Ebola 2014 - CIEMSD · ebola 2014 10/27/2014 06:00 - 11/03/2014 06:00 this incident action plan shall remain in effect until: - the current ebola situation has ended; or - until a

For Additional Information Contact: A.J.Mumm, Director

PolkCounty EMA 515-286-2107

[email protected]

POLK COUNTY EMERGENCY MANAGEMENT

Proudly serving the communities of: Alleman,Altoona, Ankeny, Bondurant, Clive, Des Moines, Elkhart, Grimes, Johnston,Mitchellville, Pleasant Hill, Polk City, Polk

County, Runnells, Urbandale, WestDes Moines, and Windsor Heights

POLK COUNTY EMERGENCY MANAGEMENT

Ebola 2014

10/27/2014 06:00 to 11/03/2014 06:00INCIDENT ACTION PLAN

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ICS 202

INCIDENT OBJECTIVES 1. Incident Name 2. Date Prepared 3. Time Prepared

4. Operational Period

5. General Control Objectives for the Incident (include alternatives)

7. General Safety Message

8. Attachments (mark if attached)

Organization List - ICS 203 Medical Plan - ICS 206

Div. Assignment Lists - ICS 204

Communications Plan - ICS 205

Prepared by (Planning Section Chief) Approved by (Incident Commander)

6. Weather Forecast For Period

Ebola 2014

10/27/2014 06:00 - 11/03/2014 06:00

THIS INCIDENT ACTION PLAN SHALL REMAIN IN EFFECT UNTIL: - THE CURRENT EBOLA SITUATION HAS ENDED; OR - UNTIL A CONFIRMED CASE OF EBOLA IS IDENTIFIED IN POLK COUNTY, AT WHICH TIME A NEW IAP WILL BE ISSUED THAT WILL COVERDECONTAMINATION, TREATMENT, TRANSPORTATION AND OTHER TOPICS.

- Minimize the risk of contraction of the Ebola virus for emergency responders and health care providers- Gain and maintain situational awareness through information from the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC)and Iowa Department of Public Health (IDPH).-Coordinate with IDPH regarding messaging and communications.-Ensure partners and the public have current information to guide decision-making regarding their health safety-Strengthen preparedness in Polk County for the early recognition, detection, and control of an Ebola exposure.-To ensure responders are prepared with the appropriate PPE and proper guidance on Donning and Doffing.

Maintain appropriate communication between the 9-1-1 centers, first responders and hospitals regarding suspected individuals with symptoms of Ebola.

All responders should be wearing the appropriate personal protective equipment during a response that involves a suspected case of Ebola.

Review and become familiar with discipline specific guidance included in each ICS 204 and the PPE information included within this Incident Action Plan.

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Weather Forecast information may be obtained at http://www.crh.noaa.gov/dmx

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ORGANIZATION ASSIGNMENT LIST

1. Incident Name:4. Operational Period

5. EOC Director & Staff

EOC Director

Deputy EOC Director

Safety Officer

PIO/JIC Officer

Policy Officer

6. Agency Representatives:

Agency Name

7. Planning Section:

Chief

Deputy

Resources Unit

Situation Unit

Documentation Unit

Demob Unit

Technical Specialists

8. Logistics Section:

Chief

Deputy

Support Branch

Supply Unit

Facilities Unit

10. Finance Section:

Ground Support Unit

Service Branch

Deputy

Time Unit

Comms Unit Procurement Unit

Medical Unit Compensation/Claims Unit

Food Unit Cost Unit

Prepared by:

2. Date 3. Time

Info/Intel Unit

Technical Specialists

Chief

Recovery/Mitigation Unit

Branch:

Branch Director

9. Operations Section:

Chief

Deputy

11. Information and Intelligence Section:

Branch Deputy Director

Branch:

Branch Director

Branch Deputy Director

Ebola 2014

Rick Kozin

AJ Mumm

Nola Aigner

Kari Lebeda Townsend

Franny Medeiros/Samantha Brear

Juan Cadenillas

10/27/2014 06:00 - 11/03/2014 06:00

Page 6

Transportation Group

Communication Group

Public Works/Eng Group

Scott Slater

Firefighting

Public Hlth & Med Services 1

Hazardous Materials

Law Enforcement & Security



Emergency Services

Infrastructure Support

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1. Incident Name 2. Operational Period (Date/Time) From: To:

Assignment ListICS 204-CG

3. Branch 4. Division/Group/Staging

5. Operations Personnel Name Affiliation Contact # (s)

Operations Section Chief:

Branch Director:

Division/Group Supervisor/STAM:

6. Resources Assigned “X” indicates 204a attachment with additional instructions

Strike Team/Task Force/Resource Identifier

Leader Contact Info. # # Of Persons

Reporting Info/Notes/Remarks

7. Work Assignments

8. Special Instructions

9. Communications (radio and/or phone contact numbers needed for this assignment) Name/Function Radio: Freq./System/Channel Phone Cell/Pager

Emergency Communications Medical Evacuation Other

10. Prepared by: Date/Time 11. Reviewed by (PSC): Date/Time 12. Reviewed by (OSC): Date/Time

ASSIGNMENT LIST ICS 204-CG (Rev 04/04)

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Infrastructure Support Transportation Group

Scott Slater

Department of Homeland Security (DHS) held a call with ACI-NA and A4A to ask the airline industry to investigate proactively re-routing travelers from the threeaffected countries in West Africa so that their U.S.-bound itineraries would be cleared into our country through one of the five airports with enhanced screeningmeasures. This morning, DHS announced it is implementing this strategy effective immediately.The approach will be two-pronged. Customs and Border Patrol (CBP) will use its targeting systems to identify travelers scheduled to travel from one of the threeaffected countries into the United States, with a first U.S. port of entry other than Atlanta, New York Liberty, Dulles, John F. Kennedy International Airport orChicago O'Hare International Airport. CBP should get this information up to 72 hours in advance of the traveler’s scheduled departure and will communicatedirectly with the booking air carrier to get the traveler rebooked with an entry into the U.S. through one of the five enhanced screening airports.This guidance does not apply to Des Moines International Airport as they were not included in the list of the five airports above.

The CDC will notify IDPH regarding Iowa-bound travelers. IDPH will notify the PCHD regarding travelers with a destination of Polk County for appropriatemonitoring. Travelers who have been in an affected country (Guinea, Liberia or Sierra Leone) in the previous 21 days with fever of 100.4 or higher with orwithout Ebola symptoms will be deferred and not allowed to continue to travel. Travelers who have been in an affected country (Guinea, Liberia or SierraLeone) in the previous 21 days no known exposure will receive instructions on self-monitoring and a CARE Kit (with digital thermometer, thermometerdirections, health advisory, symptom card, symptom log, reminder card, list of state health department phone numbers).

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Branch Director:






7. Work Assignments






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Infrastructure Support Communication Group

Scott Slater

It is important for PSAPs to question callers and determine if anyone at the incident possibly has Ebola. This shall be communicated immediately to EMSpersonnel before arrival. PSAPs shall review existing medical dispatch procedures and coordinate any changes with their EMS medical director and with theirlocal public health department.

- PSAP call takers shall screen callers for symptoms and risk factors of Ebola. Callers will be asked if they, or someone at the incident, have fever of greaterthan 100.4 degrees Fahrenheit, and if they have additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, orunexplained bleeding.- If PSAP call takers suspect a caller is reporting symptoms of Ebola, they shall screen callers for risk factors within the past 3 weeks before onset of symptoms.Risk factors include: Contact with blood or body fluids of a patient known to have or suspected to have Ebola; - Residence in–or travel to–a country where an Ebola outbreak is occurring; or direct handling of bats or nonhuman primates from disease-endemic areas.

- If PSAP call takers have information alerting them to a person with possible Ebola, they shall make sure any first responders and EMS personnel are madeconfidentially aware of the potential for Ebola before the responders arrive on scene.

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Branch Director:






7. Work Assignments






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Infrastructure Support Public Works/Eng Group

Scott Slater

Waste Management:CDC guidance indicates that sanitary sewers are acceptable for patient bodily fluids. Royce Hammitt, the Wastewater Reclamation Authority OperationsManager said that they will follow the CDC guidelines.

Royce Hammit (515) 323-8001 515-208-0641

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Branch Director:






7. Work Assignments






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Emergency Services Firefighting

Scott Slater

1.Address scene safety:- If PSAP call takers advise that the patient is suspected of having Ebola, personnel shall put on the PPE appropriate for suspected cases of Ebola beforeentering the scene. Please see the end of this IAP for updated guidelines on PPE.- Keep the patient separated from other persons as much as possible.- Use caution when approaching a patient with Ebola. Illness can cause delirium, with erratic behavior that can place personnel at risk of infection, e.g., flailingor staggering.

- Patients shall be asked if they, or someone at the incident, have fever of greater than 100.4 degrees Fahrenheit, and if they have additional symptoms such assevere headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained bleeding.- If a patients is reporting symptoms of Ebola, they should be questioned for risk factors within the past 3 weeks before onset of symptoms. Risk factors include:Contact with blood or body fluids of a patient known to have or suspected to have Ebola; - Residence in–or travel to–a country where an Ebola outbreak is occurring; or direct handling of bats or nonhuman primates from disease-endemic areas.

- Based on the presence of symptoms and risk factors, put on or continue to wear appropriate PPE and follow the scene safety guidelines for suspected case ofEbola. The patient should be placed in a gown, mask and gloves according to the same PPE recommendations.

- If there are no risk factors, proceed with normal EMS care.

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Branch Director:






7. Work Assignments






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Emergency Services Public Hlth & Med Services 1

Scott Slater

Public Health X

Medical Supplies Management & Distribution Task Force - Check local inventory of PPE for adequate suppliesMass Prophylaxis Task Force - At this time, no vaccination is available for the Ebola Virus. Polk County Health Department has a Mass Prophylaxis plan shoulda vaccine become available.Medical Surge Task Force - Individual hospitals maintain medical surge plans that may be implemented as neededIsolation & Quarantine Task Force - Polk County Health Department has an Isolation & Quarantine plan that may be implemented if necessaryLaboratory Testing Task Force - Iowa Department of Public Health and Polk County Public Health will coordinate any lab testing of suspected Ebola casesFatality Management Task Force - Polk County Emergency Management and the Polk County Medical Examiner have a fatality management plan that may beimplemented as neededDisaster Mental Health Task Force - Polk County Emergency Management has a Disaster Mental Health plan that may be implemented as neededEnvironmental Health Task Force - Polk County Emergency Management has a Environmental Health plan that may be implemented as neededResponder Safety & Health Task Force - Maintain coordination and communication on safety and health issues between agencies and departments

Epidemiological Surveillance & Investigations - If patient meets clinical and exposure criteria for high or low risk Contact IDPH immediately at 800-362-2736 or515-323-4360. If patient meets the clinical and “no known exposure” criteria, order appropriate testing which may include continued use of infection controlmeasures until cause identified; Rule out more common infections, including influenza, malaria, and diarrheal pathogens; If no cause is identified and Ebolainfection is suspected, contact IDPH at 800-362-2736 or 515-323-4360 to discuss Ebola testing.Use a U.S. Environmental Protection Agency (EPA)-registered hospital disinfectant with a label claim for a non-enveloped virus (e.g., norovirus, rotavirus,adenovirus, poliovirus) to disinfect environmental surfaces in rooms of patients with suspected or confirmed Ebola virus infection. Although there are noproducts with specific label claims against the Ebola virus, enveloped viruses such as Ebola are susceptible to a broad range of hospital disinfectants used todisinfect hard, non-porous surfaces. In contrast, non-enveloped viruses are more resistant to disinfectants. As a precaution, selection of a disinfectant productwith a higher potency than what is normally required for an enveloped virus is being recommended at this time. EPA-registered hospital disinfectants with labelclaims against non-enveloped viruses (e.g., norovirus, rotavirus, adenovirus, poliovirus) are broadly antiviral and capable of inactivating both enveloped andnon-enveloped viruses.

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ASSIGNMENT LIST ATTACHMENT ICS 204a-CG (Rev 04/04)

1. Incident Name 2. Operational Period (Date/Time)

From: To:

ASSIGNMENT LIST ATTACHMENTICS 204a-CG

3. Branch 4. Division/Group

5. Strike Team / Task Force/Resource (Identifier) 6. Leader 7. Assignment Location

8. Work Assignment Special Instructions, Special Equipment/Supplies Needed for Assignment, Special Environmental Considerations, Special Site Specific Safety Considerations

Approved Site Safety Plan Located at:

9. Other Attachments (as needed)Map/Chart Weather Forecast/Tides/Currents


Ebola 2014 11/03/2014 06:0010/27/2014 06:00

Public Hlth & Med Services 1Emergency Services

Public Health

10Page

Clinical presentation and level of exposure are taken into account when determining appropriate public health actions for individuals with potential Ebolaexposure, as follows.

Mandatory Quarantine: Asymptomatic individuals with high or low exposure risk will be placed under mandatory quarantine order in their home and monitoredby the Polk County Health Department. A Communicable Disease Nurse and/or designee will conduct visits twice daily to observe the individual taking theirtemperature from outside the residence during the incubation period (21 days). Symptom review and other discussions will be conducted by phone while onand off the premises as appropriate. Symptomatic individuals with high or low exposure risk will be placed under a mandatory quarantine in the hospital.

Self-Monitoring: Asymptomatic individuals with "No Known Exposure" will be required to self-monitor for fever and symptoms under a mandatory Submit to SelfMonitor Order and report to the Polk County Health Department. The individual will be evaluated and report their temperature and symptom status twice dailyduring the incubation period (21 days). Individuals do not have movement restrictions as with quarantine but must refrain from using mass transportation,including airplanes, trains, cruise ships, or busses, unless they receive written permission from the Iowa Department of Public Health/CDC prior to engaging insuch travel.

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Branch Director:






7. Work Assignments






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Scott Slater

Emergency Medical Services X

During patient assessment and management, EMS personnel shall consider the symptoms and risk factors of Ebola:- All patients shall be assessed for symptoms of Ebola (fever of greater than 100.4 degrees Fahrenheit, and additional symptoms such as severe headache,muscle pain, vomiting, diarrhea, abdominal pain, or unexplained hemorrhage). If the patient has symptoms of Ebola, then ask the patient about risk factorswithin the past 3 weeks before the onset of symptoms.- Based on the presence of symptoms and risk factors, put on or continue to wear appropriate PPE and follow the scene safety guidelines for suspected case ofEbola. The patient should be placed in a gown, mask and gloves according to the same PPE recommendations.- If there are no risk factors, proceed with normal EMS care.

EMS personnel shall notify the receiving healthcare facility when transporting a suspected Ebola patient, so that appropriate infection control precautions maybe prepared prior to patient arrival. EMS personnel involved in the ground interfacility transfer of patients with suspected or confirmed Ebola should wearrecommended PPE. Please see the end of this IAP for updated guidelines on PPE.

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ASSIGNMENT LIST ATTACHMENT ICS 204a-CG (Rev 04/04)

1. Incident Name 2. Operational Period (Date/Time)

From: To:

ASSIGNMENT LIST ATTACHMENTICS 204a-CG

3. Branch 4. Division/Group

5. Strike Team / Task Force/Resource (Identifier) 6. Leader 7. Assignment Location

8. Work Assignment Special Instructions, Special Equipment/Supplies Needed for Assignment, Special Environmental Considerations, Special Site Specific Safety Considerations

Approved Site Safety Plan Located at:

9. Other Attachments (as needed)Map/Chart Weather Forecast/Tides/Currents


Ebola 2014 11/03/2014 06:0010/27/2014 06:00

Public Hlth & Med Services 2Emergency Services

Emergency Medical Services

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- EMS crews should wear properly fitting PPE as identified in CDC guidance included at the end of this IAP.

- Number of EMS personnel/care providers should be kept to an absolute minimum.

- EMS crews shall call the destination hospital with a pre-arrival report and to receive directions for the transport and specific hospital arrival procedures.

- Air transport via rotary wing aircraft (helicopters) will NOT occur

- Suspect cases should NOT be transported to Iowa Lutheran Hospital, Methodist West Hospital, or Mercy West Lakes. Patients should instead be transportedto Broadlawns Medical Center, Iowa Methodist Hospital, Mercy Medical Center or the VA Medical Center (if they are a veteran).

- Upon arrival at destination hospitals, the ambulance should pull into the patient unloading area as normal. The EMS crew should STAND BY THEIRAMBULANCE until a hospital staff member comes out to greet them and guide them to the appropriate room via the appropriate route. NOTE unloading theambulance may be delayed until the hospital is ready to receive the patient in the ED. Transfer of the patient to hospital staff will otherwise occur as normal.

- The ambulance will not be allowed to leave the garage until decontamination has occurred. The EMS crew is responsible for performing the decon in thegarage under the guidance and supervision of hospital staff, with materials provided by the hospital

- EMS PPE will be doffed under the direction and supervision of hospital staff. The used PPE will be left at the hospital for disposal.

- EMS crews should compile basic contact information for not only their own crews but other close contacts who may have been present at the time of patientpick up. This will aid the health department in determining potential exposures.

- Rural ambulances and others that feel they are not prepared, equipped, or are uncomfortable with transporting suspect cases should instead contact IowaMethodist Hospital, Mercy Medical Center, or one of the private ambulance services for transport/ inter-hospital transfer.

- Limit activities, especially during transport, that can increase the risk of exposure to infectious material (e.g. airway management, cardiopulmonaryresuscitation, use of needles).

- Limit the use of needles and other sharps as much as possible. All needles and sharps should be handled with extreme care and disposed in puncture-proof,sealed containers.

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Branch Director:






7. Work Assignments






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Scott Slater

Hospitals/Clinics

The CDC will direct where a confirmed Ebola case will go, however hospitals should be prepared to house confirmed cases for up to 5 days until such transfercan occur.

If clinics receive a phone with a suspect case and the screening questions indicate a strong likelihood of a case, DO NOT advise to come to the clinic. Instead,EMS should be called to conduct the transport to Broadlawns Medical Center, Iowa Methodist Hospital, Mercy Medical Center or the VA Medical Center (if theyare a veteran).

Rural hospitals should not perform blood draws or other medical procedures beyond screening questions.

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Branch Director:






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Emergency Services Hazardous Materials

Scott Slater

The Ebola virus is a Category A infectious substance regulated by the U.S. Department of Transportation’s (DOT) Hazardous Materials Regulations (HMR, 49C.F.R., Parts 171-180). Any item transported for disposal that is contaminated or suspected of being contaminated with a Category A infectious substance mustbe packaged and transported in accordance with the HMR. This includes medical equipment, sharps, linens, and used health care products (such as soiledabsorbent pads or dressings, kidney-shaped emesis pans, portable toilets, used Personal Protection Equipment [e.g., gowns, masks, gloves, goggles, faceshields, respirators, booties] or byproducts of cleaning) contaminated or suspected of being contaminated with a Category A infectious substance.

- Personnel performing cleaning and disinfection should wear the recommended PPE outlined at the end of this IAP.- Patient-care surfaces (including stretchers, railings, medical equipment control panels, and adjacent flooring, walls and work surfaces) are likely to becomecontaminated and should be cleaned and disinfected after transport. A blood spill or spill of other body fluid or substance (e.g., feces or vomit) should bemanaged through removal of bulk spill matter, cleaning the site, and then disinfecting the site. For large spills, a chemical disinfectant with sufficient potency isneeded to overcome the tendency of proteins in blood and other body substances to neutralize the disinfectant’s active ingredient.- An EPA-registered hospital disinfectant with label claims for viruses that share some technical similarities to Ebola (such as, norovirus, rotavirus, adenovirus,poliovirus) and instructions for cleaning and decontaminating surfaces or objects soiled with blood or body fluids should be used according to those instructions.After the bulk waste is wiped up, the surface should be disinfected as described in the bullet above. Contaminated reusable patient care equipment should beplaced in biohazard bags and labeled for cleaning and disinfection according to agency policies. Reusable equipment should be cleaned and disinfectedaccording to manufacturer's instructions by trained personnel wearing correct PPE. Avoid contamination of reusable porous surfaces that cannot be madesingle use.

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Branch Director:






7. Work Assignments






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Emergency Services Law Enforcement & Security

Scott Slater

Address scene safety:- If PSAP call takers advise that the person is suspected of having Ebola, personnel shall put on the PPE appropriate for suspected cases of Ebola (beforeentering the scene. Please see the end of this IAP for updated guidelines on PPE.- Keep that person separated from other persons as much as possible.- Use caution when approaching a patient with Ebola. Illness can cause delirium, with erratic behavior that can place personnel at risk of infection, e.g., flailingor staggering.

- Correctional facilities should consider revising intake/booking procedures to include the questions below

If you observe a person you suspect may be ill, you will ask if they, or someone at the incident, have fever of greater than 100.4 degrees Fahrenheit, and if theyhave additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained bleeding.- If a patients is reporting symptoms of Ebola, they shall be questioned for risk factors within the past 3 weeks before onset of symptoms. Risk factors include:Contact with blood or body fluids of a patient known to have or suspected to have Ebola; - Residence in–or travel to–a country where an Ebola outbreak is occurring; or direct handling of bats or nonhuman primates from disease-endemic areas.

- Based on the presence of symptoms and risk factors, put on or continue to wear appropriate PPE and follow the scene safety guidelines for suspected case ofEbola. The patient should be placed in a gown, mask and gloves according to the same PPE recommendations.

- Request EMS response to the scene as appropriate

- If there are no risk factors, proceed with normal law enforcement duties.

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Branch Director:






7. Work Assignments






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Command Staff Public Information

Scott Slater

Coordination between IDPH and Polk County Public Health. Public Health will send out relevant information to their partners as necessary.

Press conferences, Flash Reports, Situation Reports, Facebook and Twitter updates will be used for public information.

Once there is a suspected case a Joint Information Center shall be established at Polk County Emergency Management Agency within the hour. The JointInformation Center shall include representatives from Polk County Public Health, Iowa Department of Public Health, Polk County Emergency Management andthe EMS Agency and Hospital involved in the suspected case. The lead Public Information Officer will come from the Polk County Health Department.

For additional information on Joint Information Center procedures, please log into DLAN and click on Documentation>Reference Library>Polk CountyComprehensive Emergency Plan>ESF#15 Public Information.

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1. Incident Name 2. Operational Period (Date / Time)

From: To:

COMMUNICATIONS LISTICS 205A-CG

3. Basic Local Communications Information

Assignment Name Method(s) of contact (radio frequency, phone, pager, cell #(s), etc.)

4. Prepared by: (Communications Unit) Date / Time

COMMUNICATIONS LIST ICS 205a-CG (Rev. 07/04)

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Johnston Schools

Johnston Schools

Unity Point RN Epidemiologist

Polk County Health Department

Polk County Board of Superviso

Polk County Medical Exam.

Broadlawns

DSM Schools

Pine Ridge Farms

DMACC

Iowa DPS

Fraser Ambulance

Mary Greeley Medical Center

Clive Fire Department

Unity Point

Unity Point

IDPH

IDPH

DSM Register

Safe Guard Iowa Partnership

Safe Guard Iowa Partnership

Ankeny PD

DMACC

Unity Point

Polk Co Court Administrator

Polk Co Public Works

Polk City PD

Polk Co Medical Examiner

Broadlawns ED

Des Moines Fire Dept

Susanne Richardson

Susan Krebs

Carrie OBrien

Scott Slater

Sarah Boese

Amanda Luick

Karen Nichols

Amanda Lewis

Nicole Sams

Sandra Foster

Alex Murphy

James Morgan

Chris Perrin

Brian Helland

Julie Gibbons

Kevin Daniels

Chris Galeazzi

Anne Garvey

Tony Lays

Jesse Truax

Jami Haberl

Makai Echer

Ned Miller

Scott Draper

Anne Sheeley

Bob Rice

Dustin Bjornn

Dr. Schmunk

Steve Carter

Dale Bunting

[email protected]/971-1312

[email protected]

515-241-6826

286-3752

664-7869

201-2275

988-4160

451-3336

608-3289

964-6352

443-3014

460-8883

[email protected]

[email protected]

241-5434

241-8622

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

286-3184

286-3705

984-6565

710-2852

282-2253

283-4929

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From: To:






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Polk County Attorney

DSM Public Schools

Polk County Sheriff Office

Westcom

Ankeny PD

DSM Airport FD

Drake University

Urbandale FD

Des Moines Fire

Des Moines Fire

Windsor Heights Fire

MWA

Polk County Health Depart

Pleasant Hill Fire

MidAmerican

Mercy Hospital

Mercy Hospital

Mercy Hospital

Iowa Homeland Security

Warren County EM

Unity Point

Newton Fire

Newton Fire

Iowa Health Association

Iowa Air National Guard

Meredith Corporation

Polk County Sheriff Comm


West Des Moines EMS

West Des Moines EMS

Iowa Telecom

Ralph Marasco

Marci Cordaro

Tim Krum

Rob Dehnert

Brian Huggins

Kevin Gill

Becky Anderson

Scott Lyon

Jim Fox

Tony Sposeto

Christopher Criss

Scott Nelson

Rick Kozin

Jamie Xayavong

Carol Ralston

Brenda McGraw

Jan Tippett

Gregg Lagan

Steve Warren

Troy Bass

Katherine Hill

Rex H.

Joe Coen

Art Spies

Cameron Stufflebeam

Katherine Reardon

John Smith

John Tayler

Mark Mc Culloch

David Edgar

Pam Boat

[email protected]

242-7618

208-4872

[email protected]

289-5258

573-424-1523

210-1293

278-4172

283-4273

283-4172

778-2772

710-1403

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

rexhnewtongov.org

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

Mark [email protected]

[email protected]

[email protected]

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Altoona Fire


VA

VA

Marion County Public Health

Marion County


VA

Urbandale Schools

Altoona Fire Department

PC Sheriffs office

Story County Hospital

Marion County Public Health

Des Moines PD

Wellmark

Ankeny Fire

Ankeny Fire

Dallas County EA

Johnston Schools

United Way 211

Des Moines Schools

Broadlawns

Dept Public Safety

Ankeny Schools

LEPC Chair

Marge Zondervain

Doug Richardson

Vic Munoz

Sean McAndrew

Tristan Johnson

Angela Blankership

Rebecca Jordan

Kim Dorn

Kim Pettyjohn

Mike Reasoner

Corey Bakaler

Dan Stein

Jerry Whetstone

Justine Wyma

Kevin Schneider

Jeff Gilchrist

Teresa H.

Gaylord Houston

Chris George

Frank Prowant

Dan Schellhase

Barry Halling

Dean MCGhee

Josh Morgan

Tim Schuh

Marci Cordaro

Jacalyn Bell

Alex Murphy

Chad Bentzinger

Mary Jo Press

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected] 641-828-2238

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

[email protected]

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Des Moines Police Comm

Community Family Youth Svcs

Sandy Morris

Betty Devine

[email protected]

[email protected]

Page 19 of 23

911 Phone call or a call from a clinic Questions to ask:1. Does the person have a temperature of 100.4 or greater?If so ask the following questions:1. A severe headache2. Muscle Pain3. Vomiting4. Diarrhea5. Abdominal Pain6. Unexplained Bleeding

Continue Normal Operations

No

Yes

Further Questions to ask:Within the last 3 weeks before the onset of symptoms have you:1. Contact with blood or bodily fluids of a patient with or suspected to have Ebola2. Residence in or traveled to an area with an outbreak of Ebola is occurring. As of 10/21/14: Guinea, Liberia, and Sierra Leone.3. Direct handling of bats or nonhuman primates from disease in endemic areas.

Dispatch EMS:Alert EMS of a

Suspected Case of Ebola

Suspected Case

Properly fitting PPE to be donned per

CDC guidelines. With supervision of a trained observer

Don suspected patient with gown,

N95 mask, and gloves.

Prior to transporting, call the hospital with a pre-arrival report and for directions on arrival procedures.

Pull into the garage. EMS crew to stand by ambulance until the hospital staff

greet you. *This may be delayed if

hospital is not ready.

Hospital staff will guide EMS staff to

the appropriate room

EMS PPE will be doffed under the

supervision of hospital staff. The

PPE will be disposed of by hospital

EMS is responsible for decontamination

of the ambulance which will occur under hospital guidance. The

hospital will supply the cleaning materials.

Suspected Case

EMS assessment of Patient per CDC

guidelines.

Continue Normal Operations

Non Suspect Case

Compile Basic Contact

information of close contacts to patients and

EMS crew.

EMS to limit the amount of

personnel exposed to suspected case.

No air transport via rotary wing

aircraft

No Transport to: Lutheran,

Methodist West, and

Mercy West.

Call Tree For Ebola2014.pdf

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CDC Guidance on Personal Protective Equipment To Be Used by Healthcare Workers

During Management of Patients with Ebola Virus Disease in U.S. Hospitals

Recommended Personal Protective Equipment

PAPR or N95 Respirator. If a NIOSH-certified PAPR and a NIOSH-certified fit-tested

disposable N95 respirator is used in facility protocols, ensure compliance with all

elements of the OSHA Respiratory Protection Standard, 29 CFR 1910.134, including fit

testing, medical evaluation, and training of the healthcare worker.

o N95 Respirator: Single-use (disposable) N95 respirator in combination with

single-use (disposable) surgical hood extending to shoulders and single-use

(disposable) full face shield.** If N95 respirators are used instead of PAPRs,

careful observation is required to ensure healthcare workers are not inadvertently

touching their faces under the face shield during patient care.

o PAPR: A PAPR with a full face shield, helmet, or headpiece. Any reusable

helmet or headpiece must be covered with a single-use (disposable) hood that

extends to the shoulders and fully covers the neck and is compatible with the

selected PAPR. The facility should follow manufacturer’s instructions for

decontamination of all reusable components and, based upon those instructions,

develop facility protocols that include the designation of responsible personnel

who assure that the equipment is appropriately reprocessed and that batteries are

fully charged before reuse.

A PAPR with a self-contained filter and blower unit integrated inside the

helmet is preferred.

A PAPR with external belt-mounted blower unit requires adjustment of

the sequence for donning and doffing, as described below.

Single-use (disposable) fluid-resistant or impermeable gown that extends to at least mid-

calf or coverall without integrated hood. Coveralls with or without integrated socks are

acceptable.

Consideration should be given to selecting gowns or coveralls with thumb hooks to

secure sleeves over inner glove. If gowns or coveralls with thumb hooks are not

available, personnel may consider taping the sleeve of the gown or coverall over the inner

glove to prevent potential skin exposure from separation between sleeve and inner glove

during activity. However, if taping is used, care must be taken to remove tape gently.

Experience in some facilities suggests that taping may increase risk by making the

doffing process more difficult and cumbersome.

Single-use (disposable) nitrile examination gloves with extended cuffs. Two pairs of

gloves should be worn. At a minimum, outer gloves should have extended cuffs.

Single-use (disposable), fluid-resistant or impermeable boot covers that extend to at least

mid-calf or single-use (disposable) shoe covers. Boot and shoe covers should allow for

ease of movement and not present a slip hazard to the worker.

o Single-use (disposable) fluid-resistant or impermeable shoe covers are acceptable

only if they will be used in combination with a coverall with integrated socks.

Single-use (disposable), fluid-resistant or impermeable apron that covers the torso to the

level of the mid-calf should be used if Ebola patients have vomiting or diarrhea. An apron

provides additional protection against exposure of the front of the body to body fluids or

Guidance on PPE.pdf

Page 3

Page 20 of 23

https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_id=12716&p_table=standards

excrement. If a PAPR will be worn, consider selecting an apron that ties behind the neck

to facilitate easier removal during the doffing procedure.

The CDC is also recommending an apron if vomiting, diarrhea occur.

For additional details including preparing for Donning and Doffing please go to this link:

http://www.cdc.gov/vhf/ebola/hcp/procedures-for-ppe.html

Guidance on PPE.pdfPage 4

Page 21 of 23

Page 23 of 23

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