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Medical
Hospital Surge Capacity Pandemic Preparedness
Pandemic Influenza Emergency Preparedness Virus Avian Bird
Flu H5N1
Mobile Field Hospitals
Surge
Capacity
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Health Resources and Services Administration (HRSA) is
providing additional grants for states to develop medical
surge capacity and capability to deal with mass casualty
events, scheduled for June 2007. This includes the
development of isolation capacity. HRSA's National Bioterrorism
Hospital Preparedness Program, "Critical Benchmark #2-2
Surge Capacity: Isolation Capacity". HRSA further defines
Surge Capacity as Mobile Field Hospitals capability to
house 10 or more suspected patients of Avian Flu.
Surge capacity for a pandemic is defined
as a healthcare facility and hospital's systems ability
to expand quickly beyond normal services to meet an
increased demand for medical surge care in the event
of a pandemic, bioterrorism or other large scale public
health emergencies. Mobile Field Hospitals capabilities
being considered are 10, 20, 50, 100, 200 dependent
on regional population coverage needed and proximity
to airports and overseas traffic.
Mobile Field Hospitals cound be deployable
rapid assembly shelters, easily and quickly erected
tents, mobile or portable field soft wall shelters, and
or trailers can be utilized as temporary emergency
Mobile Field Hospitals and the Pneumatic Airephase™
Mobile Surge Capacity Hospital System for the implementation
and creating of negative pressure isolation
rooms within these emergency areas.
Hospital Surge Response Shelters which can quickly be
deployed for triage facilities and or second level
triage facilities may be needed to be established
out of mobile field hospitals for surge capacity. Emergency
Response Facilities for Emergency Housing, Shelters
and Tents in various designs and sizes can be viewed below.
Businesses are also exploring the use
of modular building systems and in plant offices.
Any type of alterative shelters or enclosures should
be considered. Airephase™
when utilized in creating a positive pressure
isolation room develops a "Safe Room"
for key personal, during a pandemic.
CDC Recommendations for Avian
Influenza, Airborne Precautions
Place the patient in an airborne isolation
room (AIR). Such rooms should have monitored negative
air pressure in relation to corridor, with
6 to 12 air changes per hour (ACH), and exhaust air
directly outside or have recirculated air filtered by
a high efficiency particulate air (HEPA) filter. If
an airborne isolation room AIR is unavailable, contact
the health-care facility engineer to assist or use portable
HEPA filters (see Environmental
Infection Control Guidelines) to augment the number
of ACH.
Photo above
shows the side of Airephase™ chasis depicting air tight
filter,
change panels and externally mounted ballast to power internal
high intensity germicidal UV Lamps. This version includes
the baffle box diffuser mounted in rear.
Click
photo for component diagram
Biological
Controls introduces for Surge Capacity and
Pandemic Preparedness the Airephase™
high capacity air purification system for the removal
of infectious airborne pathogens and other airborne contaminants.
Used in applications requiring constant air filtration
and air changes or establishing isolation and pressurized
environments such as negative or positive pressure isolation
areas. The Airephase™
utilizes both high efficiency HEPA filtration and
high output germicidal UVC lamps providing an ideal combination
of contaminant containment to emergency planners for use
as “in-line” duct connections or recirculation of air
within large volume areas and providing as many as 20
(ACH) air changes per hr. in a typical 12,000 cubic foot
space, nearly double CDC guidelines..
Units can be portable or stationary mounted
with power requirements of
115V or 230V.
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FILTRATION
SYSTEM
The first filter in line in our progressive
filtration design is a pre-filter to capture the larger
size particulates. That would otherwise clog the final
filter and reduce its life expectancy. This filter is
composed of a blend of high loft synthetic and natural
fibers for better than 90% arrestance on particles as
small as 4µ in size. This filter has a MERV 8
rating.
more details ... |
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The HEPA is a specially constructed air filter designed
to perform with an efficiency rating of at least 99.97%
on particles 0.3 microns in size. Particles of this
size have been determined to be the most penetrating
or difficult particle size to capture whereas particles
larger or smaller are filtered out even at higher efficiencies.This
assures there is a high level of protection against
airborne disease transmissions. more
details ...
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| GERMICIDAL
UV LAMPS
Ultraviolet germicidal
irradiation (UVGI) is a highly effective method of sterilization
that utilizes ultraviolet (UV) light in the short wavelength
(UVC) to breakdown micro-organisms. UV light is electromagnetic
radiation that operates in the 253.7 Angstrom (254nm)
range. UV irradiation destroys the nucleic acids by
breaking their molecular bonds within micro-organismal
DNA which in turn removes their growth and reproductive
more
details...
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LIQUID SEAL
One of the most critical aspects of a HEPA
filter is to insure that efficiencies are maintained
throughout its service life and remain at their highest
level, and this involves a leak-free filter seal. The
seal is the interface that exists between the filter
and the mounting surface of the hardware. Compression
seals that normally involve a neoprene type of closed
cell sponge gasket can dry out and
deteriorate or leak due to under or over torquing
more details...
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The Baffle Box: is a rear exhaust atttachment
that can be used when the Airephase™ is more
details...
Differential Gauge: This gauge allows a constant monitoring
of the performance more
details...
Hour Meter: Another means of identifying total run time
is the installation of the electronic more
details.. |
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Mobile Field Shelters
for Surge Capacity Emergencies
New methods to address
the urgent needs of the medical, military, governmental
and civilian sectors for the rapid deployment of medical
facilities has become a major concern and issue of every
state?s emergency preparedness program. The U.S. Government
has determined through |
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studies that surge shelters
have played and can play a significant role both for
victims of public health and natural emergencies in
addition to victims of terrorism in reducing chaos and
saving lives. The potential for huge influxes of patients
or victims due to natural or man-made catastrophes,
or the possibility of bird flu or infectious pandemics
demonstrates the need for large scale deployable shelters.
Within these soft-walled shelters hospital
like environments can be created providing an Emergency
Surge Capacity Facility, where patient isolation, advanced
trauma life support, and intensive care wards can be
deployable directly to the disaster site. These structures
can be utilized as Casualty Collection/Triage Centers,
Emergency Trauma/ Surgical Facilities, Isolation Wards,
Decontamination, Mass Vaccination and Blood Donation
centers. They can function as independent stand alone
units or supplement existing medical facilities.
Multiple usages such as a command center,
hospital, school or billet can be quickly deployed,
erected , repackaged and transported to another location
without requiring specialized supervision or tools.
Portability and flexibility in a time of crisis along
with the ability to provide shelters as small as 110
square feet to multiple structures connected together
provide efficient solutions to manage most emergency
preparedness situations. |
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Biological Controls
Equipment and Systems for
Hospital Isolation Rooms
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The MICROCON®
is a high capacity mobile air purifier specifically designed
to remove hazardous microbial airborne particulate. It
is the only system more
details...
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Mobile
Hospital Air Purification |
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The MICROCON® EXhaust product line
is a series of HEPA filtration systems designed to exhaust
controlled amounts of room air to create negative more
details... |
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Negative/Positive
Pressure Isolation
Ceiling Mounted
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The MICROCON® EX Series was developed
to exhaust air directly to the outside. This is suitable
for rooms with direct outside exposure more
details... |
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Negative/Positive
Pressure Isolation
Window or Wall Mounted
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The ACCUSTAT® room pressure
monitors are designed specifically for monitoring low,
negative or positive pressure differentials. Accurate
pressurization
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Negative
or Positive Room
Pressure Monitor |
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The ISOPORT™ is a heavy-duty vinyl
enclosure that encapsulates the patient and isolates them
in a negative pressure setting while aerosolized
more
details... |
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| Mobile
Isolation Enclosure |
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HRSA National Bioterrorism Hospital
Preparedness Program
HRSA currently is awarding Grants (see our
Links page above) to hospitals nationwide. Awardees must
identify at least one regional healthcare facility in each awardee
hospital preparedness region that is able to support the
initial evaluation and treatment of at least 10 adult and
pediatric patients at a time, in negative pressure isolation
room within 3 hours post-event. Further, HRSA has all states
BT Managers working in creating collaborative planning
models, that hospitals, local public health agencies, and
emergency medical services EMS can use to jointly prepare
for, and respond to public emergencies specifically for
hospital surge capacity.
HRSA Guidance Document on Surge
Capacity (HRSA Grants)
"Ensure that all participating hospitals have the
capacity to maintain, in negative pressure isolation room,
at least one suspected case of any highly infectious disease
(e.g. Avian Flu 5HN1 Influenza) "Surge capacity is
defined as to 10 or more patients, in such an emergency"
it would be to a healthcare facilities' advantage to have
extra Portable MICROCON Mobile Purification units available
to quickly convert patient rooms into additional negative
pressure isolation rooms to house suspected or diagnosed
patients of Avian Flu or for any febrile patient
with a suspect rash or other symptoms of concern who might
possibly be developing a potentially highly communicable
disease.
While this is the minimum criteria for surge capacity
as defined by HRSA, "everyone has their own individual
agenda and have taken steps in the past that might help
meet this criteria, while others are adding. The big question
still remains "How much is enough?" The Interorganizational
planning process, hospitals participate in regional emergency
preparedness planning. Differences in the state public
health management systems, use the state hospital associations
as emergency preparedness planning subcontractors, and
state and community planning models affect hospital participation
in regional emergency planning.
As the primary recipients of federal preparedness
funds, state health departments are charged with ensuring
hospital surge capacity and response planning. While a few
states have contracted this work to hospital associations,
hospitals and hospital associations typically participate
in the planning process through the state's bioterrorism
preparedness planning committee.
Airephase™ as a negative pressure
isolation air filtration system fits your needs as specified
above. Airephase™ can filter the air and
capture the virus in a 12,000 cubic foot space and create
a negative pressure isolation area. This is a large surge
capacity area and could house 20 to 50 patients. Mobile
tents can be quickly erected with an Airephase™ unit providing
purified air thru air a HEPA filtration system and
creating the negative pressure area for isolation.
Improvising is the key to any housing
shortage. Being able to erect special shelters,
or over flow health facilities that needs to be set up quickly.
Utilizing school auditoriums, shuttered hospitals, hotels,
university dormitories etc. Airephase™ can provide
air handling purification which will isolate these areas,
purify the air from potential spread of the influenza virus
and keep the all persons isolated and safe.
A worse case scenario would be
that it might not be possible to transport patients to neighboring
hospitals. Instead second level triage facilities may be needed
to be established out of mobile field hospitals for
surge capacity. Again, Airephase™ meets the
needs of a HEPA filtration system mandatory for isolation
rooms for hospital use.
World governments, institutions, private
business sector, and residential families are planning
for a pandemic. Biological Controls' Airephase™ air
filtration system can help the blueprint for a unified and
coordinated response to an infectious disease emergency in
any given situation.
Homeland Security DHS Pandemic Influenza
Preparedness, Response, and Recovery
Guide for Critical Infrastructure and Key Resources
(In the Links button above.) The Pandemic
Influenza Preparedness, Response, and Recovery Guide is
one of the practical tools DHS has developed for business
owner-operated and their contingency planners to enhance
pandemic planning. A must read for the business
community for pandemic preparedness.
It is essential for the private business
sector both large, medium and small to start preparations
now for a pandemic or any other health emergency event.
Our entire economic infrastructure could be devastatingly
effected, if not. Pandemic
Flu: Potential for U.S. Economic Recession specifically
details the potentially strong negative effects
an outbreak of Pandemic Flu would have on the U.S. economy.
Soft Walled Shelter Tents and Modular Enclosures protecting
Key Personal in any given area:
If and when a pandemic strikes and the virus
is airborne it will take at least six weeks for it
to pass and or persons become immune to the virus. All forms
of Government, businesses, and state and local agencies
etc should take the precaution of establishing "Safe Rooms"
for key personnel. Airephase™ should be used
to create a positive pressure isolation room in
developing a "Safe Room,"
The Airephase™ unit can be used for
recirculation. The high intensity UV and high efficiency HEPA
filters which will kill virtually anything that goes
through them, virus and or bacteria. For protection the
rooms should be under positive pressure. The Airephase™
unit can do that by drawing air from outside the room and
exhausting it inside the room to produce positive pressure.
Eighty-five percent of critical infrastructure
resources reside in the private sector, which generally
lacks individual and system-wide business continuity plans
specifically for catastrophic health emergencies such as
pandemic. Many businesses have extensive contingency plans
in response to threats from diverse
natural and man made disasters. While useful
for their intended purposes, these plans may prove ineffective
given they do not account for the extreme health impact
assumptions and containment strategies projected for a severe
pandemic influenza.
International Pandemic Preparedness
and Surge Capacity
Indonesia has had 100 human H5N1 cases
with 80 deaths, more than any other country. WHO data
show that from January through May of this year, the country
had 26 cases with 21 deaths, versus 31 cases and 24 deaths
for the same period in 2006. Indonesia is one of three countries,
along with Egypt and Vietnam, where the H5N1 virus is endemic
in poultry.
Government funded case studies, both federally
and locally have mixed findings about the perceptions
of pandemic risk here in the US. CIDRAP
Center for Infectious Disease, University of Minnesota's
physician survey, at a recent conference in Europe finds
that half of physicians in Europe who respond to the conference said
they thought an influenza pandemic was very likely
in the next few years. An infectious disease coarse at Oxford
university in England, found that half of the 161 physicians,
mostly from Europe was anonymous. There where many other
very mixed messages derived at the conferences, but one
message that really stands out, is a statement form Peter
M Sandman, PhD, a risk communication expert from Princeton,
NJ. " It is good news that many respondents still think
a pandemic well may be imminent. But it would be better
news if they realized that nobody has a clue whether a pandemic
is imminent or not, and if they understood that preparedness
doesn't depend on whether a pandemic is imminent or not."
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SPECIAL REPORT
CSTE
Avian Influenza Page |
Rapid Response
Training: The Role of Public Health
in a Multi-Agency Response
to
Avian Influenza in the United States
Overview: The
Centers for Disease Control and Prevention
(CDC) and the Council of State and Territorial
Epidemiologists (CSTE) provided three
day training courses adapted from the
DHHS/CDC Guidance for State and
Local Health Departments for Conducting
Investigations of Human Illness Associated
with Domestic Highly Pathogenic Avian
Influenza Outbreaks in Animals.
Training courses were provided in Washington
DC; Denver, CO; and Atlanta, GA in early
2007. The trainings included 295
participants and facilitators and represented
local and state health agencies, federal
agencies including CDC and USDA, wildlife,
agriculture, public health laboratories,
public health veterinarians, nursing,
and industry. Training was provided
to representatives of all fifty states
and Washington DC; several large cities
including Seattle, Chicago, Houston,
and New York City; Puerto Rico, American
Samoa and the Virgin Islands.
All participants were individuals responsible
for the identification, surveillance,
or response of avian influenza (AI).
This three day training course, developed
in conjunction with the North Carolina
Center for Public Health Preparedness,
provided guidance for state and local
health departments in identifying and
controlling human infections and illness
associated with high pathogenicity avian
influenza (HPAI). The training
focused on the human health perspective
during an avian influenza outbreak or
case clusters and provided a mechanism
through didactic lecture, reference
materials, cases studies and tabletop
exercises to facilitate discussion,
interaction and planning with individuals
within the same or neighboring states.
Although the curriculum focused on human
health, this training provided a context
for officials working together with
key agencies with different but related
responsibilities during an AI outbreak.
Training Objectives:
- identify potential for human health
problems associated with cases of
HPAI,
- minimize the risk of spread or further
human infection if human infection
or disease is identified,
- provide guidance to individuals
who are involved in the response to
an HPAI cases and other HPAI exposure
settings,
- protect against the risk of infection
and disease and minimize the risk
of viral reassortment (i.e., mixing
of genes from human and avian influenza
viruses) should an outbreak of HPAI
occur,
- provide guidance for multi-disciplinary
rapid response teams to discuss, plan,
and to facilitate discussion between
all state and local avian influenza
rapid response teams, and
- provide funding for state and local
health agencies to conduct their own
rapid response training session(s).
The finalized course materials presented
at the regional trainings are now available
and provide a standardized curriculum
to state and local public-health responders
about how to identify and control human
infections and illness associated with
avian influenza A (H5N1). Users
are encouraged to download and use these
free materials including presentations,
case studies, and tabletop exercises and
adapt the materials to meet the training
and preparedness needs of individual state
health agencies.
Contact Information:
For more information, please contact Jennifer
Lemmings at 770-458-3811 or jlemmings@cste.org.
To download materials in PowerPoint or
Word format, please click ?save? when
prompted and save the file to the appropriate
location on your computer
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Module
2 - Case Management |
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Module
3 - Personal Protective Equipment |
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Module
4 - Poultry Farm Investigation |
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Module
5 - Management and Public Health Action |
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Additonal
Resources |
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CDC
(www.cdc.gov) |
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USDA
(www.usda.gov) |
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FDA
(www.fda.gov) |
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State
Epidemiologists
POC
Chronic Disease
POC
Environmental Hlth
POC
Infectious Disease
POC
Injury
POC
MCH
POC
Occupational Hlth
POC
Veterinarians
Executive
Committee
CSTE
Staff
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