BE INFORMED MAKE A PLAN BUILD TWO KITS CASCADIA MEDICAL READINESS LEARNING OBJECTIVES

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Sydney Greene
5 years ago
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LEARNING OBJECTIVES CASCADIA MEDICAL READINESS The Cascadia Subduction Zone (CSZ)

disasters on health services Characterize the role of health services in disasters

Discuss key steps for managing a mass casualty incident Characterize the crucial role

1 LEARNING OBJECTIVES CASCADIA MEDICAL READINESS The Cascadia Subduction Zone (CSZ) Earthquake s Impact on Central Oregon s Medical Care Characterize the consequences of disasters on health services Characterize the role of health services in disasters Describe different strategies for setting up health services in emergency situations Discuss key steps for managing a mass casualty incident Characterize the crucial role of healthcare providers in emergencies LEARNING OBJECTIVES OUTCOMES BE INFORMED MAKE A PLAN BUILD TWO KITS

2 DO YOU WANT THE TRUTH? GEO 101: TECTONIC PLATE MOVEMENT GEO 101: SUBDUCTION GEO 101: LOCKED PLATES Cascadia Subduction Zone (CSZ): Subduction of the Juan de Fuca Plate beneath the North American Plate. The two plates are locked creating stress that pushes the western edge of the North American Plate up. When the lock slips, we have the subduction zone earthquake

CASCADIA SUBDUCTION ZONE (CSZ) WHEN? (42) over the past 10,000 years Subduction of the Juan de Fuca Plate beneath the North American Plate.

Cascadia Subduction Zone in northern California, Oregon, and Washington, with events in human history.

Earthquake data provided by Chris Goldfinger, Oregon State University; time line by Ian Madin, DOGAMI. (19) M 9+ earthquakes along the entire CSZ.

3 CASCADIA SUBDUCTION ZONE (CSZ) WHEN? (42) over the past 10,000 years Subduction of the Juan de Fuca Plate beneath the North American Plate. Creates a 600 mile fault zone, from southern British Columbia to northern California Comparison of the history of subduction zone earthquakes along the Cascadia Subduction Zone in northern California, Oregon, and Washington, with events in human history. Ages of earthquakes are derived from study and dating of submarine landslides triggered by the earthquakes. Earthquake data provided by Chris Goldfinger, Oregon State University; time line by Ian Madin, DOGAMI. (19) M 9+ earthquakes along the entire CSZ. About one real big one every 500 years. (22) M 8+ earthquakes along the southern section of the CSZ About one big one every 250 GEO 101; Earthquake Magnitude (M) Scale: PACIFIC NORTHWEST SEISMIC NETWORK ANIMATION 1c

GEO 101: SHAKING IN CENTRAL OREGON AFTER SHOCKS, shock, shock, SHOCK, SHOCK, shock, SHOCK, shock, shock, shock, SHOCK, shock, SHOCK, Light = parked cars will rock Moderate = unstable objects fall

1 Major Aftershock 12:10 PM, December 26, 2010 6.3 Earthquake 12:51 PM, February 22, 2011 5.3 Major Aftershock 6:00 PM, April 16, 2011 5.5 Major Aftershock 1:00 PM, June 13, 2011 6.

4 GEO 101: SHAKING IN CENTRAL OREGON AFTER SHOCKS, shock, shock, SHOCK, SHOCK, shock, SHOCK, shock, shock, shock, SHOCK, shock, SHOCK, Light = parked cars will rock Moderate = unstable objects fall over Strong = heavy furniture moves Very Strong = moderate damage to normal buildings Modified Mercalli Intensity (MMI) Scale Christchurch NZ: 7.1 Earthquake 4:30 AM, September 4, Major Aftershock 12:10 PM, December 26, Earthquake 12:51 PM, February 22, Major Aftershock 6:00 PM, April 16, Major Aftershock 1:00 PM, June 13, Major Aftershock 2:27 PM, June 13, 2011 CENTRAL OREGON SEIZMIC EXPECTATIONS JAPAN & OREGON COMPARISON OEM & DAGAMI: Central Oregon ground shaking levels should be similar to or greater than those experienced during two previous Oregon earthquakes: Scotts Mills and Klamath Falls. Cascadia subduction zone earthquake will be of MUCH longer duration than crustal events, it will have greater damage potential

5 STRUCTURAL: SEIZMIC IMPACT FACTORS NON STRUCTURAL: SEIZMIC IMPACT FACTORS Proximity Location Soil Type Engineering Workmanship Age Updates Connections Ground Moisture Fixtures Furniture Decorations Connections Storage Equipment TRANSPORTATION IMPACT: BRIDGES & LANDSLIDES LOGISTICAL IMPACT: RESOURCES Top 10 Cargo Import Ports: 1.Los Angeles 2.Long Beach 3.New York 4.Savannah 5.Seattle 6.Oakland 7.Norfolk 8.Charleston 9.Houston 10.Portland

LOGISTICS: MAJOR TRUCK TRANSPORT OUTCOMES BE

PLANNING ASSUMPTIONS THE BIG PLAN May cause

standard operating procedures May create extended,

expectations May integrate personal and professional

6 LOGISTICS: MAJOR TRUCK TRANSPORT OUTCOMES BE INFORMED MAKE A PLAN BUILD TWO KITS EARTHQUAKE PLANNING ASSUMPTIONS THE BIG PLAN May cause increased medical demands May interfere with standard operating procedures May create extended, compounded, aggravated, and escalating problems and expectations May integrate personal and professional problems May change demographics Will ALWAYS be the catalyst for the unexpected!

IMPACT PHASES: Sprint followed by Marathon IMPACT PHASES: Sprint

crash, falls, fire, shock, flood, heart failure, breathing, panic,

.. Secondary impact: rescue efforts, damaged infrastructure; strains,

followed by Marathon Tertiary impact: damage to lifelines, resources,

treatments, infections, wound care, psychiatric, withdrawal,

7 IMPACT PHASES: Sprint followed by Marathon IMPACT PHASES: Sprint followed by Marathon Primary impact: due to initial event; crush, crash, falls, fire, shock, flood, heart failure, breathing, panic, births,... Secondary impact: rescue efforts, damaged infrastructure; strains, sprains, cuts, bumps, exposure, exhaustion, fatigue, shocks, lack of, IMPACT PHASES: Sprint followed by Marathon IMPACT PHASES: Sprint followed by Marathon Tertiary impact: damage to lifelines, resources, and facilities: medications shortages, lack of chronic care, treatments, infections, wound care, psychiatric, withdrawal, violence, domestic, hygiene, disease, Quaternary impact: staffing shortages, facility repair,,

EARTHQUAKE MEDICAL TRENDS; Japan, Chile, NZ, Kashmir, Nepal, California, MIGRATION: FACT OR FICTION Medical

Non structural damage, to building services and equipment.

THE GROUND Professional Challenges: Loss of friends and coworkers Lack of information and communication

8 EARTHQUAKE MEDICAL TRENDS; Japan, Chile, NZ, Kashmir, Nepal, California, MIGRATION: FACT OR FICTION Medical services outside of impact area were overwhelmed Prolonged surge staffing. Non structural damage, to building services and equipment. Critical resources interrupted, Lack of emergency Pharmaceutical shortages Requested mutual aid Populations flee direct threats to life. Destruction of essential services Regulated by terrain and weather Complex impact BOOTS ON THE GROUND BOOTS ON THE GROUND Professional Challenges: Loss of friends and coworkers Lack of information and communication Severely disrupted environment Limited resources Extended hours Limited capabilities Overwhelming demands Fear Personal Challenges: Loss of family and friends Lack of information and communication Severely disrupted environment Limited resources Loss of capabilities Conflicting demands Fear

9 THE UNEXPECTED ALWAYS HAPPENS THE UNEXPECTED ALWAYS HAPPENS THE UNEXPECTED ALWAYS HAPPENS : Continuity of Operations

10 : Continuity of Operations : Continuity of Operations Surge, Volunteers Surge, Volunteers

11 Surge, Volunteers

12 Odd Partnerships

13 THE PLANNING FOCUS: PEOPLE OUTCOMES Insert your picture here! BE INFORMED MAKE A PLAN BUILD TWO KITS GO KIT: 72 HOUR HOME KIT: 21 DAYS OR MORE Camping equipment Medications Portable Important documents Emergency Passports Money Comfort Food Car / Office Water (basic: 21 gals / person) Food (rotation) Shelter First Aid Heat / Warmth Medications Alt Power Solar Lights Alternate Transport

14 Japanese Red Cross Ishinomaki Hospital MEGAQUAKE RECONSTRUCTION VIDEO tbkha4#t=19 E Resources Earthquakes and Peoples Health (WHO; 1997; Earthquake damage to hospitals and clinics in Kobe, Japan Concepts in Disaster Medicine, Challenge of Hospital Emergency Preparedness: Analysis and Recommendations: Joseph A. Barbera, MD, Dale J. Yeatts, MD and Anthony G. Macintyre, MD TheNewNormal: Twelve Months of Resiliency and Recovery in Christchurch; Graeme J. McColl; Frederick M. Burkle Jr, MD, MPH, DTM Earthquakes and Peoples Health (WHO; 1997; Earthquake damage to hospitals and clinics in Kobe, Japan Earthquakes and Peoples Health (WHO; 1997; Earthquake damage to hospitals and clinics in Kobe, Japan Earthquakes and Peoples Health (WHO; 1997; Earthquake damage to hospitals and clinics in Kobe, Japan

15 HOSPITALS & CLINICS: BETWEEN A ROCK AND HARD PLACE Resources Social Service to Business Model and Back: Expected to operate using business efficiencies Still expected to provide disaster services Provide critical medical services in spite of direct disaster impact Constrained price setting Unfunded preparedness mandates Closures due to medical economics Increase surge capacity in disasters Earthquakes and Peoples Health (WHO; 1997); Earthquake damage to hospitals and clinics in Kobe, Japan Concepts in Disaster Medicine, Challenge of Hospital Emergency Preparedness: Analysis and Recommendations: Joseph A. Barbera, MD, Dale J. Yeatts, MD and Anthony G. Macintyre, MD The New Normal: Twelve Months of Resiliency and Recovery in Christchurch; Graeme J. McColl; Frederick M. Burkle Jr, MD, MPH, DTM Pacific Northwest Seismic Network: pnsn.org Oregon Department of Geology and Mineral Industries: oregongeology.org Cascadia Region Earthquake Workgroup: crew.org Oregon Office of Emergency Management: oregon.gov/omd/oem The Oregon Resilience Plan: oregon.gov/omd/oem/osspac/docs/oregon_resilience_plan_final.pdf

Portland Water Bureau. Preparing Portland s Water Supply for The Big One. July 11, Tim Collins, P.E., G.E.

Portland Water Bureau. Preparing Portland s Water Supply for The Big One. July 11, Tim Collins, P.E., G.E. Portland Water Bureau Preparing Portland s Water Supply for The Big One July 11, 2018 Tim Collins, P.E., G.E. Presentation Outline Portland water system overview Pacific Northwest seismic hazards Building