1. ALTERNATE CARE SITE RANAY STORMS, RN AV CO-LEADER

2. ASSESS YOUR SITE  DOES IT HAVE THE NECESSARY INFRSTRUCTURE  DOOR WIDTH- 46 “ FOR STRETCHERS?  LOADING DOCK  HVAC  WATER  PARKING/ACCESSABILITY FOR AMBULANCES AND HELICOPTERS  TOILET/HANDWASH/ SHOWER FACILITIES  ADA COMPLIANT  BACKUP GENERATOR  ADEQUATE LIGHTING  ELECTRICAL

3. ASSESS THE LAYOUT  FOOD PREP AREA  ISOLATION AREA  STAFF REST AREA  REGISTRATION AREA  TRAIGE AREA  ASSESS THE TRAFFIC FLOW THRU THE SITE

4. COMMUNICATIONS  TELEPHONE  CELL PHONE  INTERNET  HAM RADIO  2 WAY RADIO  AWIN RADIO  TELEVISION WITH SATELLITE OR CABLE

5. OTHER CONSIDERATIONS  CAN YOU LOCK DOWN THE FACILITY  IS THERE A PLACE TO SECURELY STORE CONTROLLED SUBSTANCES  HOW WILL YOU HANDLE BIOHAZARD AND WASTE DISPOSAL  24/7 POINT OF CONTACT AND ACCESS

6. EVALUATE  WHAT WOULD BE THE BEST USE OF THE SITE  CRITICAL CARE  ISOLATION SITE  MEDICAL SURGE  GENERAL NON-MEDICAL SHELTER ONLY  OR IS IT INNAPPROPRIATE FOR USE AS AN ACS

7. COORDINATE WITH COMMUNITY PARTNERS  LOCAL, STATE AND FEDERAL ORGANIZATIONS  LAW ENFORCEMENT  COUNTY OFFICE OF EMERGENCY MANAGEMENT  PUBLIC HEALTH  NATIONAL GUARD

8. VOLUNTEER ORGANIZATIONS  COMMUNITY EMERGENCY RESPONSE TEAMS –CERT  MEDICAL RESERVE CORPS-MRC  RED CROSS-( HAS A VERY GOOD SHELTER COURSE AND CAN PROVIDE FOOD AND COTS, ECT)  SALVATION ARMY

9. COMMERCIAL ORGANIZATIONS & BUSINESS PARTNERS  AIRPORTS  COMMUNICATION COMPANIES  BIG BOX STORES  PUBLIC WORKS/UTILITIY COMPANIES  RESTAURANTS, CATERERS  PUBLIC TRANSPORTATION  VETERINARIANS

10. COMMUNITY ORGANIZATIONS  FAITH BASED ORGANIZATIONS  SCHOOLS  HAM RADIO CLUBS

11. BEHAVIORAL HEALTH  ENGAGE BEHAVIORAL HEALTH RESOURCES  FOR THE PATIENTS IN THE SHELTER  FOR THE STAFF TO ALLOW DECOMPRESSION FROM THE EVENT

12. ACS CAPABILITIES  WHAT CAN YOU BRING TO THE ACS?  RESPIRATORY THERAPY  PORTABLE O2, BIPAP, PORTABLE VENTS  ABG’S  INHALERS  LAB  STAB LAB—GLUCOSE, CREATININE, SPUN HEMATOCRIT, OTHERS?  RADIOLOGY  PORTABLE X RAY AND VIEWING

13. ACS CAPABILITIES  STOCKPILED SUPPLIES AND EQUIPMENT  COTS  LINENS  SCRUBS  MEDICAL SUPPLIES  CASTING SUPPLIES  AMBU BAGS  SUTURING SUPPLIES  PHARMACEUTICALS (SECURE/REFRIGERATED STORAGE)

14. ACS CAPABILITIES  CONSIDER WORKING WITH YOUR COMMUNITY PARTNERS TO PRE-STAGE CACHES OF SUPPLIES AND EQUIPMENT AT YOUR CHOSEN ACS.  MAINTAIN INVENTORY AND SUPPLY LISTS TO FACILITATE CHARGING AND RESTOCKING  CONSIDER STORAGE NEEDS SUCH AS HEATING / COOLING AND A DRY ENVIRONMENT  CONSIDER STAFF/SUPPLY AND EQUIPMENT TRANSPORT NEEDS

15. STAFF CONSIDERATIONS  LOOK AT STAFFING LEVELS AND REQUIREMENTS FOR THE ACS BEFORE YOU NEED IT. REACH OUT TO CLINICS, NURSING HOMES, RETIRED NURSES AND PUBLIC HEALTH, FOR ADDITIONAL STAFF  ESTABLISH CREDENTIALING CRITERIA, CREATE AND STANDARDIZE THE FORMS. (PHOTO ID, CURRENT LICENSE, DECLARED COMPETENCIES, ECT)

16. STAFF CONSIDERATIONS  MAKE ARRANGEMENTS FOR CHILD AND PET CARE FOR YOUR STAFF  FACILITATE COMMUNICATIONS BETWEEN STAFF AND THEIR FAMILIES  DESIGNATE STAFF REFRESHMENT, REST AND SLEEPING AREAS FOR EXTENDED SHIFT STAFF  ENCOURAGE YOUR STAFF TO HAVE AN EMERGENCY KIT READY WITH PERSONAL CLOTHING ITEMS, MEDICATIONS AND TOILETRIES  ENCOURAGE YOUR STAFF TO MAKE AN EMERGENCY PLAN FOR THEIR FAMILY; WHO WILL CARE FOR CHILDREN, WHERE WILL THEY STAY, ECT. IN THE EVENT THE STAFF MEMBER BECOMES QUARANTINED OR MUST WORK AN EXTENDED SHIFT

17. STAFF CONSIDERATIONS  PROVIDE TRAINING  TRIAGE-MOST NURSES HAVE NEVER DONE DISASTER TRIAGE  PRACTICE SETTING THE ACS UP / PROVIDE MAPS/TEMPLATES OF HOW TO SET UP THE ACS FOR PATIENT CARE  FOLLOW ICS TO MANAGE THE STAFF AT THE SITE/TRAIN YOUR STAFF ON ICS AND HICS

18. CONSIDER YOUR PATIENTS  HOW WILL YOU REGISTER AND TRACK YOUR PATIENTS THRU THE ACS AND ON TO OTHER FACILITIES  DEVELOP PT TRACKING FORMS WHICH CAN BE UTILIZED QUICKLY AND COLLECT AS MUCH PERTINENT INFORMATION AS POSSIBLE  CONSIDER BAR CODING TO ASSIST WITH IDENTIFICATION OF PATIENTS AND THEIR BELONGINGS

19. CONSIDER YOUR PATIENTS  PROVIDE AS MUCH PRIVACY AS POSSIBLE  MAINTAIN CONFIDENTIALITY AS MUCH AS POSSIBLE  ASSIGN A PERSON TO FACILITATE REUNITING/FINDING FAMILY MEMBERS  INVITE THE CLERGY TO PROVIDE EMOTIONAL AND SPRITUAL SUPPORT

20. RESOURCES  CREATE A LIST OF AVAILABLE RESOURCES WITH CONTACTS, KEEP THIS UPDATED AND ACCESSABLE TO EVERYONE IN YOUR ORGANIZATION.  KEEP AN UP TO DATE MOU WITH YOUR ACS PARTNER ON FILE AS WELL.  BECAUSE AS WE ALL KNOW DISASTERS NEVER HAPPEN WHEN WE ARE AT WORK, THEY HAPPEN WHEN WE ARE IN LITTLE ROCK AT A PREPAREDNESS CONFERENCE!

21. RESOURCES  www.ahrq.gov www.ahrq.gov  DISASTER ALTERNATE CARE FACILITY SELECTION TOOL  ALTERNATE CARE FACILITY PATIENT SELECTION TOOL  DISASTER ALTERNATE CARE FACILITIES: SELECTION AND OPERATION

22. RESOURCES  www.bepreparedcalifornia.com www.bepreparedcalifornia.com  CALIFORNIA DEPARTMENT OF PUBLIC HEALTH STANDARD AND GUIDELINES FOR HEALTHCARE SURGE DURING EMERGENCIES: GOVERNMENT- AUTHORIZED ALTERNATE CARE SITE OPERATIONAL TOOLS MANUAL