Southwest Florida Healthcare Coalition
Resources
Helpful information and links to important resources both locally and nationally.
NERVE AGENT INFORMATION FOR EMERGENCY MEDICAL SERVICES AND HOSPITALS
**Meticulous attention to standard protocols for personal protection, recognizing toxidromes, and treating patients continues to be the best way to prepare for and respond to chemical agent exposures**
Purpose
This document provides a quick refresher on standard protocols for recognizing, treating, and protecting yourself from nerve agent exposures. Comprehensive follow-up guidance for Law Enforcement, Fire, EMS, HazMat, and Hospital-Based First Receivers incorporating lessons learned and best practices from the recent United Kingdom incidents will be forthcoming.
Background
Nerve agents are extremely toxic chemical warfare agents. Several nerve agents exist and are generally categorized as either “high volatility” or “low volatility” chemicals, a measure of how likely they are to disperse in air. A high volatility nerve agent (easily dispersed in air) means that the exposure is likely to occur from breathing in its vapors resulting in the rapid onset of symptoms.
A low volatility nerve agent (not easily dispersed in air) typically gets absorbed through the skin and has a delayed onset of signs and symptoms. An example of a high volatility nerve agent is sarin, whereas VX is a low volatility agent. In the body, a nerve agent exerts its effects by inhibiting an enzyme (acetylcholinesterase), resulting in acute illness – specifically, cholinergic crisis.
Organophosphorus or carbamate pesticides produce similar effects to nerve agents.
FULL DOCUMENT CAN BE FOUND HERE
SIGNS AND SYMPTOMS OF NERVE AGENT POISONING
Caveat: Poisoned patients may not demonstrate all of these symptoms
- Mouth/Skin: Drooling (Salivation), foaming at the mouth, and excessive sweating
- Nose/Eyes: Runny nose and watery eyes (Lacrimation) with small (often pinpoint) pupils (Miosis)
- Chest: Cough, chest tightness, difficulty in breathing, wheezing, respiratory failure, “wet” fluid filled lungs
- Abdominal: Urination, Diarrhea, abdominal (Gastrointestinal) cramps, belching, nausea, and/or vomiting (Emesis)
- Mental Status: Confusion, drowsiness, slurred speech, ataxia, unconsciousness, coma
- Muscle/Neurological: Fatigue, weakness, twitching, tremors, cramps, absent reflexes, seizure
- Underlined findings = “SLUDGE”- Salivation, Lacrimation, Urination, Diarrhea, Gastrointestinal cramps, Emesis
- Other mnemonic used = “DUMBBELS” – Diarrhea, Urination, Miosis/Muscle weakness, Bronchospasm/Bronchorrhea, Bradycardia, Emesis, Lacrimation, Salivation/Sweating
Federal Aviation Administration (FAA)
Public Safety Agencies, such as Law Enforcement, are in the best position to deter, detect, and investigate unauthorized or unsafe UAS operations. While drones can serve as a useful tool, these agencies also have an important role in protecting the public from unsafe and unauthorized drone operations. This information will help law enforcement and public safety professionals understand safe drone operations and their authority.
Operate a Drone, Start a Drone Program
Understand Your Authority: Handling Sightings and Reports
Access Our Public Safety Toolkit
FAA Contacts for Law Enforcement
Public Safety Unmanned Aircraft System Resource Guide
Volunteer Florida – Emergency Management
Volunteer Florida is the state’s lead agency for volunteers and donations before, during, and after disasters. In partnership with the Florida Division of Emergency Management, Volunteer Florida:
- Coordinates with Florida Voluntary Organizations Active in Disaster (VOAD) and local and state government emergency management agencies to meet volunteer and donation needs
- Provides staffing during activation of the State Emergency Operations Center
- Provides training and presentations on the roles of government and nongovernmental organizations in disaster preparedness, response, recovery, and mitigation
- Provides fiscal and program management for federal, state, and privately funded programs
- Provides training for government, non-government, and private sector organizations on disaster volunteer and donations management
- Mobilizes and deploys resources to assist communities responding to and recovering from disaster
- Operates the ESF (Emergency Support Function) 15 and deploys trained Volunteer Florida staff to assist the Florida Division of Emergency Management if necessary
- Operates the Volunteer and Donations Hotline and the Florida Donations Portal
Emergency Management Resources
G 489 – Management of Spontaneous Volunteers in Disasters – Student Manual
O2 To Go Cylinder Duration Web Calculator
Easy to use online calculator and mobile App for oxygen cylinder duration estimation. The free calculator & app is ideal for technicians, therapists, patients and caregivers to easily calculate the approximate available oxygen remaining in an oxygen cylinder, based on the patient’s device and cylinders size & contents.
O2 To Go Cylinder Duration Web Calculator & App
Emergency Preparedness
Hospitals are required to conduct and annually review their Hazard Vulnerability Analysis (HVA). The HVA provides a systematic approach to recognizing hazards that may affect demand for the hospitals services or its ability to provide those services. The risks associated with each hazard are analyzed to prioritize planning, mitigation, response and recovery activities. The HVA serves as a needs assessment for the Emergency Management program. This process should involve community partners and be communicated to community emergency response agencies.
Hazard Vulnerability Analysis (HVA) – California Hospital Assoc.
HPH Risk Identification and Site Criticality (RISC) Toolkit 1.0
Emergency Management Glossary of Terms
emPOWER Map
Over 2.7 million Medicare beneficiaries rely on electricity-dependent durable medical and assistive equipment and devices, such as ventilators, to live independently in their homes. Severe weather and other emergencies, especially those with prolonged power outages, can be life-threatening for these individuals. The HHS emPOWER Map is updated monthly and displays the total number of at-risk electricity-dependent Medicare beneficiaries in a geographic area (i.e., state, territory, county, or ZIP Code), as well as near real-time natural hazard data.
Map users can select different geographies, as needed, to identify at-risk populations and download selected data results to inform emergency preparedness, response, recovery, and mitigation public health activities. Users can also access near real-time natural hazard data layers to anticipate and address the needs of at-risk community members in emergencies. For more information, review the job aids in the top right corner.
Special Needs Shelters
In Florida, there are two types of shelters – general population shelters and special needs shelters. It is important to note that not every person with a disability is eligible to evacuate to a special needs shelter. The best place to shelter for every Floridian is outside the evacuation area, in a safe and secure structure, with family and friends
Job Action Sheets for Special Needs Shelters in Florida
CHEMM – Chemical Hazards and Emergency Management
Enable first responders, first receivers, other healthcare providers, and planners to plan for, respond to, recover from, and mitigate the effects of mass-casualty incidents involving chemicals.
Provide a comprehensive, user-friendly, web-based resource that is also downloadable in advance, so that it would be available during an event if the internet is not accessible.
CHEMM was produced by the U.S. Department of Health and Human Services, Administration for Strategic Preparedness and Response, Tactical Programs Division, Office of Emergency Management, in cooperation with the National Library of Medicine, Division of Specialized Information Services, and many medical, emergency response, toxicology, and other types of experts.
In the First Minutes of an Incident — The Basic Overview
Information for the First Responders
Information for the Hospital Providers
Information for Incident Preparedness
Federal Emergency Management Agency (FEMA)
The FEMA Acronyms, Abbreviations & Terms (FAAT) List is not designed to be an authoritative source, merely a handy reference and a living document subject to periodic updating. Inclusion recognizes terminology existence, not legitimacy
Resilience Analysis and Planning Tool (RAPT)
Acronyms, Abbreviations, and Terms: A Capability Assurance Job Aid
Free Preparedness Publications
Integrated Public Alert & Warning System (IPAWS)
Get Assistance After a Disaster
Incident Command System (ICS) – Federal Emergency Management Agency (FEMA)
The Incident Command System (ICS) is a standardized approach to the command, control, and coordination of emergency response providing a common hierarchy within which responders from multiple agencies can be effective. ICS was initially developed to address problems of inter-agency responses to wildfires in California and Arizona but is now a component of the National Incident Management System (NIMS)[2] in the US, where it has evolved into use in all-hazards situations, ranging from active shootings to hazmat scenes.[3] In addition, ICS has acted as a pattern for similar approaches internationally.
ICS consists of a standard management hierarchy and procedures for managing temporary incident(s) of any size. ICS procedures should be pre-established and sanctioned by participating authorities, and personnel should be well-trained prior to an incident. ICS includes procedures to select and form temporary management hierarchies to control funds, personnel, facilities, equipment, and communications. Personnel are assigned according to established standards and procedures previously sanctioned by participating authorities. ICS is a system designed to be used or applied from the time an incident occurs until the requirement for management and operations no longer exist.
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