Ebola TTXDivision of Public Health, Public Health Preparedness Wisconsin Department of Health...

Ebola TTX Division of Public Health, Public Health Preparedness

Wisconsin Department of Health Services

INSERT DATE/LOCATION HERE

Ebola Virus Table Top ExerciseUnknown Patient

1



2

Purpose

To provide participants an opportunity to evaluate current response concepts, plans and capabilities in response to a possible outbreak of a viral disease with high mortality.



Disclaimer

The current Ebola Viruses Disease outbreak continues to evolve and guidance from the Centers for Disease Control and Prevention (CDC) and the Department of Health Services (DHS) frequently changes. The information presented in this exercise may be quickly outdated. Check the CDC and DHS websites for up-to- date information.

3



4

ObjectivesCritical Transport: Discuss how critical transportation would occur in region/jurisdiction in the event of an Ebola case.

1. Determine criteria and process for transport to local hospital2. Determine criteria for inter-hospital transport 3. Discuss responder safety as it relates to: Personal Protective

Equipment (PPE), transport from one facility to another, decontamination of ambulance, etc. . .



Objectives

Operational Communications (Information Sharing and Emergency Public Information and Warning): Ensure timely, accurate, internal and external communication throughout response

1. Identify internal communication and info sharing needs 2. Identify external communication needs3. Develop risk communication strategy for public

5



Objectives

Medical Services: Determine the ability to provide appropriate, safe care to an Ebola Virus Disease patient.

1. Provide lifesaving medical treatment to an Ebola Virus Disease patient

2. Ensure responder safety and health throughout the course of providing treatment

6



Objectives

Public Health Functions:1. Surveillance and Epi Investigation: • Investigate case and identify contacts to patient• Assemble appropriate screening tools/forms/resources to ensure

consistent data collection• Identify/activate local, regional, state and/or federal resources for

surge capacity in contact tracing

2. Quarantine (if needed):• Ensure the ability to appropriately quarantine those who may have

been exposed to Ebola in alignment with recommended guidance• Ensure isolation/quarantine plans are updated and ready to be

operationalized

7



ObjectivesFatality Management Services: Discuss the coordination of fatality management services as it pertains to a fatality caused by Ebola.

1. Ensure responder health and safety throughout processing of the deceased

2. Ensure most current guidance is followed as it relates to handling Ebola contaminated remains

3. Provide mental/behavioral health services for those impacted by event

8



9

Exercise InstructionsThis is an exercise based on a possible event.

Process the information just as you would in a real-life incident. Avoid the temptation to “solve” the entire scenario.

There is no “hidden agenda” or any trick questions.

Participation is the key to making this exercise a success.

Feel free to make valid assumptions based on the information provided.

Respond based on your knowledge of current plans and capabilities (you may use only existing assets).



10

Rules of Engagement• This is an open, low-stress,

no-fault environment.• Offer any suggestions or

recommended actions that could improve response and preparedness efforts.

• Be respectful of others, as varying viewpoints, even disagreements, may occur.



11

Scenario• At 7 pm on Friday a 23-year-old male who is ill

presents at the local emergency department. • Vitals/Symptoms:• Temp 101.5• Headache• Muscle pain• Abdominal cramps



12

DiscussionEmergency Department:• How would ER registration handle

a patient that has flu-like symptoms or says “I think I have Ebola”?

• What symptom-related questions would you ask this patient?

• What travel history questions would you ask this patient? NOTE: Patient NOT being actively monitored.

How would this scenario change if the patient had called 9-1-1?

15 minutes for discussion



13

DiscussionPatient was in Liberia 11 days ago. Traveled from Africa to Germany, where spent a few days with friends. Upon return to United States, he did not end up on the Active Monitoring list.

Assumption: Substantial patient history info needed from the time period of return to US.

NOTE: Patient worked for the American Red Cross teaching healthcare workers about infection control practices. He was considered low-risk.



14

Discussion- Initial transportA unified command teleconference is held between the local hospital, state public health, local public health, and the CDC. Based on policy and criteria, what would the likely recommendation be for initial management?

• Should the patient remain where heis or be transferred?



Discussion- TransportUnified Command decision that patient should be seen at the nearest Category II facility.

15



Update- Testing• What testing should be performed in a rule-out

scenario?• What lab capabilities and employee protections need

to be in place to perform this testing?• Is the facility able to perform this testing (Category II)

or only screen and isolate the patient (Category III)?

• How about YOUR hospital?

16



Update- Testing• Patient arrives at the nearest Category II facility for

monitoring/assessment/initial care.

• Discuss the process of specimen collection, packaging, transport.• Ensure permission is received to transport.• Is there a written protocol?• What technical support might be needed?

17



INJECT- Decon• The EMS unit that transported the patient from

home to the Category II hospital is requesting guidance on how to properly decon the rig.• What is your guidance to them?• Where would you turn for technical support?

18



Update- Patient Care and Responder Safety and Health

• Please discuss your internal hospital response plan to ensure the following:• Appropriate patient care• Appropriate isolation • Appropriate PPE to ensure Responder Safety and Health• Appropriate monitoring of healthcare workers and

coordination with public health

• NOTE- Include specific names of policies/procedures where appropriate

19



INJECT- RISK COMMUNICATION• Due to media and public interest, activate your Risk

Communication Plan.• Do you have one? If so, describe it.• How will the messaging be consistent between:• Hospital• Local public health• Local government• State government• CDC

20



Update- Patient Deteriorates• While at the hospital and awaiting test results, the

patient begins to deteriorate.• A decision is made between Unified Command at all

levels to transport to a Category I facility.

• INJECT: INITIAL TEST FOR EBOLA POSITIVE

21



Inter-hospital Transport• How would this process occur?• Has the EMS that would be transporting already

been identified?• If not, which EMS would transport the patient?• Where would you turn for technical support?

• Once patient is transported:• Who monitors staff?• How is waste handled?• How does hospital return to normal operations?

22



The investigation. . . • How is contact tracing/investigation occurring?• Who is the lead?

• Where can you get surge capacity for contact tracing?

• How are you handling the ‘worried well?’

• Is there a hotline/phone bank option?

23



Investigation Update:• Extensive contact tracing has identified three close

contacts (girlfriend and two co-workers).

• There are other possible contacts that are being investigated.

• How would you monitor these contacts? What restrictions would you put on their movements?

• Who handles contact tracing and monitoring? Who can assist?

24



OPTIONAL INJECT-• Patient dies at your facility

• Activate fatality management plan for an Ebola victim• How are Ebola infected remains handled?• What is the guidance?• What is your recommendation to the Medical

Examiner/Funeral Home Director?

25



DHS Ebola Website• Frequently updated by DHS Incident Command

structure to reflect the most current guidance:

• Go to: http://www.dhs.wisconsin.gov/communicable/diseasepages/ebola.htm

• OR http://www.cdc.gov/vhf/ebola/index.html

• These are the two most current, up-to-date sites

26

http://www.dhs.wisconsin.gov/communicable/diseasepages/ebola.htm




http://www.cdc.gov/vhf/ebola/index.html

http://www.cdc.gov/vhf/ebola/index.html



27

Hotwash

Date post:	27-Dec-2015
Category:	Documents
Upload:	juniper-turner
View:	215 times
Download:	1 times

Ebola TTXDivision of Public Health, Public Health Preparedness Wisconsin Department of Health...

Documents