ASPR Response Hazard Exposure Risk Assessment (HERA) OPEO Chief Medical Officer Program

Transcription

1 ASPR Response Hazard Exposure Risk Assessment (HERA) OPEO Chief Medical Officer Program Last Updated 11 March 2011 POC: Mission: Response to Earthquake(Japan) creating Tsunami conditions, potentially affecting Pacific Islands and the West Cost (CONUS) including Alaskan Islands. Scope & Applicability: This HERA applies to all ASPR-deployed Federal Responders (employees and USPHS Commissioned Corps officers) deploying to areas affected by the 11 March 2011 Earthquake/Tsunami in Japan/Pacific Islands/Pacific Coast. Deployed location: Deployed locations/mobilization Center Sites are currently undetermined. This HERA is based on post Tsunami guidance provided by the National Oceanic and Atmosphere Administration s Pacific and Alaskan Tsunami Warning Centers. The product will be updated as information becomes available. Climatic Conditions: A wide spread TSUNAMI WARNING is in effect for Hawaii, and the American territories of Guam, American Samoa, the Northern Mariana Islands, Wake Island, Midway Island, Howland, Baker and Johnston Islands and the West Coast from California to the Oregon/Washington border and Alaska. Worksite circumstances: Some evacuations have currently been ordered for low lying and coastal areas by governmental officials. A Tsunami warning indicates a series of long ocean waves, lasting fifteen minutes or more, has been generated. The DANGER can continue for many hours as subsequent waves arrive. Wave heights cannot be predicted. Tsunami waves effectively wrap around islands. Extremely strong near shore currents can accompany a Tsunami. Debris picked up and carried by a Tsunami will have destructive power. Subsequent to a Tsunami disaster conditions (no power, impassible roads, lack of infrastructure including clean water/food) may be anticipated. Quarters/Meals: Deployed personnel may be quartered in austere conditions (See Climatic Conditions above and Security Statement below). Personnel should be prepared for quarters in tent areas and carry fresh water with them. Teams should be prepared to provide two (2) MRE/person/day, and 150 ounces of fresh water/person/day. There is no guarantee that onsite water systems will provide safe drinking water. Deployed personnel should bring medication for a 30 day period, as well as spare necessities such as eye glasses. Security: Security concerns may present, due to non-intact infrastructure, however law enforcement presence is currently in place in all locations. Recommended practices include: Page 1 of 5

2 A federal ID is required. Carry personal identification and HHS ID badge with you at all times. Carry credit cards with you. Bring U.S. PHS 731: Record of Immunization/Vaccination. Maintain valuable personnel items in locked or secured condition or leave home. Do not leave computers or electronic equipment unattended. DO NOT BRING VALUABLE ITEMS TO THIS RESPONSE. Always travel in pairs, use the buddy system, and follow accountability procedures published for this response [ALWAYS IDENTIFY TRAVEL LOCATIONS AND SIGN- IN/OUT]. Maintain continuous communications (cell/radio) with your base of operation (KNOW YOUR 24/7 TEAM CONTACT MEMBER). Federal agencies are identified as Lead for security activities to occur on site. PLAUSIBLE HAZARDS: Biological: Areas of widespread destruction may occur. Subsequently multiple biological hazards may be present. All personnel should follow UNIVERSAL PRECAUTIONS in ALL cases. Change gloves frequently. Nitrile gloves will be provided to teams. WASH YOUR HANDS with soap and water or an alcohol-containing hand gel before eating or preparing food, after using the washroom, after sneezing or coughing, and before and after any patient contact. WASH HANDS FREQUENTLY. Risks of waterborne illnesses exist with standing water: STAY OUT OF POOLED WATER. DO NOT USE POOLED WATER FOR MAINTENANCE PURPOSES. WASH IMMEDIATELY WHEN YOU HAVE TOUCHED STAGNANT WATER. Physical: Activities are performed in an austere environment, and (potentially) wet conditions. All individuals should have slip resistant footwear and be cognizant of slip, trip and fall hazards. Noisy areas will be posted by Site Safety Officers. Assume generators will be in use and noisy and stay away. Generators may be in place for activities and should be 50 feet from all structures and tents. CO exposure mimics flu symptoms: BE AWARE OF GENERATOR USE AND CO POISONING CONCERNS. DO NOT APPROACH ANIMALS WHO MAY BE DISPLACED BY THIS RESPONSE. Behavioral Health: There is an increased risk for behavioral health complications in responders who participate in critical incidents. Feelings of uneasiness should be reported through Team Chain of Command. Page 2 of 5

3 Hazardous Weather: Basic Principal: Anticipate a high-risk situation and move to a low risk situation. Warning: Utilize NOAA weather radio for warnings OR have commercial communication systems available to monitor for severe weather. Each NDMS deployed team should process a NOAA weather radio. Know safe spots in buildings and routes to them. Ensure you have a signal for staff to communicate the hazardous condition (move to SAFE location) and a means to communicate with Command (cell/radio). Suspend operations when a hazard has been identified: TORNADO: If underground shelter is not available, move to an interior room. Do not shelter under a highway underpass. FLASH FLOODS: Do not walk or drive through floodwaters. Do not operate electrical equipment in these areas. SEVERE THUNDERSTORM: Seek shelter in interior structures (NOT TENTS). Stay away from windows. Do not use electrical appliances. Earthquake: Get under a sturdy desk or table and hold it. Stay clear of windows, shelves and cabinets. Stay inside. POST STORM: Turn off utilities and provide first aide per your plan. Notify Command of your status. Go to your outdoor rally point and stay clear of electrical wires and debris. RECOMMENDED ACTIONS: If hazards are identified, remove the hazard, perform administrative or engineering actions to remove the hazard from the individual or reduce exposures. Finally, utilize PPE as designated in the HASP for this event. 1. Required immunizations (OSHA): current Hepatitis B. 2. Recommended immunizations: Seasonal influenza and tetanus. 3. Injury prevention: The following injury prevention procedures are identified in the HASP: Driving may be difficult and roadways blocked: DO NOT DRIVE THROUGH STANDING WATER. DO NOT DRIVE THROUGH DEBRIS FIELDS. Mandatory use of seatbelts while driving, zero tolerance for driving under the influence of alcohol or medications; proper footwear and fall precautions are necessary if personnel are operating in a slippery environment. Proper footwear for rugged terrain is required. 4. Resilience: a) Team Leaders must be aware of signs of deployment stress and support behavioral intervention when deemed necessary. Page 3 of 5

4 b) A minimum of 8 hours rest will be provided for all personnel PRIOR to assignments. 5. Personal Protective Equipment: a) N-95 Respirators: Anticipated need for N-95 respirators is for use during medical operations. All medical personnel MUST be clean-shaven (defined as less than 24 hours growth of facial hair) medically pre-approved to use a respirator, and have been successfully fit tested within the previous 12 months of deployment. Fit testing may be provided at a Mobilization Center. b) Standard Bloodborne Pathogens and Infection Control Precautions for patient care includes mucus membrane covering (eye protection safety glasses) and gloves (nitrile) when operating with known infectious patients or performing aerosol-generating operation. THESE PROCEDURES WILL BE PROTECTIVE OF OTHER HAZARDS IN DISASTER ENVIRONMENTS. c) Sturdy, closed toe and ankle supporting footwear is required. d) Heat stress protocol is identified in the HASP, and includes routine hydration; hydration requirements are 150 ounces a day of water for responders in hot environments. If temperatures are above 90 o F, a SAFETY BULLETIN advising of site-specific protocol will be issued by the IRCT Safety Officer. PPE Requirements: Bring rain gear and sturdy, closed toe ankle supporting footwear. Safety glasses are required by the HASP for work in disaster environments. Nitrile gloves will be provided and should be used for both medical and other (duty) procedures. Medical personnel must be clean-shaven (daily) and be medically approved to use an N-95 respirator. Fit tests will be provided at the Mobilization Center. Medical Clearance Instructions: Staff should self-screen and notify the Team Medical Director prior to deployment. Any change in health status should be immediately brought to the attention of the Team Medical Director. The Team Medical Director will make specific recommendations regarding restrictions to activity. 1. There is no assurance of ADA compliance. All deployed staff should, at a minimum, be fully ambulatory over uneven terrain, capable of carrying 40 pounds for short distances and climbing three (3) flights of stairs without significant shortness of breath. Responders with lower extremity casts, splints, or walking assist devices should remove themselves from the deployment roster or request review for waiver consideration by the Team Medical Director or CMO designee. Page 4 of 5

5 2. Persons with conditions at risk for heat-related illness should remove themselves from the deployment roster or request review for waiver consideration by the Team Medical Director or CMO designee. Certain prescription and OTC medications, poor physical conditioning and obesity (BMI >35) should be considered. 3. Persons with uncontrolled or poorly controlled chronic medical conditions are immunocompromised, or that requires follow-up during the deployment period should remove themselves from deployment rosters or request review for waiver consideration by the Team Medical Director or CMO designee. Persons with any chronic health condition should consult with their physician and the Team Medical Director. Persons with certain acute health conditions should remove themselves from the deployment roster or request review for waiver consideration by the Team Medical Director or CMO designee. Conditions can include acute sprains, recent fractures, pneumonia, sinusitis, diarrhea, recent hospitalization or surgery (past 6 weeks), and conjunctivitis. 4. Persons requiring use of powered durable medical equipment should remove themselves from the deployment roster or request review for waiver by the Team Medical Director or CMO designee. Electricity is not assured. 5. All staff should carry 30-day supply of any prescription item, personal hygiene, and sunscreen/insect repellent. 6. Staff requiring special diets (preference, health, religious, or allergy) cannot be assured accommodation and should remove themselves from the team roster. 7. Staff with health concerns are encouraged to see their physician prior to departure and discuss with the Team Medical Director or CMO designee. Doc/Shelly/HERA ( ) Tsunami (Japan) Page 5 of 5