Emory leads two-day radiation response exercise at Emory University Hospital and Dobbins Air Reserve Base

At Dobbins Air Reserve Base (DARB) in Marietta on Saturday morning, Sept. 17, Emory nursing and public health students walked onto the airfield and into the cavernous body of a C-130 Hercules aircraft, where they were cheerfully strapped onto stretchers piled five-high. Moments after the two back flaps of the airplane were folded up behind them, they heard the call: “the exercise has begun.”

Georgia State Defense Force and Cobb Medical Reserve Corps personnel walked in formation onto the airplane, secured the stretchers, and briskly carried the volunteers, who were simulating patients with radiation injuries, into a bustling triage area established in a huge aircraft hangar nearby.

Emory and Atlanta VA Medical Center physicians and nurses performed simulated medical evaluations, and EMTs from Atlanta Fire and Rescue and Gwinnett County Fire and Emergency Services placed the most severely injured “patients” onto rolling stretchers, wheeled them into two mobile ambulance buses, and placed them on stretchers stacked in bunk-bed fashion. Cobb/Douglas Public Health personnel assisted the VA with command and control functions.

This mock scenario was part of a drill named “Operation Gateway,” which included more than 250 people representing over 15 health care and government agencies simulating the local response to a mock radiation incident with mass casualties. The drill began in reverse at Emory University Hospital the day before, as medical personnel and EMTs simulated unloading the injured patients from the mobile ambulance buses.

Sam Shartar, senior administrator of Emory’s Office of Critical Event Preparedness and Response (CEPAR), directed the full-scale exercise. “This exercise is important because we are able to test the processes required to receive large numbers of casualties. Improvised nuclear detonations are low probability, high consequence events. Having said this, these same processes will be utilized for response to hurricanes, floods or earthquakes, which are a higher probability event,” says Shartar.

The drill was conducted by the Emory Radiation Injury Treatment Network (RITN), which is part of the national response plan for  a mass casualty radiation incident resulting in bone marrow-toxic injuries. Emory University Hospital (EUH) is a RITN center. If a nuclear device were detonated somewhere in the United States, the National Disaster Medical System (NDMS) would be activated. Military aircraft would transport persons injured by ionizing radiation to DARB. The patients would then be transported to Emory University Hospital and Northside Hospital for treatment. Radiation injuries would include bone marrow damage, with some patients potentially requiring bone marrow transplants.

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Over capacity forecast to cost hospital $7M in 2016-17 Sciences North continues to battle with capacity issues, as the hospital operated at a critical level for as much as 75 per cent of last year.

Most days, HSN is sitting at 110 per cent occupancy, or in the red level of the hospital’s surge plan that is divided into four categories, with red identified as “Escalation Level 2,” just one level before the fourth and final, black category, “Escalation Level 3 – crisis.”

In the 2015-16 fiscal year, overcapacity cost HSN $3.5 million and that number is projected to double for 2016-17, up to $7 million. A report presented to the HSN board on March 14 by David McNeil, the vice-president of patient services, indicated the hospital is forecasting 5,000 patient days over capacity, with the average cost per patient per day pegged at $1,400.

“We’re in the black (Escalation Level 3) almost 50 per cent of the time,” said David McNeil, vice president of patient services, HSN. “In that instance, we’re shutting down to any patient that is non-life or limb (critical). Obviously, if there’s a life and limb patient we help them.”

“This isn’t a matter of having an inefficient hospital, it’s a matter of being overcapacity,” said McNeil. “We can’t solve this alone and more beds aren’t the solution, it’s a matter of getting patients in the right place at the right time.” See more…


Full scale emergency exercise conducted showcases local history

The National Disaster Medical System (NDMS) conducted a full-scale exercise involving all Centr


al Region Hospitals that tested the transfer, wellness check, and loading of patients from four area hospitals, utilizing the Virginia Air National Guard and the Chesterfield County Executive Airport. Volu

The scenario for the exercise is that an earthquake has struck Richmond, within the Central Virginia Seismic Zone. The earthquake has killed and injured thousands of individuals. Local, regional, and state resources have been depleted. In response to the disaster, the president has declared a federal disaster, resulting in the activation of the NDMS. The Federal Coordinating Center and Chesterfield County Fire & EMS have been activated to send patients out to Feder See more…

911 director honored by commission for work on storm shelters,8399See more… The Walker County Commission honored E-911 director Roger Wilson on Tuesday for leading the effort to install storm shelters throughout the county.

Seventeen storm shelters have been installed since 2014. Approval for a change of location on three more is currently pending.

Wilson was quick to share credit after accepting a plaque from Commission Chairman Billy Luster at the start of Tuesday’s meeting.

“This wasn’t done by myself. If it wasn’t for these men right here [commissioners], it wouldn’t have happened. If it wasn’t for the Walker Area Community Foundation board of directors and Paul Kennedy, it wouldn’t have happened. The Governor’s Emergency Relief Fund — if it wasn’t for them, it would not have happened,” Wilson said.

WACF and GERF provided the bulk of the match money required to complete each shelter.

A $2.3 million federal grant covered 75 percent of the cost of the project.

Most communities relied on WACF or GERF to provide the other 25 percent.

Residents in Thach, Carbon Hill and Kansas raised the funds themselves, according to Wilson.

The county also provided some in-kind services.

“Everybody worked together, and that’s what it takes,” Wilson said.

Wilson and the commissioners also took a moment to reflect on the dedication of late Thach Fire Chief Terry McCullar, who worked alongside Wilson to secure a storm shelter for Thach residents.

McCullar underscored the importance of the project in January 2014 when Thach became the first community to receive its storms shelter.

McCullar underscored the importance of the project in January 2014 when Thach became the first community to receive its storms shelter.

In an interview with the Daily Mountain Eagle, McCullar recalled the three lives that were lost in Thach during a 2002 tornado outbreak.

“If we can prevent the loss of one life, it will be worth it,” McCullar said.

On Tuesday, Wilson laughed as he recalled how McCullar kept order in a packed shelter during the first tornado warning after the shelter was in place.

“They had 218 people in it, and it’s only rated for 99. He said every time somebody knocked on the door, he would open it and say, ‘Move back,’” Wilson said.


Homeland Security Today: Getting Ahead of the Impact: Emergency Preparedness Key to Biodefense

The more prepared we are, the faster and better we will respond. Of course, budgets are finite and we cannot possibly prepare for every contingency. Prudent emergency managers, therefore, often first consider the threat and use that assessment to drive allocation of preparedness dollars. Many of them have recognized that the biological threat from nature and terrorists alike is real and present. The key to biodefense and management of biological emergencies therefore, is getting ahead of the impact of these inevitable incidents. The public and private sectors have taken many important steps to prepare, but we remain far from capable of responding optimally to events with the potential for far-reaching consequences.

The Blue Ribbon Study Panel on Biodefense recently released the report, A National Blueprint for Biodefense: Leadership and Major Reform Needed to Optimize Efforts. This bipartisan report contains 33 recommendations, each with action items designed to aid implementation. Six of the recommendations address emergency preparedness in particular, and, if acted upon, will enable the Nation to get ahead of the impact of biological incidents.

Allow emergency service providers to protect themselves

Intelligence will only get us so far in addressing the biological threat, so we must take other measures to mitigate the impacts of an outbreak. Vaccination is one of our best defenses, preventing illness if intelligence fails us or if a serious threat emerges from nature. For instance, the events of 2001 demonstrated the reality of the anthrax threat, yet each month, the federal government discards hundreds of thousands of short-dated, excess or expired anthrax vaccine doses.

After years of consideration, the Department of Homeland Security (DHS) should pilot a program to offer these vaccines before they expire to emergency service providers that want them. If successful, DHS should subsequently develop a more comprehensive voluntary vaccination program addressing additional biological threats faced by emergency service providers. Pre-deployment of medkits and the establishment of personal protective equipment guidelines and requirements would have significant downstream benefits, and the Department of Health and Human Services (HHS) carry these out.

Forward deploy Strategic National Stockpile assets

The federal government has resisted putting medkits in the hands of emergency service providers, fearing loss and misuse of their contents – despite pilot programs demonstrating the opposite. Similarly, requests for forward deployment of Strategic National Stockpile (SNS) assets have met with resistance. The Centers for Disease Control and Prevention (CDC) should forward deploy elements of the SNS to at-risk jurisdictions that have demonstrated they can manage the contents of their allotment responsibly. New York City, for instance, has shown it can stand up points of distribution faster than federal SNS assets can arrive. This wasted time unnecessarily puts lives at risk.

Institute a process to develop infection control guidelines

We can also pre-establish the process for developing infection control guidelines. There is no reason to wait for the next biological incident before emplacing a process that ensures federal agencies such as CDC and Occupational and Safety and Health Administration work together; solicit and incorporate input from non-federal public and private sector experts and practitioners; and communicate new or modified guidelines clearly. While it is not possible to predict exactly which infectious disease will create the next biological event, it is possible to establish in advance a process to develop effective infectious control guidelines when needed.

Create a stratified hospital system

Successful hospitals provide expedient life-saving treatment while executing sound business plans. Some choose to offer specialized care (e.g., pediatric, trauma), which in turn allows them to be reimbursed for a greater variety of increasingly expensive services. A national system of stratified hospitals offering tiered levels of care allows patients to get the treatment they need relatively nearby. Making treatment of highly pathogenic infectious diseases a specialty reimbursable by the Centers of Medicare and Medicaid Services if a hospital is accredited to do so would build on our existing hospital system and leverage an exponentially larger and more reliable source of funding than the much smaller Hospital Preparedness Program.

Strengthen the public health community

Beyond the delivery of healthcare to individuals, surveillance, laboratory testing, bioinformatics and epidemiology are also critical to effective emergency preparedness and maintenance of public health. The public health community depends on federal funding to execute these activities. To ensure the public health community can alert emergency service providers and healthcare deliverers to take action and best direct their limited resources, Congress must increase funding for CDC’s Public Health Emergency Preparedness (PHEP) cooperative agreements.

The Blueprint for Biodefense contains additional recommendations and action items to improve our national ability to prevent, deter, prepare for, detect, respond to, attribute, recover from and mitigate biological incidents. While all of these areas are important, emergency preparedness is key to effective biodefense.

via Homeland Security Today see more