Welcome to Athens-Limestone Hospital

Responsibilities

A. Intermediate Treatment Unit Leader (Emergency Department Charge Nurse)
1. prior to patient arrival
a. evaluate the situation and determine based on available information:

PLAN 1 - unannounced walk-ins
PLAN 1A - 1 or 2 CBRN patients
PLAN 2 - 3 or more CBRN patients

b. notify Emergency Department staff and ALH Incident Command Center of plan requirements
c. assign staff to decontamination area and buffer zone and request additional staff if required based on the following minimum staffing

PLAN 1/1A
decontamination area –two Nurses
buffer zone – one Nurse
PLAN 2
decontamination area – two Nurses
buffer zone – one Nurse
triage – one Physician (on-call) and one Nurse

d. ensure staff has been trained for assigned duties
e. ensure staff wear appropriate protective equipment
f. take and record vital signs of staff required to wear protective equipment

2. upon patient arrival
a. provide guidance and direction to team members
b. do not allow First Responders to enter the Emergency Department
c. assign a staff member to obtain information on the CBRN agent – SEE Appendix A, Resource List
d. do not talk to the media or allow media to enter Emergency Department – arriving media members must be escorted to the media center
e. update the Incident Command Center on the situation

B. Emergency Department Physician
1. receive briefing from Intermediate Treatment Unit Leader and EMS on patients' medical conditions and CBRN hazard
2. based on primary medical assessments and the CBRN hazards – provide medical treatment
3. direct all necessary medical procedures
4. direct all BIOASSAY procedures

Note: The Emergency Department staff and pre-incident patients in the Emergency Department are the Physician's primary concern. Patients arriving from the incident site must not be allowed to pose a hazard to staff or patients.

C. Decontamination Support Staff
1. prior to patient arrival
a. receive briefing from Intermediate Treatment Unit Leader on patients' medical conditions and CBRN hazard
b. have vital signs taken and recorded
c. don required protective equipment – see Appendix B

2. after patient arrival
a. assist in clean team transfer
b. assist Physician in providing medical treatment
c. obtain BIOASSAYS
d. assist with decontamination
e. doff protective equipment before leaving decontamination area, see APPENDIX B

Note: To the extent conditions permit, only staff members in the respirator program will be assigned these duties. Staff members who are or may be pregnant, ill or have respiratory or other medical conditions shall not be assigned these duties.

D. Buffer Zone Nurse
1. located in the buffer zone (clean area) and does not handle patients unless required to enter decontamination area – this individual must don protective equipment, see Appendix A

2. upon patient arrival
a. record medical and CBRN hazard information provided by EMS and others
b. transfer medical equipment to decontamination area as requested
c. control personnel and equipment entering from the clean side and exiting the decontamination area
d. provide additional information about CBRN hazard as it becomes available
e. document all medical information, sampling and decontamination performed by the decontamination personnel

3. post patient exit – assist decontamination personnel and ensure the following are done
a. all decontamination personnel doff their protective clothing in the decontamination area, see Appendix C
b. exit vital signs are taken and recorded
c. security staff secures the decontamination area before the decontamination personnel leave.

E. Manpower Pool Personnel/Human Services Chief
1. assist decontamination personnel in setting up the tent and other equipment
2. augment the security force

F.Security/Safety and Security Officer – augmented by the Manpower Pool and Athens Police Department
1. prior to patient arrival
a. when directed by the Incident Commander – lock down hospital
b. post a guard (with a radio) at each entrance to direct everyone requesting to enter the hospital to the Emergency Department
c. assist the Emergency Department staff in screening everyone entering the Emergency Department
d. place ropes, signs and stanchions in the ambulance receiving area
e. redirect vehicular and foot traffic as necessary
f. direct ambulances to designated receiving area

2. upon patient arrival
a. secure ambulances with rope and stanchions
b. limit access to controlled areas and maintain control points
h. instruct ambulance personnel to remain with vehicles until cleared for release
i. ensure EMS and Athens Fire & Rescue personnel do not enter the hospital
j. secure the decontamination site when last patient has been decontaminated
k. escort media to designated media center

G.Infection Control Staff
1. Intermediate Treatment Unit Leader will determine when Infection Control Staff are needed and request assistance from the Incident Command Center
2. assist with biological agent contamination control in the Emergency Department and other areas of the hospital as required

H.Nuclear Medicine Staff
1. Intermediate Treatment Unit Leader will determine when Nuclear Medicine Staff is needed and request assistance from the Incident Command Center
2. assist the Emergency Department staff in checking patients and staff for radiation contamination
3. contact the on-call X-Ray technician and have them report to the hospital as needed
4. when adequate Nuclear Medicine personnel are available, one individual will be assigned to assist the Physician and Nurses in decontamination to contain contamination and survey patients and equipment
5. a second technician will assist in the buffer zone to check people and equipment exiting the zone for contamination

I. ALH Incident Commander & Liaison Officer
...will notify the Emergency Management Agency as soon as ALH becomes aware of an incident and provide periodic updates

J. Public Information Officer
...will establish the media center and provide periodic briefings

K. Director of Environmental Services
...will notify the clean up contractor and oversee the clean up.

US Patent Numbers 7,720,998 B2, 7,836,207