field treatment sites

FIELD TREATMENT SITESAnother PIECE of the PUZZLE

Presented by: Doug Buchananwww.DisasterDoug.com

OBJECTIVESAfter this course, you should be able to answer…

What Are They?Identify several resources available to help augment current Treatment Facilities

Why Do We Need Them?Describe the purpose and function of a Field Treatment Site.

How Do We Activate an FTS?Outline the Activation and Set-up Process for an FTS.

Where Do We Get the Equipment/Supplies ?Describe the Logistics and Support Process for an FTS.

What Happens at the End of 3 Days?List the options for Demobilization of an FTS.

1- WHAT?1- WHAT?

Who Decides When We Need to Activate an FTS?Describe the Decision Process for Activation of an FTS.

2- WHY?2- WHY?

3- WHO?3- WHO?

4- HOW?4- HOW?

5- WHERE?5- WHERE?

6- WHEN?6- WHEN?

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What is an EMS Field Treatment Site?

• An EMS Field Treatment Site is a temporary facility, designed to provide Triage and Treatment of patients awaiting transportation, for up to 72 hours.

How does this relate to other facility types?

How does this relate to other facility types?


• The California EMS Authority currently has three 200-bed Mobile Field Hospitals available for deployment.

MOBILE FIELD HOSPITALS

Don’t We Already Have Options?.. like:

ALTERNATE CARE SITES

• Many Operational Areas have already developed plans for establishing Alternate Care Sites as part of the local Medical Surge plan.


YES. Local and State Government agencies currently have Assets and

Plans to help augment Treatment locations during a Medical Surge.

• However… most of these plans require a minimum of 72 hours to fully activate.

• An EMS FTS is designed to use Paramedics, EMTs, and EMRs to provide care up to 72 hours.


• Establishing an EMS Field Treatment Site to fill in the gap between the onset of a local Medical Surge event, and the time it takes to activate a Mobile Field Hospital or an Alternate Care Site is one possible scenario (i.e. Medical Surge).

• Another reason why an EMS Field Treatment Site may be activated is that Transportation of patients to definitive care is not possible, due to:

• Unavailable Transportation Routes• Unavailable Transport Resources

Field Treatment SitesFilling in the Gap.



• Scenario: A bridge on the local highway had partially collapsed during a mud slide earlier today. At 6pm, a 50 passenger bus and several automobiles didn’t notice the problem… until it was too late. This highway is the primary route to local hospitals. Taking alternate routes could take hours. You now have 58 patients, and the weather forecast is calling for freezing temperatures tonight. You anticipate that getting adequate transport resources here could take until morning. You decide to…

TEST YOUR KNOWLEDGELet’s examine what we’ve learned so far…

A. Request a Mobile Field Hospital

B. Request an Alternate Care Site

C. Request a Field Treatment Site


• If you answered “C. Request a Field Treatment Site,” you’re correct.

• Our problem is not places to send our patients, it is that the transportation routes are significantly affected, and transport resources are significantly delayed.

• Requesting an FTS should allow us to getpatients out of the environment, andprovide facilities to maintain patients overnight.


• An Incident Commander may decide to contact the MHOAC to request an FTS Activation when it appears that patients will have to be cared for greater than 12 hours on scene.

• T he OA EOC may elect to activate an FTS due to a Healthcare Surge event.

• The MHOAC may use the FTS Decision Checklist and tools found in the FTS Planning Guide to:

• Evaluate Resource Options

• Determine number, type, and locations of FTSs

• Sign an FTS Activation Order

• Appoint an FTS Activation Team Leader

• FTS Activation Team Leader oversees the Activation and set-up of the FTS.

Deciding to Activate Requests for FTS Activation come to the MHOAC from a local

Incident Commander or the OA EOC.


A Medical / Health Technical Advisory Committee may be convened to help assess the available alternatives or Medical Surge strategies, prior to FTS activation.

FTS Decision ChecklistDesigned for use by the MHOAC


Assessment Factors To assist the MHOAC or the EOC MH Branch in evaluating the need

for an FTS, many factors should be considered. This tool is available in the FTS Planning Guide.


Pre-Surveyed Facility: If the County has a pre-designated FTS within the area , this location should be considered first. A list of Pre-designated sites can be found in the Appendix of the FTS Planning Guide. Non-Surveyed Facility: If no pre-designated sites in the target area are available, other non-surveyed facilities should be considered, such as halls, community centers, etc. Non-Fixed Site: If there are no targetable facilities within the area, an FTS will need to be identified and established in close proximity to the incident, which may require assets such as tents, portable water / sanitation, and generators, etc.

FTS OptionsConsidering what is available.


This is the first part of the form, designed to be used by the MHOAC or Med/Health Branch Director at the EOC.

FTS Activation OrderAfter Identifying the Site


The second portion of the FTS Activation Order is designed to list the Team Leader, appointed by the MHOAC or Med/Health Branch Director of the EOC.

FTS Activation OrderAfter Identifying the Site


The MHOAC or MH Branch needs to consider when, and how the FTS might be demobilized. Planning must begin as early as possible to ensure a smooth transition. The options for consideration may be:

Decision to Demobilize or TransitionThinking ahead…

•Maintain the FTS until all patients are disbursed, then demobilize the site.

•Utilize the FTS for initial care and treatment, then transition the care of patients to an FTS or ACS at different location.

•Utilize the FTS for initial care and treatment, then transition the FTS into an ACS at the same location.


The following graphic provides examples of transitioning an on-scene Treatment Area to an FTS and transitioning an FTS into an ACS for longer term care.

Decision to Demobilize or TransitionThinking ahead…


Decision to Demobilize or TransitionOnce an FTS is Activated…


Activating an EMS Field Treatment SiteFTS Activation Team Leader Checklist

• Once the decision has been made to activate a Field Treatment Site (FTS), and an FTS Activation Team Leader has been assigned, the team leader is responsible to:

•Assign the Activation Team staff,

•Secure the selected FTS location,

•Acquire the necessary resources to staff and equip the site, and

•Set-up the site.


This tool from the FTS Planning Guide is meant to assist the FTS Activation Team Leader.

Additional supporting tools are listed in the column to the right.

Activation Team Leader Checklist


This tool is intended to give the FTS Activation Team leader an overview of the tasks and responsibilities involved in the FTS activation process, and shows how these tasks may be assigned to various Section Chiefs and Unit Leaders.

FTS ACTIVATION TEAMPlanning Tool

TEAM LEADER (Command and Control)

LOGISTICS SECTION CHIEF• Facility Procurement Unit (Select and Secure a Site) • Staffing Unit: (Establish Initial Operational Period

Staffing)• Equipment / Supply Unit: (Order of Equipment and

Supplies)• Communications Unit: (Establish Communication

Systems)

OPERATIONS SECTION CHIEF • Staging Manager: (Receive and inventory incoming

equipment / supplies)• Site Set-up Unit: (Site Set-up)• Security Unit: (Establish Site Security Plan)


This chart utilizes Smart Art which is feature in PowerPoint 2007. If you wish to make charts like this and don’t have PPT 2007, we have provided the graphical elements to help you build this yourself.

Here is the description of the chart. You may change or delete this text as you wish.

FTS Activation Org ChartExample of how the Activation Team may be organized.

FTS logistics will by

managed by, or in

cooperation with, the

OA EOC

FTS logistics will by

managed by, or in

cooperation with, the

OA EOC


Job Action Sheets are included in the FTS Planning Guide for each position on the FTS Activation Team.

In addition to the Job Action Sheets, the supporting tools, such as the ICS Forms, can be found in the Attachments section.

Job Action SheetsThe right tool for the right job.



FTS Equipment / Supplies ToolAnd Recommended Quantities for a 50 patient FTS

• Example: Available in Local Cache?This is designed to be filled out in advance, based upon known local assets.


FTS Equipment / Supplies ToolHow do we use this form?

PHD 50PHD 150PHD 200OES 100OES 200

• Example: Select for OrderingThis is designed to be filled out to reflect the actual need during an incident (e.g. if your incident requires care for only 30 patients, the column should reflect that.)


FTS Equipment / Supplies ToolHow do we use this?


309030620

• Example: Have – Need These columns are designed to indicated what items we already HAVE, versus what we still NEED (e.g. We have 10 cots, 2 Tables, & 2 Chairs; we need everything else).




309030620

100022

209030418

• Example: Requested – Order FilledThe last two columns are meant to help us track what has been requested, and if an order has been filled.




309030620

100022

209030418

209030418


FTS LayoutSample Layout of a Field Treatment Site

• Scenario: You have been assigned as an FTS Activation Team Leader, and are tasked with activating this facility for 50 patients. Besides patient cots, bedding, and food, what additional items might need to be considered?

A. Portable toilets.

B. Storage area for medical supplies.

C. Nothing.



• If you answered “C. Nothing,” you might need to restart this lesson.

• If you answered “A. Portable toilets,” you have begun thinking like an FTS Activation Team Leader.

• Caring for 50 people will likely require more than one toilet. You might also consider additional handwash stations.

A good rule of thumb is: 20/1



The FTS Organization Chart is largely modeled after the current FIRESCOPE MCI organization chart.

FTS Operations


Job Action Sheets are included in the FTS Planning Guide for each position in the FTS organization.

In addition to the Job Action Sheets, the supporting tools, such as the ICS Forms and FTS Report Forms can be found in the Attachments section.

FTS OperationsJob Action Sheets, Forms, & other Tools


Several forms have been developed to assist the personnel with FTS operations, including the:•FTS Report Form

•FTS Staffing Roster

•FTS Time Sheet

•FTS Patient Record


FTS Tools

• Most Operational Areas in California have had the opportunity to conduct FTS Assessments on local target facilities.

• The FTS Assessment allows us to identify in advance what services or features already exist at a target facility, and what will likely need to be brought in to make a facility functional as an FTS.

In addition to the county –specific FTS Surveys and Site Diagrams, a generic FTS Diagram has been included in the Appendix of the FTS Planning Guide that demonstrates an FTS set-up at or near the site of an incident, using Tents, Cots, etc.


FTS Site Surveys/DiagramsDeveloped through HPP Grant Funding

Field Treatment SitesAnother piece of the puzzle.

You have completed the FTS Overview.

-Thank you.www.DisasterDoug.com

field treatment sites

Documents

ems field treatment

field treatment sitewww

treatment of patients

treatment locations

ems fts

mobile field hospitalsdont

transportation of patients

definitive care