Public Health Practices

Toolkit paves the way for hospitals to meet children's needs during a disaster

A Washington healthcare coalition created a toolkit for managing neonatal and pediatric medical needs and evacuation during an emergency.

Radiological preparedness activities focus on at-risk populations living in proximity to nuclear power plant

An Arizona human services agency developed plans and exercises for emergency evacuations of the elderly, people with disabilities, and children living near a nuclear power plant.

Resource directories and medical management guidelines for response to a chemical emergency

Michigan developed streamlined tools to help responders make quick decisions during chemical emergencies.

Dirty bomb/radiological contamination interactive training

An online course uses a first-person, gaming format to train responders in radiological decontamination, mass fatalities management, and establishment of a community assistance center.

college student registering online

SurveyMonkey used for campus vaccine registration

Michigan State University used its online course management system to register students for H1N1 vaccine.

Quality Improvement Redesign a Tool in Pandemic Planning and Response

The University of Chicago needed to act quickly in late April 2009 when it discovered a Medical Center staff member was diagnosed with H1N1 as cases of the virus were appearing in California and Mexico. Lacking complete knowledge about the scope of the outbreak and the morbidity and mortality rate, Student Care Center (SCC) director Dr.

Telephone triage and treatment protocol

Decision-making templates and staffing plans for an H1N1 hotline allowed nurses to screen and prescribe antivirals to ill students.

Resident Assistant Checklist for Assessing Students

During the 2009 H1N1 outbreak, ill students living in on-campus housing posed a special concern for the University of Iowa (UI). The Office of Residence Life focused many of their efforts on training Resident Assistants (RAs) to respond appropriately to ill students living in their halls.

Phone monitoring of students with ILI

During H1N1, Pennsylvania State University health providers monitored ill students daily by phone or through secure electronic messages.

Minnesota H1N1 FluLine

Minnesota created the nation's first hotline to screen and prescribe antivirals or clinical evaluation to ill callers during H1N1.

Pandemic Influenza Planning Guidance for Healthcare Institutions

Philadelphia's Pandemic Influenza Planning Guidance for Healthcare Institutions addresses the needs and situations that may be experienced by hospitals during a pandemic.

Definitive care for the critically ill during a disaster

Five articles from the Task Force for Mass Critical Care address difficult issues around patient triage and resource allocation that may need to be implemented during an influenza pandemic.

Santa Clara Clinical Triage Guidelines

The Santa Clara Clinical Triage Guidelines include a protocol and a flow chart that use a modified pneumonia severity index to triage influenza patients. Patients are stratified by objective criteria (e.g., blood pressure, oximetry, age) to hospital admission, Influenza Care Center admission, palliative home care, or recovery at home.

Medical Coordination and Care Delivery Process

The Tacoma-Pierce County Health Department developed a concept of operations for integrating community care providers into a Medical Reserve Corps as a means of reaching specific triage and treatment objectives during a disaster.

Medical and public health surge in Alexandria

This document presents the concept of Community Care Stations (CCS). These facilities are designed to provide initial assessment triage and would be opened when the hospital system begins to become overwhelmed. The document describes triage criteria, lists required supplies, and presents a staffing plan for the CCS. It also describes criteria for opening and supplying Alternate Care Facilities (ACF) in the area.

Clinical Review: Allocating Ventilators During Large-Scale Disasters - Problems, Planning, and Process

The article is a thoughtful assessment of important issues surrounding ventilator allocation during a large-scale disaster. Although the article emphasizes the importance of developing a decision-making process that will be followed during a disaster, it recognizes that some processes and tools will be event-driven. Thus, implementation of certain procedures will depend on the nature of the disaster and occur during the event.

Development of a Triage Protocol for Critical Care during an Influenza Pandemic (Ontario, Canada)

A collaborative, evidence-based triage protocol was designed for use as a decision-making tool when a critical care system becomes overwhelmed. The system of triage is applicable to patients with and without pandemic influenza, since all patients would share the same scarce resources.

Community Based Assessment Centres (New Zealand)

The Community Based Assessment Centres plan offers practical information on establishing sites for initial screening and triage of patients with suspected pandemic influenza. The materials are noteworthy, because they provide a concept of operations for establishing alternate care sites in such a way that the approach could be incorporated into state, local, or hospital preparedness efforts.

Pandemic Influenza Response and Management Toolkit: Appendix D: Alternative Care Site Management Tools (British Columbia, Canada)

Fraser Health's toolkit outlines key parameters for establishing alternate triage and care centers by providing guidance for selecting a site, organizing personnel, conducting triage and process flow, and discharging patients. The materials are still in draft form, and any triage or care site would need to modify the materials to fit its individual needs.

Acute Care Services Tools (Ontario, Canada)

The Acute Care Services Tools provide the following: 1) a triage protocol for patients who may need critical care; 2) an assessment form and triage protocols for patients who may have pandemic influenza; 3) a hospital admission form for influenza patients; and 4) standing admission orders for influenza patients. The triage protocol outlines inclusion and exclusion criteria for evaluating patients who are being considered for critical care.

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