Coalition plans for disaster

Figuring out how to do the greatest good for the greatest number of people should a disaster strike Washington County is the job of the Washington County Healthcare Preparedness Coalition. Two members of the coalition made a presentation on "Crisis Standards of Care" to the Washington County Board of Health during the board's monthly meeting on March 12.

Public health administrator Danielle Pettit-Majewski said the Crisis Standards of Care focuses on extreme crises, such as tornadoes, flu pandemic, snow/ice storms and acts of terrorism. The plan also looks at scarce medical resources.

Brandice Armstrong, Washington County Hospital ER and quality director, was the second coalition member to speak to the board.

Pettit-Majewski said the plan assumes that Washington County may have to fend for itself for 96 hours before help arrives.

"Basically you have to assume the first 96 hours you're on your own," Pettit-Majewski said. "That's how hospitals plan. So we need to use the best judgment in those first 96 hours to make our resources last as long as possible."

The Crisis Standards of Care document defines disasters where people's needs exceed available resources and help cannot arrive fast enough. Some disasters could be long lasting and widespread, such as a flu pandemic. Some disasters could be sudden and geographically located, such as a tornado or terrorist act.

The challenges of disaster preparedness include: a shortage of critical medical resources and shortages that require tough decisions such as who would get vaccines or antiviral drugs first, and which patients should receive lifesaving measures such as ventilators or blood products.

"In extreme cases, some patients will not receive any of the treatments or care that they need," the document states.

The document helps health officials make decisions about health care before a crisis occurs, especially when scarcity means a patient wouldn't receive the level care he or she would receive under normal circumstances.

The document notes that Crisis Standards of Care is a piece of a bigger puzzle that may include community preparedness, community recovery, emergency operations, informing the public, managing volunteers and protecting responders.

The Crisis Standards of Care can be invoked by the Washington County Healthcare Preparedness Coalition on the local level, or by organizations such as the Centers for Disease Control and Prevention and the Iowa Department of Public Health.

The board unanimously voted to adopt a resolution approving the plan.

The board also approved a radio policy for the county public health department.

Pettit-Majewski said the public health department purchased mobile radios for the agency and for other county departments, with an eye to what happened in Jackson County when a shooter opened in a board of supervisors meeting. She said the radios could be used to notify county departments if there is an active shooter in a county department. The policy was approved by other county department heads, she said.

Panic buttons have also been installed in county departments for security.