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2. Inventory is Comprehensive
The list of resources to be itemized in EPRI is comprehensive and covers resources that might be available in major urban settings, as well as in rural areas like central Pennsylvania. Included in the tool are virtually every type of organization, agency and location that might have resources to contribute in the case of a major emergency, and the specific resources each might be expected to control. Not only health care providers and first responder agencies were included, but also public schools, mortuaries, animal control facilities, community pharmacies, and others.
The tool's flexibility makes it possible to add to, or subtract from, the resources currently included. A State or region wishing to use the tool to create their own inventory might want to restrict themselves to a smaller set of organizations, or might wish to restrict the list of resources to those relevant only to immediate incident response. EPRI offers full flexibility so that the inventory structure can be tailored to the needs and circumstances unique to any given setting or purpose.2
Three terms are used in this report to explain the inventory structure and contents:
- Location Types are places (hospitals, fire stations, public schools) that might be expected to control useful resources.
- Resource Types are categories of resources (antibiotics, physicians, emergency vehicles) that help to organize the inventory.
- Resources are the specific sorts of equipment, personnel and supplies that might be needed to respond to a natural or man-made disaster.
Types of Locations Included in the Inventory
EPRI currently contains thirty-three location types, encompassing a large array of services (Box 1 lists location types alphabetically).
|Box 1. Location Types in EPRI Inventory|
|Adult Day Care Centers |
Animal Care & Kennels
Arenas & Stadiums
Blood Banks/Blood Centers
Child Care Centers
Colleges & Universities
Emergency Management Agencies
Emergency Medical Services/Ambulance
Free-standing 911 Centers
Free-standing Clinics & Surgical Centers
Gyms, Clubs & Community Centers
Home Health Agencies
Major Utilities & Industry
Medical Equipment/DME Suppliers
Outpatient Dialysis Centers
Parks & Resorts
Prisons & Jails
Private Physician Offices
Public Health Departments
Rehabilitation Facilities & Hospitals
Healthcare locations include hospitals, home health nursing agencies, nursing homes, freestanding medical and surgical centers, private physician offices, rehabilitation and psychiatric hospitals, blood banks, and public health departments. Each of these location types was chosen for inclusion based on its capacity to provide medical services, to contribute medical supplies or patient beds, or to house or shelter patients.
Emergency response locations include emergency management agencies, emergency medical services, fire departments, law enforcement agencies, the American Red Cross, and the National Guard. Each of these location types provides unique services during any emergency situation or disaster response. Each can contribute specially trained personnel and equipment during an emergency and should be included in planning and incident response efforts.
Miscellaneous other types of locations have been included as well, although we normally do not think of these as bioterrorism response locations. Keeping in mind that any disaster, in particular one prompted by biological agents of terrorism, may affect the animal population as well as the human population, animal care facilities and animal containment facilities have also been included in the inventory. Due to the fact that a large-scale disaster may create mass fatalities, funeral homes have also been included. Location types such as arenas, stadiums, warehouses, gymnasiums, and community centers were included because they have extensive space that could be used for housing or sheltering individuals in need, creating a vaccination or antibiotic distribution site, housing animals, or serving as a storage location for imported equipment, supplies, or medication and have also been included in the inventory. Due to the ever-changing nature of planning needs, the tool was designed to be readily customizable to any region and/or any planning and incident response need.
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Types of Resources Included in the Inventory
A resource class designates the way data are collected. For example, Personnel is a resource class and collects information about full time and part time personnel. Facilities Capabilities is another resource class and contains yes/no questions about the sorts of capabilities a facility might have (e.g. back-up water supply, food preparation). All types of resources are assigned a resource class so that data collection is correctly formatted.
Resource type is a category of personnel or equipment resources. Some examples of resource types include physicians, antibiotics, and communication equipment (Box 2).
|Box 2. Resource Types in EPRI Inventory|
Emergency Response Capability
Emergency Response Equipment
Emergency Transportation Equipment
Major Medical Equipment
Other Medical Equipment
Other Medical Personnel
Within each resource type are specific resources; examples include pediatricians (within physicians), azithromycin (within antibiotics), and mobile radios (within communications equipment). Each resource type, and the resources specific to it, represent personnel or equipment critical in planning and responding to large-scale emergencies. An Internet search was undertaken to identify any list previously compiled for the wide range of location types in our inventory, but none was located. Emergency response directors on the project steering committee indicated that no such list exists. As a result, project staff developed what is believed to be the first comprehensive list of this type. Resources were initially identified through an extensive review of the literature, expert consultation, interviews with emergency response and healthcare providers, and meetings of a project Steering Committee.
Rather than asking every type of location to go through the entire list within the inventory and fill in information where applicable, each resource has been assigned to specific location types where that resource is likely to be found. Fire stations are not asked about hospital beds, for example, and home health agencies are not asked about fire trucks.
To facilitate data entry for the end user and effective use of the data by planners and responders, resource nomenclature has been standardized when possible. For example, personal protective equipment (PPE) resources have been standardized in accordance with the Occupational Safety and Health Administration (OSHA) guidelines regarding PPE.
Those resources that have been standardized are listed and defined in a Help Guide that is incorporated into EPRI. This allows users to refer to the help guide to ensure that data entry regarding existing resources reflects the intent of the inventory. Due to potential differences in planning needs across the country, resources currently included in the inventory can easily be edited or removed, and additional resources can be added to make the inventory specific to the needs of each community, region, or administrative agency using the tool.
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Specific Resources Included in the Inventory
For every resource type (Box 2) there is a list of specific resources; some resource types have just a few resources, others have many.
There are hundreds of specific resources in the inventory, all organized by resource type. (Box 3 provides an example of the specific resources included in the resource type: Antibiotics.)
|Box 3. Example Resource Type: Antibiotics|
|IV Cipro 200MG Doses on hand|
IV Levofloxacin 500mg Doses on hand
IV Penicillin Doses on hand
IV Penicillin G—4 million dose units on hand
Oral Amoxicillin 500mg Doses on hand
Oral Cipro 500MG Doses on hand
Oral Doxycycline 100mh Doses on hand
Oral Levofloxacin 500mg Doses on hand
Oral Ofloxacin 200mg Doses on hand
Oral Rifampin 150mg Doses on hand
Oral Tetracycline 500mg Doses on hand
Streptomycin IM—1 gram vials on hand
The entire list of resource types, resources and locations types appears in a separate Appendix accompanying this report.
2. The accompanying Technical Manual contains detailed instructions for hosting the inventory tool, customizing the structure of the data warehouse to meet local needs, granting access to users, and other technical functions.
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