Access the entire webinar series here:

https://files.asprtracie.hhs.gov/documents/aspr-tracie-
healthcare-system-preparedness-considerations-speaker-series-
summary.pdf
Access the recording here: https://attendee.gotowebinar.com/
recording/7398763696510544391

TRACIE
HEALTHCARE EMERGENCY PREPAREDNESS
IN FORMATION GATEWAY

Healthcare System Preparedness Considerations

Speaker Series
December 2021
ASPR
ASS I ST A N T SEC RE TA RY F OR
PR EPAREDNESS AND RESPONS E

Unclassified//For Public Use Unclassified//For Public Use

 Access speaker bio here:
https://files.asprtracie.hhs.gov/documents/using-the-aspr-tracie-burn-
surge-templates-to-enhance-a-healthcare-coalition-speaker-bio.pdf

TRACIE
HEALTHCARE EMERGENCY PREPAREDNESS
IN FORMATION GATEWAY

Annette Newman, MS,RN,CCRN, Community Outreach/Burn Disaster

Coordinator, Western Region Burn Disaster Consortium Coordinator

ASPR
ASS I ST A N T SEC RE TA RY F OR
PR EPAREDNESS AND RESPONS E

Unclassified//For Public Use Unclassified//For Public Use

 Using the ASPR TRACIE Burn Surge
Templates to Enhance a Healthcare Coalition
Annex

Photo Credit Keith Bedonie

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 Objectives

• Discuss general burn surge planning

• Review utilization and customization of the ASPR
TRACIE burn surge and TTX templates
• Examine lessons learned
• Consider next steps

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 General Burn Surge Planning and
Disclosures
• Passion
• WRBDC (CONOPS finalized December 2020)
– Multi-regional template which could be used by all HCC ...!J '-!.. UTAH DEPARTM ENT OF

_., ,- HEALTH
– Some degree of standardization
– Seamless activation of aid for specialty care
• Existing partnerships
– Local/State/Region/National
WRAP-EM (nj<!:Q
• Existing technology (CSC website/ App) Ped ia tr i<'. Frnl' '!< """Y'AHriag<'T!f' nt 'W'" "W"

– http//:crisisstandardsofcare.utah.edu W•s>•""'""'"""""'""'"'·--· -··

• Global pandemic

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Utilization of the Burn Surge Templates- Initial Draft

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 WESTER N REG I O N BURN WR~ DC ~ ~ I~ MA SS CAS U AL - y O Pl: ~A JI ONS LA N

DISASTER CO
TA 1
BLE OF CO NTIEN TS
I NTtOt>UC1 10N ..................... ···········- - - - ················· ······················- - - · ················ .........................3
~ 1 - -- - ·····································- - -··· - - - - -····· ······························· ......:a
l'urpo,<>-·················· - - - -·································- - - -···································.-3
Scope - - - - - - - - -·····-···········...:.l
l.egd !vlhamic, ··-···-··· -········ -· ·····- - - - - - - - - - - - - - -···········-········-···-···-·...:.l
locli:1ilrat.a1d -· ····································- - - - ···· ·· - - - - -······································..A
v.•~·ern lk.Jm ~ " ·······················- - - ································- - - - - -··································_.4
BYm M,mC=>dl), id•r'o ······- - - -·································· .......................................4
~"'····································- - - -····································· ...................................... .5

C•O NC !'1" 01 O~HATIOtU ....... - - - --·································- - - - - ····· ····· ··············· ········-"

n,• Pl'rl:24Hou.rs ······-········ -···-··· -· ··- - - - - - - - - _ _ _ __
t-loiiooction, ..........-···-········-······- - - - - - - ·-···-···-········.,6
k clioru ·····································- - - --·································- - - - - ···································~
ll~ e T I ~ IBLrTI BedCen.m _ _ _ ··············-·········-····-·········- - - ·- .................................... ____.i6

. . , .- :;.
~
.
h:mcl Potio,; Cootclnclion ..........- - - -·····································
in:1• Ongoing IHpons• ······················· - - -·····································
.................................... _ 7
.................................. -8
I.Ide, !. llcspor,;ibiities .................... - - - ················· ......................8
Wa,si•m ,:.,~ llum Coordklaian OMI,.._ _ ___ ___________________________________ _ 10

BURN MASS CASUALTY Cl>gona<Jlionol Slruclure ············ · - - - - - · ································- - - - -

Opon:,funcl O>.-cr,;ew.................... - - - - - - - -···················ll
..................• 10

Potieri r..,ns1e,
C,.,,,,=mor, ·····- - - - ······· ·····························- - - - -····································· 11

O·PERATIONS PLAN ~ e lii!~ue;f- Cocn::fination _____ __ ----- -------························- - - - - _____________________________________l-4

Cfnt::al Support to Non-&.mfodlie< _ _ ····························· ··········· ................................... 15
Ja caty MHkal Cm• Op«aHoll!li ..._ _ _ _ ........................................ ................................... lG
lvti>-CX=irm-dCKYPl:Jicio,;··········- - - -······································· ..................................... l<!
dfJeri Documentation 2. Privaqt---· ····································- - - - - ................................... - 145
rtODUC~D IN COO~HA110N W IT H:
Patie:ri Ccn!: ~rc~··················- - - ·····································- - - - - .............................. _17
!.Si.ppies .... -· ··- - - - - - - - - - _ _ _ _ _ ···········-········-···-···-·· 17
lhc 96 H-ovrl'lan ··-···-········-··········· · - - - - - - -·····-···-······· l7
UH~ l~99. Bum Crisi.. ~ cndords ,cf Co.re Glidei~ - ·····································- - - - - ................................... 18
Ped'ahic Coreiderotions I. .ie:sourc~- - ····································· ................................... 19
llehmoornl lfeaHh ····- ····················•- - - · - - - - ··· ············· ··················..:zi.
F.:m-.y ~etrifiocficn . ······- - - ··· ........ -2:1
f<Jld"rtyMa,._.,,.nt ...................... _ _ _ __

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 DRAFT Burn Surge Annex TABLE OF CONTENTS
<<Insert
Template for Healthcare Coalitions>> Healthcare I. INTRODUCTION 4
<< Usable as is - additional resou rces to come>> C o alition Logo 1. 1 Purpose 4
H ere>>
<=.;: Insert Date / Version #::- ~
1.2 Scope 5
1.3 Legal Authorities 6
1.4 Overview/Background of HCC and Situation 6
<<INSERT YOUR HEALTHCARE COALITION
1.5 Assumptions 7
NAME HERE>> 2. CONC EPT OF OP ERATIONS 8
2. 1 Activation & Notifications 9
2.2 Roles and Responsibilities 12
2.3 Logistics 15
2.3.1 Space 15
2.3.2 Staff 15
2.3.3 Supplies 16
2.4 Operations - Medical Care 18
2.4 .l Triage and Secondary Triage 18
2.4.2 Treatment 22
2.5 Special Considerations 23
2.5.1 Behavioral Health 23
2.5.2 Pediatric 24
2.5 .3 Combined Injury 25
2.5.4 Crisis Standards of Care (CSC) 26
2.6 Transportation 26
2.7 Tracking 27
2.8 Rehabilitation and Outpatient Follow Up Services 27
2.9 Deactivation and Recovery 28
3. RESOURCES 28
3. 1 Websites and Contact Information 28
3.2 Acronyms 30
U' ~.~!~1.:,lj ~ R~ -~ M 
- - - , -111-w
•
EaQo, APPENDIX
A Transfer Decision Flowchart
31

.!I~ - - -..-~ UHA l19Q B. Bum Patient Transfer Checklist

,_ HEALTH
C. Helping Children during Disasters
D. Burn Resource Tobie
8
E. Regional Hospital Tier Designations for a BMCI
Unclassified//For Public Use F. BMCI Hospital Acute Bum Man agement Algorithm
G. Burn Injury Guidelines for Care, Second Edition
8
 Utilization and Customization of the Templates
Tactics
• We copied the outline
• Request/mobilize any coalition/regional caches of burn supplies.
• Activate coalition coordination mechanisms and any bum-specific
plans.
• Coordinate local lists of casualties and clinical informa tion.

• We reviewed and used suggested

• Triage/prioritize pa tients for forward movement to specialty centers in
accordarice with established BMC! protocols and /or expert input.
• Coordinate w ith bum experts to determine appropriate destinations

resources
for patients that cannot be accommodated in the local healthcare
system with assistance from state and ABA.
• Assure that appropria te clinical information is relayed between the
referring and receiving facilities during the transfer process.
Secondary Roles:

– Mass Burn Event Overview

• Coordinate information w ith state/federal ABA partners.
• Provide patient core.
• Activate facility and regional surge capacity plans to

• We pulled in other applicable ASPR

accommoda te multiple patients.
• Liaison between local response and regional ABA coordinating
center.

TRACIE recommendations
Secondary Roles:
• Assist with patient triage for forward movement.
• Support facilities providing care for burn patients in the area via
telephone or telemedicine and/or request support from WRBDC

coordination center.
• Ensure bum surge facilities use existing resources (96 Hour Plan].
• Support local jurisdiction with state-level coordination a nd requests
for assistance (e .g., state and federal declarations).
• Assure that patient triage, tracking, and transport needs ore
addressed.
• Make requests for bum care assets, including dressings and
materials from the Strategic National Stockpile (SNS).
• Engage Em ergency Management Assistance Compact (E
assets lo p rovide inter-state support for transportation, staff,
logistics.
Secondary Roles:
• liaison between local. state and federal resources.
• Support bed polling and matching functions as required in
coordination with ABA regional center.
• Optimize bum patient distribution and healthcare capacity
augmenting EOCs with clinical experts that assist with coord
• Coordinate burn resource and supply needs belvveen healt
s stems
– MOCC
MCH:ticol Operations Coordination
Federol guidO"ICe odvocotes the use of one or more Medicol Operotions Coordi'lotion
Cek {MOCq lo assist W1 en Incident !hot overwhelms Iha capacity of hospitals In o given
aeo. The rol owlng descr"~lion of how o MOCC moy provide needed c oordinotlon
dul'lng ai Incident Is from the EstOOlshlng Medical Operalioffl CoorOOotlon Cels
w eblna-, provided b y the Ass lstail Secretory of Preparedn,ess end Response 's Technical
Resources, Assistance Center, and Information Exchange
{hllps://fles.osprtrocle.lYu.gov/documenls/aSJ)f-trocie·mocc-webinor-4-24·20-find­
slldes.pdf, pa~es 7-8):
Some hospitals ore ovefWhelmed with {bLm} patients, wtile successful mitigation
has created exces5 capacity in nearby ho5;>itols. creating an opportl.Klity to
transfer pofients
MOCCs ore o strategy to optimize patient Wlribution by augmenting EOCs with
clinlcd experts lhol ~nthe$ize and coorcfinale healthcare copocity
• The MOCC strategy con be implemented notiOnwide fol svb-stote. slate-. and
reglonol levels). permitting fle.xjbility for slates v.hlle optmlzing pol~nt distrbullon
In order to meet the goal of best possible patient outcomes ofter o burn moss cosvorty
Incident, lhe <qiCCn, If overwhelmed and reql-0)9 msislance oul<;ide of the
Juisdlctioo, wil request stole heollh represenlolN"es authorized l o establish o «Sub-state

Unclassified//For Public Use or Slate MOCC or equivalent>> to help coord..-.ale patient tmnsfe, and resouce sho1ilg.
In h..m, II assistance Is required beyond the stale level, the Western Region Bum ASPR TR AC IE 9
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UIPAUD-"111 ~l<D UHO~II I NfORMAT ION GAllWAT
“Two things are necessary for great achievement: a plan
and not quite enough time.” Leonard Bernstein

Timeline - 2021
• February 9th - First meeting
• March 18th – DRAFT due for HCC to customize
• April 1st – DRAFT due for HCC CAT upload
• May 4th – Final due for distribution
• June 30th – Final HCC deadline/customized plan

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 “Can’t get too much in the weeds or we will never get out
or done!” – verbiage spoken frequently

Date: « Insert dale»

Version Number: <<Insert #>>
Tactics
Partners convened to develop this plan:
<<Insert list of partners>> • Put the audience first (WIIFM)
Record of Partners this Annex has been distributed to :
<<Insert list of partners>>
– Plug and play
Record of Burn Surge Training and Exercises conducted or planned:
– Replicable resources
– Shared as a word document
«This section should include re levant baseline or just-in-time training provided by or
available to the HCC to support bum surge care and evalua tion and exercise p la n for
bum surge . NOTE: The Western Regional Bum Disas ter Consortium (WRBDC) has put

• KISS
together an extensive collection of burn resources for non-burn and b urn facilities,
available online and on the Bum CSC opp. »

– Use of algorithms and flowcharts

• In-state p a tient
d istribution w/ transfer ctrs
• Coordination with in-state
Bum Ce nter{s)
• Coord ination wi h fe d eral
partners, as ap p licable
• Alignment with existing
• Regional burn b ed
coordination
local/state/regional response plans
• M edical Control for bum
consult via telem edicine

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 Utilization and Customization of
A: Transfer Decision Flowchart & Triage Tables

Hospital Burn Paflenl Transfer Decision flowchart

the Templates: Appendices

~ flowcha1 does not su persede local/ state protocols

Sum Patients m Non.Bum Fac1lrty c onsult with a eurn

Care physicia n via the
Requiring Transport
nearasl 81Jrn Center or
lhe wesiem Region
Bum Coordination
obtoin/eslimole each patient's age
Cen te r (WR8CCJ .
9'6 ..S& 4 .8824
V•tffy total body surfoc• are a {TBSA siJ using the Rule of Nines a nd /or the Lund and 'Browd Etf

Additional resources/references
Burn Eslimole Chort with o second pro ctilK)ner. This should be done ofter wounds ore
cleaned c;md pre lerobly vtilizrig telemediclne in consullction with o bum cf:lnler provider.

In coloborol fon with o Sum center provide r, vse lhe Bau~ SCOl'EI end/or Si.m triage Tobie$ to

• Operationalized information
de termine the triag e- c ategory (or (kel hood of svrvivolloral patients. Con.sider tran,fer ol
patients in the folowing pootity order (SH patient colegones and Tobles below):
I. Medium . High. ond Very High SutVivol o re most likely to benefit from specioi2ed core
2. Low Survivol cotegory potienl1 hove o morto6ty role of 50-9~ even with prolonged,
intensive resources

– Existing evidence-based data

3. Very LOW Su!'Vivo l co tegoty poluilnts hove >909ili morta lity

Dotormlnatlons regotdl'\g which speck pot,ents should be

lronsported and in which order, will ultimately rest with the

– Alignment into one flowchart

proctrhoner's judgement. The following vonoblei. in addition to the
Bou,c SCOflil ond/o, Bum lnoge Tobie cotegory.1hould be considered:

– Replicable tromporl
methodfsj

– Doesn’t supersede local/state

protocols Burn Triage Table Patient Categories
• very high. high, end medium survival pof1ents ore more likely lo benefit from 1.peciolized bum care.

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 Additional Resources / References
D: Burn Resource Table

• Diverse selection
Burn rra1n1ng / Resources Source Target Type Weblink
Audience
Hospital Clinical llesources
Exten5ive Clinical Care&. Univen.ity of Uta h Response, G u idance/ https://crisisslandordscfcore.utah_edu

• One stop shopping

Resnnnse Resources Health Cinical Video11
Bum Wound Care&. Unive~ity of Uta h Cinical Video~ http~://www.focebooLcom/UofUBumCenler/
Outpatient Videos Bum Center
ABA Burn Center Referral American Bum Response, Guidance http://amenburn.org/wp-contenl/uploads/2017/05/bumcenl erreferrolcrileria_pdf
Critet"ia Association Cinical

– Resource
Bum E-leoming OPEN Ped iatric s Cinical Vid eo htl ps://learn.openpediafrics.org/leam/global-search/bums
Burn Nurse Compe tencies American Burn Cfoical Guidance httpJ/ameribvm.org/wp-contenl/upbad:1/2017/05/bnci-competency-documenl-
Association february-20 17-finol. pdf

Bum Core for Children American Cfoical Guidance https://pedsinreview.oappublications.or1;;1/content/39/6/27J

– Source
Academy o f
Pediatrics
Burns 101 Initial Management UW Medicine Cinical Video https://www.uvvmedicine.or1;;1/provider--resource/videos/bums- 101-inilial-
rnonogemenl

– Target audience
Bum Surge Video Series Minnesota ~ o f Cinicol Video https://www.heotth.stofe.mn.u:i/cammunities/ep/surge/burn/VK:Jea.html
Health

Bum Surge Module 4: Minnesota ~ of Cinical Video https://www.heotth.stole.mn.u:i/communities/ep/surge/burn/module4advanced.html

– Type
Advance Special Treolment Health
Considerations
Determining Burn Depth Minnewta ~ of Cinical Guid ance htlps://www.heatth.stale.mn.us/cammunities/ep/surge/burn/burndeplh.html
Health

– Weblink
Determining Total Body Minnesota ~ of Cinical G uidance htlps://www.heatth.stafe.mn.us/cammunities/ep/surge/burn/t bsa .html
Surface Area Hea lth

96-Hour Core Guidelines for Illinois ~ of Ci"nical Guidance https://www.luriechildrens.org/1;;1\obalassets/documents/emsc/disaster/slate-

Pediohic Bums Pubic Health p l n-i/burncoreguidelinesiu ne.201 7.pd!

Triage of Polienls with Minne sota Qs..m. of Cinicol Guid ance htlps://www.heollh.sl ole.rnn.us/communities/ep/surge/burn/friogeburns.html
Cutaneous Bums Only During Health
Moss CosuoHv Incidents

37

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Utilization and Customization of the TTX Template
• September 22nd 2020 CONOPS TTx (3 hours)
– 342 registrants from 14 states and 4 countries
– 278 attendees
• December 3rd 2020 Creek Fire 1(2 hours)
Activation/situational awareness/care in non burn centers
– 160 registrants from 10 US states
– 90 attendees
• April 16th 2021 Creek Fire 2 (2 hours)
Care in non burn centers/ transfer and transport of patients
– 294 registrants from 22 states, 1 US District and 2 Canadian Provinces
– 170 attendees
• August 10th 2021 Creek Fire 3 (2 hours)
Focus telemedicine, mental health considerations and gap closure
– 258 registrants from 17 US states, 1 US District and Canada
– 176 attendees

* Recordings, slides, plans, resources and AAR/IP all available on the CSC site in the WRBDC tile.

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Utilization and Customization of the TTX Template (cont.)

• Real world incident - Creek Fire

(September 4th 2020) St
0
ton

• Wildland fire preparedness is an ongoing challenge

• Actual scene data used

• Use of exercise for HCC grant

STATUS AGE
IMM EDIATE 30 i

deliverable (WIIFM)
IMMEDIATE 17 I

IMMEDIATE 25 ~
j
IMMEDIATE 27
• FEMA RECS DELAYED 37
DELAYED 23 i
• HSEEP AAR/IP MINO R 24 I
MINO R 26
• Recommended agencies also prepare own IP MINO R 26

• TTx template and AAR/IP most requested resource

MINO R 27
MINOR 26 I
Ir no
• Free CME credit (WIIFM)
0 MINO R 6
MINO R 31
MINO R 36
• Thank you Steward MINO R 8

• Pre–exercise materials
MINO R 11
v, MINO R 5
MINO R 39
• Videos MINO R 12
MINO R 10

Unclassified//For Public Use

15
 Pre-Exercise Materials
Plans:
o WRBDC Burn Mass Casualty CONOPS Plan
o Healthcare Coalition Burn Surge Annex Template
o YOUR Organization/Facility Burn Surge Plan
Previous Exercises:
o BMCI CONOPS Plan Tabletop Exercise, September 22, 2020
o Creek Fire Tabletop Exercise, Part 1, December 3, 2020
o Creek Fire Tabletop Exercise, Part II, April 16, 2021
o Ongoing Drills: Regional Bed Counts
Participant Pre-Exercise Materials:
o Exercise Plan (ExPlan)
o Resource Toolkit
o Baseline Pre-Exercise Survey

Unclassified//For Public Use ASPR 16

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 Resource Toolkit

• Added TTx specific

FIRE 3 TABLETOP EXERCISE
RESOURCE TOOLKIT

resources
Additional Burn Planning resource.scan be found o nline at crisisstgndordsofcare utah edu .
Plan fast links: WRBDC BMCI CQNOPS Plan Heattbcare Coalition Bum Surge Annex Template.

Resource Source rargef Type Webllnk

• Lessons learned
Audience

Cybersecmily - Did You Western Alk mce for Clinica l Fachheel hllm-//wmp--em grg/jmggm/HllB/CxMrsecuritv Did Ynu Know FINA[ pdf
Kn o w ? Pediatric Em er,;iency

– Led to SME invites

Monai;iemenf
[WRAP-EM )

Explo ,ing E""'='•g e ncy legal Jomes Hodge, Clinica l Video https·lfuctf qpp box com/s/rnhhd.4pb}xhr'9gyyzdoi1122wcofw84yhc
Pre J)Clre dness and Resp o nse Western Alliance for
Issues Pediatric Emer,;iency

– Additional resource
Mona.iemen f
[WRAP-EM )

James Hodge, Guidance hllps-f/wrqp--em pm/jmgges/2021 {WRAP-FM I r:ggl G11ide - Rrzpprl pdf

creation & collaboration

W e stern Allianc e for
Pediatric Emer.gency
Mona.;iemen f
[WRAP-EM )

Te le me dicine for Emergenc y UC Da vis

– Willingness to hold
Response Guidance/ bffp;·//ucdaYis bo&com/sfl;bMCQl3as3bbloemnf4b65osro9Jrron
Re spond..,,.
https·lfdrrve gogg le com/li½/d/ I a l 3k;y2glJglJZib2TPKdmPCPD26Gwi086/view
~

education for participants

http;:/11/Kieo ucdavis edu/medioOelemedicine+tor+Emernencv+Precore:dnea
+WRAP·EM+7·2021/1 5Sxbs2cd
Mental Health Resources for Patients I. Pa tient Management

Anticipa te. Plan. Cope. FOi" Dr. Merritt Schre iber, Public Guidance htfp;·//wrop-em prg/medig/qllgchmentr/202] !08/04/gpc•focl•
sheet lrgnt~ne cdt

Unclassified//For Public Use ASPR 17

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 Utilization and Customization of the TTX
• Modulation
– Page numbers to applicable content
• Lessons learned
– Clear theme and clear direction to applicable resources
– Assisted with definitive time allocation
– Guided SME guest time

Photo Credit: Bryan R. Smith/AFP/Getty Images

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 Page Numbers to Applicable Content – Example
Resources to support burn victim care at non-burn facilities
• WRBDC Burn Mass Casualty Concept of Operations Plan resources:
– Clinical Support to Non-Burn Facilities, page 15
– Patient Care Resources, page 17
– The 96 Hour Plan, page 17-18
– Burn Equipment and Supplies, Appendices H & K
• Healthcare Coalition Burn Surge Annex Template resources:
– Burn Resource Table, Appendix D

Considerations to determine which patients should be transferred, in what order, and where
• WRBDC Burn Mass Casualty Operations Plan resources:
– 96 Hour Plan – Module 4 Transfer and Transport, pages 56-59
• Healthcare Coalition Burn Surge Annex Template resources:
– Transfer Decision Flowchart & Triage Tables, pages 30-31

What help can the WRBCC provide?

• WRBDC Burn Mass Casualty Operations Plan resources:
– Clinical Support to Non-Burn Facilities, page 15
– Patient Transfer Coordination, page 11-12
• Healthcare Coalition Burn Surge Annex Template resources:
– Transfer Decision Flowchart & Triage Tables, pages 30-31
– Patient Transfer Checklist, page 32-33

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 Leveraging Technology for Audience Engagement

Which key elements of a Burn Surge Response is your facility/

organization well prepared to handle? Select all that apply.

What are the top two areas of a Burn Surge Plan that your
• • Use of polling and discussion questions
– Everyone could talk
• Use of assigned audience SME
– Telemedicine, mental health, burn center providers
facility/organization could use more help in?

What funding sources have your utilized that have aided in your

• Lessons learned
efforts to prepare for a burn mass casually incident? Please write
your answers in the chat.

– Knowledge of the audience

9. Paper Patients (next slide) - all patients are currently in
a Community Hospital. Given patient data, how
– Ask the audience (verbalize & chat function)
should they be prioritized for transfer, and where should
they go?
HP = High Priority for Transfer to a Burn Center
– Use of probing and difficult enough questions
– Built in discussion filler slide for time constraints
LP= Low Priority fa Transfer to  Bum Center
NT= No Transfer necessary, patient moy remain at Community Hospital with support
from a Burn Center if needed

– Graphic image warning

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 Operationalizing the Annex- TTX Poll Question
• What steps, if any, would you take to address potential mental
health risks/concerns for Patient C?
Healthy 13-year-old female
3% TBSA
On room air
Vital signs stable
History of treatment for depression

Patient has reported the following:

• Evacuation from active fire was “delayed” & complicated
• She thought she & her family would die before being evacuated
• She saw many injured animals & her own pet is missing, & she feels it
*Red = Third degree has “burned & died”
Blue =Second degree • Says she felt so scared during the evacuation that she couldn’t think,
thought she was going “crazy”

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Pediatric Considerations: Alignment of Multiple
Annex (Burned Child)
• Have your staff been trained on caring for a pediatric patient?
• Have you assembled necessary resources, such as pediatric burn supplies?
• What resources and training are available for other vulnerable populations?

– WRBDC Burn Mass Casualty Concept of Operations Plan resources:

• Operational Overview, page 11-12
• Burn Disaster Bed Census, page 27-28
• Crisis Standards of Care Burn Triage Decision Table, page 33-34
• Pediatric Planning Considerations, page 60
• Pediatric Equipment and Supplies page 61-62
– Healthcare Coalition Burn Surge Annex Template resources:
• Burn Patient Transfer Decision, page, 21
• Special Considerations Pediatric, page 23 -25
• Appendix C: Helping Children & Adolescents During Disaster

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 Utilization and Customization of the TTX-
Hotwash and Participant Feedback Form

creek Fire 3 TIX Averaged Pan icipant Lea rn ing Outcomes

s c:al:e: 1-s trong ly Disag ree t o- 5-Strong ly A.gree • Use of pre and post exercise survey
– Same questions
– Based on exercise objective topics
– Measurement of learning
• Hotwash
• Lessons learned
– Multiple opportunities for survey completion
~--
Ul\dHslitnd ~ti.a I.J!g ;illtllls far UH! llf wlM!n 1D trli1 J~5Cll! C! II. F.mlllitrltw'il[[llil l D Good undl!rst:lndlf\ll I!( Fimltlilrlt'l'f;unm t o,
ldr!mclikme Ii; t:J ~U t d i:!mcdldN! lll.!r'l4:I ii burnwtlilms formen~ p.!IIC!N ;illds.nU kit,' DC!IIMIIIB c(burn. " lliBJCl:t!m pbnnlflEI
un:di,rnt;;:iBMCl BMC k.llilo:ir,;:a'Jl:I; mcm:;il h.:;ikl\ sur~rci;pomcplMi & c:a;crdior:ICHIUKCJ;

 PR£•E>:ERCISESIJAV£1'  PCl!iT E:tEll:CISE SURY£1'

– Capture dialogue in the chat
– Post survey completion tied to CME credit
} ore we start, please comple – Able to prove TTx increased knowledge
~ Pre-Exercise Survey
(Link in the Chat & be/o

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 Additional Lessons Learned
• Use available resources – Thank you ASPR TRACIE!!
• Spoon feed whenever possible – bandwidth for all is tight
• Focus on what would be done today if an incident occurred
– KISS
• Alignment of plans
– Boots on the ground to the federal level
• Leverage technology
– Have the IT team on speed dial
– Involve them from the beginning and acknowledge their work
– Enhanced information sharing and audience diversity
– Take people on a journey of discovery
– Have no fear
• Teamwork makes the dream work
• It doesn’t have to cost a lot of money

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“Continuous effort-not strength or intelligence is the key
to unlocking our potential” Winston Churchill
Next Steps
• Revision of CONOPS
– Inclusion of all resource toolkit information
– Addition of applicable HCC annex
information
• Enhance telemedicine capabilities
– Medpic App linked to CSC site
• Patient transfer refinement and testing
– Another TTx May 2022
*http://crisisstandardsofcare.Utah.edu

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 It’s a gift to do work that feels meaningful!!
annette.matherly@hsc.utah.edu

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Contact ASPR TRACIE

asprtracie.hhs.gov 1-844-5-TRACIE askasprtracie@hhs.gov

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