Mass Fatality Management Guide for Healthcare Entities January 31, 2013
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Mass Fatality Management Guide for Healthcare Entities January 31, 2013 Los Angeles County Emergency Medical Services Agency 2011-2013 Los Angeles County Medical and Health Exercise Program PROJECT OVERSIGHT GROUP The Mass Fatality Management Guide for Healthcare Entities was led by the Los Angeles County Emergency Medical Services Agency and developed in coordination with a multi-agency, multi-discipline Project Oversight Group. Project Oversight Group members provided strategic guidance regarding guide development, validation, and implementation. PROJECT MANAGER ElaINE FORSYth, RN Los Angeles County Department of Health Services EMS Agency PROJECT OVERSIGHT GROUP MEMBERS Roel AmaRA, RN Los Angeles County Department of Health Services EMS Agency GERtha BENsoN Los Angeles County Department of Health Services EMS Agency LOUIse BRoomfIeld, RN Pomona Valley Hospital Medical Center GARY ChambeRS, RN Los Angeles County Department of Health Services EMS Agency JohN CHUNG Los Angeles Operational Area Alliance Los Angeles County Department of Public Health ANA DE LA TORRE, phd Los Angeles County Department of Mental Health ELIssa FleaK, ms, D-abmdI Los Angeles County Department of Coroner ReNee GRAND PRE, RN, bsN, D-abmdI Los Angeles County Department of Coroner Tom MedleY California Association of Health Facilities GRegoRY MERcado Los Angeles County Department of Public Health SGT. AmbeR MORales Los Angeles Operational Area Alliance Los Angeles Police Department JocelYN MONtgomeRY California Association of Health Facilities AshU Palta, MPH, CHEP Los Angeles County Office of Emergency Management ACKNOWLEDGEMENTS StephaNIE RabY, RN, bsN,phN Los Angeles County Department of Health Services EMS Agency SADINA ReYNaldo, phd Los Angeles County Department of Public Health TRevoR Rhodes Community Clinic Association of Los Angeles County SANDRA staRK SHIelds, LMFT, CTS Los Angeles County Department of Health Services EMS Agency KathLEEN SteveNsoN, RN, BSN Children’s Hospital Los Angeles AMY ChaN YEE, mph Los Angeles County Department of Public Health RIchaRD ZORasteR, md Los Angeles County Department of Health Services EMS Agency CONTRIBUTORS The list below reflects the individuals who participated in interviews and other review sessions - serving as important contributors to the plan. TONY BELIZ, PHD Los Angeles County Department of Mental Health RYAN BURGESS, RN, MSN Hospital Association of Southern California KAY FRUHWIRTH, RN, MSN Los Angeles County Department of Health Services EMS Agency JIll GlasbaND California Funeral Director’s Association BARBARA CIENFUEGOS ENGLEMAN, LCSW Los Angeles County Department of Mental Health CheRYL Ites U.S. Department of Defense, Mortuary Affairs KatY HYmaN Long Beach Memorial Medical Center, Decedent Affairs BARBARA MORIta, pa Alameda Health Consortium/Disaster Medical Assistance Team CONSULTANTS Constant and Associates, Inc. served as the project consultant. The following individuals supported content development: MIchelle CONstaNT JIM SIms, ms KIM GUevaRA-HARRIS, ma ACKNOWLEDGEMENTS 1 OVERVIEW SCOPE..................................................................................................1 BACKGROUND....................................................................................1 WHAT IS MASS FATALITY.....................................................................2 GUIDE DEVELOPMENT PROCESS.....................................................2 HOW TO USE THIS GUIDE...................................................................2 ASSUMPTIONS.....................................................................................3 7 PLAN DEVELOPMENT OveRVIew of sectION...................................................................7 REGULATORY REQUIREMENTS, GUIDES, AND AUTHORITIES......11 15 ACTIVATION OveRVIew of sectION..................................................................15 SAMPLE PLAN ACTIVATION LEVELS...............................................19 LOGISTICS AND STAFFING..............................................................23 SURGE CAPACITY PLANNING TARGETS.......................................27 MASS FATALITY MANAGEMENT SUPPLIES/EQUIPMENT CHECKLIST.........................................................................................28 SURGE DECEDENT STORAGE SUPPLIES/EQUIPMENT CHECKLIST.........................................................................................29 SAMPLE MASS FATALITY MANAGEMENT SUPPLIES/EQUIPMENT CHECKLIST: HOSPITALS WITH A MORGUE....................................30 SAMPLE MASS FATALITY MANAGEMENT EQUIPMENT/ SUPPLIES CHECKLIST: HEALTHCARE FACILITIES WITHOUT A MORGUE...........................................................................................31 PHYSICIAN IN CHARGE CONCEPT................................................32 ADMINISTRATIVE STAFF....................................................................32 CONDUCT JUST-IN-TIME TRAINING...............................................32 SAMPLE HICS DECEDENT AFFAIRS GROUP SUPERVISOR JOB ACTION SHEET..........................................................................33 CONTENTS WITNESS FORM.................................................................................36 39 OPERATIONS OveRVIew of sectION..........................................................................39 DECEDENT PROCESSING........................................................................39 DECEDENT PROCESSING FLOW CHART................................................41 DECENDENT IDENTIFICATION.................................................................42 NEXT OF KIN NOTIFICATION....................................................................45 DEATH CERTIFICATES AND CA-EDRS.....................................................48 DECEDENT TRACKING.............................................................................51 DecedeNT INfoRmatION FORM..........................................................56 DecedeNT TRacKING Log....................................................................57 DECEDENT BELONGINGS........................................................................58 DECEDENT HANDLING AND STORAGE.................................................61 MEDIA COORDINATION..........................................................................66 71 DEMOBILIZATION OveRVIew of sectION..........................................................................71 75 APPENDICES COMMUNITY-WIDE RESPONSE MATRIX................................................75 KEY CONTACTS....................................................................................... 79 HIPAA....................................................................................................... 81 SECURITY...................................................................................................83 INTERNET RESOURCES.............................................................................97 REFRIGERATION TRUCKS FOR STORAGE..............................................99 MENTAL AND BEHAVIORAL HEALTH RESOURCES..............................101 RELIGION AND CULTURE RESOURCES................................................104 FACT SHEETS............................................................................................135 GLOSSARY...............................................................................................145 ACRONYMS LIST.....................................................................................148 CONTENTS ONLINE TOOLKIT These resources are available at: http://ems.dhs.lacounty.gov/ FORM 18 TRIAGE TAG TRAINING Mass FatalITY PlaN Template WITNESS FORM DECEDENT INFORMATION FORM DECEDENT TRACKING LOG SAMPLE DECEDENT AFFAIRS GROUP SUPERVISOR JOB ACTION SHEET OVERVIEW PRESENTATION SECTION ONE Overview Mass Fatality Management Guide for Healthcare Entities OVERVIEW 7 Mass Fatality Management Guide for Healthcare Entities OVERVIEW Partners should modify practices identified The medical care system will be severely taxed herein based on the unique attributes of their during a disaster. Healthcare entities will have facility and the availability of local resources. a primary focus on surging to facilitate life- Special consideration has been given to the saving operations. At the same time, there will identification of scalable tiered plan activation be a myriad of complex issues, which may in- requirements; methods and considerations for clude a significantly increased number of fa- expedited decedent processing; and coordi- talities. Partners have an opportunity and re- nation with family assistance/information re- sponsibility to plan for the timely, respectful sources (e.g., Family Assistance Centers, and management of the surge of fatalities that may Family Information Centers). be caused by a disaster. BACKGROUND This Mass Fatality Management Guide for The previous version of this guide, Mass Fatality Healthcare Entities was created to aid partners Incident Management: Guidance for Hospitals in the development of a detailed plan and Other Healthcare Entities was originally to manage a surge of fatalities. It was con- developed in 2008 by the Los Angeles County structed to facilitate the creation of a well or- EMS Agency in coordination with the Los Ange- ganized, realistic plan that supports mass fatal- les County Department of Coroner and the Los ity surge, to include the clear delineation of Angeles County Department of Public Health. the transition from normal to disaster At the time of its original publication, the guide operations.