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Home My WebLink About982222.tiff NORTHEAST COLORADO AREA TRAUMA ADVISORY COUNCIL MINUTES WELD COUNTY September 15, 1998 1° e F'^'.! 12 i. 2:00 - 4:00 PM "1 9: 05 Sterling Regional MedCenter CLERK Sterling, Colorado TO THE DC ^D Attendees: Douglas Smith NCATAC-Chair Life Care Medical/Logan County Larry Lund NCATAC Coordinator Jeff Schanhals NCATAC-Co-Coordinator/EMS Howard McCormick NCATAC Member Sedgwick County Ambulance Shirley Terry Denver Health Medical Center Dr, James Ley NCATAC Member Phillips County/Haxtun Hospital John Rickert NCATAC Member Washington County Commissioner Remote Sites(Videoconference): Jody Kramer NEATAC Member Wray Hospital, Trauma Coordinator Eric Fuhrman, MD NEATAC Member McKee Emergency Physician Chris Hoffman NEATAC Member NCMC Nurse Lori McDonald STAC Member/ PVH Trauma Coordinator Karen Lindhorst McKee Medical Center Trauma Coordinator Liz Davis PVH, EMS Staff Development Coordinator Valerie Lind NCMC Registrar Judy Kain Haxtun Hospital Trauma Coordinator Sandy Bowman Yuma County Ambulance Mitch Wagy NCATAC Member Weld Co. Ambulance Elaine Neislanik Yuma Hospital Dennis Young Thompson Valley Ambulance Service Agenda: • Mass Casualty Planning for ATACs • ATAC Grant status • ATAC Plan presentation to STAC • Council Reappointments ■ Reports ■ PHTLS form Columbia Health One • 98-99 Goals for ATAC 982222 CG72� dQ. NEATAC Minutes September 15th, 1998 Page 2 • Minutes approved from August 18, 1998 meeting. PROGRAM: OLD BUSINESS: • Follow up reports were called for from the various sub-committees on regional disaster planning: Triage (completed); Facilities, facilities are being urged to review disaster plans and update and then drill plan; Supplies, Mr. Lund continues to gather information for this committee and forward it to the supplies committee; Transportation, no report; Communications, memo from Lyle huff was reviewed (see attached). It was suggested by Mr. Lund that Jeff Schanhals and he work with the various sub- committees and develop a rough draft for the regional disaster plan. This was adopted by the council. • The status of the ATAC Grant money was discussed. It was decided that a letter should be written from the council and sent to the county commissioners for signature and support to be sent to the Health Department expressing the concerns that the ATAC is not able to uphold its financial obligations and this issue needs immediate resolution. Jefff Schanhals, Doug Smith and Larry Lund will write this letter and present it for approval and distribution. • The ATAC will be reviewed and presented at the October STAC meeting. It was decided that, as authors of the plan, that Jeff Schanhals and Larry Lund would present the plan and be available at the meeting for questions and comments. • Doug Smith stated that he had received approvals back from Weld, Logan and Sedgwick counties for new appointments for the council. Discussion was held as to the necessity for all of the county commissioners to approval appointments for all of the counties. It was decided that this was not necessary, they only need to approve appointments from their county. Doug, Jeff Schanhals and Larry Lund will draft appropriate wording for a bylaws change to be considered at the next meeting. • Larry Lund reported that he will have been in all facilities at least once in the month by the end of the month. He has attended site visits for Haxtun, Holyoke, and Wray. Haxtun's certification has been recommended for approval by the STAC. Holyoke's and Wray's certification will be reviewed at the September STAC meeting. Larry also attended the Facilities sub-committee where the 9 month review process was the main subject of discussion. This review which will occur in 9-12 months after the initial certification will be a complete re-review and will be done from a new and more comprehensive scoring tool. It was the expressed desire of the state to use the same reviewers for this visit as for the initial visit in order to provide for consistency. The data sub committee is expanding its composition and will now include several new representatives. Jeff Schanhals will be representing pre-hospital on this sub-committee. The subcommittee reviewed and revised the cases for inclusion. This revised list of inclusion criteria should be available in a couple of months. Jeff Schanhals reported that the High Plains Regional EMS Council grant application for laptops for use on ambulances with data collection software had been approved. This will continue to move forward. The state has adopted a system of assigning standardized numbers for pre-hospital agencies. This should be completed by the weeks end. The Regional EMS council has been approved as a training group for paramedic level education. NEATAC Minutes September 151°, 1998 Page 3 • Doug Smith requested discussion and ideas about goals to be achieved in the next period of time. Suggestions included: Grant for pre-hospital data collection software, community education project review and consideration of Safe Kids program. Know community activities at present are: ENCARE, child safety seat program and bicycle safety. This will be looked at again at the next meeting. • Larry Lund requested that the council provide direction for him when there would be discussion items at various meetings to represent the feelings of the ATAC. Example: A community applying for a waiver and how the ATAC stands on the issue. Any known issues should be brought to the ATAC for consideration and direction, if any for the coordinators. • Larry Lund requested that individuals presenting reports at the meetings forward a copy of their report to him for inclusion in the minutes to insure accuracy of the report given. Copies of the bylaws were distributed. Elections will be held at the July meeting. TRESURERS REPORT (None given) All residual mony from 1997-98 has been returned to the state as per their instructions, therefore, the bank account balance is zero. STAG UPDATE Lori reviewed the facility surveys that had been presented at the last STAC meeting. All were approved. She reviewed the discussion that occurred at the meeting about the 9 month review. Issues were similar to those presented in the facilities sub-committee report by Larry Lund above. Wray's request for waiver to use mid level practitioners to care for trauma patients was reviewed. This was denied.. EDUCATIONAL UPDATES: McKee Medical Center, Loveland: Oct. 13, 1998, Dr. Richard Milian will present maxillo-facial injuries at 12:30 PM North Colorado Medical Center, Greeley: Case presentation will be Oct. 12, 1998 at 12:00 PM Poudre Valley Hospital, Fort Collins: Trauma Grand Rounds: Sept. 28, 1998 12:30 PM: Ultrasound for blunt abdominal trauma in the ED, Ginna Heath MD; ACLS Re-cert. Course (one day) Sept. 22.1998 ACLS Course (two days) Sept. 15 & 22, 1998 ENPC (Emergency Nursing Pediatric Course) Sept. 30, Oct.1 CATN (Course in Advanced Trauma Nursing) Oct. 8 & 9 PALS (Pediatric Advanced Life Support) Oct 28 & 29 Northeastern Junior College, (Sites not yet determined) BTLS Nov. 14 &15, 1998, Dec. 5 & 6, 1998, Feb. 20 & 21, 1999 & March 1999. 9fi9)aa� • NEATAC Minutes September 151°, 1998 Page 4 NEXT MEETING: Tuesday, October 20, 1998 2-4 PM McKee Medical Center Loveland, CO. Personal attendance is encouraged however, video-conferencing will be available for remote sites. Please call Karen Lindhorst at (970) 635-4072 to arrange hook-up for the meeting. Teleconferencing arrangements need to be made at your earliest convenience. Respectfully Submitted, Larry A. Lund Coordinator Northeast Colorado Area Trauma Advisory Council `�a3t (fn4, Larry A. Lund, Coordinator ,mod tang TO9,Q 4, 130 Cortez Ot f� Sterling, Colorado 80751 S� �.. (970)522-5512 Irk, p ' w Fax (970)522-4872 I. G? E-mail 11und@henge.com G �.OVQ Paget'` et October 20, 1998 AlutyQ Gail Finley-Rarey CDPHE 4300 Cherry Creek Drive South Denver, CO 80246-1530 Dear Mrs. Finley-Rarey, We are writing to express our concerns regarding the ATAC financing for the second year. Our areas of concern are: • Lack of communication regarding required record keeping • Lack of information regarding format of reporting • Lack of information on how to close out year-end • Preplanning for year three funding As an ATAC we have found ourselves unable to do the work that we should be doing due to lack of a cash flow. We have four(4) MONTHS of unpaid bills, including back pay for our coordinator due to the lag time between year one funding and year two funding. It is unacceptable to ask our coordinator to dip into his personal savings account to do the work of the state and the NEATAC. Larry Lund is to be highly commended for his sacrifice and dedication to the Trauma system and the NEATAC. We cannot expect Larry to continue to operate in this fashion. As you can see, we have forwarded a copy of this letter to the County Commissioners in the NEATAC for their review and support. A timely resolution of this matter from the State would be greatly appreciated. Sincerely, Northeast Area Trauma Council Larry, This is some good info,thought you might also want it. Lori >>>Lyle Huff 09/14 9:21 AM>>> Jeff, Lori McDonald reminded me that you and I are on the "disaster"radio communications task force. If I recall,we were to develop a"mutual aid" frequency for use by EMS and hospitals. This task will be made harder because of all of the talk about 800 MHZ on the front range. Some issues to discuss: The "near far" dispatch center concept: Our experience during the flood showed that local dispatch may be overwhelmed with 911 calls and unable to perform mutual aid call up for EMS.One solution is to have a nearby center perform this function, but that requires having updated call up plans and good communications between centers. I think a regional call up plan would facilitate this. The"near far"hospital concept: Similar to the dispatch plan,the near hospital acts as a triage point and has its own supply of ambulances staged for transfer to far hospitals.This eliminates the problem of sending all of your emergency crews out of town and running out of ambulances at the scene.Again this requires good communication between hospitals.Our current MCI III plan calls for 10 ambulances to respond to the scene and 10 to respond to the hospital(both require staging areas and a transport officer). This could be part of a regional plan too... for example if local EMS requested 5 ambulances to the scene, 5 additional ambulances would automatically be sent to the near hospital. EMS mutual aid communications: in my opinion the least important area.Very little communication is required between EMS units as long as ambulances receive assignments from dispatch i.e.respond the to staging area,wait at the hospital,etc. Bottom line: 1. Find a common channel between EMS units and dispatch centers. 2. Develop "near far"hospital plans and establish a communication network between hospitals(radio,phone, intemet,etc.). 3. Develop a regional call up plan and "near far"dispatch centers. This could also lead to a regional EMS disaster plan(and a basis to hold regional drills).My experience has been that the different ICS systems among fire departments will create conflicts between plans as everyone has a different idea of how these should mesh. We"borrowed"our plan directly from CA Fire Chiefs Ass. and have tested it at numerous drills. Sincerely, Lyle Huff Poudre Valley Hospital Ambulance Service 1024 S. Lemay Ave. Fort Collins, CO 80524 970 495-8010 Fax 495-76667 DISASTER SUPPLY STATUS WITHIN NCATAC HAXTUN: 2-3 days stock in hospital Ambulance restocks from hospital Ambulance owned by hospital No known stockpile of supplies in their area Suppliers primarily located in Denver Some items, in an emergency, can be overnighted Informal agreements to get supplies form nearby facilities HOLYOKE: 1 week supply on hand Agreements with LHS for restocking Premier contract Informal agreements with nearby facilities for emergincies Ambulance re-supplied by hospital Most suppliers located in Denver No stockpile of supplies known of in area FT. MORGAN: 1 week supply in departments 1 week supply in materials Most suppliers out of Denver Columbia buying contract Informal agreements with Columbia facilities and facilities in the region to re-supply in emergency If supplies needed and available at another facility, maintenance dept. will pick them up according to plan. Ambulance Service restocks self Has 2 months stock on hand Most supplies can be obtained from vendors in 3 days No known stockpile of supplies YUMA: 2 days supplies in hospital Stock of basic supplies at middle school Premier Contract 24 hour service on most supply replacement No known stockpile of supplies other than at middle school Informal agreements with other facilities in area to help with supplies in emergency Ambulance service restocks self Ambulance has 2-3 days supplies on hand 1 week turnaround on re-supply WRAY: HSCA contract Most suppliers in Denver 1-2 weeks supplies on hand Has 24 hour service on most supplies No known stockpile of supplies Informal agreements with most facilities in area to assist in emergencies No written plan for transportation of supplies from other facilities Ambulance has 3 days supplies on hand Ambulance supplies self JULESBURG: 14 days supply on hand Most suppliers out of Denver CMMA contract 24 hour turnaround on re-supply Informal agreements with other facilities in area to asist in emergency No known stockpile of supplies Agreement with supplier (Allegiance) to re-supply in 3 hours in emergency Ambulance restocks self Ambulance suppliers located all over Ambulance has only 1 day supply of IV equipment on hand Ambulance has 2 weeks supply of dressing materials on hand Ambulance can restock from hospital in emergency Restock time is 3 days GREELEY: 3-4 days supplies on hand Ambulance supplies self Helicopter supplied by hospital No known stockpile of supplies Primary vendors are in the front range area Participates in buying contract with other LHS facilities Can turn orders around in 24 hours in emergencies as a rule ESTES PARK: 3-4 days supplies on hand Ambulance supplied by hospital Informal agreements with front range facilities for emergency supplies VHA contract Most vendors in Metro Denver area 24 hour turnaround on routine orders Special orders turn around in 24-48 hours No known cache of supplies NORTHEAST COLORADO AREA TRAUMA ADVISORY COUNCIL MINUTES October 20, 1998 2:00 -4:00 PM McKee Medical Center Loveland, Colorado Attendees: Eric Fuhrman, MD NEATAC Member McKee Emergency Physician Larry Lund NEATAC Coordinator Jeff Schanhals NEATAC-Co-Coordinator/EMS Lori McDonald STAC Member/ PVH Trauma Coordinator Karen Lindhorst McKee Medical Center Trauma Coordinator Dave Dodson Loveland Fire and Rescue Remote Sites (Videoconference): Jody Kramer NEATAC Member Wray Hospital, Trauma Coordinator James Ley, MD NEATAC Member Haxtun Hospital Douglas Smith NEATAC-Vice Chair Life Care Medical/Logan County Liz Davis PVH, EMS Staff Development Coordinator Donovan Ehrman NCMC Trauma Coordinator Sandy Bowman Wray Ambulance Elaine Neislanik Yuma Hospital Judy Kain Haxtun Hospital Mitch Wagy NCATAC Member Weld County Ambulance and Air Life Paul Cocking PVH EMS Director Marlowe Hain PVH Trauma Case Manager Agenda: • Mass Casualty Planning for ATACS • ATAC Grant/Cash Flow Process • Letter to County Commissioners from ATAC • ATAC Plan presentation • Coordinators' Reports • 98-99 Goals for ATAC • Other Reports NEATAC Minutes Oct. 20th, 1998 Page 2 • Minutes approved from September 15, 1998 meeting. With the correction of the spelling of Jeff Schanhals' name in the second bullet point on page 2. OLD BUSINESS: • Dave Dodson presented three documents which may be used as templates for writing a regional disaster plan for the ATAC (See attached). The first is a template for organization for responding to a disaster using the Incident Command System. The second Was a template for an Area Mass Casualty Plan, and third was a template for Haz Mat which could be adapted to use for mass casualties. Dave gave explanations of the various documents. The Haz Mat template will be reproduced in color and distributed to various agencies for consideration and review. Dave pointed out that the Incident Command System has been mandated by the state when the state becomes involved in a situation. The Federal Government has a similar requirement if they are involved. Discussion was held as to where various agencies in the region might be in relation to Incident Command System. It was felt that most have been exposed and probably already are using some form of the system. Discussion was also held about the potential of using this same system in facilities so that everyone is used to and using the same terminology. Discussion was also held as to what authority the ATAC had to impose a system on the region. Jeff and Larry agreed to take this around to the various facilities and agencies to see what their feelings were on this. Mr. Lund reported that he had forwarded data about supplies which he had accumulated from facilities to the supplies subcommittee along with some recommendations that had come to light during his research. • Discussion was held as to the process that funds would go through to be reimbursed for this year. Larry has received a check for the first three months of this year and October's is in the works. Lori explained the very lengthy and convoluted process that it will require to get reimbursed for items due. Discussion was held regarding the ATAC filing for 501C3 status and obtaining a tax ID number in order to help clean up the process in the future. Jeff and Lori will work on this issue. • The letter drafted to send to Gale Finley-Rarey regarding the situation of ATAC funding was approved by the council. Courtesy copies will be sent to all County's Commissioners with a cover letter requesting their support of this letter. Doug Smith will accomplish this immediately. Larry will also send a copy to all ATACs for their support. • Larry informed the group that he and Jeff would be presenting the ATAC plan at the STAG meeting on Thursday, 10/22/98. The council was briefed as to the format and content of the presentation. • It was approved to make changes in the bylaws as follows: Article 3, section E will read: Reappointment of Members-Recommendation of new or reappointed members may be made by the Council however, final appointment of the members will be by the County Commissioners of the county represented. (See attached) • Larry reported on matters which had arisen out of the Facilities Subcommittee of the STAC. It was explained that in the near future at least chapter 3 of the rules and regulations would be opened for changes that need to be made. It is likely that chapters one and two will also be opened at approximately the same time. This will provide an opportunity to get needed or desired changes made in the rules and regulations. This is also a time that everyone needs NEATAC Minutes Oct. 20`h, 1998 Page 3 to stay informed to try to divert any changes that might have a negative impact on the state trauma system. • Jeff Schanhals reported that he continues to work with the pre-hospital software and would like to put together a grant application which would provide funding for any agencies in the ATAC to purchase the software at a more reasonable cost than if they were to go out and purchase it on their own. • Jeff also has requested that all agencies send him the Attachment A to their EMS plan for the transportation subcommittee of the ATAC disaster plan. NEW BUSINESS • Larry reported on the five listed goals in the plan for 98-99. Discussion was held regarding issues around the ATAC doing QA. It was pointed out that the problems that exist with confidentiality and discoverability are being dealt with, but this is felt to be a very long process to get accomplished. Further discussion on goals for 98-99 will be tabled until a further meeting. • No treasures report was available at the meeting. STAC UPDATE • Lori gave a report of the last STAC meeting. Lori announced that both Holyoke and Wray have been approved for certification as level IV Trauma Centers. One facility was denied certification with the proviso that the Health Dept. would work with the facility to resolve issues to see if they could come in line with rules and regulations and their application will be reconsidered next month. Lori reported on the review process that was going on of ATAC plans. This will continue at the next ATAC meeting. The "Facilities Subcmte" is revising the survey tool that will be used for the 9 month review of Trauma Centers. The tool for Level IV will be completed soon then one for Levels I-Ill will follow in the same format. This second survey is expected to meet criteria 100% for successful designation. A facility failing any criteria will not continue it's initial designation. EDUCATIONAL UPDATES: Northeastern Junior College (Sterling) BTLS: NJC, November 14 & 15, 1998, 8:00 AM to 5:00 PM both days, Knowles Hall room 312, check in time 7:30 AM on Saturday. Haxtun, December 5 & 6, 1998, 8:00 AM to 5:00 PM both days, Haxtun High School, Check in time 7:30 AM on Saturday. A class will be forthcoming in Yuma county after the first of the year. McKee Medical Center (Loveland) Second Tuesday of the month Judith Anderson will be presenting from NCMC on infectio in the trauma patient, Time, 12:00 Noon. NEATAC Minutes Oct. 20', 1998 Page 4 Poudre Valley Hospital, Fort Collins: Trauma Grand Rounds (every 3r° Mon): Monday, November 16", 12:30pm* "The Role of Hyperbaric Medicine in the Care of the Trauma Patient" Dr. Eric Olsen, PVH Emergency Physician PALS: Oct. 281° & 29th TNCC: Nov 11th & 12'" * Telemedicine available NEXT MEETING: The next meeting will be held at North Colorado Medical Center on November 177 1998 at 2:00 PM. ATTENTION!! LATE NOTICE- **MEETING DATE CHANGE** Next Meeting: Thursday, December 3r", 1998 2-4 pm Union Colony Meeting Room North Colorado Medical Center Greeley, CO. Personal attendance is encouraged however, video-conferencing will be available for remote sites. Please call Rhonda Squires @ (970)356-2424 to arrange hook-up for the meeting. Teleconferencing arrangements need to be made at your earliest convenience. Respectfully Submitted, Larry A. Lund Coordinator BYLAWS NORTHEAST COLORADO AREA TRAUMA ADVISORY COUNCIL COUNTIES OF JACKSON, LARIMER, LOGAN, MORGAN, PHILLIPS, SEDG WICK, WASHINGTON, WELD AND YUMA ARTICLE I- NAME OF COUNCIL The council shall be called the "Northeast Colorado Area Trauma Advisory Council" ADBA"Northern Colorado Area Trauma Advisory Council". ARTICLE 2- FUNCTIONS OF THE COUNCIL The functions and duties of the Northeast Colorado Area Trauma Advisory Council are: To serve as the"Northeast Colorado Area Trauma Advisory Council"as required by the provisions of C.R.S. 25-3.5- 704, for Colorado counties of Jackson, Larimer,Morgan, Phillips, Sedgwick, Washington, Weld, Logan and Yuma. To recommend an"Area Trauma Plan"to the County Commissioners of each of the counties listed above for approval and submittal, on or before July 1, 1998, to the State of Colorado Board of Health. To update the "Area Trauma Plan" on an "as needed"basis for recommendation to said County Commissioners and resubmitted to the State Board of Health. To perform any other tasks as required of an Area Trauma Advisory Council by statute or regulation, or as requested by the counties listed above. ARTICLE 3- MEMBERSHIP OF COUNCIL A. Membership The Council shall consist of eleven members. The membership shall, at a minimum, include persons of the following occupations or having the following educations, training, license or skills: I.A surgeon involved in trauma care. 2.A licensed physician involved in providing emergency trauma or medical services. 3.A licensed nurse. 4.A facility administrator. 5.A prehospital care provider. 6.A representative from a "key resource facility for the area." as identified in the Area Trauma Plan. 7.A representative designated by the Counties listed above. B. Appointment of Initial Members - The initial members of the Council shall be appointed by the County Commissioners of the counties listed above. Page I of 3 C. Terms of Members - The terms of members of the Council shall be for three years, except for the initial membership which shall be appointed on a staggered term basis with actual terms ranging from one to three years starting July 1st through June 30th. D. Alternate members- Each member may designate an alternate member, confirmed by the County Commissioners, who may attend Council meetings in the members absence and have the full rights and responsibilities of membership. If an alternate member attends more than three consecutive regular meetings due to the absence of the regular member, that regular member may be subject to replacement by the Council and notification to the County Commissioners. E Reappointment of Members - Recommendation of new or reappointed members may be made by the Council, however, final appointment of the members will be by the County Commissioners of the county represented. F. No member shall serve more than two consecutive terms. C The year end is July 1st through June 30th ARTICLE 4- OFFICERS A. The Council shall elect from its own members a Chairperson and Vice-Chairperson. Terms of office shall be for one year. 13. In the absence of the Chairperson,the Vice Chairperson will act in that capacity. C. In the absence of the Chair and Vice Chairperson, a temporary Chairperson will be selected by the Council. D. A secretary will be appointed by the Council. E. A treasurer will be appointed by the Council. ARTICLE 5-NOMINATION AND ELECTION OF OFFICERS The nomination and election of annual officers shall be held during the first regular meeting of each fiscal year July 1). Each nomination shall be seconded to be placed on the ballot, and elections shall be written unless there is no contest for the office. ARTICLE 6- MEETINGS A. Regular meetings of the Council will be on the third Tuesday of each month provided there is business to conduct. B. Written notice of all regular meeting will be mailed at least one week prior to the meeting date. C. Special meetings may be called when deemed necessary by the Chairperson. Page 2 of 3 D. .A quorum shall consist of not less than six members of the Council. A quorum will be necessary at any meeting where the agenda includes: I.Changes in these Bylaws. 2.Appointment of members and review of members attendance 3.Election of Officers. d.Special meetings. The concurring vote of a majority of those present shall be required to approve any item of business coming before the Council. Votes to abstain shall neither be considered a"yes I I nor a —no I, vote. F. Roberts rules of Order shall prevail to the extent they are not in conflict with specific provisions of these Bylaws. ARTICLE 7- DUTIES OF THE CHAIRPERSON It shall be the responsibility of the Chairperson to call all regular meetings, preside at all meetings, appoint committees, when and as required, and carry out general chairperson responsibilities. ARTICLE 8- DUTIES OF THE VICE-CHAIRPERSON It shall be the responsibility of the Vice Chairperson to assume the duties of the Chairperson in his/her absence. Also, he/she shall perform other duties assigned by the Chairperson. ARTICLE 9 - DUTIES OF THE SECRETARY It shall be the responsibility of the secretary to send members notice of all meetings, and keep minutes of all meetings. ARTICLE 10- DUTIES OF THE TREASURER The Treasurer will be responsible for maintaining all financial records, providing a monthly report to the Council, paying bills and receipting revenues. ARTICLE 11- DISSOLUTION Should the ATAC ever dissolve, the assets of the ATAC, if any, shall be divided equally amongst all adjoining ATAC's. There is no equity interest for any individual or county with regard to ATAC assets except in case of complete dissolution of the ATAC. If this occurs then the moneys are distributed equally among the participating counties. ARTICLE 12- AMENDMENT OF THE BYLAWS These Bylaws may be amended according to the following procedure: I. The proposed amendments to the Bylaws may be presented at any meeting of the Council, provided seven days notice has been given each member. 2. The proposed amendments must receive the vote of the majority of the entire membership of the Council to be approved. Page 3 of 3 Northeast Colorado Area Trauma Advisory Council Ss\¢�3t TN Larry A. Lund, Coordinator re Ong TOS r4'4 130 Cortez �Ot % h Sterling, Colorado 80751 ^ (970)522-5512 p et Fax (970)522-4872 j°ry i� ea *- E-mail 11und@henge.com G. A/' e y op() t Pa October 7, 1998 /4 Al y4 " Gail Finley-Rarey CDPHE 4300 Cherry Creek Drive South Denver, CO 80246-1530 Dear Mrs. Finley-Rarey, We are writing to express our concerns regarding the ATAC financing for the second year. Our areas of concern are: • Lack of communication regarding required record keeping • Lack of information regarding format of reporting • Lack of information on how to close out year-end • Preplanning for year three funding As an ATAC we have found ourselves unable to do the work that we should be doing due to lack of a cash flow. We have four(4) MONTHS of unpaid bills, including back pay for our coordinator due to the lag time between year one funding and year two funding. It is unacceptable to ask our coordinator to dip into his personal savings account to do the work of the state and the NEATAC. Larry Lund is to be highly commended for his sacrifice and dedication to the Trauma system and the NEATAC. We cannot expect Larry to continue to operate in this fashion. As you can see, we have forwarded a copy of this letter to the County Commissioners in the NEATAC for their review and support. A timely resolution of this matter from the State would be greatly appreciated. Sincerely, Northeast Area Trauma Council American College of Surgeons COMMITTEE C1N TRAUMA AMERICAN COLLEGE OF SURGEONS COMMITTEE ON TRAUMA If you wish to place an order for Resources for Optimal Care of the Injured Patient 1999, please complete the form below and return with prepayment to: • American College of Surgeons ATTN: Publication Orders 633 N. Saint Clair Street Chicago, IL 60611 I wish to order the booklet Resources for Optimal Care of the Injured Patient 1999. Please send copies. I have enclosed $15.00 (US funds) per copy for a total of Please make check payable to the American College of Surgeons. Please send to: NAME ADDRESS CITY STATE ZIP Draft Northern Colorado ATAC Mass-Casulaty Plan Incident Command System Organizational Chart Level 1 : Local Incident Incident Commander Search Group Extrication Group Medical Group Supervisor Supervisor Supervisor Level 2: Major Incident (site specific) Incident Commander Operations Section__ Staging Chief Manager • • e•ica • Police Branch Fire Branch Branch Director Director Director Treatment ransportation Traige Group Group Group Supervisor Su. rvisor Su•ervisor Level 3: Area Disaster Incident commander EOC I � Ops Section Plans Section Logistics Chief Chief Section Chief Co-Located Field EMS Branch Fire Branch Police Branch Service Branch Command Post Director Director Director Director Field Transportation re•ica eni West Division East Division Group (Rehab/Care Supervisor Supervisor Supervisor and Sh-I -r LARIMER COUNTY Draft HAZMAT INFORMATION, RESPONSE & NOTIFICATION CHART '_ ' F L.VEL I = Mln%o 00- - - Community A Minor Incident: Local response with Private Needs — — Legislation First Responder- Operations Level personnel. Agency Needs Education Federal Regulations -0- LEPC Planning — LEVEL 2 - MAJOR INCIDENT Local Ordinance — — I Major Incident: Technician Level response. f May require regional HazMat teams. Fire & Rescue Depts— TECH TEAMS — Procedures Law Enforcement Poudre Training EMS Providers is- Loveland i Equipment Disaster: Technicial Level and Milti-Agency Industry Teams Mutual Aid Pre-Plans — — response. EOC activation, mass warning, 4. I mass evacuation. A 4 . - INCIDENT AUTHORITY HAVING JURISDICTION (AHJ) FIRST RESPONDER Y + WSW** LEVEL 2 wt v... i�r+rz+asr�.7c a f,;c . • Notifications As • AHJ Tech-Level Team or • Level 2 AHJ Response a Needed Mutual/Auto-Aid Team • Tech-Level Teams • Documentation As • AHJ Law Enforcement -Poudre -Mutual Aid Required -Loveland -CSP ....---I • AHJ EMS Provider • EOC Activation as needed: • EOC Activation as needed: • Notifications -Fort Collins -Fort Collins -Loveland -Larimer County Health -Larimer County -Larimer County -Estes Park -Tech Specialists -Loveland -Local Hospital -Estes Park • Notifications: -Involved Utility or Mass Evacuation Waminas Works • Post Incident Analysis -American Red Cross -EAS -Media • Documentation -ARESNOAD -NOAH -Appropriate (Forward to LEPC -School District -Media State/Federal and Tech Teams) Agencies I • Contamination AirNVater/Soil Other -Involved Utility or -Mutual Aid or • Post-Incident Analysis • Recovery Plan Works Support -Local Government Officials -Larimer County -Contractors • Documentation Health/EPA Health as needed (Forward to LEPC - State OEM -EPA -State OEM and Tech Teams) - FEMA -Tech Specialists -Appropriate ..._J -4111 . -dilfl_ -Logistics as needed State/Federal Agencies Oetober 20. 1998 raft PROPOSED AREA MASS CASUALTY PLAN NORTHERN COLORADO ATAC PURPOSE. A mass-casualty event within the area requires a coordinated response of fire, police, ambulance, and hospital resources. Mass-casualty events shall be categorized based on the number of victims involved and the potential for additional victims. Further, an incident management system shall be utilized based on the size or magnitude of the incident. This plan outlines the mass-casualty system to be utilized for the Northern Colorado area. II. SITUATION AND ASSUMPTIONS. A. This plan is designed to satisfy the needs of the NORTHERN COLORADO AREA TRUAMA ADVISORY COUNCIL (NCATAC). The NCATAC mass-casualty plan is part of the statewide Trauma plan. B. The department with primary control responsibilty for mass-casualty incidents is typically the local FIRE&RESCUE DEPARTMENT. Jurisdictions not covered by a Fire and Rescue service are typically the responsibility of the Local COUNTY SHERIFF. C. A mass-casualty incident shall be managed using the Incident Command System adopted by the State of Colorado. III. CONCEPT OF OPERATIONS A. A mass-casualty event is any incident where the number of victims exceeds the resources available for medical treatment and transport. In these cases, victims are triaged and additional resources are requested. Area hospitals are notified in order to trigger internal emergency plans at each hospital. B. Mass-casualty incidents shall be classified based on the potential impact of the event. Classification of mass-casualty incidents include: 1. LEVEL 1: LOCAL INCIDENT A LOCAL INCIDENT can be handled using resources available within the local area. Typically, this will include incidents with less than 15 patients. A local incident can be managed using a MEDICAL GROUP SUPERVISOR that reports directly to the INCIDENT COMMANDER. 2. LEVEL 2: MAJOR INCIDENT(SITE SPECIFIC) A MAJOR INCIDENT is one where 15 - 50 patients stress area resources. Typically,these events will be site-specific; that is, the patients are victims of an event that took place in one geographic area. Activation of the NCATAC Mass Casualty Plan shall be made. Management of a major incident includes the formation of a MEDICAL BRANCH that reports to the OPERATIONS SECTION CHIEF. The MEDICAL BRANCH DIRECTOR will establish a TRIA GE GROUP, TREATMENT GROUP,and TRANSPORT GROUP. 3. LEVEL 3: AREA DISASTER An AREA DISASTER is an event that involves fifty or more patients from a single-site event or one that results in an unknown number of potential victims from a natural or man-made disaster (earthquake, flood, terrorist action). Activation of the Area Mass Casualty Plan shall be made. Management of the Area Disaster shall include the activation of the local Emergency Operations Center (E.O.C.) with the Command Staff and Section Chiefs reporting to the E.O.C. AN EMS BRANCH will be designated in the field. The EMS BRANCH DIRECTOR shall co-locate with the FIRE BRANCH DIRECTOR at the FIELD COMMAND POST. Typically, the FIRE BRANCH DIRECTOR will segment the field operations into geographical DIVISIONS. The EMS BRANCH DIRECTOR shall follow these segments. The creation of task groups can help manage tasks that cover multiple geographical locations. Additionally, a MEDICAL UNIT will be established by The SERVICE BRANCH DIRECTOR (LOGISTICS SECTION). The MEDICAL UNIT LEADER shall establish medical aid and rehab stations for responders as well as establishing EMS capabilities at designated care and shelter facilities. IV. SPECIFIC PROCEDURES A. INITIATION. 1. The fust-arriving FIRE or EMS officer shall classify the level of the incident. In disaster situations with multiple incidents, the Acting Response Commander for FIRE or EMS may declare a LEVEL 3 MASS-CASUALTY AREA DISASTER if warranted. 2. The Incident Commander shall develop an incident management system for the specific situation in accordance with the Concept of Operation above (see sample organization charts). 3. The MEDICAL GROUP SUPERVISOR (Level 1), MEDICAL BRANCH DIRECTOR (level 2), or EMS BRANCH DIRECTOR (level 3) shall notify the primary receiving hospital Emergency Department and advise them of the situation. If overload of the primary receiving hospital is anticipated, notification of other hospitals shall be accomplished. B. ESSENTIAL MEDICAL RESPONSIBLILITIES. 1. TRIAGE. All Triage shall be accomplished using the "METTAG" universal triage tag system. All tags shall be placed on the right hand or foot. Typically, triage will be performed under the direction of a TRAIGE TEAM LEADER or TRIAGE GROUP SUPERVISOR. In cases were victims are exposed to a hazard (fire, collapse, etc.), rescuers shall remove the victim to a triage area. In other cases, victims may be triaged where they are found. 2. TREATMENT. All triaged patients shall be stabilized and packaged for transportation by personnel working under the direction of a TREATMENT TEAM LEADER OR TREATMENT GROUP SUPERVISOR. Triaged patients need to be package with precautions and moved to a treatment area arranged based on triage priority (group reds together, yellows together, etc.). Patients triaged as "black" shall he the last treatment priority. Obvious death victims shall not be moved until directed by the coroner. 3. TRANSPORT. A TRANSPORTATION TEAM LEADER or TRANSPORTATION GROUP SUPERVISOR will responsible to: a. Request transport resources including ALS ambulances. BLS ambulances, helicopters, transpon fire apparatus, and!or buses. The resource request is best handled through the Incident Command System. b. Maintain communication with receiving hospitals and designate radio frequencies and destinations to transporting vehicles. c. Establish a traffic flow for vehicles. 4. UNIJURED CARE. Persons involved in the incident that are uninjured shall be moved to a designated care and shelter facility. An EMS provider with BLS equipment shall be assigned to the care and shelter facility. In disaster situations, the Red Cross will open pre-defined care and shelter facilities. 5. CARE OF RESCUERS. A rest and rehab area shall be designated for rescuers. An EMS provider with BLS equipment shall be assigned to the rehab area. V. RESOURCE MANAGEMENT A. FIELD RESOURCES. 1. Mutual Aid. Most Fire and EMS field response agencies have reciprocal agreements to provide mutual aid when local resources are stressed. 2. Mass-Casualty Cache. A mass-casualty trailer is available for Larimer County and the western regions of Weld County (stationed at the Fort Collins-Loveland Airport). Additional field caches are encouraged. 3. Air Evacuation. An EMS helicopter is available 24/7 through Air Life of Greeley. Additional helicopters may be requested through Air Life (Denver). The use of military helicopters may be requested through the Army National Guard(Colorado and Wyoming). Fixed-wing aircraft are also available through Air Life(Denver) and the Air Force National Guard(Wyoming). 4. Community and Unsolicited Volunteers. Local OEM officials are tasked with organizing community volunteers. Unsolicited volunteers are common during disaster situations. If EMS responders choose to utilize unsolicited volunteers, attention to scene safety, body substance isolation, and directed patient handling are essential. B. HOSPTIAL RESOURCES.(to be developed) 1. In-house plans 2. Regional Trauma Facility designations 4. Communication/Capability updates with field responders C. EMERGENCY SUPPLY RECOVERY (to be developed) I. Vendor agreements 2. Local E.O.C. assistance 3. Mass donation processing Hello