Medical responses to catastrophic events in the u s israel and abroad
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Medical Responses To Catastrophic Events In The U.S, Israel and Abroad. Presented to the. Scripps health And the U.S. Mexican border Health Commission. June 15, 2005. By Dr. Boaz Tadmor. Modes Of Responses. Passive- follow the events without self initiative

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Medical Responses To Catastrophic Events In The U.S, Israel and Abroad

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Medical responses to catastrophic events in the u s israel and abroad

Medical Responses To Catastrophic Events In The U.S, Israel and Abroad

Presented to the

Scripps health

And the

U.S. Mexican border Health Commission

June 15, 2005

By Dr. Boaz Tadmor


Modes of responses

Modes Of Responses

  • Passive- follow the events without self initiative

  • Active- take the initiative after the events and prevent deterioration

  • Proactive- prevention and mitigation prior to events.


Flow of stages of responses

Flow of stages of Responses

  • Prevention- at all times.

  • Hyper-acute phase- Immediate Response : first 24 hours

  • Acute phase- primary response : 24-96 hours post event

  • Continuous phase- 96 hours- days, weeks, months

  • Recovery phase- Resuming normal life


Web of responses

Web Of Responses

  • w.w.w.w

  • Who—When—With What—Why


Gant chart of responses

individual

familial

Community

First responders

county

state

Federal

IR

AR

Prevention

PR

Recovery

Weeks

96H

24H

Gant Chart Of Responses


Need to know areas of responses

“ need to know” Areas of responses

  • non specific knowledge, basic survival skills, - individual based

  • specific knowledge- individual, familial, community-web, risk communication

  • expert knowledge- community, local, state, federal- agency based

  • leadership skills and knowledge – at all levels.


Goals of responses in disaster

Goals of Responses in Disaster

  • Prevent and Reduce as much as possible all types of damages.

    (human life, injuries-mental and physical, societal, economical, technological)

    BY

  • Synergistic interaction and collaboration through constant feedback mechanism

  • Look where are your relative advantages/ disadvantages and behave accordingly.


Goals of the medical system

Goals of the medical system

  • Providing timely and needed care at all levels to all , at all times by all means.


Different additional concerns in disasters

Different, Additional concerns in Disasters

  • limitation of specific knowledge

  • limitation of needed resources

  • limitation of physical space: surge capacity

  • role of primary physician, HMO’s , hospitals

  • define orders of priority of care- “Damage Control” mode


Different additional concerns in disasters1

Different, Additional concerns in Disasters

  • Define level and type of care for each level of medical system

  • Delegate authority

  • Added responsibility

  • Decision making without “ evidence based medicine”

  • Different network of care and information

  • Reserve medical corps, NDMS, deployment, public health, web info


Role of the physician in times of disaster

Role of the physician in times of Disaster

  • Hub of information- bilateral feed back mechanism

  • Reliable and knowledgeable

  • Has official authority and responsibility

  • Leader in the community

  • Specific different role in specific situation

  • New desired skills.

  • Part of a new team

  • Delegate authority

  • Learning and implementing capabilities.


Generic u s a mode of responding to disaster

Generic U.S.A mode of responding to Disaster

  • Individual-community-local (county)-state-federal

  • No involvement of the army resources or national guard.

  • Minimal involvement of the private sector

  • No “ ONE SHOP STOP” for decisions

  • Long and convoluted lines of communication.

  • Different lines and modes of responsibility

  • “Babel -Tower” of integration and collaboration


Put some web sites www fema gov

put some web sites: www.fema.gov

  • Are you ready, National Response Plan


U s a medical model of responding

U.S.A. Medical model of Responding

  • Individual-self care, HMO’s, primary physician, hospital

  • Community and Local- DOH, Hospitals, First Responders, Academia

  • State- DOD, Hospitals, HMO’s, specific units (DMAT, S&R, Epi), Academia

  • Federal- All of the above, DHHS( CDC, NIH, NDMS, National Stockpile), HLS, Different agencies in different ministries.


Continue 13

continue-13

  • Hierarchy of knowledge, expertise and resources

  • Different arms, different engagements, different language, different expertise, different leadership


Main scenarios threat assessments 1 of 2

Main Scenarios/Threat Assessments(1 of 2)

  • Mega terror events

  • Toxicological events

  • Specific chemical events

  • Bioterrorism events

  • Mass vaccinations

  • Primary and secondary deployment

  • Antibiotic distribution


Main scenarios threat assessments 2 of 2

Main Scenarios/Threat Assessments(2 of 2)

  • Public health disaster and preparedness issues

  • Principles of debriefing

  • Mental immunity issues

  • Rehabilitation issues

  • Quality control/evaluation issues

  • Special population issues


Integrated working milieu

Integrated Working Milieu

Israeli

Police

Home Front

Command

Medical

Corps

Military

clinics

Local

Municipalities

Combat

medical

forces

HFC

HQ

HFC

Regional

commands

  • MDA

  • Integrated Hospital

  • organs

  • Representative at the

  • Supreme Health Authority

  • Assistance to

  • Health Advisory

  • Committees

Logistic&

Technological

HQ

Unique

forces

  • Surg. General HQ

  • Part of the Supreme

  • Health Authority

  • Authority for

  • deployed Medical

  • personnel

Primary care

clinics

Professional

committees

Professional Advisory

Secondary deployment

international assistance

Integrated HQ at war time

Blood donation at war time

Instruction and guidance for medical forces

Members of the Supreme Health Authority

Medical forces as integrated hospital organs

National medical forces

MDA personnel

National Medical forces

Medical assistance

Guidance

Aviational evacuation

Level A Medical Companies

Ministry of Health


Responsibility and preparedness medical department hfc

Responsibility and Preparedness-Medical Department-HFC

REHABILITATION

ALERT

Active Defense

Passive Defense+

Treatment and Evacuation

Preparedness and

readiness

Siren

Back to Routine

  • Individual

  • Community

  • Medical center

Ministerial offices

Surg. Gen. HQ

Medical Company-Level A

Medical Company-Level B

Medical Center

Primary care clinics

Physical Protection

Medical Protection

Illness surveillance

Public knowledge

R&D

International cooperation

MOH Committees

Assessment of Special

Population physical protection

needs

Rehabilitation

Overseas cooperation

Continued surveillance

improvement according to

the experience gained

Evacuation/quarantine in the affected area

Secondary deployment of casualties

Blood Donation

Hospital assistance

life saving

integrated work with national HQ

Antibiotics and Vaccinations

Public information centers

3


Responsibility of the citizens

Responsibility of the Citizens

  • Understanding the threat

  • Motivation to collaborate with authorities

  • Suspicion and possible alarm

  • Surveillance

  • Isolation

  • Protection

  • Treatment

  • Follow up

  • Reporting


Civilian population responsibility

Civilian Population Responsibility


Overall responsibility treatment and follow up

Overall Responsibility: Treatment and Follow Up


Responsibilities of healthcare agencies and professionals

Responsibilities of Healthcare Agencies and Professionals


Points of difference 1

Points of difference (1)

  • Characterization of the threat

  • Type, kind, timeline, perspective

  • Size and diversity of agencies, organizations, academia, government

  • Individuals’ background

  • Military-civilian relationship


Points of difference 2

Points of difference (2)

  • Command and control systems

  • Resources: workforce, logistics, money

  • Education

  • Training

  • Mental and child consideration

  • Risk communication and the media

  • Synergy of first responders

  • Academia

  • Leadership perspective


Generic mutual concerns

Generic mutual concerns

  • Leadership and decision making

  • Synergy between first responders

  • Risk communication

  • Individual based responsibilities

  • Resiliency

  • Training and drilling

  • Academic involvement


Relative advantages israel

Relative Advantages:Israel

  • Resiliency: individual, community

  • Hospital readiness and preparedness

  • Synergy of first responders

  • Military-civilian collaboration

  • Short lines of communication for command and control

  • Motivation to share experience and knowledge


Relative advantages united states

Relative Advantages:United States

  • Diversity:

    • Academia

    • Local, state, and federal agencies and organizations

    • Excellent brainstorming

  • Media and technological capabilities

  • International collaboration

  • Scientific excellence

  • Resources


Collaboration

Collaboration

  • Practical knowledge and experience

  • Scientific knowledge and innovation

  • Sharing and mutual involvement and understanding

  • Create the cutting edge of understanding preparedness, mitigation, practicability and recovery


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