HomeMy WebLinkAbout20020320 RESOLUTION
RE: APPROVE LOCAL EMERGENCY OPERATION PLAN FOR ANNEX I HEALTH AND
MEDICAL
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with a Local Emergency Operation Plan for
Annex I Health and Medical for the County of Weld, State of Colorado, by and through the
Board of County Commissioners of Weld County, on behalf of the Weld County Sheriff's Office,
with terms and conditions being as stated in said plan, and
WHEREAS, after review, the Board deems it advisable to approve said plan, a copy of
which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of
Weld County, Colorado, that the Local Emergency Operation Plan for Annex I Health and
Medical for the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Weld County Sheriff's Office, be, and hereby
is, approved.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 6th day of February, A.D., 2002.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY COLORADO
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V ATTEST: ¶
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Weld County Clerk to tho{e$§.r 0ectc
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Robert D. Masden
Date of signature: Its
2002-0320
CC ICJ SO0023
WELD COUNTY
LOCAL EMERGENCY OPERATION PLAN
ANNEX I
HEALTH and MEDICAL
2002-0320
WELD COUNTY
LOCAL EMERGENCY OPERATION PLAN
ANNEX I
HEALTH and MEDICAL
UPDATE
Resolution Signed:
WELD COUNTY
LOCAL EMERGENCY OPERATION PLAN
ANNEX I
HEALTH and MEDICAL
Table of Contents
Page
I. INTRODUCTION
A. Mission 2
B. Situation & Assumptions 2
C. Legal 2
II. CONCEPT OF OPERATIONS 2
III. ORGANIZATIONAL RESPONSIBILITIES
A. Fire Districts 3
B. Ambulance Service 3
C. Air Medical Transportation 4
D. Law Enforcement Agencies 4
E. Medical Treatment Facilities 4
F. Weld County Department of Public Health & Environment 4
G. Weld County Coroner 4
H. Weld County Office of Emergency Management 5
APPENDICES
Appendix 1 Definitions 6
Appendix 2 Fire Districts 9
Appendix 3 Forward Command Post 10
Appendix 4 Triage 11
Appendix 5 Public Health & Environment 17
Appendix 6 Fatalities 19
1
WELD COUNTY
LOCAL EMERGENCY OPERATION PLAN
ANNEX I
HEALTH and MEDICAL
VI. INTRODUCTION
A. Mission
To describe the policies and procedures related to lifesaving transport,
evacuation, and treatment of the injured; disposition of the dead; and disease
control. The focus of this annex is primarily large-scale disaster events
that would cause casualties and /or fatalities sufficient to overwhelm local
capabilities.
B. Situations and Assumptions
1. Existing capabilities of the jurisdiction' s emergency
medical, hospital, health, and mortuary services
2 . In catastrophic disasters, some planned for medical
resources may be damaged, destroyed, or unavailable.
3. It may be necessary to relocate hospital facilities to
contingency field hospitals.
4 . Assumptions that apply to the Health and Medical function.
Examples of these assumptions are:
a. Public and private resources that are located in the
jurisdiction will be available for use during disaster
situations.
b. Resources that are available through area and regional
mutual aid agreements will be provided.
C. Legal
1. Title VI of PL 93-288, as amended, The Robert T. Stafford
Disaster Relief and Emergency Assistance Act.
2 . Title 24, Article 32, Part 2101 et. seq. , Colorado Revised
Statutes, as amended; entitle the "Colorado Disaster
Emergency Act of 1992" .
3 . Title 25, Article 32, Part 101 et. seq. , Colorado Revised
Statutes; entitle the "Radiation Control Act" .
4 . Title 25, Article 1, Parts 107 and 506 for quarantine and
enforcement of isolation of property and persons.
5. Weld County Resolutions pertaining to the establishment and
standard operating guidelines of Emergency Management and
Ambulance Service in Weld County.
II . CONCEPT OF OPERATION
A. Arrangements for establishing an on-scene medical command post
with a single individual in charge of all medical operations.
B. Provisions for coordination medical response team efforts.
C. Provisions for triage.
D. Provisions for medical transport of the injured.
E. Arrangements with area hospitals to receive the injured and
diseased.
F. Provisions for initial notification of supplemental support
agencies.
G. Communications linkages between responding health and medical
2
organizations, other emergency support services, field deployed
units, animal care and control services, and the EOC.
H. Provisions for definitive care of the injured.
I. Provisions for the identification, care, and disposition of the
injured.
J. Provisions for the identification and care of the deceased,
including determining cause of death, inventory and protection of
personal effects, and locating and notifying next of kin.
K. Provisions for identifying and controlling environmental health
hazards.
L. Provisions for issuing health advisories to the public on
emergency water supplies, waste disposal, mass feeding services,
vector, immunizations, and disinfection.
M. Mutual aid arrangements with adjacent jurisdictions for obtaining
or providing medical assistance.
N. All agencies assigned responsibilities in this plan are
responsible for developing and updating internal action plans that
will ensure a continuing acceptable degree of operational
readiness to carry out their responsibilities . Essential to any
internal plan is a current listing of responsible individuals and
alternates who may be contacted at any time in any emergency.
III. ORGANIZATIONAL RESPONSIBILITIES (reference ordinances and SOP' s of local
authorities)
A. Fire Districts:
1. When notified of an emergency situation, send response
teams/personnel, equipment, and vehicles to the emergency
site, staging areas, or other locations, as appropriate.
Assess scene and request additional resources as
appropriate,
2 . Send a senior representative to the EOC, when the EOC has
been activated,
3 . Notify the EOC of the situation if the original source of
notification did not come from the EOC,
4 . Perform field commander duties at the emergency scene, if
appropriate. Establish a command post if first on scene,
5. Manage fire and rescue resources, direct fire operations,
rescue injured people during emergency operations, and
determine the need for evacuation of the immediate area in
and around the emergency scene. Initiate triage if first on
scene,
6 . Assist in the evacuation of people at risk in the immediate
area in and around the scene,
7. Alert all emergency response organizations of the dangers
associated with technological hazards and fire during
emergency operations, and
8. Provisions for establishing Air Medical Staging and Landing
Zone (LZ) areas.
B. Ambulance Service:
1. Respond to the disaster scene with emergency medical
personnel and ambulances in order to administer emergency
medical assistance at the disaster scene,
2 . Establish and perform triage as necessary and appropriate to
the incident,
3. Implement a medical incident management system under
3
Incident Command,
4 . Coordinate with local and regional hospitals to ensure that
casualties are transported to the appropriate hospital,
5 . Establish and maintain a casualty/patient tracking system,
6 . Establish and maintain field communications and coordination
with other responding emergency teams (medical, fire,
police, public works, etc. ) , and radio or telephone
communication with hospitals, as appropriate, and
7. Establish a command post if first on scene. Transfer
command responsibilities to appropriate agency upon their
arrival.
C. Air Medical Transportation is responsible for transport of
victims.
D. Law Enforcement Agencies:
1. Dispatching a communications unit to support the forward
command post,
2 . Controlling access to the disaster area,
3 . Crowd control,
4 . Assisting in removal of victims of hazardous areas while
coordinating with the Incident Commander, and
5. Investigate crime scene.
E. Medical Treatment Facilities, upon notification, will implement
their emergency response plan.
F. Weld County Department of Public Health & Environment:
1. Maintain liaison as necessary with appropriate State and
Federal agencies regarding health and environmental issues.
2 . Designated representative at incident command - provide
information related to health and environmental issue to the
Weld County Board of Commissioners or City Governments as
necessary.
3 . Based on the information gathered, provide advice and
assistance to incident commander and to response agencies as
appropriate.
4. Evaluate health risks associated with and make
recommendations for:
a. Solid waste disposal,
b. Sewage disposal,
c. Potable water supply,
d. Basic food supply,
e. Vector control,
f. Hazardous waste disposal, and
g. Communicable disease surveillance and prevention
(immunization) and prophyloris.
5. Provide public information as necessary.
6. Consult with coroner concerning public health issues, and
7. Provide assistance at triage operations as needed.
G, Weld County Coroner:
1. Use procedures in relations to the care of deceased victims,
and
2 . Should no representative of the Weld County Coroner' s Office
be available a Deputy with the Weld County Sheriff' s Office
will fill this position.
4
H. The Office of Emergency Management is responsible for coordination
with the Incident Commander for:
1. activation/operation of the HOC,
2 . coordinate personnel,
3 . materials,
4. supplies,
5. transportation,
6 . hazard mitigation,
7 . security,
8. communications,
9. public information, and
10 . other resources/support as necessary.
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WELD COUNTY
LOCAL EMERGENCY OPERATION PLAN
ANNEX I
HEALTH and MEDICAL
APPENDIX 1
Definitions
1. Weld County Ambulance Service and other County Licensing
Services: Those agencies responsible for transporting and
aiding the sick and injured.
2 . Casualty: Victim of an accident.
3 . Central Morgue: A facility designated jointly by the
coroner and the Weld County health officer to receive and
process fatalities.
4. Chief of Medical Staff: The physician designated by his/her
peers to head the medical staff of his/her hospital or
medical institution.
5. Communications: Those communications systems that include,
but are not limited to, established telephone, telegraph,
radio and message.
6. Emergency Medical Disaster: Any incident that generates an
emergency patient load that exceeds the expanded emergency
patient treatment and/or transport capability of the area's
emergency services.
7. Emergency Operating Center (EOC) : The facility especially
designed and staffed to coordinate support activities
including, but not limited to, communications, public
information, personnel and resources beyond that normally
needed.
8. EOC Information Officer: Official at the EOC who is
responsible for collecting statistics from the medical
treatment facilities regarding injured and deceased and for
preparing releases to the media regarding casualty and
situation summaries.
9. Fire Districts: Those agencies responsible for preventing,
suppressing, or controlling fire: leading search and
rescuing of entrapped persons: and assisting in evacuation
of effected areas.
10 . Incident Command Post: That area established by the
responding fire department or law enforcement officer
situated at a location of his/her discretion, taking into
account the hazard involved, the accessibility and space
requirement to marshal and manage the personnel and material
to combat the hazard. The incident command post serves as
the on site communications and intelligence link to the EOC.
6
11. Hospital Administrator: The administrator or chief
executive of a hospital or their designee.
12 . Hospital Disaster Coordinator: The individual designated by
North Colorado Medical Center, or Other Medical Care
Facilities, administrators to report to the EOC and serve as
medical community coordinator for disaster/emergency
operations.
13 . Hospital Information Officer: The official at the hospital
who is responsible for the rapid collection of statistics
concerning disaster victims, the notification of next of
kin, and timely dissemination of information to the EOC.
14. Medical Treatment Facilities: Those facility designed to
treat medical problems.
15 . Law Enforcement: Those agencies responsible for maintaining
law and order through traffic and crowd control and for
providing security for vital facilities and supplies,
controlling access to operating scenes and vacated areas,
initial notification of specific agencies and evacuating
danger areas if appropriate.
16 . Temporary Morgue: A facility designated jointly by the
coroner and the Weld County Office of Emergency Management
Director to receive and process fatalities during the
disaster/emergency that is not used as a morgue on a day-by-
day basis. After the disaster/emergency the temporary
morgue will be disassembled and returned to its pre-
disaster/emergency condition.
17 . Triage Team: A team of Emergency Medical Personnel who are
organized, trained, and equipped for deployment to disaster
areas to sort and route casualties for distribution to
medical treatment facilities.
Triage Personnel: May consist of Triage Control
Officer, Triage Supervisor, Transport Supervisor,
Treatment Supervisor, Area Leaders and Supply
Supervisor.
♦ Triage Control Officer: First medically
qualified person on scene who is responsible for
coordination with Incident Command concerning
triage activities.
♦ Triage Supervisor: Reports to Triage Control
Officer and shall be responsible for
organization of the actual triage team.
♦ Transport Supervisor: Reports to Triage Control
Officer and coordinates with Triage Supervisor
to determine transportation of patient.
♦ Treatment Supervisor: Reports to Triage Control
Officer and is responsible for treatment of
patients in the triage area.
7
♦ Area Leaders: Reports to the Treatment
Supervisor and is responsible for coordination
of patient treatment in assigned patient care
areas.
♦ Supply Supervisor: Reports to Triage Control
Officer and is responsible for maintaining
adequate supplies for the operation of the
triage area.
8
ANNEX I
HEALTH and MEDICAL
APPENDIX 2
Fire Districts
Fire Protection Districts are responsible for:
• Assisting in warning the public of impending danger or evacuation.
• Initial response to natural and manmade disasters.
• Containment and/or removal of fire to minimize the loss of life
and property.
• Control and/or eliminate hazardous conditions.
• Identify and establish the command post if first on scene. A
written account of the events will be maintained as part of
command duties.
• Perform initial triage if first on scene using the physician
advisor approved triage system.
• Provide extrication/removal of victims.
• Coordinate and assist with search and rescues.
• Provide initial treatment of victims.
• Assess the situation and request additional resources.
Request mutual aid.
• Activate the EOP.
• Advise Weld County Regional Communications Center and all
incoming units as well as the local hospitals of the
situation.
9
WELD COUNTY
LOCAL EMERGENCY OPERATION PLAN
ANNEX I
HEALTH and MEDICAL
APPENDIX 3
Forward Command Post
• Upon occurrence of a medical disaster, control of the situation
may be assumed by the initial responding fire department officer,
who will become the Incident Commander.
• The Incident Commander will immediately establish an incident
command post situated at a location of his/her discretion, taking
into account the hazard involved, the accessibility, and space
requirement to marshal and manage the personnel and materials to
combat the hazard.
• The local on-scene fire officer along with law enforcement within
jurisdiction are responsible for the coordination of the incident
command post and all support units will report to them and operate
under their jointly made decisions from this fixed position.
• The initial responding fire department officer will remain in
charge as Incident Commander of the incident command post until
relieved by a senior fire and/or law enforcement official from the
appropriate jurisdictional area.
• It is essential that the incident command post management team
remain at its established position to coordinate the on-scene
combat forces.
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WELD COUNTY
LOCAL EMERGENCY OPERATION PLAN
ANNEX I
HEALTH and MEDICAL
APPENDIX 4
Triage
PREPAREDNESS:
■ All ambulance and emergency rescue vehicles in Weld County will be
equipped with "airport option" METTAG' s,
■ All ambulances serving in Weld County shall contain at all times
those essential items as specified by the Colorado Department of
Health and Environment, Emergency Medical Services Division and
pertinent Weld County Resolutions, and
■ Training and evaluation of this annex will be performed by
agencies responsible for triage in Weld County.
RESPONSE:
■ The triage team shall consist of the following members as outlined
by the Colorado State Triage System model:
• The Director of Weld County Ambulance Service or his/her
designee shall respond to the the EOC and also to the scene
and assume the responsibilities of Medical Operations.
• Medical personnel capable of providing advanced life support
in the field will respond immediately to designated staging
areas. They will work with the triage officer and apply
their skills to disaster victims.
• Initial equipment and medications for administering advanced
life support to trauma victims will be transported to the
scene by appropriate local agencies. Additional supplies
will be obtained from area hospitals and other emergency
services agencies.
• A separate category of triage should also be noted, as it
supersedes all others. Patients who have been contaminated
and are themselves carrying contaminated particles must be
decontaminated as an initial step. They should not be
allowed to contaminate other patients, ambulances or
hospitals. All ambulance personnel shall ideally have
received training on radiological monitoring and handling a
contaminated patient.
11
WELD COUNTY
LOCAL EMERGENCY OPERATION PLAN
ANNEX I
HEALTH and MEDICAL
APPENDIX 4
Triage (cont)
Incident Commander
I
Operations
Branch Medical Branch Breach
Nan) Director p,.t„ I
T
I I I
Triage Treatment Trouped Supply
Supervisor Supervisor Supervisor Officer
Triage Area 1 [hasty Transport
Group _ Leaden I Supervisor
.-I Clerk
1 i
leader r Leader
Areal Anal AnaI Ana III
maaa non rcat..) (dm)
s
`Area Staff! Area Staff litres Staff 1 Area Staff
12
WELD COUNTY
LOCAL EMERGENCY OPERATION PLAN
ANNEX I
HEALTH and MEDICAL
APPENDIX 4
Triage(cont)
RESPONSIBILITIES:
■ Medical Branch Director
• The first medically qualified person on scene shall initiate
duties of Operations. Operations shall be
responsible for coordination with Incident Command,
the Medical Branch Director, assigning and briefing:
♦ Triage Supervisor
♦ Treatment Supervisor
♦ Transport Supervisor
♦ Supply Officer
• Establish physical location of the following:
♦ Triage.
♦ Holding and Stabilization Area.
♦ Transport area including pathways for ambulance
staging and loading.
• Maintains communication with IC and MCO, advising them of
needs such as personnel and supplies.
♦ Contact Weld County Regional Communications Center.
Inform them of the nature of incident, location of
incident, number of casualties or victims, and
resources needed to initiate management of incident.
• Triage Supervisor
♦ Triage shall be initiated by the most senior medically
qualified person on scene. The first Paramedic on
scene or that person appointed by Operations shall
assume the duties of Triage Supervisor. He/She shall
be responsible for organization of the actual triage
team under the direction of the TCO. This TS will
follow duties as outlined under the "Field Disaster
Duties of the Medical Team. "
♦ Coordinates activities of Triage only. Does not
become involved in treatment of patients
♦ Appoint Triage Team and establish information pathway
to the TCO.
♦ Supervise triage activities.
■ DO NOT PROVIDE SPECIALTY CARE. Only airway control and pressure
control on major bleeding should be performed. CPR should not be
part of a triage activity unless there are two team members
available for each victim.
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WELD COUNTY
LOCAL EMERGENCY OPERATION PLAN
ANNEX I
HEALTH and MEDICAL
APPENDIX 4
Triage(cant)
■ Triage Priorities. Patients with certain conditions of injuries
have priority for transportation and treatment over others. These
priorities are:
BLACK: Category O - Non-salvageable/dead. Last to be transported and by
coroner's vehicles.
RED: Category I - Immediate, Critical: First to go. Help maintain airway,
respirations greater than 30/minute, poor perfusion, or abnormal mental
status.
YELLOW: Category II - Delayed, Serious: Can wait a little longer for
transport. Respirations less than 30/minute, normal perfusion, and
mental status clear.
GREEN: Category III - Walking wounded, Minor: First to be separated and
later to be transported by non-ambulance transport (first aid) .
14
WELD COUNTY
LOCAL EMERGENCY OPERATION PLAN
ANNEX I
HEALTH and MEDICAL
APPENDIX 4
Triage (cont)
■ Treatment Supervisor
• The Treatment Supervisor shall be designated by Operations.
This is generally the second paramedic arriving on scene.
• Appoint teams for stabilization of victims. Assign
Paramedics, EMTs, and First Responders as appropriate to
patient needs and as resources allow.
• Assign physical locations within the holding area for groups
of victims according to triage categories.
• Supervise the moving of tagged victims to the appropriate
holding area.
• Record victim tag number and triage level and destination if
known.
• Establish communications with Transportation Officer.
• Maintain communications with Supply Officer.
• Keep Operations advised.
■ Transport Supervisor
• Communicate closely with the Treatment Officer to determine
the patients to be transported at which time.
• Designate a patient loading area and communicate that to
Incident Command for traffic control of incoming and
outgoing ambulances.
• Coordinate with Operations or Medical Branch Director the
appropriate destination of patients.
• Appoint a Deputy Transport Supervisor to coordinate
transport operations.
• Keep Operations and IC advised of transport needs.
■ Clerk
• Document activities of the transport supervisor.
• Coordinate transport operations with transport supervisor.
• Items to document include:
• Transporting Ambulance Unit / ID number
• Patient' s Name (if available)
• Receiving hospital or destination
• Time of Transport
• METTAG ID number
■ Supply Officer
• Be responsible for communications with all field operations
to assess and communicate supply needs to Incident Command.
15
WELD COUNTY
LOCAL EMERGENCY OPERATION PLAN
ANNEX I
HEALTH and MEDICAL
APPENDIX 4
Triage(cont)
■ Area Leaders
• Appoint available medically trained personnel as appropriate
and needed.
• Coordinate with other area leaders the continuous triage and
update of patients' status.
• Communicate patients' status to Transport Supervisor.
• Communicate updates to Operations .
16
WELD COUNTY
LOCAL EMERGENCY OPERATION PLAN
ANNEX I
HEALTH and MEDICAL
APPENDIX 5
Public Health & Environment
• Identify and coordinate all public health services necessary in
emergency response operations for residents of Weld County.
• Assess, evaluate, and communicate health and environmental risks
to the community. Enforce applicable public health regulations as
necessary.
• Conduct and coordinate inspections, investigations, education, and
provide recommendations for:
• Diseases -surveillance, evaluation, prevention, and outbreak
control.
• Air Quality -burning, fugitive dust control, air
contaminates issues, etc.
• Food Protection issues -condemnation, disposal, and safety.
• Solid, Hazardous and Medical Wastes -hazardous material
incidents, trash disposal, animal carcass disposal, etc.
• Vector Control -insect and rodent control issues.
• Water Supplies -public, private, testing, disinfection, etc.
• Wastewater- disposal, individual sewage disposal, clean up,
sanolets, etc.
• Animal Control issues -animal bites.
• Advise County Commissioners on actions taken regarding all public
health matters.
• Coordinate and/or distribute necessary prophylaxis for the
prevention of diseases -i .e. , tetanus shots, antibiotics.
• Establish public health services as needed in designated shelters.
• Maintain communication in the Emergency Operation Center
• Coordinate with media through the Weld County designated Public
Information Officer to warn, advise, and educate public on health
and environmental issues.
• Provide referrals to other community services.
• Provide 24-hour-a-day public health assistance as necessary.
• Establish and maintain liaison with appropriate federal, state and
local agencies.
17
WELD COUNTY
LOCAL EMERGENCY OPERATION PLAN
ANNEX I
HEALTH and MEDICAL
APPENDIX 5
Public Health & Environment (cont)
• Coordinate with coroner.
• Coordinate with mental health agencies and clergy.
• Monitor status of health and medical facilities and equipment and
report to EOC and the Colorado Department of Public Health and
Environment.
• Maintain vital records -i.e. , birth, morbidity, mortality
statistics.
• Maintain liaison with area laboratory testing facilities as
necessary, i.e. Colorado Department of Public Health and
Environment.
• Maintain a tracking system for Weld County Department of Public
Health and Environment Departments' disaster related expenses.
• Provide assistance with triage operations as needed.
• Identify and issue Administrative Orders related to disease
containment - i.e. , quarantine, travel restrictions.
18
WELD COUNTY
LOCAL EMERGENCY OPERATION PLAN
ANNEX I
HEALTH and MEDICAL
APPENDIX 6
Fatalities
RESPONSIBILITY:
The ultimate responsibility for the collection, process, identification,
storage, and dispatch of deceased victims will lie with the Coroner of
Weld County as set forth by the laws of the State of Colorado.
PREPAREDNESS:
• Memorandum of Understandings with neighboring counties.
• Maintain and inventory disaster kits.
RESPONSE:
• Establish a primary perimeter.
• Maintain scene integrity.
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