Post on 16-Apr-2017
IMproving Preparedness and Response of HEalth Services in major criseS
Ioannis Galatas, George Eftychidis, George Leventakis, Ilias GkotsisCenter for Security Studies (KEMEA), Athens, GreeceFP
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The Challenge
Current health emergency management systems consist of
disconnected command & control operationslacking of
appropriate coordination mechanismsfor the actions of their composing services
that will allow them to reform intoan effective, multi-faceted crisis response mechanism
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IMPRESS aims to advance the preparedness of emergency medical services
(health emergency operations centers, ambulance dispatch centers, hospitals
ED, first responders and volunteer communities etc) through:
planning for all-hazards;
increasing surge capacity;
tracking the availability of beds and other hospital resources using
electronic systems;
Monitoring health emergency operations and
developing systems that are interoperable between the involved
response actors
The general objective
is to provide preparedness and response capabilities through guidelines and
tools applicable in disaster scenarios
Aims & objective
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Re-balance the disproportion between response needs and health
system capacity, through proper mobilization of additional resources (material,
logistics and health personnel) and enhanced organization (e.g. e-triage,
interoperability of health services)
Remediate the information deficit with rapid collection of relevant
data and exchange of adequate information
Support decision making according to the impact of crisis and incident
type to the health status of the community
Improve the response and preparedness level of HS based
on efficient planning, integral organization and comprehensive training, using
interoperable tools and systems
Enhance interoperability within the same and among different EMS
organizations using common taxonomy and providing stakeholders in the emergency
response domain with a compatible operational framework
Objectives’ analysis
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Disasters’
Taxonomy
Response/
Ambulance
Injured Non-injuredED Specialized Units Other Sections
First Responders
EOC
EU
Customized response
according to disaster type
Stakeholders
CIV-MIL
Incident
Command Zone
Resources
Concept & Stakeholders
Dis.Med. @ Incident Scene
1
2
Hospital ED
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LOGEVO (LOGistics EVOlution)
a suite enabling the use of
models for the logistics of
health care resources
WARSYS (WARehouse SYStem)
a database with real time
medical & logistics information
from available repositories
SICKEVO (SICK patients
physiological EVOlution forecast)
addressing physiologic trajectory
assessment and forecast
SORLOC (SOuRce LOCalization)
module for localizing likely
exposure in Chemical and
Radiological incidents and
contaminants spread in case of
epidemics
High level architecture
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Nuclear weapons
Radiological dispersal devices (RDDs);
Radiological emitting devices (REDs);
Nuclear power plants’ accidents; R-waste depots
Biological warfare agents (BWAs);
Toxins;
Pandemics
Chemical warfare agents (CWAs);
Toxic industrial chemicals (TICs)
CBRNE threats
Low/high level explosives;
IEDs
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CBRNE stress factors
CHEMICAL BIOLOGICAL RADIOLOGICAL
Difficult, time-consuming
identification
BA not perceivable Cannot be noticed
Genetic effects Specialized LABs Hard to control
Carcinogenic Incubation period Children – pregnant
Limitation of personal
freedom
Delayed effects
Hereditary defects
Carcinogenic
Affecting both
Citizens & Responders
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PARAMETERS DISASTER CRE DISASTER
IMPACT Local Massive
ZONES HZCZ HZWZCZ
AREA OF
OPERATIONS
Non-contaminated
Non-lethal
Contaminated
Lethal
VICTIMS Save ALL Save NOT ALL
HOSPITALS Dedicated ALL hospitals/clinics
WORRIED-WELL None 1:5
AFTERMATH Restoration Ghost city (R)
Long lasting (C)
Genetic/carcinogenic
Medical CRE response
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Exercises/drills
Earthquake
Flooding
Tunnel explosion
Wildfire @
Palermo waste
dump
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CBRNEPalermo waste dump fire: July 29 – Aug 17, 2012
Day 1
Palermo District «Borgo»
160,000 inhabitants
504,000 m2
Day 2
Day 3
Day 4
Day 5
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- Bellolampo fire data will be used to validate IMPRESS emergency response modeling. Toxic cloud dispersion simulation will be also validated against Bellolampo fire data
- For the IMPRESS scenario will be simulated sudden release of high concentrations of toxic compounds from a tank fire developing on-board a ship moored in the Palermo harbor
- The test area, supposed to be affected, is the Palermo District “Kalsa” sized 0.8 km2 which includes several institutional buildings such as the Marine Institute, the Harbor Authority, and the Customs Office, the administrative offices of the University of Palermo, a private hospital and a church
- The areas in the Warm zone are suitable for triage, evacuation and landing of helicopters. The nearest hospital is 2 km away and is accessible directly through the seafront boulevard.
Field test of IMPRESS against Chem Acc
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According to the planned test
- the fire developing on-board the ship shall produce a toxic cloud
- The cloud due to the wind blowing from NE will be spread over the Kalsadistrict
- the IMPRESS modules will be activated
- at the Emergency Service,
- Emergency Department of local hospitals and
- at the National Health Service Operation center
for managing the public health aspects of the incident
- the Italian Civil protection Agency (PCI) shall coordinate the operations
System components
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The IMPRESS modules will be demonstrated/tested as follows:
SORLOC module is used to identify the distribution of potential patient flow, linked withthe distribution pattern of the toxic smoke cloud. Information will be shared with theNHS and the ED departments of the relative hospitals
WARSYS is accessed by authorized users of the involved authorities (NHS and EMS) toretrieve data concerning real time medical and logistics information.
SICKEVO shall provide physiological forecast of patients’ status evolution to the EMS andto the ED of relevant hospitals in order to support relevant decisions
LOGEVO module will support at the NHS and EMS level the monitoring and logistics ofhealth care resources
INCIMAG shall be used to exchange information regarding the incident/situation, receivedata and develop the situational picture (victim health status resource availability ) andreceive prediction of the scenario evolution based on the taken decision (calls toSICKEVO, LOGEVO,…,)
INCIMOB will provide field data collection and management support allowing theinsertion of patient data, exchanging and recording Triage data and displaying the actualsituational picture
IMPRESS components to be tested
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