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Care of the Critically ill and Injured During Pandemics and Disasters: Hospitals and Health-care IT Preparedness Planning

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We suggest hospitals have a plan for rapid movement of the data center to offsite remote operations in the case of prolonged local power disruption for critical functions.
We suggest a plan be in place to provide power to the client machines, analyzers, networking equipment, etc along with the data center for an extended period of time.
We suggest hospitals plan around extended supply disruption of critical IT supplies, such as servers and disk drives. www.medicine-against-diabetes.net
When a disaster directly damages a hospital’s facilities, direct damages to the IT infrastructure are likely, as well as to local utility and transportation networks. Continuity of operations will require both onsite and offsite redundant systems. Hospitals are required to have 72 h of onsite power generation capability; however, although in an extended disaster this is insufficient, extended-capacity systems are not required by the Joint Commission on Accreditation of Health-Care Organizations and are unlikely to be installed because of current financial pressures on hospitals. If local transportation networks are affected, difficulties may occur in obtaining sufficient quantities of diesel fuel to run generators as well as transport fuel where it is needed.
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Care of the Critically ill and Injured During Pandemics and Disasters: The information priorities

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Care of the Critically ill and Injured During Pandemics and Disasters: The information prioritiesFor these reasons, we strongly suggest setting up emergency networks that use consumer products, including laptop computers, “smart” cell phones, and electronic note pads, among others. The power of consumer mobile computing devices now rivals traditional desktop computers. They are ideal devices for use during mass casualty events because of high mobility and built-in network capability, low cost, and very low power usage. They are already owned and routinely used by most hospital staff and are quite rugged, surviving daily usage in unprotected settings. Although not traditionally managed by the hospital’s IT protocols, they are a large reservoir of readily available portable technology with low capital investment. best eye drops
The information priorities established by the task force under these circumstances are:
•    Have the necessary portable hardware and software functionality to store health information when hospital systems are unavailable, and being able to upload information when systems are again online.
•    Track basic patient information, including patient demographics with next of kin with contact information, and a defined minimal database of medical history that can be transferred with every patient to other points of care (see the “Evacuation of the ICU” article by King et al in this consensus statement).
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Care of the Critically ill and Injured During Pandemics and Disasters: Functioning Information Network

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Wireless local area networks are suggested, as they may be less vulnerable to damage, can be used for monitoring patients and for high-speed data applications (eg, picture archiving and communication system), and are capable of supporting most portable or handheld hardware (Fig 1). Cellular-based solutions maybe less preferred, as cellular networks are not available in all circumstances.
There are no ready-made disaster network solutions, but effective network communication systems have been implemented under actual disasters and in training exercises.’’’ An example implemented after the Haiti earthquake in 2010 was a field hospital that used laptop computers with a wireless local area network powered by gas generators, which was operational within 6 h after arrival; a wired network was added within 48 h and was capable of managing data-intensive applications, such as picture archiving and communication systems. Generators may maintain electrical power even under extreme circumstances, but plans for alternative power sources should include sufficient battery power, or possibly even solar power.
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Care of the Critically ill and Injured During Pandemics and Disasters: Portable Mobile Support Information Networks

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Care of the Critically ill and Injured During Pandemics and Disasters: Portable Mobile Support Information NetworksWe suggest hospitals have the ability to effectively and quickly download all patient-related information into a mobile package (eg, a flash drive or disk) that can be easily read by other information systems, and can be rapidly prepared for transport with the patient. This should obey the clinical document architecture/continuity of care document documents currently specified under meaningful use proposals, making them both human and digitally readable.
We suggest hospitals have real-time connection to databases for uploading and downloading clinical information.
We suggest hospitals have the necessary IT functionality to store health information when hospital systems are not available, and be able to rapidly upload and download clinical information once connections are re-established.
We suggest hospitals have the means to ensure confidentiality of all patient protected information.
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Care of the Critically ill and Injured During Pandemics and Disasters: Health Information Technology Continuity in Disasters

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Strategy 5: Once an impending medication or supply shortage is identified, health-care facilities should institute protocols to encourage the use of alternative products whenever possible and to restrict use of the product in shortage such that it is only used when there is no available alternative or when the use of alternatives is prohibited due to substantial differences in efficacy or toxicity. www.medicine-against-diabetes.net
Strategy 6: Health-care facilities and the healthcare industry should support ongoing efforts from policy makers and national and international governmental and nongovernmental organizations to reduce supply chain vulnerability in medical supplies and medications. Interventions currently considered include requirement of early reporting of anticipated shortages or manufacturing difficulties, expedited review of alternative manufacturing processes, providing incentives to manufacturers to produce critical medical products, requiring regulatory approval for manufacturing redundancies in sourcing and production, and improving communication between manufacturers and regulatory authorities.
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Care of the Critically ill and Injured During Pandemics and Disasters: Strategies

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Care of the Critically ill and Injured During Pandemics and Disasters: StrategiesStrategy 2: Pre-event planning should be tailored at individual health-care facilities to identify commonly used critical care products and alternatives for which providers at the facility already have some degree of familiarity. To limit adverse events, it is preferable to use alternative products already in use and familiar to health-care workers rather than similar product alternatives with which they may have little experience. As such, determining alternative agents in pre-event planning requires multidisciplinary provider engagement. starlix medication
Strategy 3: Use of computer systems that integrate purchasing, storage, and use of medical supplies through technologies such as radio-frequency identification or other bar code system will allow a health-care facility to assess its real-time inventory and use of medications and medical supplies. The ability to track medication and supply levels in real time will alert a facility to predictable patterns of increased use (eg, increased use of masks during influenza season) and provide information on how much inventory is on hand at any given time.
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Care of the Critically ill and Injured During Pandemics and Disasters: Strategy 1

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In critical care medicine, supply chain vulnerabilities have already resulted in many key medication shortages, including antimicrobials, sedatives, vasopressor medications, and anesthetics (Table 2, e-Table 1). These shortages are not due to disasters, and, hence, when disasters occur, they will exacerbate these preexisting vulnerabilities. cheap wellbutrin
When medication shortages occur, alternative agents are often used, but they are often associated with suboptimal results or adverse events. Reasons attributed to inferiority of these substitutes include a lack of familiarity with the substituted medications, inherent increased toxicity of the alternative agent, and others, such as increased antimicrobial resistance rates. Even when substitutions can be made without immediate clinical consequences, they may lead to increased costs or use of a branded medication and a substantial increased time and effort by providers, pharmacists, and hospital administrators to address shortages.
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