For Additional Information Contact: A.J.Mumm, Director
PolkCounty EMA 515-286-2107
POLK COUNTY EMERGENCY MANAGEMENT
Proudly serving the communities of: Alleman,Altoona, Ankeny, Bondurant, Clive, Des Moines, Elkhart, Grimes, Johnston,Mitchellville, Pleasant Hill, Polk City, Polk
County, Runnells, Urbandale, WestDes Moines, and Windsor Heights
POLK COUNTY EMERGENCY MANAGEMENT
Ebola 2014
10/27/2014 06:00 to 11/03/2014 06:00INCIDENT ACTION PLAN
Page 1Page 1 of 23
ICS 202
INCIDENT OBJECTIVES 1. Incident Name 2. Date Prepared 3. Time Prepared
4. Operational Period
5. General Control Objectives for the Incident (include alternatives)
7. General Safety Message
8. Attachments (mark if attached)
Organization List - ICS 203 Medical Plan - ICS 206
Div. Assignment Lists - ICS 204
Communications Plan - ICS 205
Prepared by (Planning Section Chief) Approved by (Incident Commander)
6. Weather Forecast For Period
Ebola 2014
10/27/2014 06:00 - 11/03/2014 06:00
THIS INCIDENT ACTION PLAN SHALL REMAIN IN EFFECT UNTIL: - THE CURRENT EBOLA SITUATION HAS ENDED; OR - UNTIL A CONFIRMED CASE OF EBOLA IS IDENTIFIED IN POLK COUNTY, AT WHICH TIME A NEW IAP WILL BE ISSUED THAT WILL COVERDECONTAMINATION, TREATMENT, TRANSPORTATION AND OTHER TOPICS.
- Minimize the risk of contraction of the Ebola virus for emergency responders and health care providers- Gain and maintain situational awareness through information from the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC)and Iowa Department of Public Health (IDPH).-Coordinate with IDPH regarding messaging and communications.-Ensure partners and the public have current information to guide decision-making regarding their health safety-Strengthen preparedness in Polk County for the early recognition, detection, and control of an Ebola exposure.-To ensure responders are prepared with the appropriate PPE and proper guidance on Donning and Doffing.
Maintain appropriate communication between the 9-1-1 centers, first responders and hospitals regarding suspected individuals with symptoms of Ebola.
All responders should be wearing the appropriate personal protective equipment during a response that involves a suspected case of Ebola.
Review and become familiar with discipline specific guidance included in each ICS 204 and the PPE information included within this Incident Action Plan.
2Page
Weather Forecast information may be obtained at http://www.crh.noaa.gov/dmx
Page 2 of 23
ORGANIZATION ASSIGNMENT LIST
1. Incident Name:4. Operational Period
5. EOC Director & Staff
EOC Director
Deputy EOC Director
Safety Officer
PIO/JIC Officer
Policy Officer
6. Agency Representatives:
Agency Name
7. Planning Section:
Chief
Deputy
Resources Unit
Situation Unit
Documentation Unit
Demob Unit
Technical Specialists
8. Logistics Section:
Chief
Deputy
Support Branch
Supply Unit
Facilities Unit
10. Finance Section:
Ground Support Unit
Service Branch
Deputy
Time Unit
Comms Unit Procurement Unit
Medical Unit Compensation/Claims Unit
Food Unit Cost Unit
Prepared by:
2. Date 3. Time
Info/Intel Unit
Technical Specialists
Chief
Recovery/Mitigation Unit
Branch:
Branch Director
9. Operations Section:
Chief
Deputy
11. Information and Intelligence Section:
Branch Deputy Director
Branch:
Branch Director
Branch Deputy Director
Ebola 2014
Rick Kozin
AJ Mumm
Nola Aigner
Kari Lebeda Townsend
Franny Medeiros/Samantha Brear
Juan Cadenillas
10/27/2014 06:00 - 11/03/2014 06:00
Page 6
Transportation Group
Communication Group
Public Works/Eng Group
Scott Slater
Firefighting
Public Hlth & Med Services 1
Hazardous Materials
Law Enforcement & Security
Public Hlth & Med Services 2
Public Hlth & Med Services 3
Emergency Services
Infrastructure Support
Page 3 of 23
1. Incident Name 2. Operational Period (Date/Time) From: To:
Assignment ListICS 204-CG
3. Branch 4. Division/Group/Staging
5. Operations Personnel Name Affiliation Contact # (s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor/STAM:
6. Resources Assigned “X” indicates 204a attachment with additional instructions
Strike Team/Task Force/Resource Identifier
Leader Contact Info. # # Of Persons
Reporting Info/Notes/Remarks
7. Work Assignments
8. Special Instructions
9. Communications (radio and/or phone contact numbers needed for this assignment) Name/Function Radio: Freq./System/Channel Phone Cell/Pager
Emergency Communications Medical Evacuation Other
10. Prepared by: Date/Time 11. Reviewed by (PSC): Date/Time 12. Reviewed by (OSC): Date/Time
ASSIGNMENT LIST ICS 204-CG (Rev 04/04)
11/03/2014 06:0010/27/2014 06:00Ebola 2014
Page 16
Infrastructure Support Transportation Group
Scott Slater
Department of Homeland Security (DHS) held a call with ACI-NA and A4A to ask the airline industry to investigate proactively re-routing travelers from the threeaffected countries in West Africa so that their U.S.-bound itineraries would be cleared into our country through one of the five airports with enhanced screeningmeasures. This morning, DHS announced it is implementing this strategy effective immediately.The approach will be two-pronged. Customs and Border Patrol (CBP) will use its targeting systems to identify travelers scheduled to travel from one of the threeaffected countries into the United States, with a first U.S. port of entry other than Atlanta, New York Liberty, Dulles, John F. Kennedy International Airport orChicago O'Hare International Airport. CBP should get this information up to 72 hours in advance of the traveler’s scheduled departure and will communicatedirectly with the booking air carrier to get the traveler rebooked with an entry into the U.S. through one of the five enhanced screening airports.This guidance does not apply to Des Moines International Airport as they were not included in the list of the five airports above.
The CDC will notify IDPH regarding Iowa-bound travelers. IDPH will notify the PCHD regarding travelers with a destination of Polk County for appropriatemonitoring. Travelers who have been in an affected country (Guinea, Liberia or Sierra Leone) in the previous 21 days with fever of 100.4 or higher with orwithout Ebola symptoms will be deferred and not allowed to continue to travel. Travelers who have been in an affected country (Guinea, Liberia or SierraLeone) in the previous 21 days no known exposure will receive instructions on self-monitoring and a CARE Kit (with digital thermometer, thermometerdirections, health advisory, symptom card, symptom log, reminder card, list of state health department phone numbers).
Page 4 of 23
1. Incident Name 2. Operational Period (Date/Time) From: To:
Assignment ListICS 204-CG
3. Branch 4. Division/Group/Staging
5. Operations Personnel Name Affiliation Contact # (s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor/STAM:
6. Resources Assigned “X” indicates 204a attachment with additional instructions
Strike Team/Task Force/Resource Identifier
Leader Contact Info. # # Of Persons
Reporting Info/Notes/Remarks
7. Work Assignments
8. Special Instructions
9. Communications (radio and/or phone contact numbers needed for this assignment) Name/Function Radio: Freq./System/Channel Phone Cell/Pager
Emergency Communications Medical Evacuation Other
10. Prepared by: Date/Time 11. Reviewed by (PSC): Date/Time 12. Reviewed by (OSC): Date/Time
ASSIGNMENT LIST ICS 204-CG (Rev 04/04)
11/03/2014 06:0010/27/2014 06:00Ebola 2014
Page 7
Infrastructure Support Communication Group
Scott Slater
It is important for PSAPs to question callers and determine if anyone at the incident possibly has Ebola. This shall be communicated immediately to EMSpersonnel before arrival. PSAPs shall review existing medical dispatch procedures and coordinate any changes with their EMS medical director and with theirlocal public health department.
- PSAP call takers shall screen callers for symptoms and risk factors of Ebola. Callers will be asked if they, or someone at the incident, have fever of greaterthan 100.4 degrees Fahrenheit, and if they have additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, orunexplained bleeding.- If PSAP call takers suspect a caller is reporting symptoms of Ebola, they shall screen callers for risk factors within the past 3 weeks before onset of symptoms.Risk factors include: Contact with blood or body fluids of a patient known to have or suspected to have Ebola; - Residence in–or travel to–a country where an Ebola outbreak is occurring; or direct handling of bats or nonhuman primates from disease-endemic areas.
- If PSAP call takers have information alerting them to a person with possible Ebola, they shall make sure any first responders and EMS personnel are madeconfidentially aware of the potential for Ebola before the responders arrive on scene.
Page 5 of 23
1. Incident Name 2. Operational Period (Date/Time) From: To:
Assignment ListICS 204-CG
3. Branch 4. Division/Group/Staging
5. Operations Personnel Name Affiliation Contact # (s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor/STAM:
6. Resources Assigned “X” indicates 204a attachment with additional instructions
Strike Team/Task Force/Resource Identifier
Leader Contact Info. # # Of Persons
Reporting Info/Notes/Remarks
7. Work Assignments
8. Special Instructions
9. Communications (radio and/or phone contact numbers needed for this assignment) Name/Function Radio: Freq./System/Channel Phone Cell/Pager
Emergency Communications Medical Evacuation Other
10. Prepared by: Date/Time 11. Reviewed by (PSC): Date/Time 12. Reviewed by (OSC): Date/Time
ASSIGNMENT LIST ICS 204-CG (Rev 04/04)
11/03/2014 06:0010/27/2014 06:00Ebola 2014
Page 17
Infrastructure Support Public Works/Eng Group
Scott Slater
Waste Management:CDC guidance indicates that sanitary sewers are acceptable for patient bodily fluids. Royce Hammitt, the Wastewater Reclamation Authority OperationsManager said that they will follow the CDC guidelines.
Royce Hammit (515) 323-8001 515-208-0641
Page 6 of 23
1. Incident Name 2. Operational Period (Date/Time) From: To:
Assignment ListICS 204-CG
3. Branch 4. Division/Group/Staging
5. Operations Personnel Name Affiliation Contact # (s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor/STAM:
6. Resources Assigned “X” indicates 204a attachment with additional instructions
Strike Team/Task Force/Resource Identifier
Leader Contact Info. # # Of Persons
Reporting Info/Notes/Remarks
7. Work Assignments
8. Special Instructions
9. Communications (radio and/or phone contact numbers needed for this assignment) Name/Function Radio: Freq./System/Channel Phone Cell/Pager
Emergency Communications Medical Evacuation Other
10. Prepared by: Date/Time 11. Reviewed by (PSC): Date/Time 12. Reviewed by (OSC): Date/Time
ASSIGNMENT LIST ICS 204-CG (Rev 04/04)
11/03/2014 06:0010/27/2014 06:00Ebola 2014
Page 8
Emergency Services Firefighting
Scott Slater
1.Address scene safety:- If PSAP call takers advise that the patient is suspected of having Ebola, personnel shall put on the PPE appropriate for suspected cases of Ebola beforeentering the scene. Please see the end of this IAP for updated guidelines on PPE.- Keep the patient separated from other persons as much as possible.- Use caution when approaching a patient with Ebola. Illness can cause delirium, with erratic behavior that can place personnel at risk of infection, e.g., flailingor staggering.
- Patients shall be asked if they, or someone at the incident, have fever of greater than 100.4 degrees Fahrenheit, and if they have additional symptoms such assevere headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained bleeding.- If a patients is reporting symptoms of Ebola, they should be questioned for risk factors within the past 3 weeks before onset of symptoms. Risk factors include:Contact with blood or body fluids of a patient known to have or suspected to have Ebola; - Residence in–or travel to–a country where an Ebola outbreak is occurring; or direct handling of bats or nonhuman primates from disease-endemic areas.
- Based on the presence of symptoms and risk factors, put on or continue to wear appropriate PPE and follow the scene safety guidelines for suspected case ofEbola. The patient should be placed in a gown, mask and gloves according to the same PPE recommendations.
- If there are no risk factors, proceed with normal EMS care.
Page 7 of 23
1. Incident Name 2. Operational Period (Date/Time) From: To:
Assignment ListICS 204-CG
3. Branch 4. Division/Group/Staging
5. Operations Personnel Name Affiliation Contact # (s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor/STAM:
6. Resources Assigned “X” indicates 204a attachment with additional instructions
Strike Team/Task Force/Resource Identifier
Leader Contact Info. # # Of Persons
Reporting Info/Notes/Remarks
7. Work Assignments
8. Special Instructions
9. Communications (radio and/or phone contact numbers needed for this assignment) Name/Function Radio: Freq./System/Channel Phone Cell/Pager
Emergency Communications Medical Evacuation Other
10. Prepared by: Date/Time 11. Reviewed by (PSC): Date/Time 12. Reviewed by (OSC): Date/Time
ASSIGNMENT LIST ICS 204-CG (Rev 04/04)
11/03/2014 06:0010/27/2014 06:00Ebola 2014
Page 9
Emergency Services Public Hlth & Med Services 1
Scott Slater
Public Health X
Medical Supplies Management & Distribution Task Force - Check local inventory of PPE for adequate suppliesMass Prophylaxis Task Force - At this time, no vaccination is available for the Ebola Virus. Polk County Health Department has a Mass Prophylaxis plan shoulda vaccine become available.Medical Surge Task Force - Individual hospitals maintain medical surge plans that may be implemented as neededIsolation & Quarantine Task Force - Polk County Health Department has an Isolation & Quarantine plan that may be implemented if necessaryLaboratory Testing Task Force - Iowa Department of Public Health and Polk County Public Health will coordinate any lab testing of suspected Ebola casesFatality Management Task Force - Polk County Emergency Management and the Polk County Medical Examiner have a fatality management plan that may beimplemented as neededDisaster Mental Health Task Force - Polk County Emergency Management has a Disaster Mental Health plan that may be implemented as neededEnvironmental Health Task Force - Polk County Emergency Management has a Environmental Health plan that may be implemented as neededResponder Safety & Health Task Force - Maintain coordination and communication on safety and health issues between agencies and departments
Epidemiological Surveillance & Investigations - If patient meets clinical and exposure criteria for high or low risk Contact IDPH immediately at 800-362-2736 or515-323-4360. If patient meets the clinical and “no known exposure” criteria, order appropriate testing which may include continued use of infection controlmeasures until cause identified; Rule out more common infections, including influenza, malaria, and diarrheal pathogens; If no cause is identified and Ebolainfection is suspected, contact IDPH at 800-362-2736 or 515-323-4360 to discuss Ebola testing.Use a U.S. Environmental Protection Agency (EPA)-registered hospital disinfectant with a label claim for a non-enveloped virus (e.g., norovirus, rotavirus,adenovirus, poliovirus) to disinfect environmental surfaces in rooms of patients with suspected or confirmed Ebola virus infection. Although there are noproducts with specific label claims against the Ebola virus, enveloped viruses such as Ebola are susceptible to a broad range of hospital disinfectants used todisinfect hard, non-porous surfaces. In contrast, non-enveloped viruses are more resistant to disinfectants. As a precaution, selection of a disinfectant productwith a higher potency than what is normally required for an enveloped virus is being recommended at this time. EPA-registered hospital disinfectants with labelclaims against non-enveloped viruses (e.g., norovirus, rotavirus, adenovirus, poliovirus) are broadly antiviral and capable of inactivating both enveloped andnon-enveloped viruses.
Page 8 of 23
ASSIGNMENT LIST ATTACHMENT ICS 204a-CG (Rev 04/04)
1. Incident Name 2. Operational Period (Date/Time)
From: To:
ASSIGNMENT LIST ATTACHMENTICS 204a-CG
3. Branch 4. Division/Group
5. Strike Team / Task Force/Resource (Identifier) 6. Leader 7. Assignment Location
8. Work Assignment Special Instructions, Special Equipment/Supplies Needed for Assignment, Special Environmental Considerations, Special Site Specific Safety Considerations
Approved Site Safety Plan Located at:
9. Other Attachments (as needed)Map/Chart Weather Forecast/Tides/Currents
10. Prepared by: Date/Time 11. Reviewed by (PSC): Date/Time 12. Reviewed by (OSC): Date/Time
Ebola 2014 11/03/2014 06:0010/27/2014 06:00
Public Hlth & Med Services 1Emergency Services
Public Health
10Page
Clinical presentation and level of exposure are taken into account when determining appropriate public health actions for individuals with potential Ebolaexposure, as follows.
Mandatory Quarantine: Asymptomatic individuals with high or low exposure risk will be placed under mandatory quarantine order in their home and monitoredby the Polk County Health Department. A Communicable Disease Nurse and/or designee will conduct visits twice daily to observe the individual taking theirtemperature from outside the residence during the incubation period (21 days). Symptom review and other discussions will be conducted by phone while onand off the premises as appropriate. Symptomatic individuals with high or low exposure risk will be placed under a mandatory quarantine in the hospital.
Self-Monitoring: Asymptomatic individuals with "No Known Exposure" will be required to self-monitor for fever and symptoms under a mandatory Submit to SelfMonitor Order and report to the Polk County Health Department. The individual will be evaluated and report their temperature and symptom status twice dailyduring the incubation period (21 days). Individuals do not have movement restrictions as with quarantine but must refrain from using mass transportation,including airplanes, trains, cruise ships, or busses, unless they receive written permission from the Iowa Department of Public Health/CDC prior to engaging insuch travel.
Page 9 of 23
1. Incident Name 2. Operational Period (Date/Time) From: To:
Assignment ListICS 204-CG
3. Branch 4. Division/Group/Staging
5. Operations Personnel Name Affiliation Contact # (s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor/STAM:
6. Resources Assigned “X” indicates 204a attachment with additional instructions
Strike Team/Task Force/Resource Identifier
Leader Contact Info. # # Of Persons
Reporting Info/Notes/Remarks
7. Work Assignments
8. Special Instructions
9. Communications (radio and/or phone contact numbers needed for this assignment) Name/Function Radio: Freq./System/Channel Phone Cell/Pager
Emergency Communications Medical Evacuation Other
10. Prepared by: Date/Time 11. Reviewed by (PSC): Date/Time 12. Reviewed by (OSC): Date/Time
ASSIGNMENT LIST ICS 204-CG (Rev 04/04)
11/03/2014 06:0010/27/2014 06:00Ebola 2014
Page 14
Emergency Services Public Hlth & Med Services 2
Scott Slater
Emergency Medical Services X
During patient assessment and management, EMS personnel shall consider the symptoms and risk factors of Ebola:- All patients shall be assessed for symptoms of Ebola (fever of greater than 100.4 degrees Fahrenheit, and additional symptoms such as severe headache,muscle pain, vomiting, diarrhea, abdominal pain, or unexplained hemorrhage). If the patient has symptoms of Ebola, then ask the patient about risk factorswithin the past 3 weeks before the onset of symptoms.- Based on the presence of symptoms and risk factors, put on or continue to wear appropriate PPE and follow the scene safety guidelines for suspected case ofEbola. The patient should be placed in a gown, mask and gloves according to the same PPE recommendations.- If there are no risk factors, proceed with normal EMS care.
EMS personnel shall notify the receiving healthcare facility when transporting a suspected Ebola patient, so that appropriate infection control precautions maybe prepared prior to patient arrival. EMS personnel involved in the ground interfacility transfer of patients with suspected or confirmed Ebola should wearrecommended PPE. Please see the end of this IAP for updated guidelines on PPE.
Page 10 of 23
ASSIGNMENT LIST ATTACHMENT ICS 204a-CG (Rev 04/04)
1. Incident Name 2. Operational Period (Date/Time)
From: To:
ASSIGNMENT LIST ATTACHMENTICS 204a-CG
3. Branch 4. Division/Group
5. Strike Team / Task Force/Resource (Identifier) 6. Leader 7. Assignment Location
8. Work Assignment Special Instructions, Special Equipment/Supplies Needed for Assignment, Special Environmental Considerations, Special Site Specific Safety Considerations
Approved Site Safety Plan Located at:
9. Other Attachments (as needed)Map/Chart Weather Forecast/Tides/Currents
10. Prepared by: Date/Time 11. Reviewed by (PSC): Date/Time 12. Reviewed by (OSC): Date/Time
Ebola 2014 11/03/2014 06:0010/27/2014 06:00
Public Hlth & Med Services 2Emergency Services
Emergency Medical Services
15Page
- EMS crews should wear properly fitting PPE as identified in CDC guidance included at the end of this IAP.
- Number of EMS personnel/care providers should be kept to an absolute minimum.
- EMS crews shall call the destination hospital with a pre-arrival report and to receive directions for the transport and specific hospital arrival procedures.
- Air transport via rotary wing aircraft (helicopters) will NOT occur
- Suspect cases should NOT be transported to Iowa Lutheran Hospital, Methodist West Hospital, or Mercy West Lakes. Patients should instead be transportedto Broadlawns Medical Center, Iowa Methodist Hospital, Mercy Medical Center or the VA Medical Center (if they are a veteran).
- Upon arrival at destination hospitals, the ambulance should pull into the patient unloading area as normal. The EMS crew should STAND BY THEIRAMBULANCE until a hospital staff member comes out to greet them and guide them to the appropriate room via the appropriate route. NOTE unloading theambulance may be delayed until the hospital is ready to receive the patient in the ED. Transfer of the patient to hospital staff will otherwise occur as normal.
- The ambulance will not be allowed to leave the garage until decontamination has occurred. The EMS crew is responsible for performing the decon in thegarage under the guidance and supervision of hospital staff, with materials provided by the hospital
- EMS PPE will be doffed under the direction and supervision of hospital staff. The used PPE will be left at the hospital for disposal.
- EMS crews should compile basic contact information for not only their own crews but other close contacts who may have been present at the time of patientpick up. This will aid the health department in determining potential exposures.
- Rural ambulances and others that feel they are not prepared, equipped, or are uncomfortable with transporting suspect cases should instead contact IowaMethodist Hospital, Mercy Medical Center, or one of the private ambulance services for transport/ inter-hospital transfer.
- Limit activities, especially during transport, that can increase the risk of exposure to infectious material (e.g. airway management, cardiopulmonaryresuscitation, use of needles).
- Limit the use of needles and other sharps as much as possible. All needles and sharps should be handled with extreme care and disposed in puncture-proof,sealed containers.
Page 11 of 23
1. Incident Name 2. Operational Period (Date/Time) From: To:
Assignment ListICS 204-CG
3. Branch 4. Division/Group/Staging
5. Operations Personnel Name Affiliation Contact # (s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor/STAM:
6. Resources Assigned “X” indicates 204a attachment with additional instructions
Strike Team/Task Force/Resource Identifier
Leader Contact Info. # # Of Persons
Reporting Info/Notes/Remarks
7. Work Assignments
8. Special Instructions
9. Communications (radio and/or phone contact numbers needed for this assignment) Name/Function Radio: Freq./System/Channel Phone Cell/Pager
Emergency Communications Medical Evacuation Other
10. Prepared by: Date/Time 11. Reviewed by (PSC): Date/Time 12. Reviewed by (OSC): Date/Time
ASSIGNMENT LIST ICS 204-CG (Rev 04/04)
11/03/2014 06:0010/27/2014 06:00Ebola 2014
Page 18
Emergency Services Public Hlth & Med Services 3
Scott Slater
Hospitals/Clinics
The CDC will direct where a confirmed Ebola case will go, however hospitals should be prepared to house confirmed cases for up to 5 days until such transfercan occur.
If clinics receive a phone with a suspect case and the screening questions indicate a strong likelihood of a case, DO NOT advise to come to the clinic. Instead,EMS should be called to conduct the transport to Broadlawns Medical Center, Iowa Methodist Hospital, Mercy Medical Center or the VA Medical Center (if theyare a veteran).
Rural hospitals should not perform blood draws or other medical procedures beyond screening questions.
Page 12 of 23
1. Incident Name 2. Operational Period (Date/Time) From: To:
Assignment ListICS 204-CG
3. Branch 4. Division/Group/Staging
5. Operations Personnel Name Affiliation Contact # (s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor/STAM:
6. Resources Assigned “X” indicates 204a attachment with additional instructions
Strike Team/Task Force/Resource Identifier
Leader Contact Info. # # Of Persons
Reporting Info/Notes/Remarks
7. Work Assignments
8. Special Instructions
9. Communications (radio and/or phone contact numbers needed for this assignment) Name/Function Radio: Freq./System/Channel Phone Cell/Pager
Emergency Communications Medical Evacuation Other
10. Prepared by: Date/Time 11. Reviewed by (PSC): Date/Time 12. Reviewed by (OSC): Date/Time
ASSIGNMENT LIST ICS 204-CG (Rev 04/04)
11/03/2014 06:0010/27/2014 06:00Ebola 2014
Page 11
Emergency Services Hazardous Materials
Scott Slater
The Ebola virus is a Category A infectious substance regulated by the U.S. Department of Transportation’s (DOT) Hazardous Materials Regulations (HMR, 49C.F.R., Parts 171-180). Any item transported for disposal that is contaminated or suspected of being contaminated with a Category A infectious substance mustbe packaged and transported in accordance with the HMR. This includes medical equipment, sharps, linens, and used health care products (such as soiledabsorbent pads or dressings, kidney-shaped emesis pans, portable toilets, used Personal Protection Equipment [e.g., gowns, masks, gloves, goggles, faceshields, respirators, booties] or byproducts of cleaning) contaminated or suspected of being contaminated with a Category A infectious substance.
- Personnel performing cleaning and disinfection should wear the recommended PPE outlined at the end of this IAP.- Patient-care surfaces (including stretchers, railings, medical equipment control panels, and adjacent flooring, walls and work surfaces) are likely to becomecontaminated and should be cleaned and disinfected after transport. A blood spill or spill of other body fluid or substance (e.g., feces or vomit) should bemanaged through removal of bulk spill matter, cleaning the site, and then disinfecting the site. For large spills, a chemical disinfectant with sufficient potency isneeded to overcome the tendency of proteins in blood and other body substances to neutralize the disinfectant’s active ingredient.- An EPA-registered hospital disinfectant with label claims for viruses that share some technical similarities to Ebola (such as, norovirus, rotavirus, adenovirus,poliovirus) and instructions for cleaning and decontaminating surfaces or objects soiled with blood or body fluids should be used according to those instructions.After the bulk waste is wiped up, the surface should be disinfected as described in the bullet above. Contaminated reusable patient care equipment should beplaced in biohazard bags and labeled for cleaning and disinfection according to agency policies. Reusable equipment should be cleaned and disinfectedaccording to manufacturer's instructions by trained personnel wearing correct PPE. Avoid contamination of reusable porous surfaces that cannot be madesingle use.
Page 13 of 23
1. Incident Name 2. Operational Period (Date/Time) From: To:
Assignment ListICS 204-CG
3. Branch 4. Division/Group/Staging
5. Operations Personnel Name Affiliation Contact # (s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor/STAM:
6. Resources Assigned “X” indicates 204a attachment with additional instructions
Strike Team/Task Force/Resource Identifier
Leader Contact Info. # # Of Persons
Reporting Info/Notes/Remarks
7. Work Assignments
8. Special Instructions
9. Communications (radio and/or phone contact numbers needed for this assignment) Name/Function Radio: Freq./System/Channel Phone Cell/Pager
Emergency Communications Medical Evacuation Other
10. Prepared by: Date/Time 11. Reviewed by (PSC): Date/Time 12. Reviewed by (OSC): Date/Time
ASSIGNMENT LIST ICS 204-CG (Rev 04/04)
11/03/2014 06:0010/27/2014 06:00Ebola 2014
Page 12
Emergency Services Law Enforcement & Security
Scott Slater
Address scene safety:- If PSAP call takers advise that the person is suspected of having Ebola, personnel shall put on the PPE appropriate for suspected cases of Ebola (beforeentering the scene. Please see the end of this IAP for updated guidelines on PPE.- Keep that person separated from other persons as much as possible.- Use caution when approaching a patient with Ebola. Illness can cause delirium, with erratic behavior that can place personnel at risk of infection, e.g., flailingor staggering.
- Correctional facilities should consider revising intake/booking procedures to include the questions below
If you observe a person you suspect may be ill, you will ask if they, or someone at the incident, have fever of greater than 100.4 degrees Fahrenheit, and if theyhave additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained bleeding.- If a patients is reporting symptoms of Ebola, they shall be questioned for risk factors within the past 3 weeks before onset of symptoms. Risk factors include:Contact with blood or body fluids of a patient known to have or suspected to have Ebola; - Residence in–or travel to–a country where an Ebola outbreak is occurring; or direct handling of bats or nonhuman primates from disease-endemic areas.
- Based on the presence of symptoms and risk factors, put on or continue to wear appropriate PPE and follow the scene safety guidelines for suspected case ofEbola. The patient should be placed in a gown, mask and gloves according to the same PPE recommendations.
- Request EMS response to the scene as appropriate
- If there are no risk factors, proceed with normal law enforcement duties.
Page 14 of 23
1. Incident Name 2. Operational Period (Date/Time) From: To:
Assignment ListICS 204-CG
3. Branch 4. Division/Group/Staging
5. Operations Personnel Name Affiliation Contact # (s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor/STAM:
6. Resources Assigned “X” indicates 204a attachment with additional instructions
Strike Team/Task Force/Resource Identifier
Leader Contact Info. # # Of Persons
Reporting Info/Notes/Remarks
7. Work Assignments
8. Special Instructions
9. Communications (radio and/or phone contact numbers needed for this assignment) Name/Function Radio: Freq./System/Channel Phone Cell/Pager
Emergency Communications Medical Evacuation Other
10. Prepared by: Date/Time 11. Reviewed by (PSC): Date/Time 12. Reviewed by (OSC): Date/Time
ASSIGNMENT LIST ICS 204-CG (Rev 04/04)
11/03/2014 06:0010/27/2014 06:00Ebola 2014
Page 13
Command Staff Public Information
Scott Slater
Coordination between IDPH and Polk County Public Health. Public Health will send out relevant information to their partners as necessary.
Press conferences, Flash Reports, Situation Reports, Facebook and Twitter updates will be used for public information.
Once there is a suspected case a Joint Information Center shall be established at Polk County Emergency Management Agency within the hour. The JointInformation Center shall include representatives from Polk County Public Health, Iowa Department of Public Health, Polk County Emergency Management andthe EMS Agency and Hospital involved in the suspected case. The lead Public Information Officer will come from the Polk County Health Department.
For additional information on Joint Information Center procedures, please log into DLAN and click on Documentation>Reference Library>Polk CountyComprehensive Emergency Plan>ESF#15 Public Information.
Page 15 of 23
1. Incident Name 2. Operational Period (Date / Time)
From: To:
COMMUNICATIONS LISTICS 205A-CG
3. Basic Local Communications Information
Assignment Name Method(s) of contact (radio frequency, phone, pager, cell #(s), etc.)
4. Prepared by: (Communications Unit) Date / Time
COMMUNICATIONS LIST ICS 205a-CG (Rev. 07/04)
11/03/2014 06:0010/27/2014 06:00Ebola 2014
19Page
Johnston Schools
Johnston Schools
Unity Point RN Epidemiologist
Polk County Health Department
Polk County Board of Superviso
Polk County Medical Exam.
Broadlawns
DSM Schools
Pine Ridge Farms
DMACC
Iowa DPS
Fraser Ambulance
Mary Greeley Medical Center
Clive Fire Department
Unity Point
Unity Point
IDPH
IDPH
DSM Register
Safe Guard Iowa Partnership
Safe Guard Iowa Partnership
Ankeny PD
DMACC
Unity Point
Polk Co Court Administrator
Polk Co Public Works
Polk City PD
Polk Co Medical Examiner
Broadlawns ED
Des Moines Fire Dept
Susanne Richardson
Susan Krebs
Carrie OBrien
Scott Slater
Sarah Boese
Amanda Luick
Karen Nichols
Amanda Lewis
Nicole Sams
Sandra Foster
Alex Murphy
James Morgan
Chris Perrin
Brian Helland
Julie Gibbons
Kevin Daniels
Chris Galeazzi
Anne Garvey
Tony Lays
Jesse Truax
Jami Haberl
Makai Echer
Ned Miller
Scott Draper
Anne Sheeley
Bob Rice
Dustin Bjornn
Dr. Schmunk
Steve Carter
Dale Bunting
[email protected]/971-1312
515-241-6826
286-3752
664-7869
201-2275
988-4160
451-3336
608-3289
964-6352
443-3014
460-8883
241-5434
241-8622
286-3184
286-3705
984-6565
710-2852
282-2253
283-4929
Page 16 of 23
1. Incident Name 2. Operational Period (Date / Time)
From: To:
COMMUNICATIONS LISTICS 205A-CG
3. Basic Local Communications Information
Assignment Name Method(s) of contact (radio frequency, phone, pager, cell #(s), etc.)
4. Prepared by: (Communications Unit) Date / Time
COMMUNICATIONS LIST ICS 205a-CG (Rev. 07/04)
11/03/2014 06:0010/27/2014 06:00Ebola 2014
20Page
Polk County Attorney
DSM Public Schools
Polk County Sheriff Office
Westcom
Ankeny PD
DSM Airport FD
Drake University
Urbandale FD
Des Moines Fire
Des Moines Fire
Windsor Heights Fire
MWA
Polk County Health Depart
Pleasant Hill Fire
MidAmerican
Mercy Hospital
Mercy Hospital
Mercy Hospital
Iowa Homeland Security
Warren County EM
Unity Point
Newton Fire
Newton Fire
Iowa Health Association
Iowa Air National Guard
Meredith Corporation
Polk County Sheriff Comm
Polk County Sheriff Office
West Des Moines EMS
West Des Moines EMS
Iowa Telecom
Ralph Marasco
Marci Cordaro
Tim Krum
Rob Dehnert
Brian Huggins
Kevin Gill
Becky Anderson
Scott Lyon
Jim Fox
Tony Sposeto
Christopher Criss
Scott Nelson
Rick Kozin
Jamie Xayavong
Carol Ralston
Brenda McGraw
Jan Tippett
Gregg Lagan
Steve Warren
Troy Bass
Katherine Hill
Rex H.
Joe Coen
Art Spies
Cameron Stufflebeam
Katherine Reardon
John Smith
John Tayler
Mark Mc Culloch
David Edgar
Pam Boat
242-7618
208-4872
289-5258
573-424-1523
210-1293
278-4172
283-4273
283-4172
778-2772
710-1403
rexhnewtongov.org
Mark [email protected]
Page 17 of 23
1. Incident Name 2. Operational Period (Date / Time)
From: To:
COMMUNICATIONS LISTICS 205A-CG
3. Basic Local Communications Information
Assignment Name Method(s) of contact (radio frequency, phone, pager, cell #(s), etc.)
4. Prepared by: (Communications Unit) Date / Time
COMMUNICATIONS LIST ICS 205a-CG (Rev. 07/04)
11/03/2014 06:0010/27/2014 06:00Ebola 2014
21Page
Altoona Fire
Polk County Sheriff Office
VA
VA
Marion County Public Health
Marion County
Polk County Sheriff Office
VA
Urbandale Schools
Altoona Fire Department
PC Sheriffs office
Story County Hospital
Marion County Public Health
Des Moines PD
Wellmark
Ankeny Fire
Ankeny Fire
Dallas County EA
Johnston Schools
United Way 211
Des Moines Schools
Broadlawns
Dept Public Safety
Ankeny Schools
LEPC Chair
Marge Zondervain
Doug Richardson
Vic Munoz
Sean McAndrew
Tristan Johnson
Angela Blankership
Rebecca Jordan
Kim Dorn
Kim Pettyjohn
Mike Reasoner
Corey Bakaler
Dan Stein
Jerry Whetstone
Justine Wyma
Kevin Schneider
Jeff Gilchrist
Teresa H.
Gaylord Houston
Chris George
Frank Prowant
Dan Schellhase
Barry Halling
Dean MCGhee
Josh Morgan
Tim Schuh
Marci Cordaro
Jacalyn Bell
Alex Murphy
Chad Bentzinger
Mary Jo Press
[email protected] 641-828-2238
Page 18 of 23
1. Incident Name 2. Operational Period (Date / Time)
From: To:
COMMUNICATIONS LISTICS 205A-CG
3. Basic Local Communications Information
Assignment Name Method(s) of contact (radio frequency, phone, pager, cell #(s), etc.)
4. Prepared by: (Communications Unit) Date / Time
COMMUNICATIONS LIST ICS 205a-CG (Rev. 07/04)
11/03/2014 06:0010/27/2014 06:00Ebola 2014
22Page
Des Moines Police Comm
Community Family Youth Svcs
Sandy Morris
Betty Devine
Page 19 of 23
911 Phone call or a call from a clinic Questions to ask:1. Does the person have a temperature of 100.4 or greater?If so ask the following questions:1. A severe headache2. Muscle Pain3. Vomiting4. Diarrhea5. Abdominal Pain6. Unexplained Bleeding
Continue Normal Operations
No
Yes
Further Questions to ask:Within the last 3 weeks before the onset of symptoms have you:1. Contact with blood or bodily fluids of a patient with or suspected to have Ebola2. Residence in or traveled to an area with an outbreak of Ebola is occurring. As of 10/21/14: Guinea, Liberia, and Sierra Leone.3. Direct handling of bats or nonhuman primates from disease in endemic areas.
Dispatch EMS:Alert EMS of a
Suspected Case of Ebola
Suspected Case
Properly fitting PPE to be donned per
CDC guidelines. With supervision of a trained observer
Don suspected patient with gown,
N95 mask, and gloves.
Prior to transporting, call the hospital with a pre-arrival report and for directions on arrival procedures.
Pull into the garage. EMS crew to stand by ambulance until the hospital staff
greet you. *This may be delayed if
hospital is not ready.
Hospital staff will guide EMS staff to
the appropriate room
EMS PPE will be doffed under the
supervision of hospital staff. The
PPE will be disposed of by hospital
EMS is responsible for decontamination
of the ambulance which will occur under hospital guidance. The
hospital will supply the cleaning materials.
Suspected Case
EMS assessment of Patient per CDC
guidelines.
Continue Normal Operations
Non Suspect Case
Compile Basic Contact
information of close contacts to patients and
EMS crew.
EMS to limit the amount of
personnel exposed to suspected case.
No air transport via rotary wing
aircraft
No Transport to: Lutheran,
Methodist West, and
Mercy West.
Call Tree For Ebola2014.pdf
Page 5
Page 22 of 23
CDC Guidance on Personal Protective Equipment To Be Used by Healthcare Workers
During Management of Patients with Ebola Virus Disease in U.S. Hospitals
Recommended Personal Protective Equipment
PAPR or N95 Respirator. If a NIOSH-certified PAPR and a NIOSH-certified fit-tested
disposable N95 respirator is used in facility protocols, ensure compliance with all
elements of the OSHA Respiratory Protection Standard, 29 CFR 1910.134, including fit
testing, medical evaluation, and training of the healthcare worker.
o N95 Respirator: Single-use (disposable) N95 respirator in combination with
single-use (disposable) surgical hood extending to shoulders and single-use
(disposable) full face shield.** If N95 respirators are used instead of PAPRs,
careful observation is required to ensure healthcare workers are not inadvertently
touching their faces under the face shield during patient care.
o PAPR: A PAPR with a full face shield, helmet, or headpiece. Any reusable
helmet or headpiece must be covered with a single-use (disposable) hood that
extends to the shoulders and fully covers the neck and is compatible with the
selected PAPR. The facility should follow manufacturer’s instructions for
decontamination of all reusable components and, based upon those instructions,
develop facility protocols that include the designation of responsible personnel
who assure that the equipment is appropriately reprocessed and that batteries are
fully charged before reuse.
A PAPR with a self-contained filter and blower unit integrated inside the
helmet is preferred.
A PAPR with external belt-mounted blower unit requires adjustment of
the sequence for donning and doffing, as described below.
Single-use (disposable) fluid-resistant or impermeable gown that extends to at least mid-
calf or coverall without integrated hood. Coveralls with or without integrated socks are
acceptable.
Consideration should be given to selecting gowns or coveralls with thumb hooks to
secure sleeves over inner glove. If gowns or coveralls with thumb hooks are not
available, personnel may consider taping the sleeve of the gown or coverall over the inner
glove to prevent potential skin exposure from separation between sleeve and inner glove
during activity. However, if taping is used, care must be taken to remove tape gently.
Experience in some facilities suggests that taping may increase risk by making the
doffing process more difficult and cumbersome.
Single-use (disposable) nitrile examination gloves with extended cuffs. Two pairs of
gloves should be worn. At a minimum, outer gloves should have extended cuffs.
Single-use (disposable), fluid-resistant or impermeable boot covers that extend to at least
mid-calf or single-use (disposable) shoe covers. Boot and shoe covers should allow for
ease of movement and not present a slip hazard to the worker.
o Single-use (disposable) fluid-resistant or impermeable shoe covers are acceptable
only if they will be used in combination with a coverall with integrated socks.
Single-use (disposable), fluid-resistant or impermeable apron that covers the torso to the
level of the mid-calf should be used if Ebola patients have vomiting or diarrhea. An apron
provides additional protection against exposure of the front of the body to body fluids or
Guidance on PPE.pdf
Page 3
Page 20 of 23
excrement. If a PAPR will be worn, consider selecting an apron that ties behind the neck
to facilitate easier removal during the doffing procedure.
The CDC is also recommending an apron if vomiting, diarrhea occur.
For additional details including preparing for Donning and Doffing please go to this link:
http://www.cdc.gov/vhf/ebola/hcp/procedures-for-ppe.html
Guidance on PPE.pdfPage 4
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