Medical Surge 101Division of Public Health, Public Health Preparedness Wisconsin Department of Health Services Brian Kaczmarski Training and Exercise Coordinator

Medical Surge 101 Division of Public Health, Public Health Preparedness

Wisconsin Department of Health Services

Brian KaczmarskiTraining and Exercise Coordinator

Office of Preparedness and Emergency Health Care 062215

Medical Surge 101- An Overview

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DefinitionThe Medical surge capability is the ability to provide adequate medical evaluation and care during incidents that exceed the limits of the normal medical infrastructure within the community. This encompasses the ability of healthcare organizations to survive an all-hazards incident, and maintain or rapidly recover operations that were compromised.

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2013 HPP CPG document



The TiersApply the definition from previous slide to the disaster tiers:

Tier 1- How do you medically surge within the walls of your organization? When are you ‘overloaded?’Tier 2- What’s your ‘area?’ Is it defined? How do you surge within your area? When are you overloaded?Tier 3- What’s your ‘region?’ How do you surge within your region? When is the region overloaded?Tier 4- Multi-region? State?Tier 5- FEMA Region 5Tier 6- Federal Response

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Functions of Medical Surge1. The Healthcare Coalition assists with the coordination of the healthcare organizationresponse during incidents that require medical surge2. Coordinate integrated healthcare surge operations with pre-hospital Emergency MedicalServices (EMS) operations 3. Assist healthcare organizations with surge capacity and capability4. Develop Crisis Standards of Care Guidance

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2013 PHEP CPG document



Function 1

The Healthcare Coalition assists with the coordination of the healthcare organization response during incidents that require medical surge

• Ensure healthcare coordination• Incident Command

• Ensure situational awareness (Info Sharing)• What is your platform for communicating?

• Use the tiered response plan for coordination

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Function 2

Coordinate integrated healthcare surge operations with pre-hospital Emergency Medical Services (EMS) operations • How do EMS and the health care organization

communicate? • Patient status and transport status• WISCOM

• Do healthcare organizations understand EMS protocols around triage and CBRNE protocols?

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Function 2 - continued• Coordinated disaster protocols for triage, transport,

documentation, CBRNE • Triage methodologies• Transport of mass casualties (Where? Is it the best

possible transport? Or will they need to be re-transported?)

• Disaster documentation (WI-TRAC, WISCOM)• CBRNE exposure care

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CBRNE Exposure Care• Suggested resources:• Standards for Personal Protective Gear for first

Responders: http://www.dhs.gov/files/programs/gc_1218226975457.shtm#0

• NFPA 472: Standards for Competence of Responders to Hazardous Materials/Weapons of Mass Destruction Incidents, 2008

• NIOSH Personal Protective Equipment for Emergency Response: http://www.cdc.gov/niosh/topics/emres/ppe.html

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http://www.dhs.gov/files/programs/gc_1218226975457.shtm



http://www.cdc.gov/niosh/topics/emres/ppe.html





Function 3

Assist healthcare organizations with surge capacity and capability• Task 1 - Assist healthcare organizations with decisions regarding surge

management by ensuring processes exist to provide healthcare organizations with ongoing communication regarding the status of the incident and the status of medical surge operations when requested (Info Sharing)

• Task 2 - Develop a process for healthcare organizations to provide multi-agency coordination regarding resource decisions during medical surge operations (Info Sharing, Resource Management)

• Task 3 - Develop, refine, and sustain processes that assist healthcare organizations to maximize medical surge capacity and capability during response operation (Emergency Operations Coordination)

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Medical Shelters• Many states have resources and plans to set up

medical shelters/tents in an impacted area as a solution to support the medical surge

• Wisconsin does have limited capacity to do this (more later)

• However, this is NOT Wisconsin’s preferred model for Medical Surge.

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Wisconsin’s Medical Surge Model• Patient off-loading and on-loading through the

Disaster Response Tiers.• Through area and regional medical coordinating centers

(AMCC and RMCC), the intent is to systematically off-load the patients to outlying areas or regions that are capable of meeting the needs of the clients.

• Another way to think of it;• Instead of surging resources IN to the impacted area,

we are pushing the patients OUT to where the resources are

• This likely will be in unison with resources coming in

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Wisconsin’s Medical Shelter ModelWisconsin DMAT (Disaster Medical Assistance Team)

• Part of NDMS (National Disaster Medical System)• a federally-coordinated system that provides medical

capabilities in the event of a large-scale emergency that overwhelms normal local medical resources.

• In Wisconsin, this team is actually an MRC (Medical Reserve Corp)

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Wisconsin DMAT Resources

Mobile Medical Care Facility (MMCF)

• Capacity to bring in and set up a total of 4 Mobile Medical Units (MMU) that, combined, form a 40 bed medical care center• Burn supplies for 20 patients

• Pediatric equipment

• PPE to safely operate within a CBRNE incident



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Wisconsin National Guard (WING) Resources

Related to Medical Surge:• Force Package• Mission

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In summary…• Know and understand the Disaster Coordination

Response Tiers• Critical to understanding medical surge in Wisconsin• Patient off and on loading

• This will occur WHILE resources are brought in

• Get the right people to the right place for the best possible outcome

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For More Information• HPP CPG- http://

www.phe.gov/preparedness/planning/hpp/reports/documents/capabilities.pdf

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http://www.phe.gov/preparedness/planning/hpp/reports/documents/capabilities.pdf





Upcoming Medical Surge Training Opportunities

• Introduction to Disaster Coordination Response Tiers- now available; http://dhsmedia.wi.gov/main/Play/368747a8e01e49568ac9d175c15d68501d

• Medical Surge 201 – Forthcoming. Check PCA Training Tab

• Healthcare Scenarios within the Tiered Response Plan- Forthcoming. Check PCA Training Tab

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http://dhsmedia.wi.gov/main/Play/368747a8e01e49568ac9d175c15d68501d





For More Information:

Brian KaczmarskiTraining & Exercise Coordinator

Office of Preparedness and Emergency HealthcareWisconsin Division of Public [email protected]

Cell: 608-215-1025

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mailto:[email protected]

Documents

Medical Surge 101Division of Public Health, Public Health Preparedness Wisconsin Department of Health Services Brian Kaczmarski Training and Exercise Coordinator