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L 11 Epidemics and Emerging Infections 1
Epidemics and Emerging
Infections
Hospital Preparedness for Emergencies
Wars of the Future:
Biological Warfare and Chemical
Weapons
Teodoro Herbosa MD FPCS
Department of Emergency Medicine
Colle...
L 11 Epidemics and Emerging Infections 3
Objective
Identify the fundamentals of a
hospital preparedness and
response plan ...
L 11 Epidemics and Emerging Infections 4
Biological Hazards
❑ “Terrorism” / Anthrax
❑ SARS
❑ Avian Flu
❑ Dengue
❑ MERSCoV
...
L 11 Epidemics and Emerging Infections 5
Biological
Hazards
Tartars used
plague-
infected
corpses in
Kaffa, 1346.
L 11 Epidemics and Emerging Infections 6
Influenza Pandemic
Nurses work in the
Red Cross rooms of
Seattle, WA with
“influe...
L 11 Epidemics and Emerging Infections 7
Basic Dictum
Safety First!
L 11 Epidemics and Emerging Infections 8
Biological Event
❑ Bacterial agents
▪ Anthrax, Brucellosis, Yersinea pestis
(Plag...
L 11 Epidemics and Emerging Infections 9
Smallpox – Bangladesh, 1976
A child stricken by smallpox is
relatively cured but ...
L 11 Epidemics and Emerging Infections 10
Biological Event
❑ Infection borne through air, food
and water
❑ Incubation peri...
L 11 Epidemics and Emerging Infections 11
Rare Diseases can be Overseen
Rare color
photo of Baby
with smallpox.
National
A...
L 11 Epidemics and Emerging Infections 12
Biological Event
❑ Delivered with conventional
explosives
❑ Emergency care,
deco...
L 11 Epidemics and Emerging Infections 13
Decontamination Area
❑ Storage for decontamination equipment
and supplies
❑ Deco...
L 11 Epidemics and Emerging Infections 14
Contamination reduction
(warm) zone
Support (cold) zone
Exclusion (hot) zone
win...
L 11 Epidemics and Emerging Infections 15
Decontamination Area
❑ First responders and medical
personnel SHOULD PROTECT
THE...
L 11 Epidemics and Emerging Infections 16
Decontamination Area
Storage for decontamination
equipment and supplies
Decontam...
L 11 Epidemics and Emerging Infections 17
Decontamination Area
L 11 Epidemics and Emerging Infections 18
Hot zone
Support zone
Decontamination
zone
Patients
No special protective gear
h...
L 11 Epidemics and Emerging Infections 19
Decontamination Area
L 11 Epidemics and Emerging Infections 20
Decontamination Area
❑ First responders (decontamination)
protect themselves thr...
L 11 Epidemics and Emerging Infections 21
Decontamination Area
❑ Maximum protection is achieved
through use of positive pr...
L 11 Epidemics and Emerging Infections 22
Decontamination Area
L 11 Epidemics and Emerging Infections 23
Personal Protective Equipment
Red Cross workers of Boston,
MA removing bundles o...
L 11 Epidemics and Emerging Infections 24
Medical Response
❑ Pandemic
▪ large number of
casualties with similar
symptoms
▪...
L 11 Epidemics and Emerging Infections 25
Medical Response
First responders
and medical
personnel
SHOULD
PROTECT
THEMSELVE...
L 11 Epidemics and Emerging Infections 26
Medical Response
Why is the level of
Epidemic
preparedness so
critical?
❑ Becaus...
L 11 Epidemics and Emerging Infections 27
Category A
The public health systems and primary health-care
providers must be p...
L 11 Epidemics and Emerging Infections 28
Category A Agents Include:
❑ Variola major (Smallpox):
❑ Bacillus anthracis (Ant...
L 11 Epidemics and Emerging Infections 29
Category A Agents Include:
❑ Filoviruses
- Ebola Hemorrhagic Fever;
- Marburg He...
L 11 Epidemics and Emerging Infections 30
Category B
Second-highest priority agents:
❑ moderately easy to disseminate
❑ ca...
L 11 Epidemics and Emerging Infections 31
Category B agents include:
❑ Coxiella burnetti (Q fever)
❑ Brucella species (Bru...
L 11 Epidemics and Emerging Infections 32
Category B
A subset of List B agents include pathogens
that are food or waterbor...
L 11 Epidemics and Emerging Infections 33
Category C
Third-highest priority agents include emerging
pathogens that could b...
L 11 Epidemics and Emerging Infections 34
Category C agents include:
❑ Nipah virus
❑ Hantaviruses
❑ Tickbone hemorrhagic f...
L 11 Epidemics and Emerging Infections 35
Category C
Preparedness for List C agents requires ongoing
research to improve d...
L 11 Epidemics and Emerging Infections 36
❑ Cholera epidemic, Europe 1830 - 1847
intensive infectious disease diplomacy
mu...
L 11 Epidemics and Emerging Infections 37
IHR (1969) to monitor and control six
serious infectious diseases:
Cholera, Plag...
L 11 Epidemics and Emerging Infections 38
1990's resurgence of epidemics
Cholera - South America
Plague - India
Emergence ...
L 11 Epidemics and Emerging Infections 39
May 2003 resolution WHA56.28 Revision
of IHR
IGWG sessions in Nov 2004 and Feb/
...
L 11 Epidemics and Emerging Infections 40
International Health Regulations of
2005, Article 5-1 Surveillance
Declaration o...
L 11 Epidemics and Emerging Infections 41DOH – CHD, REGIONAL EPIDEMIOLOGY and SURVEILLANCE UNIT (RESU)
Priority Diseases/S...
L 11 Epidemics and Emerging Infections 42
Medical Response
First responders must take
care that they don't become
victims ...
L 11 Epidemics and Emerging Infections 43
Medical Response
A 1995 NBC exercise in New York City
determined the first 100 e...
L 11 Epidemics and Emerging Infections 44
Why is the level of epidemic 

preparedness so critical?
Because the
consequence...
L 10 Complex Emergencies 45
Terrorism
❑ ‘War Within Borders’
❑ Asia - a nesting place for terrorism and
lead member of the...
L 10 Complex Emergencies 46
Weapons of Mass Destruction (WMD)
❑ In warfare for 2500 years
❑ Biological - Tartars used plag...
L 10 Complex Emergencies 47
Nuclear Agents
❑ Nuclear detonation through
conventional explosives
❑ Activation of Radioactiv...
L 10 Complex Emergencies 48
Injury Profile – Nuclear Agents
❑ Thermal injury - burns
❑ Eye injuries - blindness due to bla...
L 10 Complex Emergencies 49
Radiation Sickness
❑ Irradiation injuries do not make
the patient radioactive!
❑ Decontaminati...
L 10 Complex Emergencies 50
Biological agents
❑ Infectious disease or toxin that can be
used in bioterrorism or biological...
L 10 Complex Emergencies 51
❑ Incubation period: delay in time of
exposure until clinical symptoms
❑ Some are rapidly fata...
L 10 Complex Emergencies 52
Biological agents
❑ Bacteria - Anthrax, Brucellosis,
Plague & Cholera
❑ Viruses - smallpox / h...
L 10 Complex Emergencies 53
Anthrax
❑
L 10 Complex Emergencies 54
Plague
❑ Bubonic Plague –
Enlarged Lymph nodes
❑
“Black Death” – Peripheral
gangrene
L 10 Complex Emergencies 55
Smallpox
❑
L 10 Complex Emergencies 56
Chemical Agents
Chlorine gas dispersion during World War I
L 10 Complex Emergencies 57
❑ About 70 chemicals are documented
in history as WMD which include:
Chlorine, Phosgene, Cyani...
L 10 Complex Emergencies 58
Nerve Gas 

(Sarin Gas Attack - Japan)
❑ Sarin - fluorinated phosphinate
❑ Similar to Insectic...
L 10 Complex Emergencies 59
NBC incident – 

Characteristics
❑ Mass casualties with similar symptoms
❑ Dissemination devic...
L 10 Complex Emergencies 60
Hospital Preparedness for 

NBC Events
❑ Management system for mass NBC
casualties
❑ HAZMAT su...
L 10 Complex Emergencies 61
Decontamination Protocols
❑ Patients could arrive at hospital
prior to decontamination
❑ Risk ...
L 10 Complex Emergencies 62
Review of Objectives
As a result of this session, you should be able
to:
❑ Describe the charac...
L 11 Epidemics and Emerging Infections 63
Summary
❑ Epidemics pose challenges for medical
personnel.
❑ Preparedness for an...
L 11 Epidemics and Emerging Infections 64
Summary
❑ Planning, disciplined & coordinated
behavior by personnel, mobilizatio...
L 11 Epidemics and Emerging Infections 65
Objectives
❑ Identify the fundamentals of a
hospital preparedness and
response p...
L 11 Epidemics and Emerging Infections 66
Exercise
❑ What resources does your hospital have
which can be applied to a CBR ...
L 11 Epidemics and Emerging Infections 67
❑ With whom should the hospital
coordinate regularly on CBR
issues?
❑ Who should...
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Pup biologic warfare

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An Introductory Lecture to the Bachelor of Science in Biology Students of the Polytechnic University of the Philippines

Veröffentlicht in: Gesundheit & Medizin
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Pup biologic warfare

  1. 1. L 11 Epidemics and Emerging Infections 1 Epidemics and Emerging Infections Hospital Preparedness for Emergencies
  2. 2. Wars of the Future: Biological Warfare and Chemical Weapons Teodoro Herbosa MD FPCS Department of Emergency Medicine College of Medicine University of the Philippines, Manila
  3. 3. L 11 Epidemics and Emerging Infections 3 Objective Identify the fundamentals of a hospital preparedness and response plan for epidemics. Upon completion of this unit, you will be able to:
  4. 4. L 11 Epidemics and Emerging Infections 4 Biological Hazards ❑ “Terrorism” / Anthrax ❑ SARS ❑ Avian Flu ❑ Dengue ❑ MERSCoV ❑ Ebola Vulnerability emerging to infectious diseases
  5. 5. L 11 Epidemics and Emerging Infections 5 Biological Hazards Tartars used plague- infected corpses in Kaffa, 1346.
  6. 6. L 11 Epidemics and Emerging Infections 6 Influenza Pandemic Nurses work in the Red Cross rooms of Seattle, WA with “influenza masks” on their faces. December 1918 (Courtesy of the National Archives, 165-WW-269B-10)
  7. 7. L 11 Epidemics and Emerging Infections 7 Basic Dictum Safety First!
  8. 8. L 11 Epidemics and Emerging Infections 8 Biological Event ❑ Bacterial agents ▪ Anthrax, Brucellosis, Yersinea pestis (Plague) & Cholera , Salmonella ❑ Viruses ▪ Smallpox, Hemorrhagic Fever Virus ❑ Biological product ▪ Botulinum toxin, Endotoxins, Mycotoxin, SEB, ricin,
  9. 9. L 11 Epidemics and Emerging Infections 9 Smallpox – Bangladesh, 1976 A child stricken by smallpox is relatively cured but his health is still threatened by malnutrition and secondary infection. (Courtesy of the National Archives, 76-845)
  10. 10. L 11 Epidemics and Emerging Infections 10 Biological Event ❑ Infection borne through air, food and water ❑ Incubation period - delay from time of exposure until clinical symptoms arise ❑ Extensive exposure may occur before the primary event is appreciated.
  11. 11. L 11 Epidemics and Emerging Infections 11 Rare Diseases can be Overseen Rare color photo of Baby with smallpox. National Archive film footage from Vietnam (RG-428- NPC-38594)
  12. 12. L 11 Epidemics and Emerging Infections 12 Biological Event ❑ Delivered with conventional explosives ❑ Emergency care, decontamination is necessary (outside the hospital) ❑ Personnel must be trained in patient decontamination
  13. 13. L 11 Epidemics and Emerging Infections 13 Decontamination Area ❑ Storage for decontamination equipment and supplies ❑ Decontamination area - cooled to reduce the heat load on personnel caused by their protective equipment ❑ The decontamination site has 3 zones: ▪ Hot zone – incoming casualties ▪ Warm zone – decontamination area ▪ Cold zone – triage and transport
  14. 14. L 11 Epidemics and Emerging Infections 14 Contamination reduction (warm) zone Support (cold) zone Exclusion (hot) zone wind CORRIDOR amp Access control points Crowd control line Decontamina tion line Hot line
  15. 15. L 11 Epidemics and Emerging Infections 15 Decontamination Area ❑ First responders and medical personnel SHOULD PROTECT THEMSELVES ❑ Personal Protective Equipment (PPE) ▪ Protect eyes, lungs and skin
  16. 16. L 11 Epidemics and Emerging Infections 16 Decontamination Area Storage for decontamination equipment and supplies Decontamination area ❑ cooled to reduce the heat load on personnel caused by their protective equipment
  17. 17. L 11 Epidemics and Emerging Infections 17 Decontamination Area
  18. 18. L 11 Epidemics and Emerging Infections 18 Hot zone Support zone Decontamination zone Patients No special protective gear hazmat teams with proper protective gear gross contaminates removed here remove victim’s contaminated clothing wash & final rinse/soap & shampoo wash & rinse clean stretcher & blankets
  19. 19. L 11 Epidemics and Emerging Infections 19 Decontamination Area
  20. 20. L 11 Epidemics and Emerging Infections 20 Decontamination Area ❑ First responders (decontamination) protect themselves through PPE. ❑ Personal Protective Equipment (PPE) respiratory equipment ❑ Garments and barrier material
  21. 21. L 11 Epidemics and Emerging Infections 21 Decontamination Area ❑ Maximum protection is achieved through use of positive pressure respirators and total body encapsulation. ❑ Surgical mask and a pair of latex gloves provide minimum protection
  22. 22. L 11 Epidemics and Emerging Infections 22 Decontamination Area
  23. 23. L 11 Epidemics and Emerging Infections 23 Personal Protective Equipment Red Cross workers of Boston, MA removing bundles of masks for American Soldiers from a table where other women are busily engaged in making them. March 1919. (Courtesy of the National Archives, 165- WW-269B-37)
  24. 24. L 11 Epidemics and Emerging Infections 24 Medical Response ❑ Pandemic ▪ large number of casualties with similar symptoms ▪ dissemination device ▪ receipt of a warning ▪ hospital may receive untreated casualties directly from the site Emergency Hospital at Brookline, MA to care for influenza cases. October 1918
  25. 25. L 11 Epidemics and Emerging Infections 25 Medical Response First responders and medical personnel SHOULD PROTECT THEMSELVES September 11
  26. 26. L 11 Epidemics and Emerging Infections 26 Medical Response Why is the level of Epidemic preparedness so critical? ❑ Because the consequences of not being prepared are so catastrophic Smallpox Vaccine
  27. 27. L 11 Epidemics and Emerging Infections 27 Category A The public health systems and primary health-care providers must be prepared to address varied biological agents, including pathogens that are rarely seen. High- priority agents include organisms that pose a risk to national security because they – ❑ can be easily disseminated or transmitted person-to-person; ❑ cause high mortality, with potential for major public health impact; ❑ might cause public panic and social disruption; and ❑ require special action for public health preparedness.
  28. 28. L 11 Epidemics and Emerging Infections 28 Category A Agents Include: ❑ Variola major (Smallpox): ❑ Bacillus anthracis (Anthrax); ❑ Yersinia pestis (Plague); ❑ Clostridium botulinium toxin (Botulism); ❑ Francisella tullarensis (Tularemia);
  29. 29. L 11 Epidemics and Emerging Infections 29 Category A Agents Include: ❑ Filoviruses - Ebola Hemorrhagic Fever; - Marburg Hemorrhagic Fever; and ❑ Arenaviruses - Lassa (Lassa Fever) - Junin (Argentine Hemorrhagic Fever) related viruses.
  30. 30. L 11 Epidemics and Emerging Infections 30 Category B Second-highest priority agents: ❑ moderately easy to disseminate ❑ cause moderate morbidity and low mortality ❑ require specific enhancements of CDC’s diagnostic capacity and enhanced disease surveillance
  31. 31. L 11 Epidemics and Emerging Infections 31 Category B agents include: ❑ Coxiella burnetti (Q fever) ❑ Brucella species (Brucellosis) ❑ Burkholderia mallei (Glanders) ❑ Alphaviruses ▪ Venezuelan encephalomyelitis ▪ Eastern and Western equine encephalomyelitis ❑ Rich toxin from Ricinus communis (castor beans) ❑ Epsilon toxin of Clostridium perfringens ❑ Staphylococcus enterotoxin B
  32. 32. L 11 Epidemics and Emerging Infections 32 Category B A subset of List B agents include pathogens that are food or waterborne. These pathogens include, but are not limited to: ▪ Salmonella species ▪ Shigella dysenteriae ▪ Escherichia coli O157:H7 ▪ Vibrio cholerae ▪ Cryptosporidium parvum
  33. 33. L 11 Epidemics and Emerging Infections 33 Category C Third-highest priority agents include emerging pathogens that could be engineered for mass dissemination in the future because of: ❑ availability ❑ ease of production and dissemination ❑ potential for high morbidity and mortality due to major health impacts
  34. 34. L 11 Epidemics and Emerging Infections 34 Category C agents include: ❑ Nipah virus ❑ Hantaviruses ❑ Tickbone hemorrhagic fever viruses ❑ Tickbone encephalitis viruses ❑ Yellow fever ❑ Multi-drug resistant tuberculosis
  35. 35. L 11 Epidemics and Emerging Infections 35 Category C Preparedness for List C agents requires ongoing research to improve disease detection, diagnosis, treatment and prevention. Linking bio-terrorism preparedness efforts with ongoing disease surveillance and outbreak response activities as defined in CDC’s emerging infectious disease strategy is imperative.
  36. 36. L 11 Epidemics and Emerging Infections 36 ❑ Cholera epidemic, Europe 1830 - 1847 intensive infectious disease diplomacy multilateral cooperation; First International Sanitary Conference, Paris 1851 ❑ 1948 WHO Constitution ❑ 1951 WHO adopted International Sanitary Regulations ❑ International Health Regulations, 1969 History of the IHR
  37. 37. L 11 Epidemics and Emerging Infections 37 IHR (1969) to monitor and control six serious infectious diseases: Cholera, Plague, Yellow fever, Smallpox, Relapsing fever and Typhus IHR (1969) - Cholera, Plague and Yellow fever remain of concern WHO must be informed History of the IHR
  38. 38. L 11 Epidemics and Emerging Infections 38 1990's resurgence of epidemics Cholera - South America Plague - India Emergence of infectious agents Ebola (48th World Health Assembly, 1995 revision of IHR, May 2001) WHA 54.14, Global health security: epidemic alert and response History of the IHR
  39. 39. L 11 Epidemics and Emerging Infections 39 May 2003 resolution WHA56.28 Revision of IHR IGWG sessions in Nov 2004 and Feb/ May 2005 58th World Health Assembly adopted IHR (2005) 23 May 2005 resolution WHA58.3. History of the IHR
  40. 40. L 11 Epidemics and Emerging Infections 40 International Health Regulations of 2005, Article 5-1 Surveillance Declaration of Policies • urges Member States to develop, strengthen and maintain as soon as possible, but no later than five years from entry into force of these regulations, and the capacity to detect, assess, notify and report events in accordance with these regulations.
  41. 41. L 11 Epidemics and Emerging Infections 41DOH – CHD, REGIONAL EPIDEMIOLOGY and SURVEILLANCE UNIT (RESU) Priority Diseases/Syndromes And Conditions Targeted For Surveillance Category I (Immediately Notifiable) 1. Acute Flaccid Paralysis 2. Adverse Event Following Immunization (AEFI) 3. Anthrax 4. Human Avian Influenza 5. Measles 6. Meningococcal Disease 7. Neonatal Tetanus 8. Paralytic Shellfish Poisoning 9. Rabies 1.Severe Acute Respiratory Syndrome (SARS) Category II (Weekly Notifiable) 1. Acute Bloody Diarrhea 2. Acute Encephalitis Syndrome 3. Acute Hemorrhagic Fever Syndrome 4. Acute Viral Hepatitis 5. Bacterial Meningitis 6. Cholera 7. Dengue 8. Diphtheria 9. Influenza-like Illness 10. Leptospirosis 11. Malaria 12. Non-neonatal Tetanus 13. Pertussis •Typhoid and Paratyphoid Fever
  42. 42. L 11 Epidemics and Emerging Infections 42 Medical Response First responders must take care that they don't become victims themselves.
  43. 43. L 11 Epidemics and Emerging Infections 43 Medical Response A 1995 NBC exercise in New York City determined the first 100 emergency responders to arrive on scene 'killed' ❑ not adequately prepared or trained to deal with this incident Los Angeles exercise ❑ doctors admitting that 'victims' have seriously contaminated hospitals
  44. 44. L 11 Epidemics and Emerging Infections 44 Why is the level of epidemic 
 preparedness so critical? Because the consequences of not being prepared are so catastrophic!
  45. 45. L 10 Complex Emergencies 45 Terrorism ❑ ‘War Within Borders’ ❑ Asia - a nesting place for terrorism and lead member of the globe in terrorism ❑ Afghanistan ➔ Japan ❑ Vulnerability of non-involved population ❑ Unclear end-point for termination of further, recurrent acts
  46. 46. L 10 Complex Emergencies 46 Weapons of Mass Destruction (WMD) ❑ In warfare for 2500 years ❑ Biological - Tartars used plague-infected corpses in Kaffa in 1346. ❑ Modern warfare (1915) - Chlorine gas ❑ Nuclear bombs - Hiroshima and Nagasaki, 1945. ❑ Nerve and vesicant agents against Iran ❑ Cyanide against the Kurds
  47. 47. L 10 Complex Emergencies 47 Nuclear Agents ❑ Nuclear detonation through conventional explosives ❑ Activation of Radioactive material ❑ Dissemination through ▪ Food ▪ Water ▪ Direct environmental spread
  48. 48. L 10 Complex Emergencies 48 Injury Profile – Nuclear Agents ❑ Thermal injury - burns ❑ Eye injuries - blindness due to blast flash ❑ Ear injuries - deafness rupture of ear drums ❑ Penetrating wounds/orthopedic injuries/head injuries
  49. 49. L 10 Complex Emergencies 49 Radiation Sickness ❑ Irradiation injuries do not make the patient radioactive! ❑ Decontamination before transport ❑ Removal of all clothing ❑ Tepid bathing of skin surface
  50. 50. L 10 Complex Emergencies 50 Biological agents ❑ Infectious disease or toxin that can be used in bioterrorism or biological warfare ❑ Viruses, microorganisms (bacteria and fungi) and their associated toxins ❑ Can be delivered with conventional explosives, air, food and water
  51. 51. L 10 Complex Emergencies 51 ❑ Incubation period: delay in time of exposure until clinical symptoms ❑ Some are rapidly fatal ❑ Others are severely incapacitating ❑ Extensive exposure may occur before the primary event is revealed Biological Agents
  52. 52. L 10 Complex Emergencies 52 Biological agents ❑ Bacteria - Anthrax, Brucellosis, Plague & Cholera ❑ Viruses - smallpox / hemorrhagic fever ❑ Biological products - Botulinum toxin, endotoxins, mycotoxin
  53. 53. L 10 Complex Emergencies 53 Anthrax ❑
  54. 54. L 10 Complex Emergencies 54 Plague ❑ Bubonic Plague – Enlarged Lymph nodes ❑ “Black Death” – Peripheral gangrene
  55. 55. L 10 Complex Emergencies 55 Smallpox ❑
  56. 56. L 10 Complex Emergencies 56 Chemical Agents Chlorine gas dispersion during World War I
  57. 57. L 10 Complex Emergencies 57 ❑ About 70 chemicals are documented in history as WMD which include: Chlorine, Phosgene, Cyanide and Vesicants (‘Nitrogen Mustard’) ❑ Exposure may not be revealed until chemical injuries are recognized ❑ On-site decontamination Chemical Agents
  58. 58. L 10 Complex Emergencies 58 Nerve Gas 
 (Sarin Gas Attack - Japan) ❑ Sarin - fluorinated phosphinate ❑ Similar to Insecticide - malathion ❑ Attacks the 
 nervous system
  59. 59. L 10 Complex Emergencies 59 NBC incident – 
 Characteristics ❑ Mass casualties with similar symptoms ❑ Dissemination device ❑ Receipt of warning ❑ Hospital may receive untreated casualties direct from the site ❑ Rescue personnel could become victims due to unavailability of information Fill in the Blank
  60. 60. L 10 Complex Emergencies 60 Hospital Preparedness for 
 NBC Events ❑ Management system for mass NBC casualties ❑ HAZMAT suits and PPE for staff ❑ Education of staff and community regarding local and regional risks ❑ Training in patient decontamination Fill in the Blank
  61. 61. L 10 Complex Emergencies 61 Decontamination Protocols ❑ Patients could arrive at hospital prior to decontamination ❑ Risk to health care professionals who would subsequently require decontamination. ❑ Designated Decontamination areas in the Hospital Fill in the Blank
  62. 62. L 10 Complex Emergencies 62 Review of Objectives As a result of this session, you should be able to: ❑ Describe the characteristics and challenges of Complex Disasters. ❑ Identify the salient features of NBC incidents and the response required. ❑ Outline major health effects and hospital preparedness for complex disasters.
  63. 63. L 11 Epidemics and Emerging Infections 63 Summary ❑ Epidemics pose challenges for medical personnel. ❑ Preparedness for an appropriate hospital response activated is essential, while ensuring the safety of personnel. ❑ EMS may not provide the most effective and immediate medical response. ❑ Successful outcome of the medical care requires adequate preparedness.
  64. 64. L 11 Epidemics and Emerging Infections 64 Summary ❑ Planning, disciplined & coordinated behavior by personnel, mobilization ability, availability of medical resources, and communication are essential in effective care. Continue…
  65. 65. L 11 Epidemics and Emerging Infections 65 Objectives ❑ Identify the fundamentals of a hospital preparedness and response plan for epidemics. Upon completion of this unit you will be able to:
  66. 66. L 11 Epidemics and Emerging Infections 66 Exercise ❑ What resources does your hospital have which can be applied to a CBR incident? ❑ What training is required for EM personnel in order to mount a safe and effective hospital response to a CBR incident? ❑ With what other agencies should the hospital be conducting joint CBR exercises?
  67. 67. L 11 Epidemics and Emerging Infections 67 ❑ With whom should the hospital coordinate regularly on CBR issues? ❑ Who should be represented on your hospital’s CBR functional preparedness committee? Exercise Continue…

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