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Agency for Healthcare Research Quality

Public Health Emergency Preparedness: Providing Mass Medical Care with Scarce Resources

Slide Presentation by Stephen V. Cantrill, M.D., FACEP

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Broadcast on November 29, 2006, the Web conference Providing Mass Medical Care With Scarce Resources: Strategies and Tools for Community Planners gave an overview of the community planning guide and provided planners at the institutional, State, and Federal levels with valuable insights and information that will help them plan for and respond to a Mass Casualty Event (MCE).

Steve V. Cantrill, M.D., Associate Director, Department of Emergency Medicine, Denver Health Medical Center, delivered a presentation during the conference entitled Alternative Care Sites. This is the text version of Dr. Cantrill's slide presentation. Select to access the PowerPoint® Slides (445 KB).

Alternative Care Sites

Slide 1

Alternative Care Sites

Stephen V Cantrill, M.D., FACEP
Associate Director
Department of Emergency Medicine
Denver Health Medical Center

Slide 2

Alternative Care Sites

A photo shows hospital-style beds in a large room not originally designed for health care.

Slide 3

Concept of an Alternative Care Site:

Nontraditional location for the provision of health care.

Wide range of potential levels of care:

  • Traditional inpatient care.
  • Chronic care.
  • Palliative care.
  • Home care.

Slide 4

Potential Uses of an ACS:

  • Primary triage of victims.
  • Offloaded hospital ward patients.
  • Primary victim care.
  • Nursing home replacement.
  • Ambulatory chronic care/shelter.
  • Quarantine.
  • Palliative care.
  • Vaccine slash drug distribution center.

Slide 5

Potential Alternative Care Sites

  • Buildings of opportunity:
    • Advantage of preexisting infrastructure support.
    • Convention centers, hotels, schools, same-day surgery centers, shuttered hospitals, et cetera.
  • Portable or temporary shelters:
    • Flexible but may be costly.
  • Sites best identified in advance.

Slide 6

Factors in Selecting an ACS

  • Basic environmental support:
    • HVAC, plumbing, lighting, sanitary facilities, et cetera.
  • Adequate spaces:
    • Patient care, family areas, pharmacy, food prep, mortuary, et cetera.
  • Ease in establishing security.
  • Access: patients slash supplies slash EMS.
  • Site Selection Tool:

Slide 7

Some Issues and Decision Points

  • Quote, ownership, unquote and command and control of the site.
  • Decision to open an alternative care site.
  • Supplies/Equipment/Staffing.
  • Documentation of care.
  • Communications.
  • Rules/Policies for operation.
  • Exit strategy.
  • Exercises.

Slide 8

Katrina/Rita: ACS Issues

  • Importance of regional planning.
  • Importance of security.
  • Advantages of manpower proximity.
  • Segregating special needs populations.
  • Organized facility layout.
  • Importance of incident command system.

Slide 9

Katrina/Rita: ACS Issues

  • The need for “House rules.”
  • Importance of public health issues.
  • Safe food.
  • Clean water.
  • Latrine resources.
  • Sanitation supplies.


Current as of November 2006

Internet Citation:

Alternative Care Sites. Public Health Emergency Preparedness: Providing Mass Medical Care with Scarce Resources. Web Conference, broadcast on November 29, 2006. Agency for Healthcare Research and Quality, Rockville, MD.


The information on this page is archived and provided for reference purposes only.


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