RI Department of Health Medical Countermeasure Dispensing During - - PDF document

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RI Department of Health Medical Countermeasure Dispensing During - - PDF document

RI Department of Health Medical Countermeasure Dispensing During Emergencies in Rhode Island 2014-2015 Disclosure Statement CONFLICT OF INTEREST The planners and presenters have declared no conflict of interest. COMMERCIAL


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RI Department of Health

Medical Countermeasure Dispensing During Emergencies in Rhode Island 2014-2015

Disclosure Statement

  • CONFLICT OF INTEREST

– The planners and presenters have declared no conflict

  • f interest.
  • COMMERCIAL SUPPORT/SPONSORSHIP

– There is no commercial support or sponsorship for this event.

  • CRITERIA FOR SUCCESSFUL

COMPLETION includes attendance at the entire

event and submission of a completed evaluation form.

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Objectives

Learners will:

1.Describe the Medical Emergency Distribution System (MEDS) in Rhode Island and identify examples of when MEDS has been utilized in Rhode Island 2.Summarize the concept of Points-of- Dispensing (POD) including the flow and function of a POD 3.Explain professional roles and responsibilities required to volunteer as staff in a POD.

What are we preparing for?

Emerging Infectious Diseases and Natural Disasters

  • Natural Disasters

– Hurricanes – Tornadoes – Floods

  • Infectious Diseases

– Influenza outbreaks requiring mass vaccination

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What are we preparing for?

Biological Agents

  • Bioterrorism agents are separated into three

categories - A, B, or C

Category A

  • Easily spread person to

person

  • High death rates
  • Major public health impact
  • Social disruption
  • Special action for public health

preparedness Specific Agents: Anthrax Botulism Pneumonic Plague Small Pox Tularemia Viral Hemorrhagic Fevers

  • A national repository of medical countermeasures

and supplies

– Ciprofloxacin – Doxycycline – Amoxicillin

  • Types of inventory

– 12 Hour push package – Managed inventory Federal Mission: Deliver critical medical assets to the site of a national emergency.

Federal Response to Biological Threats

CDC’s Strategic National Stockpile (SNS)

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HEALTH’s Mission: Coordinate distribution to PODs and dispensing at local PODs ALL RI Municipalities’ Mission: To get the first pill in the last person in line within 48 hours!

Rhode Island’s Response

Medical Emergency Distribution System plan (MEDS)

Timeline of MEDS Response

Rhode Island MEDS/POD Activation Timeline

Declaration of Public Health Emergency

Disease

  • utbreak/

Release

  • f agent

Hour 0

Aware of threat & SNS assets requested

Hour 6

Notify leaders to activate PODs

Hour 12

SNS arrives; Deploy to PODs

Hour 12-48

PODs

  • pen to

dispense to public

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Secondary Objectives:

  • Keeping anxiety in check / not

adding to anxiety levels

  • Keep accurate records

Rhode Island Dispensing Method

Objectives within a POD

Primary Objective:

  • Medicate/vaccinate the public
  • Educate the public
  • Patient history review / drug dispense decision

making

Types of Dispensing

  • Open PODs

– Open to the public – Each municipality opens at least one POD

  • Closed PODs

– For a specific list of individuals – Usually a facility with their own medical professionals

  • n staff

– Examples: hospitals, Adult Correctional Institution

  • Alternate Dispensing

– Possibly take countermeasures to homebound populations etc.

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“Open” PODs

Prophylaxis

Symptomatic Individuals

Treatment The Public Prophylaxis POD 4 Simple Steps

Step 1: Fill out form Step 2: Have form reviewed Step 3: Get medication or vaccine Step 4: Exit (15 minute observation if vaccine)

POD: Flow

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7 Standardized, on-scene, all-hazards incident management approach.

POD Commander Operations Logistics Planning Finance Medical Director Site Pharmacist Safety Officer Public Information

Incident Command System (ICS)

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Just-In-Time Training

JITT is tailored to the specific threat and includes but is not limited to the following elements:

– Infectious agent – Specific medical countermeasures being used at POD – Incident Command at POD – POD flow and policies ( functions of stations) – Communication devices being used (ex. Radios) – Job Action Sheets (explanation of assignments) – Questions and Answers

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RI-Specific POD Policies

  • No IDs will be asked for
  • No residency requirements
  • Unaccompanied minors OK
  • Head of Household (HoH) policy during a

pill response (never vaccine)

  • POD workers and their families receive

prophylaxis before POD opening

Liability

National Health Emergency

  • PAHPRA Act (2013)
  • PREP Act (Pub. L. 109-148)
  • Volunteer Protection Act (1997)
  • Emergency Use Authorization
  • Investigational New Drug

Rhode Island

  • RIGL 30-15-15 states:
  • Governor's executive order
  • Expanded scope of practice

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9 42 Vaccination Stations 69 PODs 2898 Vaccinators

Why We Need You?

Minimum # of Staff Needed for One Shift 25 Pill Dispensing Stations 69 PODs 1725 Dispensers (for a pill response)

1725 Dispensers

  • r

2898 Vaccinators ~ Per shift ~ in order to dispense/vaccinate 500 people per hour!

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Why We Need You?

Roles and Responsibilities

Forms Review- Review patient history; make countermeasure selection; and pass out information sheets Dispensing- 2nd review of form- confirm proper drug/vaccine according to algorithm; refer special cases to medical director Inventory Management- Sign for countermeasures; ensuring proper storage, quarantine, and waste management; distribute to dispensing areas or alternate dispensing Medical Evaluation- Evaluate whether a person can be seen at POD; troubleshoot special cases; send patients to doctor or hospital as needed

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Case Studies

Station: Forms review station. Patient: 10 year old with 4 history forms Forms: Adult Male = good health, no allergies Adult Female = pregnant and has multiple allergies including eggs, and peanuts 2 Children = (ages 10 and 2) no allergies or medical problems According to the provided algorithm, what would the appropriate prescription be for each person?

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Case Studies

Station: Dispensing Problem: You are sitting at the dispensing station working along side two non-medical staff. You over hear

  • ne of the staff members telling a

patient only to take the medication if they feel ill. What should your response to this be?

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Case Studies

Station: Observation area Additional Information: You are staffing the

  • bservation area during a vaccination POD.

You notice a young man approximately 20 years old scratching his arms and legs. Who should be notified about this situation?

Case Studies

Station: Dispensing Patient: 19 year old Male One Form: Allergy to peanuts, no medical problems Additional Information: Patient arrives at your dispensing station, refusing to sit down, agitated, nervous and demanding more than ten days worth of medicine because he is “sure he has been exposed and has the disease”

How would you handle this situation?

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Get Involved

  • Contact your local Emergency

Management Director to volunteer IN ADVANCE to work a POD

  • Take some ICS courses

http://training.fema.gov/IS

  • Develop a personal preparedness plan

www.ready.gov

Next Step’s

50 additional day supply plan to re-open PODs.

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If you would like to volunteer at a POD or have any questions please contact: Brittan K. Bates-Manni Strategic National Stockpile Coordinator 401-222-4905 Brittan.Bates@health.ri.gov

Thank you!