preparedness

Ebola: New Health Care Worker Guidance on Equipment, Testing, and Personal Protection

Posted in Department of Public Health, Ebola, preparedness on October 21st, 2014 by Erica Noonan – Comments Off on Ebola: New Health Care Worker Guidance on Equipment, Testing, and Personal Protection

MMS has updated its website with new guidance for health care workers related to Ebola Virus Disease from the Massachusetts Department of Public Health and the Centers for Disease Control and Prevention.

Ebola Virus

New guidance from the CDC for Personal Protective Equipment  for health care workers treating Ebola patients:

Both the CDC and MDPH guidance reflect one change to the clinical criteria for a patient under investigation for Ebola Virus Disease having a fever of >100.4 °F. Previous guidance for fever was 101.5°F. (Guidance regarding additional symptoms remains: the patient must also exhibit additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained hemorrhage, AND within the 3 weeks prior to the onset of symptoms, either having contact with the bodily fluids of a patient suspected to have EVD, or having traveled from an EVD-endemic region.)

Links to these resources are available at www.massmed.org/ebola, which is updated as new information and guidance is released.

— Robyn Alie

Ebola Outbreak Underscores the Benefits of Preparedness

Posted in Ebola, preparedness, Public Health on August 26th, 2014 by MMS – Comments Off on Ebola Outbreak Underscores the Benefits of Preparedness

Paul Biddinger, MDBy Dr. Paul Biddinger

The Ebola outbreak currently befalling several West African countries is the most serious outbreak to date.

The outbreak has claimed more than 11,000 lives,* has yet to be contained, and has certainly generated much anxiety, especially among health care workers. While there is no doubt that the Ebola outbreak is serious, it is also important to know the facts about the disease in order keep the threat from Ebola in perspective.

Experts agree that Ebola is not likely to become a pandemic.  In contrast to other viruses such as influenza, SARS and MERS, Ebola is spread only through direct contact with the blood or body fluids from an infected person or animal, not through the air.

Additionally, the virus is only transmitted when patients are symptomatic, making control of the virus more manageable. Unfortunately, the current outbreak is happening in some of the poorest countries in the world with the fewest number of doctors, and in cities with much larger concentrations of people than in previous occurrences, which has made the current situation very difficult to control.

It is very important that clinicians know what to look for and how to manage the virus. Since the initial symptoms are nonspecific, it is essential to obtain a detailed travel history from all patients and additionally ask about potential exposures to infected persons or animals. Early recognition that a patient may be infected with Ebola is critical in order to implement appropriate isolation and personal protective measures.

Understandably, there has been confusion about which facilities can care for patients who may be infected with Ebola. In the modern world, a patient who has been infected with Ebola could present to any hospital.

Therefore, all hospitals must be prepared to recognize potential suspect cases, isolate patients, and teach staff how to properly don and doff personal protective equipment.  Because lab testing and other issues may be complex, hospitals should review the available CDC guidance on how hospitals can safely manage patients with Ebola.

The Ebola epidemic underscores that preparedness efforts are needed every day, and are crucial to responding to any threat to the public health system. The best thing we can do is use this opportunity to review our infection-control measures, strengthen our capacity for detecting and managing infectious disease, and continue to engage the community in proper prevention and containment practices.

* As of May 30, 2015

Paul Biddinger, MD, is chair of the Massachusetts Medical Society’s Committee on Preparedness. He is vice chairman for Emergency Preparedness in the Department of Emergency Medicine at Massachusetts General Hospital, and director of the Emergency Preparedness and Response Exercise Program at the Harvard School of Public Health.

Preparing Your Practice for Emergencies

Posted in Disaster Preparedness, preparedness on September 30th, 2013 by MMS – Comments Off on Preparing Your Practice for Emergencies

Paul Biddinger, MDBy Paul Biddinger, MD

Last in a series of articles in support of  the month-long Mass. Dept. of Public Health project, “Together We’re Ready-Massachusetts Prepared.”

Sometimes I hear physicians comment that they think that disaster planning is for those who are based primarily at a hospital.

As it turns out, care in a doctor’s office accounts for the majority of medical care delivered every day. Therefore, private medical practices are also a crucial part of our health care infrastructure that needs to be prepared for and resilient against disasters. No matter what the event, the physical health of our patients, and the financial health of our practices can depend on good disaster planning and preparedness by private medical practices and clinics.

While each practice should assess its own needs, there are some universal steps that all practices can take to better prepare.

The first thing to think about is communication, both with your patients and with your staff. Be proactive in educating patients on the proper way to contact your office. Post this information on your website and include it in your patient literature. Have ready access to contact information for your staff members including e-mail addresses and cell phone numbers. Know how to reach your EMR tech support vendors.

Further, you should maintain a list of local and state emergency and public health agencies so you can keep informed of official information such as shelter availability and road closures. Remember to periodically update this information and to keep a copy offsite. Since power is often down during a major disaster, consider keeping an old-fashioned phone in your office that does not require electricity.

Being able to access information is critical. Take steps to protect your EMR, billing, and financial records. Back-up all data regularly. If your charts are paper-only, devise a plan for preserving and protecting patient information. Check with your insurance company to make sure that you have adequate coverage for disasters likely to occur in your area. More information on protecting your practice is available at www.fema.gov.

Remember, the best time to plan for any disaster is before it occurs.

Dr. Biddinger, a practicing emergency physician, is the Medical Director for Emergency Preparedness at Massachusetts General Hospital. He also serves as the Director of the Emergency Preparedness and Response Exercise Program (EPREP) at the Harvard School of Public Health and is chair of the Massachusetts Medical Society’s Committee on Preparedness.

Ensuring That Patients are Prepared for Emergencies

Posted in Disaster Preparedness, preparedness on September 25th, 2013 by MMS – Comments Off on Ensuring That Patients are Prepared for Emergencies

Paul Biddinger, MDBy Paul Biddinger, MD

Third in a series of articles in support of  the month-long Mass. Dept. of Public Health project, “Together We’re Ready – Massachusetts Prepared.”

When an emergency or disaster occurs, our patients can suffer, not just from the event itself, but also from the subsequent disruptions to access to medical care that disasters often cause.

Therefore, just as we support and protect the health of our patients with preventive health strategies such as wearing seatbelts and smoking cessation, so too should we be working with our patients to help make them more resilient in the face of emergencies and disasters.

There are several ways in which physicians can help their patients mitigate against the adverse effects of disasters.

First, we can encourage patients to maintain a copy of their updated medical history and all present medications.  They should be advised to keep these records and any other health related documents, such as health care proxies and insurance information, in a safe and accessible location.

Second, patients should be encouraged to make a habit of reviewing their medication supplies before anticipatable events, such as blizzards and hurricanes and try to work with their pharmacies and insurers to ensure an adequate supply of medications to last through the event.  Underscore the importance of having necessary prescriptions and medical supplies in case pharmacies are closed or medical equipment deliveries are disrupted.

Third, they should be alerted to the importance of having a good home emergency plan that includes provisions for food, water, environmental protection, and other considerations that will make them less vulnerable to emergencies.  Resources for home emergency planning can be found at www.ready.gov.

Lastly, communication is often one of the biggest problems commonly encountered during an emergency. Make sure your patients know the best way to contact you and what they should do in case they cannot.

Physicians who provide care for patients with chronic illnesses, cancer, or other special healthcare needs should emphasize the need to maintain existing medication and treatment regimens.

It is also helpful to discuss plans for how a patient would continue critical treatments, such as chemotherapy or dialysis, if the patient’s current treatment facility is closed or they need to evacuate.  Patients with an illness or disability are more likely to be vulnerable in an emergency.

The Massachusetts Department of Public Health has compiled a number of resources for individuals  with special healthcare needs  that can be shared with patients and caregivers.

Taking the opportunity to talk about medical preparedness with your patients now will help ensure they know what to do should a disaster strike.

Dr. Biddinger, a practicing emergency physician, is the Medical Director for Emergency Preparedness at Massachusetts General Hospital. He also serves as the Director of the Emergency Preparedness and Response Exercise Program (EPREP) at the Harvard School of Public Health and is chair of the Massachusetts Medical Society’s Committee on Preparedness.

Physician Volunteering: Get Involved!

Posted in Disaster Preparedness, preparedness on September 16th, 2013 by MMS – Comments Off on Physician Volunteering: Get Involved!

Paul Biddinger, MDBy Paul Biddinger, MD

Second in a series of articles in support of  the month-long Mass. Dept. of Public Health project, “Together We’re Ready – Massachusetts Prepared.”

When a disaster or mass casualty event strikes, it is natural for people to want to help. Over the last two decades, medical volunteers have been asked to respond to numerous incidents, such as hurricanes, tornadoes, threats of pandemic disease and violent acts – in our own backyard and beyond.

Physician volunteers from all corners of medicine can provide invaluable expertise that augments and reinforces the front line emergency response efforts to support the local community immediately affected by the event.

Yet, while there is no doubt that physicians are uniquely qualified to provide aid when an emergency occurs, many doctors have yet to appreciate that the decision to volunteer is one that is best made well in advance of an actual event.

Well-meaning, but untrained and unverified volunteers who spontaneously show up after a disaster can sometimes make things worse, not better. Optimal medical volunteer response requires pre-planning, credentialing and orientation to the community response.

Whether you want your response to be as an individual or as part of a volunteer group, local or statewide, if you think you may want to assist, the best way to get involved is to register and affiliate with an established volunteer organization.

MA Responds is the Commonwealth’s online registration system used to manage volunteers in response to emergencies. There are four ways to volunteer within MA Responds including joining a local Medical Reserve Corps unit or becoming a state unaffiliated volunteer. I encourage you to learn more by visiting the MA Responds website.

The anniversary of September 11th reminds us that we never know when an emergency will occur. Taking a few minutes of your time to register today as a volunteer helps ensure that we will all be ready to respond when needed.

Dr. Biddinger, a practicing emergency physician, is the Medical Director for Emergency Preparedness at Massachusetts General Hospital. He also serves as the Director of the Emergency Preparedness and Response Exercise Program (EPREP) at the Harvard School of Public Health and is chair of the Massachusetts Medical Society’s Committee on Preparedness.

Emergency Preparedness: It’s Important for Physicians,Too

Posted in Disaster Preparedness, preparedness on September 8th, 2013 by MMS – Comments Off on Emergency Preparedness: It’s Important for Physicians,Too

Paul Biddinger, MDBy Paul Biddinger, MD

First in a series of articles in support of  the month-long Mass. Dept. of Public Health project, “Together We’re Ready – Massachusetts Prepared.”

Recent weather events and the Boston Marathon bombings serve as an important reminder not only that an emergency or disaster can occur at any moment, but also remind us of the critical importance of emergency  preparedness efforts in advance of any event.

Those of us who practice disaster medicine and emergency medicine know firsthand the impact that pre-planning has on our ability to respond effectively; yet, it is important to remember that all physicians have an obligation to care for the ill and injured, and anyone may be needed to provide care during  a disaster.

The ability to respond efficiently and effectively, whether at your own institution or in a volunteer capacity, requires many things, but often starts at home with personal preparedness.

September is National Preparedness Month. Now is the time to put together that “go bag” of immediate items that your family may need in case of an emergency.  Equally important is having a clear family communication plan in the likely event that family members are not all in the same place when an emergency occurs.

A list of recommended supplies and a preparedness checklist are available online at www.mass.gov/dph/ready.   It is also a good idea to familiarize yourself with the available emergency information outlets, your community’s notification procedures, and the types of disaster events that are most likely to occur in your area.

Resilient communities are comprised of resilient individuals who know what to do and are able to take care of themselves and their family.

All physicians have a responsibility to prepare themselves, their families, their practices, and their patients. In an emergency, each of us will need to strike a balance between taking care of ourselves and our family and taking care of patients. The better prepared we are personally, the more likely we are to be successful at both.

Dr. Biddinger, a practicing emergency physician, is the Medical Director for Emergency Preparedness at Massachusetts General Hospital. He also serves as the Director of the Emergency Preparedness and Response Exercise Program (EPREP) at the Harvard School of Public Health and is chair of the Massachusetts Medical Society’s Committee on Preparedness.