Welcome to Medical Center Hospital

INCIDENT COMMANDER
Establish initial and ongoing contact with the following agencies to determine the specific nature and extent of the infectious issue:

Ector County Health Department

Emergency Management System

Based on information and recommendations from these agencies, determine the scope and depth of the organization's planned response. Implement appropriate aspects of the Emergency Response Plan as deemed necessary.

Communicate pertinent information receive from these outside agencies to the Emergency Department and other appropriate clinical services. It is recommended that the Infection Control Coordinator and the Medical Director be assigned to the Command Center in an advisory capacity.

OPERATIONS SECTION CHIEF
The primary responsibility is to assure that sufficient protective and isolation equipment and supplies are available to respond to emergency situations. Priority is given to assuring that triage and immediate care areas (such as the Emergency Department) are well supplied. Supply levels should be monitored and calls to vendors made for priority re-supply as needed.

As necessary, arrange for emergency delivery of medical equipment such as ventilators, portable hepa-filtration units, etc. from vendors. Work directly with the Biomedical Department to place the equipment into inventory and perform minimum required electrical and safety checks.

If it appears that supplies and equipment levels are insufficient, the Command Center should be notified and asked to suspend non-essential operations and transfer equipment and supplies to the areas of the organization impacted by the situation.

Pharmacy is to assure that there is an adequate supply of critical medications during the emergency. Ensure an adequate supply of emergency drugs – especially antibiotics or other agents designed to treat the infectious process. Evaluate the drug supply on hand. Should it be anticipated that supplies of drugs might be inadequate to last through the situation, contact other hospitals, pharmacies, and vendors to determine if additional supplies can be procured.

PLANNING SECTION CHIEF / SITUATION UNIT LEADER
The primary purpose is to facilitate the transfer and discharge of existing inpatients so that beds can be made available for emergency admissions. Priority should be given to discharging or transferring existing patients housed in isolation rooms if they are no longer infectious.

This function should work closely with the Operations Section Chief / Medical Care Branch Director to determine those inpatients that can be discharged and/or moved to a lower level of care. Consideration should be given to the impact of the infectious process on the community to where the patient will be discharged to determine if additional precautions or services are warranted.

OPERATIONS SECTION CHIEF / MEDICAL CARE BRANCH DIRECTOR
The need to maintain appropriate infection control precautions will be paramount during this type of emergency. Appropriate information should be obtained on any potential admissions to assure that bed placement is consistent with infection control needs. Particular attention should be paid to patients requiring respiratory isolation to assure that these individuals are assigned to a negative pressure room or other appropriate environment.

The Emergency Department is likely to be heavily impacted in the event of an influx of infectious patients. The Charge Nurse or Supervisor on duty is to appoint Registered Nurses to the following functions:

Triage Area

Immediate Care Area

Initiate and maintain contact with the Command Center to receive specific information about the infectious process and recommended response activities.

Determine numbers and qualifications of staff necessary. Determine supply and equipment needs. Contact the Command Center for assistance.

Inpatient nursing units should provide an appropriate level of nursing care to patients during the emergency.
Evaluate patients for possible transfer or discharge in the event that it becomes necessary to release selected existing patients. The priority should be to free up as many isolation rooms as possible.

In addition, non-infectious patients should be removed from areas anticipated to house incoming infectious patients. If necessary, a unit should be cleared of non-infectious patients and designated as the admission unit for patients presenting to the organization with an infectious process.

Should an infectious patient require surgery, the case should – whenever possible - be scheduled at the end of the day. The surgical suite should then be terminally cleaned.

LOGISTICS SECTION CHIEF / INFRASTRUCTURE BRANCH DIRECTOR
The primary purpose of will be to assure that essential utilities are maintained during the emergency. A quick assessment as to the status and operational readiness of utilities should be made and reported to the Command Center.

Assess the impact of the infectious process on the provision of utility services. Consideration should be given to the following:

1.Impact of airborne agents on air intake systems and circulation.

2.Impact of water borne agents on city water supplies and potable water in the facility

If necessary, air handlers and returns may need to be shut down to protect occupants in buildings. Incoming water supply may need to be restricted. Consideration should be made to implement “defend in place” strategies as warranted.

In addition maintain cleanliness and infection control needs in the care areas. All non-essential cleaning services will be suspended during the emergency. Extra linen, hampers, trash bins, and biohazard waste containers should be brought to the triage and immediate care areas. Ascertain appropriate protective equipment and process needs for staff working in exposed areas.

LOGISTICS SECTION CHIEF / HAZMAT BRANCH DIRECTOR
If the need for decontamination facilities is warranted, coordinate setting up appropriate areas. Ascertain appropriate protective equipment and process needs for staff working in exposed areas. Implement appropriate isolation and decontamination procedures.

LOGISTICS SECTION CHIEF / SUPPORT BRANCH DIRECTOR
Staff should be informed of the following before assuming responsibility for providing care during the emergency:
1.The specific nature of the infectious process
2.The mode of transmission
3.The clinical manifestation
4.What precautions need to be implemented to prevent cross-contamination
5.The location and use of appropriate protective equipment

LOGISTICS SECTION CHIEF / SECURITY BRANCH DIRECTOR
Communicate with the Command Center and determine what access restrictions – if any –must be imposed to prevent infectious individuals from entering the organization without appropriate infection control precautions being implemented. If necessary, implement shelter-in-place and facility lock-out procedures.

US Patent Numbers 7,720,998 B2, 7,836,207