen events

Planning Exercises Look for deficiencies Look for deficiencies Single components vs. multi-group Single components vs. multi-group - Moulage useful but complex - Inter-group cooperation

Planning after Exercise Debriefing after exercise Debriefing after exercise - Share information - Improve plan - Ensure dissemination of changes to plans Honest not defensive feedback from all Honest not defensive feedback from all

During the Disaster Constant revision of plan Constant revision of plan - New risks and resources - Loss of resources Flexibility Flexibility - Alternate uses of resources - Alternate ways of transporting patient to resources or resources to patient

Incident Command System IncidentCommander Planning CommandStaff Finance LogisticsOperations

Identified central commander with limited scope of control Identified central commander with limited scope of control - leave chain of command for smaller groups intact Unified command Unified command Modular system Modular system Expand as needed Expand as needed

Medical control - Decisions for children Disaster interventions differ from everyday Disaster interventions differ from everyday - less information - more victims - different priorities Stress for responders Stress for responders “Greatest good to greatest number” “Greatest good to greatest number” - may not be optimal care for each person Triage/treatment protocols for children Triage/treatment protocols for children will help providers

Documentation Need to provide permanent record Need to provide permanent record Transfer of information from field to base hospital Transfer of information from field to base hospital Limit information Limit information - will lose some details

Documentation problems Data loss / inaccuracies Data loss / inaccuracies Patient limitations - unable to obtain / convey accurate information Patient limitations - unable to obtain / convey accurate information Multicopy permanent record Multicopy permanent record Deterioration of record Deterioration of record Identifying the nameless victim Identifying the nameless victim

Documentation uses To track patient movements To track patient movements To reunite families To reunite families Epidemiological studies Epidemiological studies Evaluation and post disaster critique Evaluation and post disaster critique Long term sequelae and resupply Long term sequelae and resupply

Conclusion Planning Planning - risk / hazard analysis - resource assessment - planning is a dynamic process Incident Command System Incident Command System