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ED Disaster Preparedness: Tertiary Medical Center Perspective. Alisa Murchek, RN, MS, CEN Associate Director of Nursing, Critical Care and Emergency Services. University of Illinois Medical Center. A Tertiary Care Center Eye Trauma Center for Chicago

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ed disaster preparedness tertiary medical center perspective
ED Disaster Preparedness: Tertiary Medical Center Perspective

Alisa Murchek, RN, MS, CEN

Associate Director of Nursing,

Critical Care and Emergency Services

university of illinois medical center
University of Illinois Medical Center
  • A Tertiary Care Center
  • Eye Trauma Center for Chicago
  • Specialty Neuro-Sciences Intensive Care Unit
  • Pediatric Intensive Care Unit
uic plans protocols are modeled on the emergency management system
UIC Plans & Protocols are modeled on the Emergency Management System
  • Illinois State Medical Disaster Plan and Hospital Emergency Incident Command System (HEICS) using:
    • Organizational Charts
    • Job actions sheets
  • Plan is flexible to adapt to each incident
activating the plan
Activating the Plan
  • Based on Type of Incident
    • Biological
    • Chemical/Decontamination
    • Mass Casualties (Trauma)
biological incident
Biological Incident
  • Victims may present intermittently over a period of days to weeks.
    • Infectious Disease Service
    • Toxicology Services
    • Pharmacy Services
    • Facilities Personnel
chemical decontamination
Chemical/Decontamination
  • Victims will arrive by personal transportation (walk-ins) or by ambulance.
  • Victims may not enter through ED but through various hospital entrances
    • Activate UIC Police for Lock-down
    • Environmental Health and Safety Office to coordinate decontamination team efforts
mass casualty incident trauma
Mass Casualty Incident (Trauma)
  • Victims present rapidly usually via ambulance.
  • Hospital must flex staffing levels upward until all victims are treated.
  • Usually in active Disaster Plan for hours not days.
    • Activate incident command, additional staffing, facilities, ITS and finance
current capabilities
Current Capabilities
  • ED treatment rooms 31
  • ED Isolation Rooms 2 fixed, 6 hepa- filtration systems.
  • Hospital Isolation Rooms 11 fixed, 16 hepa-filtration systems
  • ED Decontamination – 6 pts per hour surging to 36 - 48 pts per hour.
surge space
Surge Space
  • 10 treatment carts on ground floor of Hospital building utilizing meeting room space for minor treatment.
  • Activate family waiting area staffed with social workers.
  • Activate American Red Cross Information Services.
  • Activate Media Center with PR personnel.
lessons from e2
Lessons from E2
  • Media
  • Security
  • Inter-hospital communications
staff response
Staff Response
  • Immediate Response is excellent
  • Sustaining response is challenging
available healthcare workers
Available Healthcare Workers
  • 835 Attending Physicians
  • 875 Residents/Fellows
  • 900 Nurses (RN/LPN)
  • How do we distribute staff to sustain disaster response?
plan for a 10 surge
Plan for a 10% surge
  • Use average daily census 320
  • Increase by 10% 64
  • Plan a caregiver ratio of 1:4 16/shift
  • A team approach is best
    • MD/RN/Tech
decontamination
Decontamination
  • Single shower unit = 6 ambulatory patients per hour
  • 3-line unit = 36 ambulatory patients per hour
  • Combination = 42 ambulatory patients per hour
surge space16
Surge Space
  • Within the Hospital
  • Campus Resources/Buildings
  • Community Resources
future plans
Future Plans
  • Increase Surge Space
  • Sustain Response for 72 hours
  • Away Teams
  • Decontamination Teams
  • Pharmaceutical Cache
  • Hospital Vaccination Response Team
  • Educational offerings of many types
summary
Summary
  • Communicate! Resources are often available in unexpected places.
  • The media is in itself a disaster! Plan appropriately.
  • Disaster Planning is an Organizational undertaking not the sole responsibility of the ED.