1. Disaster Medical Hospital Control Adam Richards RN, BSN Director of Emergency Services Deaconess Medical Center

2. Region 9 DMHC Implementation Procedure “Disaster Medical Hospital Control will make every effort to place patients initially at a facility most appropriately to care for them, and to avoid secondary transfer from facility to facility if possible.”

3. The trigger Multiple ambulances dispatched to one incident Multiple ambulances dispatched to one incident multi-unit housing structure fire multi-unit housing structure fire MVC- multiple vehicles or Haz-Mat situation MVC- multiple vehicles or Haz-Mat situation Public venue incident Public venue incident Aircraft incident Aircraft incident Explosion or building collapse Explosion or building collapse

4. The contact From first responders: SFD, SVFD, SPD From first responders: SFD, SVFD, SPD Dispatch (AMR, CCC, SPD) Dispatch (AMR, CCC, SPD) All Law Enforcement agencies All Law Enforcement agencies Incident Command Incident Command Local/Regional Hospitals Local/Regional Hospitals Department of Emergency Management Department of Emergency Management Public Health Public Health

5. The Decision Does this exceed the capacity or create a surge event for the immediate facilities affected? 1. Evaluate capacities locally/regionally 2. Initiate calls to nursing supervisors in local/regional hospitals to evaluate capacity 3. Initiate a blue line informational update on Ramses… an ALERT.

6. Start with the “ALERT” Currently Region 9 is using RAMSES to create an alert for other hospitals. Currently Region 9 is using RAMSES to create an alert for other hospitals. Simultaneously; phone calls to the local/regionally affected hospitals will help determine the need for full activation of the DMHC Simultaneously; phone calls to the local/regionally affected hospitals will help determine the need for full activation of the DMHC

7. The DMHC Alert Call Data Sheet

8. Decision to activate… Made by the Incident Command in conjunction with the DMHC Made by the Incident Command in conjunction with the DMHC Based on the capacity of the locally affected hospitals Based on the capacity of the locally affected hospitals Size of event Size of event Number of patients Number of patients

9. The ACTIVATION Once the decision to activate has been made then “Activation” will occur via the RAMSES system or WaTRAC. Once the decision to activate has been made then “Activation” will occur via the RAMSES system or WaTRAC. Initiate an “All Call” on HEAR Initiate an “All Call” on HEAR Contact the Poison Control Center if Haz Mat is involved Contact the Poison Control Center if Haz Mat is involved Contact the Blood Bank (509)624-8591 Contact the Blood Bank (509)624-8591 Initiate forward movement of patients Initiate forward movement of patients

10. “All Call” on HEAR “This is Deaconess Medical Center your Disaster Medical Hospital Control calling all regional hospitals. This is a (drill or disaster). Do not use call letters until instructed to do so. (Briefly describe the disaster/drill.) Please acknowledge as your facility is called.”

11. DMHC needs during Disaster Patience Patience A response if a Disaster alert “all call” is initiated. A response if a Disaster alert “all call” is initiated. An update on Ramses for bed availability An update on Ramses for bed availability An update if you are not able to raise a subspecialist for your hospital (i.e. neurosurgery). An update if you are not able to raise a subspecialist for your hospital (i.e. neurosurgery). Communication with DMHC if you are exceeding your capacity Communication with DMHC if you are exceeding your capacity

12. DMHC All Call Directory/Log

13. Capacity In a disaster situation when all hospitals have exceeded their capacity, it is known that DMHC will continue to send patients to them.

14. MCI Patient Triage/Destination List

15. What do we do? 1. Alert 2. Activate 3. Designate one person and a secretary if possible to be stationed at the HEAR Radio to initiate the “All Call.” 4. Connect with local/regional hospitals for a quick inventory of resources 5. Initiate Internal Disaster Protocol

16. Goals for DMHC Have a yearly review of DMHC policy/procedure Have a yearly review of DMHC policy/procedure For updates in policy Changes in capabilities Educational purposes to stay current Hot Wash large scale incidents Hot Wash large scale incidents Train staff on off hours Train staff on off hours Create education for all staff that do not work the customary day shifts where the majority of practice takes place.