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06/12/2013

Medical Surge Trailers

Montrose County took ownership of two Medical Surge Trailers from the WRETAC in June 2011.

These trailers were issued to the WRETAC via a grant from CDPHE.

Currently these trailers are housed at Montrose Memorial Hospital.

The trailers receive yearly maintenance by the Montrose County Fleet department.

Inventory in maintained by Montrose County Emergency Management and Montrose Memorial Hospital.

These trailers are designed to act as a secondary hospital during a patient surge at a hospital. (See attached Hospital Surge Site Cache)

The ownership and subsequent use of these trailers has been a subject of discussion at previous WRETAC meetings. (See Attached WRETAC Report to the BOCC)

The consensus among most EMS personnel present at these meetings is these trailers are designed as medical surge trailers and NOT mass casualty incident trailers.

Medical surge trailers are equipped to supplement the needs of hospitals for patient care. (See Medical Surge vs Mass Casualty Incident definitions and supplies)

Mass casualty incident trailers are equipped with trauma and triage supplies; needed at the scene of an incident. (See Medical Surge vs Mass Casualty Incident definitions and supplies)

There is a recognized need for a Mass Casualty Incident cache at the West End of Montrose County. The Montrose County Office of Emergency Management is currently researching the cost of a MCI trailer and possible funding.

At this time funding for a MCI trailer for the West End is being considered through the 2014 RETAC Provider Grant Program, with the possibility of supplemental funding through 2013 Homeland Security Grant program and/or 2014 Homeland Security Grant program.

The best location for the Medical Surge Trailers is in Montrose. Not only will they be readily available to Montrose Memorial Hospital in the event of a surge, but also centrally located in the county for a more rapid deployment within the region as these are a regional resource.

Debra Veo Montrose County Emergency Manager

Temporary Site Check List Inventory of Caclie Supplies I Temporary Site Signage

This cache was developed through a federal grant awarded by the US Department of Health and Human Services, Health Resources and Services Administration (Hospital Preparedness grant) in 2002 and 2003.

The Hospital Surge Cache is intended to support emergency response (ESF# 8: Health, IVIedical and Mortuary) by providing essential supplies to create the basic infrastructure for a temporary hospital Activation of this cache is at the discretion of local emergency manager. Replacement of supplies must occur by the entities that use them.

Trailer Layout -1

Plastic Storage Containers

MONTROSE COUNTV

Top Level Bottom Level

\ Bottom Level Top Level

Privacy Screens (2) Cots (52) Cots (48) Privacy Screens (3)

Child Gates (6) Large Cots (3) Large Cots (3) Tables (2)

Crib Mattresses (7) IV Poles (25) IV Poles (25) Hamper Stands (4)

Wheelchairs (2) Wheelchairs (2)

Portable Cribs (3) Portable Cribs (4)

Bag Stands (2) Bag Stands (3)

Stretchers w/o wheels (2) Stretchers w/ wheels (3)

Folding Chairs (4) Folding Chairs (4)

Inventory List -1 MONTROSE COUNTY

Product Name 20" (100) Added Final

Count Product Name 20" (100) Added Final

Count 06/06/08 06/06/08

1 -Shipping container at. Child 6 6 1-Trailer- 12• Mattress, Portable Crib 7 7 1-Trai!er-16' Mattress Under pad, Crib 75 75 1-Trailer-20' 1 1 Name Badge /Holder, clip-on 160 150 1-Trailer-24' otepads 24 24 1-Trailer - Semi Pack, Ice 48 48 Applicator cotton tipped 200 200 Pack, Warm 48 48 Bag Holder 5 5 Pallet Bag, Ambu (adult) 3 3 Penlight, disposable 18 15 Bag, Ambu (infant) 3 3 Pens, Standard 48 48 Bag, disposable Pillowcase, disposable 200 200 Bag, Disposable, Biohazard 121 121 Pillows, disposable 126 126 Batteries, AA Pole, IV 50 50 Bedpan 50 47 Scissors, Lister bandage 6 6 Bedpan, Fracture 60 53 Screen, Privacy, 3-panel 3 2 5 Blanket, Flannel 120 144 Sharps Containers, Biohazard 24 24 Blanket, infant 36 22 22 Sheets, Stretcher 150 150 Blanket, thermal 54 54 Soap, Liquid 9 9 Blood Pressure Unit/ Adult 10 10 Spectacles, Eye Protective 25 25 Blood Pressure Unit/ Child 3 3 Stethoscope, dual head 7 7 Brief, Adult 96 96 Storage container 4 12 Bungee Cords 40 40 Stretch Wrap Chair, Folding 8 8 Stretcher, Folding 5 2 Clip Boards 132 128 Stretcher, wAW heels 3 Cots, Portable 100 100 Table, Folding 2 2 Cots, Portable 500 lb rated 6 6 Tape, Cloth 24 24 Crib, Peds, Portable 7 7 Tape, Duct 3 3 Diapers, disposable 192 192 Thermometer, Dispos Strips 300 300 Disinfectants/ detergent 12 12 Tongue depressor 1,800 1200 Emesis Basin 250 250 Tourniquet 100 100 Gate, Child 6 6 Urinal, Female 4 4 Gloves, MED 600 600 Urinal, male 50 50 Gloves, LG 200 200 Wheelchair 4 4 Gown, Patient, disposable, ADULT 150 150 Hand truck Gown, Patient, disposable, PED 125 125 Disposable Backboards Gown, Provider, MED 120 120 Tire Pump Gown, Provider, LG 90 90 Patient Bags 100 100

(1)

Administration

Patient Care

Trailer Layout -2

Plastic Storage Containers

MONTROSE COUNTS (2

Health Care Provider tineas

Patient Gowns Plastics

Top Level Bottom Level

\ Bottom Level Top Level

Privacy Screens (1) Cots (52) Cots (48) Privacy Screens (4)

Child Gates (7) Large Cots (3) Large Cots (3) Tables (1)

Crib Mattresses (8) IV Poles (25) IV Poles (25) Hamper Stands (4)

Wheelchairs (2) Wheelchairs (2)

Portable Cribs (4) Portable Cribs (4)

Bag Stands (2) Bag Stands (3)

Stretchers w/ wheels (2) Stretchers w/o wheels (3)

Folding Chairs (4) Folding Chairs (4)

Inventory List -2 MONTROSE COUNTY

Product Name 20" (100) Added Final

Count Product Name 20" (100) Added Final

Count 06/06/08 06/06/08

1-Shipping container Mat, Child 6 6 1-Trailer -12' Mattress, Portable Crib 8 8 1-Trailer-16' Mattress Under pad, Crib 75 75 1-Trailer-20' 1 1 Name Badge /Holder, clip-on 200 160 1-Trailer-24' Notepads 24 24 1-Trailer - Semi Pack, Ice 48 48 Applicator cotton tipped 300 300 Pack, Warm 48 48 Bag Holder 6 5 Pallet Bag, Ambu (adult) 3 3 Penlight, disposable 16 14 Bag, Ambu (infant) 3 3 Pens, Standard 48 48 Bag, disposable Pillowcase, disposable 200 200 Bag, Disposable, Biohazard 150 150 Pillows, disposable 126 126 Batteries, AA Pole, iV 50 50 Bedpan 50 50 Scissors, Lister bandage 6 6 Bedpan, Fracture 60 58 Screen, Privacy, 3-panel 3 2 5 Blanket, Flannel 144 126 Sharps Containers, Biohazard 24 24 Blanket, infant 58 94 Sheets, Stretcher 150 150 Blanket, thermal 54 54 Soap, Liquid 9 9 Blood Pressure Unit/ Adult 10 10 Spectacles, Eye Protective 25 25 Blood Pressure Unit/ Child 3 3 Stethoscope, dual head 8 8 Brief. Adult 96 96 Storage container 4 13 Bungee Cords 40 40 Stretch Wrap Chair, Folding 8 8 Stretcher, Folding 5 3 Clip Boards 132 132 Stretcher, w/W heels 2 Cots, Portable 100 100 Table, Folding 1 1 Cots, Portable 500 lb rated 6 6 Tape, Cloth 24 48 Crib, Peds, Portable 8 8 Tape, Duct 3 2 Diapers, disposable 192 192 Thermometer, Dispos Strips 400 400 Disinfectants/ detergent 12 12 Tongue depressor 1,200 1800 Emesis Basin Tourniquet 100 100 Gate, Child 7 7 Urinal, Female 4 4 Gloves, MED 600 600 Urinal, male 50 50 Gloves, LG 300 300 Wheelchair 4 4 Gown, Patient, disposable, ADULT 250 250 Hand truck Gown, Patient, disposable, PED 100 150 Disposable Backboards Gown, Provider, MED 90 90 Tire Pump Gown, Provider, LG 120 120 Patient Bags 100 100

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Delta ^V^^ Gunnison m > Hinsdale

Montrose

^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ San Miguel

300 North Cascade Avenue, U-10 Montrose, CO 81401

(970) 249-5685

May 2013

Report to Board of County Commissioners, Town Councils, Board of Directors

This report is a summary of the items that could potentially affect future decisions by your respective governing agency as they relate to the trauma system within your respective agency. These items were discussed at the last meeting of the Western Regional EMS Council, Inc., and are presented to you for informational purposes. The Potential Board Action is what action may be required by your governing agency in the future.

Agenda Topic Details Potential Action

Budget 2013-2014 The Budget for the next Fiscal Year was approved. Currently, there is no money for special events or special projects for other agencies.

Intergovemmetal Agreement/ Bylaws Update

Before the IGA can be approved by County Commissioners, the Bylaws need to be rewritten and approved. A committee of Debbie Veo, Kim Mitchell and Terri Foectherle was established, with a committee meeting date of May 21 to review the changes.

Review and approval of the IGA.

Surge/ Mass Casualty Incident trailers

The Western Regional EMS Council owns several trailers stocked with either surge or mass casualty incident supplies. A Task Force including Paula Holman, Debbie Veo, Kirby Clock and Arden Anderson was convened to determine if the supplies are the most useful as well as estabHshing a policy about how to activate these trailers in the event of a regional emergency.

Employee Handbook The Board sent out a draft of the updated manual. The Executive Board is seeking comments.

Biennial Plan Every two years, the RETACs are to submit a new Biennial Plan to the Colorado Department of Public Health and Environment which outlines goals for the next two year. Terri is soliciting goals and objectives for this next draft.

The mission of this RETAC is to promote, foster and support cooperative organization of Emergency Medical and Trauma Services in the Western Region and State, utilizing data, communications, protocols and training to provide Quality Improvement. The RETAC will be composed of individuals concerned with promoting,

fostering and supporting excellence in emergency services within and between the counties represented.

Medical Surge Medical Surge is the capability to rapidly expand the capacity of the existing healthcare system (long-term care facilities, community health agencies, acute care facilities, alternate care facilities and public health departments) in order to provide triage and subsequent medical care. This includes providing definitive care to individuals at the appropriate clinical level of care, within sufficient time to achieve recovery and minimize medical complications. The capability applies to an event resulting in a number or type of patients that overwhelm the day-to-day acute-care medical capacity. Medical Surge is defined as the rapid expansion of the capacity of the existing healthcare system in response to an event that results in increased need of personnel (clinical and non­clinical), support functions (laboratories and radiological), physical space (beds, alternate care facilities) and logistical support (clinical and non-clinical equipment and supplies). "

Supplies typically include:

Cots Intravenous Poles Wheelchairs Portable Cribs Folding Chairs

Privacy Screens Hamper Stands Tables Stretchers Hospital type I.D. bands

Tongue Depressors Pillow Cases Gloves Hot/Cold Compresses

Blood Pressure Cuffs

(see Trailer Inventory Sheets for further items)

The supplies in a medical surge trailer are designed to supplement a hospital in the event of a surge of patients at the facility.

Mass Casualty Incident Defined - A Mass Casualty Incident (MCI) can be defined as an incident that has produced more casualties than a customary response assignment can handle. Types of incidents that can produce mass casualties include, but are not limited to:

• Multiple vehicle collision

• Building collapse

• Mass transit accidents

• HAZMAT incidents

• WMD

• Multiple-shooting victims

• Chemical exposure

Success in dealing with a mass casualty incident (MCI) incident requires the responder to deal with immediate rescue and treatment, transportation of survivors to medical facilities.

Mass Casualty Trailer

Typical Inventory includes:

Trauma Kits: gauze pads tape triangle bandages paramedic shears roller bandages irrigation water cold packs burn towels splints face masks eye shields gloves

roller stretchers orfoldable backboards some type of ground cover and patient cover

Medical Triage Management Kit: green, yellow, red, and black tarps

arm bands or other color coding device for emergency workers in the triage area patient triage tags clip boards

Other items may be included based on location and need.