Disaster Net Radio Greater Cincinnati Health Council

Overview To coordinate communications regarding the distribution of victims/patients in a mass casualty or hazardous materials situation in the most timely, systematic, and efficient manner possible.

Early notification and coordination of medical resources among hospitals in the Tristate region are intended to ensure that victims/pts are: Transported to the facilities most able to quickly stabilize their conditions; Relatively evenly distribute among the receiving hospitals, especially those closest to the incident; Taken to hospitals that are prepared to manage any contamination in a manner that protects staff & the facility

Appropriate Uses Appropriate Uses Situations that include, but are not limited to: Multi-casualty event/ terrorist incidents; Hazardous materials incidents (including situations from which no victims will be transported, but where toxic plumes move toward any hospital Fire: 4 Alarm or more Hospital evacuations NDMS response

Where is the Disaster Net? The Hospital Disaster Network consists of two components: RADIO: The radio backbone of the system lies with Hamilton County Communications on an 800 trunked system. Radios are present in all ED’s- tone activated. WEB: The web-based component is Surge-Net; housed on the GCHC website where hospitals enter current LMCI and NDMS data. (

Definitions LMCI Local Mass Casualty Incident/ED Capability Please enter the number of triage patient types the ED is presently able to receive, (capacity) and the number of triage patient types the facility has received (census). Red (First Priority) - Patients have serious, life threatening injuries, but are salvageable if immediately transported to a facility to receive lifesaving, definitive care. Yellow (Second Priority) - Patients have serious, potentially life threatening injuries, but can be managed and stabilized for a short period in the field treatment area. Transport to a facility can be delayed, but not for long. Green (Third Priority) - Patients have injuries that are not life threatening. Patients can be managed for even a lengthy period of time in the field and will be the last ones transported. Black (Deceased Patients)

Definitions NDMS National Disaster Medical System * Information obtained from the Public Health Emergency web site. Our Vision To serve the Federal response by providing disaster medical care to the nation. Our Mission It is the mission of the National Disaster Medical System to temporarily supplement Federal, Tribal, State and Local capabilities by funding, organizing, training, equipping, deploying and sustaining a specialized and focused range of public health and medical capabilities. Components of the National Disaster Medical System Medical response to a disaster area in the form of personnel, teams and individuals, supplies, and equipment. Patient movement from a disaster site to unaffected areas of the nation. Definitive medical care at participating hospitals in unaffected areas.

Definitions Adult Bed Availability/NDMS Status Surge Capacity Please enter the number of staffed beds available at 12 hours, 24 hours and 72 hours from the time of request: Adult- NDMS Bed Types: Medical/Surgical* Psychiatric* Burn* Critical Care* Pediatric - NDMS Bed Types: Medical/Surgical* Psychiatric* Burn* Critical Care* Adult – Other Bed Types: OR* Negative Flow Isolation* Other Isolation* Obstetrics* Rehabilitation Long Term Acute Pediatric – Other Bed Types OR* Negative Flow Isolation* Other Isolation* Rehabilitation Long Term Acute *Indicates Surge Capacity Bed Category

Activation

ACTIVATION ACTIVATION Scene commander, hospital, GCHC, or dispatch can request activation of the Disaster Net Notification of Hamilton County Communication via radio, landline or cell Net Control also has the ability to open the Net also Recommend it is opened as early in an incident as possible to allow hospital preparation time. Beverly Hills

Steps once Activated Hamilton County Communication Center performs a hospital roll call and provides an overview of the incident and what the hospitals are expected to do, ie; LMCI or NDMS Hospitals acknowledge the receipt of the communication and then enter the information into the SurgeNet System.

Once the roll call is complete, HCCC turns over NET CONTROL to the dispatch center at University Air/Mobile Care. They will bring up the SurgeNet and establish communications with the Scene transportation officer. The transportation officer is to track number, level (red, yellow, green), of victims and where the hospital they are transported to.

Net Control notifies the Hospital the number of victims, who is transporting, ETA, and the triage level. The hospital should acknowledge receipt of this information (# of victims, who is transporting, ETA & triage level). The hospital is to update capability in SurgeNet frequently as not to become overwhelmed unnecessarily. Net Control will remind hospitals to update their status on a frequent basis.

The Transport Officer is to notify Net Control when the victims have been transported. Net Control will notify HCCC the event is over and the Net can be closed. The Net will be closed and the number of victims per hospital that were transported are to be reconciled between the scene and Net Control.

Scene Responsibility

Upon EMS or Fire arrival at the scene of an incident – notify the Communication Center to OPEN THE NET. Once the Communication Center opens the Net – the Transportation or Scene to Hospital Coordinator communicates only with Net Control for patient distribution Tracks what life squad transports what type of patients to the hospital.

SCENE-TO-HOSPITAL COORDINATOR Job Action Sheet Review Record pertinent transport information including: Transport unit name Number of victims on board Triage tag color and special patient needs Triage tag number

SCENE-TO-HOSPITAL COORDINATOR Job Action Sheet Review Receive hospital destination from Net Control and advise transport unit of destination Keep appropriate sections of triage tag Periodically obtain estimated number of victims still needing transport and notify Net Control

ASST. SCENE-TO-HOSPITAL COORDINATOR Job Action Sheet Review Primarily assists by performing record keeping and communications functions

Net Control Coordination with Scene

Net Control… Notifies/verifies the destination hospital of the incoming patients Logs the transport Periodically gets an update on scene status and communicates that to the hospitals Number of victims remaining Estimated time of event

Net Control Coordination with Hospital

Net Control… Reminds hospitals to update SurgeNet whenever they have: A change in capabilities Too many patients (walk ins and/or squads) Additional staff arrive ORs full Space now available

Hospitals outside Radio Range Some hospitals are out of range and are not able to participate on the “Disaster Radio Network”. These facilities will receive communication via the MARCS radio system. Hospitals not on the Disaster Radio Network: Adams County Regional Medical Center Brown County General Hospital Highland District Hospital Margaret Mary Community Hospital (Phone only)

Net Control Assistants… Help with the radio communications Monitor activity on SurgeNet – follow-up by phone any hospitals not reporting capability. Receive fax updates from the hospitals if SurgeNet is not operational Log transports Perform other duties as assigned by Net Control

Hospital Notification

Initial Hospital Notification Hamilton County Communication Center (HCCC) opens the Net and initially notifies the hospitals of the disaster. Tone activation of the hospital’s disaster radio This can also be done directly by Net Control if HCCC is unable to activate. Hospital acknowledges and assigns a person to staff radio as “In-Hospital Disaster Radio Operator” Stands by for more information Type of event Number of victims estimated Unique circumstances (haz mat, unknown illness, etc.) Assesses ability to receive victims – enters all information into SurgeNet Prepares to accept victims

The Hospitals then… Assess their immediate receiving capability for: Red Patients Yellow Patients  Green Patients Assess their immediate OR capabilities How many surgical patients can be received within 30 minutes? Enter patient receiving capabilities into the Local MCI section of SurgeNet Or as a backup, complete the “Local Side – Side 1” of the “Green Form” and report information to Net Control

Back-Up System If the radios are not operational, communications will occur via Landline telephone. If the Web is not operational, the information is to be faxed on the “Green Sheets” Net Control to Scene, can communicate via cell phones or MARCS if available

GREEN FORM SIDE 1 FOR LOCAL INCIDENTS

Receiving Victims

Area Hospital Responsibility For Receiving Victims Hospitals will be notified by Net Control when an ambulance is enroute to that hospital Enter the expected victim on the hospital log Transport unit Patient status Notify Net Control of changes in receiving capabilities Enter all changes into SurgeNet

Area Hospital Responsibility As Victims Arrive Re-triage and provide care per the hospital disaster plan Register the patient in the hospital registration system Update the log with the patient’s name, medical record number, etc. Red Cross Hospital Liaison may be available to assist with family notification

Demobilization Procedures

Area Hospital Responsibility Immediately After the Event Reports totals to Net Control Works with Net Control to reconcile any differences

After Action Submit event report to GCHC representative for inclusion in after action report of exercise or event. Make recommendations for changes that would enhance the process.

Contact Information Tonda L. Francis, RN, MSN Vice President Regional Healthcare Disaster Coordinator Greater Cincinnati Health Council 2100 Sherman Avenue, Suite 100 Cincinnati, OH P: F: Nakia Paris Emergency Readiness & Safety Coordinator Greater Cincinnati Health Council 2100 Sherman Avenue, Suite 100 Cincinnati, OH P: F: