Emergency Preparedness: The Role of the CHC Dentist -

Emanuel Finn, DDS, MS, DC Department of Health/ASTDD

OHMRT Committee 1

Emergency Preparedness:

The Role of the CHC Dentist

Emanuel Finn, DDS, MSEmanuel Finn, DDS, MS

Chief, Oral Health Program

DC Department of Health

Washington, DC


OHMRT Committee 2

City of Newburgh, NY in the Mid Hudson Valley


OHMRT Committee 3

Today’s New Paradigm

In response to natural & man-made disasters, what is the state dental director’s role? What roles should CHC Dental Providers play?

• The New Public Health Marching Song is

(or should be): Be Prepared


OHMRT Committee 4

History Repeats Itself

“Communities should make plans now for dealing with any recurrences. The most promising way to deal with a possible recurrence is to sum it up in a single word, ‘preparedness,’and now is the time to prepare.”

—Rupert Blue

Civilian Surgeon General, 1919


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Are YOU ready?

� MITIGATION - Any action taken to reduce or eliminate the long-term risk to human life and personal property from hazards

� PREPAREDNESS - Preparedness incorporates a range of measures, actions, and processes accomplished before an incident happens

www.ready.gov


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CHC Dentist’s Role

1. Preparedness/Detection

2. Surveillance

3. Diagnosis

4. Response

5. Communication

ADA’s plan is organized around 5 themes:

JADA , Vol 133, Dentistry’s response to bioterroism, A report of a consensus workshop, A.H Guay, D.M.D., September 2002


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Key Questions & Concerns

� What can I do?

� Who should I contact?

� How do I get on board?

� What about additional training?

� What about certification?

� What about the availability of liability

insurance to cover actions performed

in an emergency?


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How Does A CHC Dentist

Participate in these Roles?

� Being a member of the Medical Reserve Corps

� Working closely with the Department of Emergency Preparedness

� Attending trainings & planning meetings in your state or jurisdiction

� Always emphasizing and promoting the roles & impact that dentistry & oral health professionals can play in emergency responses to disasters


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Dentistry's Role

� In disaster response role has yet to be defined & established

� Can fulfill several functions; education, risk communication, diagnosis, surveillance & notification, treatment, distribution of medication, decontamination, sample collection.

� Forensic dentistry’s role in other disasters (plane crashes) has been developed & proven to be fully effective


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Wake Up Calls

� 9/11- Pentagon , WTC

� On the doorsteps of the Capital & DC

� There was no formal plan to involve oral healthcare professionals

� Hurricanes Katrina & Rita

� 3/03 ADA conference in Washington


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That Image of Dentistry has

Changed


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FloodsOHIO RIVER VALLEY FLOOD OF MARCH 1997

Credit: FEMA News Photos

4-Jul-10 Dr. Finn, SEA 13

Glasse Cliffs in Dominica


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Steps That Are Recommended

� Lead efforts:

-build capacity and infrastructure; and

promote the inclusion of oral health

professionals in crisis planning, response &

recovery

-Promote practices to mitigate the impact of

hazards and disasters on the availability and

accessibility of oral health services


OHMRT Committee 16

Preparedness Leadership

� Know your state structure for planning & response and its

hazard assessment

� Identify & confirm oral health professional credentialing

and scope of practice within your state in response to

crisis events

-Illinois Public Act 49-409-modiies the scope of dental

practice*

� The dentist should be represented at emergency/disaster

planning meetings so that the role of oral health within

emergency response & preparedness may be better

understood

* The dental emergency responder: Expanding the scope of dental practice: JADA , Vol.137, April 2006


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Key Action Steps

� Understand the process of generating an Action Request Form (ARF) and the Federal mission assignment

� Be familiar with the National Response Training- FEMA 700 series of courses.

� Encourage dentists to take & complete these courses

� Assist in the Coordination of oral health volunteer information & response


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Identification of Emergency

Planning & Response Systems

� Be familiar with Federal, state & local systems

� Identify & communicate with leaders

of the Emergency Management Agencies (EMAs, Departments of

Health & other key stakeholders

� Develop & establish a formal liaison

plan with state & local leaders with crisis response responsibilities


OHMRT Committee 20

Participation in State’s Hazard &

Disaster Response

� Coordinate & communicate information

� Develop oral & medical response

teams for your CHC and community

� Work with the state’s coordinator for Medical Reserve Corps (MRC)

� Know the emergency command

structure (who should you report to?)


OHMRT Committee 21

Contingency Plans

� Create a list of responders as your team

� Prepare a phone list (tree)

� Identify mobile & portable dental units, prepare stockpile of oral health care supplies (Doctor response packs)

� Examine all central and essential services and personnel


OHMRT Committee 22

Creation of Framework to

Participate in Crisis Planning

� Dentists should work in partnership with the Preparedness planners and the president of the state and local dental associations

� Develop fact sheets indicating dentistry’s role in emergency preparedness

� Integrate oral health professionals into training opportunities e.g. Disaster Mortuary Response Team (DMORT)


OHMRT Committee 23

Who Is in Charge?

Bioterrorism

or

disaster event

Incident Command System

Collaboration Collaboration

No collaboration


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Initial Meeting with DCDOH’s Health Emergency

Preparedness Administration (HEPRA) –8/04

� Discussed Dentistry’s & OHD’s role in a catastrophic event in Washington DC

� Proposed that OHD work with HUCD & DC Dental society's as part of a response team

� Perform outreach lectures at dental school

� Collaborate with HEPRA to prepare educational plan/curriculum for the dental school

� Attend scheduled trainings & participate in events


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Familiar Territory

If you can hit this . . .If you can hit this . . . You canYou can ’’t miss this!t miss this!

Plus Plus ……

•• infection controlinfection control

•• medical historymedical history

•• prescribing and dispensing drugsprescribing and dispensing drugs

•• surgerysurgery

•• calm ing upset patientscalming upset patients

•• and much more and much more …… . . Frederick G. More, DDS, MSNYU College of Dentistry


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Partnering, Planning &

Evaluating

� Join existing & emerging systems & Programs

� Partake in planning & policy

development

� Remove barriers (changing perceptions & resolving liability issues)

� Accelerate knowledge transfer

� Partner & evaluate

Dentistry’s role in responding to bioterroism and other catastrophic events: www.nidr.nih.gov/news/bioterroism.asp


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New Partnerships

� Emergency management system

� Police departments

� Fire departments

� Emergency medical system

� Community health centers

� FBI

� Local public health department

� Department of Homeland Security


OHMRT Committee 28

Family/Business Preparedness

� Get a kit

� Make a plan

� Be informed

� Get involved

www.ProtectYourFamily.ky.gov

Original Message-----

From: Sari Finn <[email protected]>

To: Emanuel Finn <[email protected]>

Sent: Tue, Apr 27, 2010 8:19 pm

Subject: life

hey daddy,

did you survive the tornado because mrs.kushnir and the class talked about it in class.

love ya ,

Sari

29

, , , Tornado Aftermath in St. Louis County, MO.


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Make a Plan

� Develop a Family Communications Plan

� Know your region's potential disasters and how you will be notified

� Create a plan to shelter-in-place

� Create an evacuation plan

� Find out emergency plans at work, daycare, and school

� Practice your plan


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Business Preparedness

WHAT'S THE PLAN, BOSS?

Source: www.ready.gov


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ASTDD’s Response

� Oral Health & Medical Response Teams (OHMRT) subcommittee

� Standard Operating Manual (SOP) for dental directors on emergency preparedness & response (www.astdd.org)

� Provide a template on how state dental directors can engage with local & state jurisdictions & authorities

� Best Practice has been highlighted e.g. Illinois*

* Disaster Preparedness: The Dental Teams Role; May 18,2005 Satellite Broadcast for Dentists, Dental Hygienists & Local Health

Department Preparedness Staff, IDPH


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Question OneHow prepared is your community to respond to a public health crisis?

A. Prepared to manage all aspects that can be

controlled.

B. Prepared to manage most important aspects

of a crisis.

C. Many important aspects of a crisis would not be effectively managed.

D. We had better avoid a major crisis.


OHMRT Committee 36

Recommendations

� Leadership in state planning

� Leadership training to coordinate volunteers (mass care)

� Forensic odontology – Disaster Mortuary Operational Response Teams (DMORT)� Locate and retrieve anti-mortem dental records

� Epidemiology / surveillance

� Immunizations, triage or other health

� Involve dental school administration


OHMRT Committee 37

What’s Your Readiness

Quotient?

� www.whatsyourrq.org

� Test your Readiness

Quotient

� View the National Results

� Tips and Tools

� Toolbox for Oral Health

Directors

www.whatsyourrq.org


OHMRT Committee 38

New Times Dictate New

Leadership Skills

Leadership will involve working at all levels of the system

Documents

Emergency Preparedness: The Role of the CHC Dentist -