EMERGENCY PLAN DEVELOPMENT

Guiding Principals Underlying NYSDA Policies with Respect to Planning for Catastrophic Events and Public Health Threats

Prepared by the New York State Dental Foundation through a grant from the New York State Department of Health

Adopted Fall 2004

BACKGROUND
The tragic terrorist events experienced in the United States during the fall of 2001, particularly the anthrax incident, alerted our nation to the potential for catastrophic events and public health threats, including but not limited to bioterrorism attacks, on our civilian population and our lack of preparedness to adequately respond to such attacks.

We believe that dentists represent a valuable resource to assist state officials within the context of a broader-based emergency plan. NYSDA realizes that dentists can play a key role not just in identifying bodies, as was proven by their extensive and exhaustive efforts with respect to identifying remains of the World Trade Center victims, but as informed resources for the latest science-based information for their patients and in the community. Additionally, we believe that dentists, by dint of their professional capacity, can refer patients for follow-up care if necessary as may be directed by public health personnel.

This document represents NYSDA’s official statement of purpose with respect to the profession’s role in and response to catastrophic events and public health threats. It represents the guidelines by which the association’s subsequent actions and decision making relating to this issue will be judged.

PURPOSE

The New York State Dental Association believes dentistry has important assets in personnel and facilities to contribute to the emergency response to catastrophic events and public health threats that can overwhelm traditional medical and emergency response capacity in a target area. We believe that dentistry should be integrated in local, regional and statewide emergency planning initiatives. We encourage all dentists to become involved in such efforts to ensure an ongoing, trained presence to assist in these situations.

This plan has been developed to provide a framework within which the local dental society can organize, prepare for and implement dentistry’s response to major emergency situations:

• Coordinate dentistry’s response within emergency response plans.
• Assist in the preparation of the profession to respond to catastrophic events and public health threats.
• Provide liaison and facilitate communications with emergency response agencies through the New York State Department of Health.
• Facilitate the deployment of dentistry’s assistance resources.
• Participate in disease surveillance activities.
• Disseminate public health information to the public.
• Other activities, as determined by the local dental society and the local, regional and statewide emergency response agencies.
• Credentialing of individuals to be responders.

This plan will be reviewed periodically and updated when circumstances require.

SITUATION AND ASSUMPTIONS

Situation: The Plan will be implemented in the event that there is a significant catastrophic event or public health threat in an area within the jurisdiction of the dental society that is of such proportion that it could initially overwhelm the traditional medical response capability and overall medical resources of the area, or where dentistry can provide important emergency assistance. Early implementation of the Plan is important, not waiting for the health care system to be overwhelmed. With bioterrorism, dental participation should primarily be employed as part of the initial response to the surge in demand for health care immediately following an attack or the manifestation of the results of the attack. In addition, longer-term involvement may also be a part of the overall general response, in surveillance activities, for example. With other catastrophic events and/or public health threats, the extent, nature and duration of the assistance dentistry can provide will depend upon the nature of the situation and the requirements of local, regional and/or statewide emergency response agencies.

Planning Assumptions: The Plan will outline the assumptions that are the basis for the Plan so that it can be understood clearly. Some of the possible assumptions might be:

• The Plan applies primarily to catastrophic events and/or public health threats that could overwhelm local medical capabilities, or in such situations where dentistry may be of assistance.
• The Plan is integrated into the general local, regional and statewide emergency response plans and will be triggered by a previously designated responsible public official who has determined the need to mobilize dental support services.
• Both dental personnel and facilities may be utilized.
• Dental personnel have skills, experience and knowledge that will be valuable in responding to a catastrophic event and/or public health threat.
• There may be a significant number of dentists who will respond in a catastrophic event and/or public health threat.
• Since the dental responders will all be volunteers, their efforts must be organized and coordinated. The dental society will assist in fulfilling that role.
• There will be a need for some training of dental personnel in order for them to adequately fulfill the responsibilities they may be asked to assume.
• There will be an on-going need for communication and coordination between the dental community and the emergency response community. The dental society will fulfill that role.
• There is a need for legal protection for dental personnel acting in response to a catastrophic event and/or public health threat.
  

ORGANIZATION AND RESPONSIBILITIES

The New York State Dental Association will work with local, regional and statewide agencies, to ensure appropriate dissemination of information and promotion of training opportunities. The ongoing relationship with emergency response agencies will provide information regarding changes in the overall area emergency response plan that may influence the dental profession.

NYSDA will make available appropriate contact numbers for emergency response agencies at the local, regional and statewide levels.

The ongoing management of activities pertaining to this Plan falls under the purview of NYSDA in collaboration with the New York State Department of Health.

COMMAND, CONTROL AND COMMUNICATIONS

This dental emergency response plan is a sub-structure of the New York State comprehensive emergency management plan. Overall command and control functions will be the responsibility of the New York State Department of Health.

NYSDA will educate and inform its members about the command and control structure of the local area plan so that those functions of the dental response plan can be completely integrated into the command and control functions of the plan.

The NYSDA executive director or his/her designee will serve as the contact between NYSDA and the Department of Health.

VOLUNTEER COORDINATION

NYSDA believes that dentists should, depending on their skills and interest, become acquainted with emergency preparedness training activities at the local, regional and/or state level. The dental society believes that it should help those interested dentists learn about training and continuing education opportunities, communications and legal updates, etc. The dental society will seek to coordinate volunteer activity, via surveys, ongoing communication with other agencies, and other means, and to maintain current databases that will help delineate crucial statistics including training levels, etc., and to communicate this information to the appropriate agency as necessary.

SPECIFIC ASSISTANCE ACTIVITIES

The degree of involvement of dentistry in the response to catastrophic events and/or public health threats will vary according to the interest that the profession has in this activity, its resources and the potential role for dentistry as envisioned by the local emergency response agencies. There are specific elements of the potential dental response that can be considered by the local dental society when determining the degree and nature of its activities in this area.

Depending on training, desire and situation, dentists can provide such assistance activities as:

• professional education;
• providing public information;
• treatment of injuries (sutures, oral-facial, etc.)
• forensics
• surveillance and notification – e.g., dentists can serve as sentinels of possible threats based on patient cancellations and symptoms;
• diagnosis and monitoring;
• administration of immunizations;
• prescribing or dispensing of medications;
• triage assistance;
• medical care augmentation, such as anesthesia (including general), taking health or medical histories, taking throat cultures, assessing skin lesions, irrigating eyes, and so forth;
• utilization of dental offices, dental schools and hospital-based dental programs ; e.g., in an emergency situation, it would make sense for civilians to walk to their local dental office for vaccinations, etc. Additionally, dental offices and dental schools are virtual mini-hospitals with air, suction, radiographic equipment, sterilization, refrigeration, etc., already in place.
• assistance of dental auxiliaries [i.e., dental hygienists, certified and uncertified dental assistants, lab personnel], via training and education and by example.
  

TRAINING AND EXERCISES

NYSDA will strive to inform its members about any approved education, training and exercises pertaining to catastrophic events and public health threats that are being conducted at the local, regional and/or statewide levels. When appropriate, the dental society will coordinate with the appropriate agencies to conduct such education, training and exercises.

REVIEW AND UPDATE

NYSDA will review and update the plan on a specified regular basis.