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Emergency Preparedness and Bioterrorism Region Training

Emergency Preparedness and Bioterrorism Region Training. Presented by the Minnesota HomeCare Association Staff and the MHCA Emergency Preparedness and Bioterrorism Task Force - 2002. Center for Disease Control Info Page on Bioterrorism. WHAT IS THE PUBLIC HEALTH PROBLEM?

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Emergency Preparedness and Bioterrorism Region Training

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  1. Emergency Preparedness and Bioterrorism Region Training • Presented by the Minnesota HomeCare Association Staff and the MHCA Emergency Preparedness and Bioterrorism Task Force - 2002

  2. Center for Disease Control Info Page on Bioterrorism • WHAT IS THE PUBLIC HEALTH PROBLEM? • Bioterrorism is a significant public health threat

  3. Center for Disease Control Info Page on Bioterrorism • WHAT IS THE PUBLIC HEALTH PROBLEM • Bioterrorism is a significant public health threat • Response to a bioterrorism event will require rapid deployment of scarce public health resources

  4. Center for Disease Control Info Page on Bioterrorism • WHAT IS THE PUBLIC HEALTH PROBLEM • Bioterrorism is a significant public health threat • Response to a bioterrorism event will require rapid deployment of scarce public health resources • The nation’s public health infrastructure currently is not adequate to detect and respond to a bioterrorist event

  5. THE NEXT STEPS FOR CDC,STATE AND LOCAL HEALTH DEPARTMENTS ARE TO: • Continue to enhance public infrastructure; • Surveillance • Epidemiology • Rapid lab diagnosis • Information systems

  6. THE NEXT STEPS FOR CDC,STATE AND LOCAL HEALTH DEPARTMENTS ARE TO: • Continue to enhance public health infrastructure • Continue to develop response capacity; • Workforce • Communications • National Pharmaceutical deployment

  7. THE NEXT STEPS FOR CDC, STATE AND LOCAL HEALTH DEPARTMENTS ARE TO: • Continue to enhance public health infrastructure • Continue to develop response capacity; • Provide training in bioterrorism preparedness and response for the public health workforce

  8. PREPAREDNESS PLANNING AND READINESS ASSESSMENT FOR HOME CARE ORGANIZATIONS • First prepare for personal and staff protection

  9. PREPAREDNESS PLANNING AND READINESS ASSESSMENT • First Prepare for personal and staff protection • Conduct an assessment of preparedness and response capacity • Review and evaluate current emergency plan

  10. PREPAREDNESS PLANNING • First prepare for personal and staff protection • Conduct an assessment of preparedness and response capacity • Conduct coordinated planning with County Public Health and local health care providers

  11. Implement planning strategies to include: • A 24/7 activation • Redundancy of systems • Training of key individuals • System for identification of clients needing essential services • System for identification of staff availability

  12. Consider: • Staying alert – avoid complacency

  13. Consider: • Staying alert – avoid complacency • Utilizing community based connections • Work with Parish Nurses • Explore working with neighborhood groups

  14. Consider: • Staying alert- avoid complacency • Utilizing community based connections • Work with Parish Nurses • Explore working with neighborhood groups • Getting on the HAN network

  15. Consider: • Staying alert – avoid complacency • Utilizing community based connections • Work with Parish Nurses • Explore working with neighborhood groups • Getting on the HAN network • Participating in Hospital or government planning activities • Make a concerted effort to keep up to date on current information • Educate staff and clients

  16. BIOTERRORISMInfection Control Planning and Response Boyd Wilson, MS, CIC System Director of Infection Control & Epidemiology HealthEast Care System

  17. Objectives • Identify the most probable agents to be used in bioterrorism • Describe how a bioterrorism act might express itself clinically • State how these agents are transmitted & precautions necessary to prevent spread • Discuss efforts that are underway to prepare for potential acts of bioterrorism and the implications for Home Care

  18. Bioterrorism . . . is the deliberate release of pathogenic microorganisms (bacteria, viruses, fungi or biological toxins) into a community to produce disease or intoxication in susceptible populations (humans, animals, plants) to meet terrorist needs.

  19. Emergency Preparedness/Disaster Plan • Policy • Definitions • - Natural Disasters • -Unnatural Disasters • Biological • Non-Biological

  20. Natural Disasters and Unnatural Disasters • Policy and Procedure • Notification- Calling Tree • Communication Failure • Reporting

  21. Definition • Disaster: is an occurrence that causes damage, ecological disruption, loss of human life, deterioration of health and human services on a scale sufficient to warrant an extraordinary response from outside the affected community area – World Health Organization

  22. History • Kaffa – plague – 1346 • French and Indian - smallpox – 1746 • Japan – Manchuria unit 731 – 1932 • 1972 Biological Weapons Convention • Georgi Markov – 1978 • Sverdlovsk – 1979 – at least 66 deaths

  23. Recent Threats • Iraq • 19,000 liters of botulinum toxin • 8.500 liters of concentrated anthrax • Aum Shinrikyo Cult • Los Angeles, other scares • Former Soviet stockpiles • 15-20 nations have biological programs • Evolving states, fringe groups, individuals

  24. Advantages of Bioweapons • Easy to procure • Invisible • Detection difficult • Incubation period/escape period • Community preparation poor • Threat alone achieves goals

  25. Agent Cost • Inflict 50% casualties over 1 square kilometer • Conventional $2000 • Nuclear $800 • Nerve Agent $600 • Anthrax $1

  26. Impact of a Biologic Incident • Potential for widespread illness and death 110 pounds of anthrax spores sprayed along a 1.5 mile line source tract upwind from a city of 500,000 could kill 24,000 people Profound pyschological stress Large numbers of casualties

  27. Environmental Constraints • Sunlight – UV light kills many bacteria • Wind – Disperses biological agents • Temperature – heat inactivates many biological agents, most are resistant to freezing • Desiccation – may inactivate or inhibit growth

  28. If you hear these hoofbeats … • Widened mediastinum on thoracic radiograph • Influenza-like illness in summer months • Pneumonia death in otherwise healthy adult • Vesicular rash that starts on extremities • Hemorrhagic fever syndrome • Cluster of unusual, severe or unexplained illnesses • Unexplained critical illness in otherwise healthy young adult

  29. ……Consider these zebras • Anthrax • Tularemia • Plague • Smallpox • Brucellosis • Viral hemorrhagic fever • Other potential bioterrorism agents

  30. AAAHHHCHCHOOOOO!

  31. DROPLET PRECAUTIONS(in addition to Standard Precautions) Patient Room Masks Room doors may be open or closed. No special ventilation required. Surgical mask required when within 3 feet of patient (arms length). Not required for room entry. See Infection Control Policies for further information. VISITORS: Wear mask when within 3 feet of patient. Not required for room entry. Wash hands when leaving room.

  32. Contact Precautions • Lice • Scabies • MRSA, VRE (resistant organisms) • Uncontained body fluids • VHF

  33. CONTACT PRECAUTIONS(in addition to Standard Precautions) Dedicate noncritical items. (Commode, stethoscope, BP cuff, thermometer, wheel chair, slide board etc.) Disinfect when removing from room and before use on another patient. Limit supplies in room. Wear gloves when entering the room. Change gloves between tasks on same patient. Do not touch clean items/supplies with contaminated gloves. Remove gloves when leaving room. Wear gown when entering room for any contact with patient or environmental surfaces. Remove gown when leaving patient’s room. Wash hands after touching body fluids, contaminated items and after removing gloves upon leaving room. Resistant organisms: use Antimicrobial soap. PATIENT ROOM GLOVES GOWN HANDWASHING See Infection Control Policies for further information. VISITORS: Follow guidelines above if providing direct care. Wash hands when leaving room.

  34. Appropriate Selection and Use of PPE

  35. Safe Handling of Sharps

  36. Safe Disposal of Sharps

  37. Labeling

  38. Environmental Management • Routine cleaning with usual products • Management of blood spills using an approved disinfectant detergent • Routine management of soiled linen • Routine management of trash and biohazardous waste materials • Gross decontamination of heavily contaminated areas (i.e. bleach)

  39. Decontamination • Most often, not necessary for biological incidents • Generally, no special equipment needed • Remove clothing and place in plastic bag • Shower with soap & water • Assure design allows for containment and separation of zones (hot, warm, cold) • Appropriate protection of workers in the zones based on level/type of contamination

  40. Anthrax Bacillus anthracis

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