1. No category

POLK COUNTY EMERGENCY MANAGEMENT
INCIDENT ACTION PLAN
11/03/2014 06:00 to 11/10/2014 06:00
Ebola 2014
For Additional Information Contact:
A.J.Mumm, Director
PolkCounty EMA
515-286-2107
Aj.mumm@polkcountyiowa.gov
POLK COUNTY EMERGENCY MANAGEMENT
Proudly serving the communities of:
Alleman,Altoona, Ankeny, Bondurant, Clive, Des Moines, Elkhart, Grimes, Johnston,Mitchellville, Pleasant Hill, Polk City, Polk
County, Runnells, Urbandale, WestDes Moines, and Windsor Heights
Page 1 of 23
Page 1
INCIDENT OBJECTIVES
1. Incident Name
2. Date Prepared
3. Time Prepared
Ebola 2014
4. Operational Period
11/03/2014 06:00 - 11/10/2014 06:00
5. General Control Objectives for the Incident (include alternatives)
THIS INCIDENT ACTION PLAN SHALL REMAIN IN EFFECT UNTIL:
- THE CURRENT EBOLA SITUATION HAS ENDED; OR
- UNTIL A CONFIRMED CASE OF EBOLA IS IDENTIFIED IN POLK COUNTY, AT WHICH TIME A NEW IAP WILL BE ISSUED THAT WILL COVER
DECONTAMINATION, TREATMENT, TRANSPORTATION AND OTHER TOPICS.
- Minimize the risk of contraction of the Ebola virus for emergency responders and health care providers
- Gain and maintain situational awareness through information from the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC)
and Iowa Department of Public Health (IDPH).
-Coordinate with IDPH regarding messaging and communications.
-Ensure partners and the public have current information to guide decision-making regarding their health safety
-Strengthen preparedness in Polk County for the early recognition, detection, and control of an Ebola exposure.
-To ensure responders are prepared with the appropriate PPE and proper guidance on Donning and Doffing.
6. Weather Forecast For Period
Weather Forecast information may be obtained at http://www.crh.noaa.gov/dmx
7. General Safety Message
Maintain appropriate communication between the 9-1-1 centers, first responders and hospitals regarding suspected individuals with symptoms of Ebola.
All responders should be wearing the appropriate personal protective equipment during a response that involves a suspected case of Ebola.
Review and become familiar with discipline specific guidance included in each ICS 204 and the PPE information included within this Incident Action Plan.
8. Attachments (mark if attached)
Organization List - ICS 203
Medical Plan - ICS 206
Div. Assignment Lists - ICS 204
Communications Plan - ICS 205
Prepared by (Planning Section Chief)
ICS 202
Approved by (Incident Commander)
Page 2 of 23
Page
2
ORGANIZATION ASSIGNMENT LIST
1. Incident Name:
2. Date
3. Time
4. Operational Period
Ebola 2014
11/03/2014 06:00 - 11/10/2014 06:00
5. EOC Director & Staff
9. Operations Section:
EOC Director
Rick Kozin
Chief
Deputy EOC Director
AJ Mumm
Deputy
Nola Aigner
Branch:
Scott Slater
Safety Officer
PIO/JIC Officer
Policy Officer
Infrastructure Support
Branch Director
Branch Deputy Director
Transportation Group
6. Agency Representatives:
Agency
Name
Communication Group
Public Works/Eng Group
7. Planning Section:
Chief
Kari Lebeda Townsend
Deputy
Franny Medeiros/Samantha Brear
Situation Unit
Juan Cadenillas
Info/Intel Unit
Branch:
Emergency Services
Branch Director
Branch Deputy Director
Firefighting
Resources Unit
Public Hlth & Med Services 1
Documentation Unit
Hazardous Materials
Demob Unit
Law Enforcement & Security
Recovery/Mitigation Unit
Public Hlth & Med Services 2
Technical Specialists
Public Hlth & Med Services 3
Technical Specialists
8. Logistics Section:
10. Finance Section:
Chief
Chief
Deputy
Deputy
Service Branch
Time Unit
Comms Unit
Procurement Unit
Medical Unit
Compensation/Claims Unit
Food Unit
Cost Unit
11. Information and Intelligence Section:
Support Branch
Facilities Unit
Supply Unit
Prepared by:
Ground Support Unit
Page 3 of 23
Page
6
1. Incident Name
2. Operational Period (Date/Time)
From: 11/03/2014 06:00
Ebola 2014
3. Branch
4. Division/Group/Staging
Transportation Group
Infrastructure Support
Name
5. Operations Personnel
Operations Section Chief:
To: 11/10/2014 06:00
Assignment List
ICS 204-CG
Affiliation
Contact # (s)
Scott Slater
Branch Director:
Division/Group Supervisor/STAM:
“X” indicates 204a attachment with additional instructions
6. Resources Assigned
Strike Team/Task Force/Resource
Identifier
Leader
Contact Info. #
# Of
Persons
Reporting Info/Notes/Remarks
7. Work Assignments
Department of Homeland Security (DHS) held a call with ACI-NA and A4A to ask the airline industry to investigate proactively re-routing travelers from the three
affected countries in West Africa so that their U.S.-bound itineraries would be cleared into our country through one of the five airports with enhanced screening
measures. This morning, DHS announced it is implementing this strategy effective immediately.
The approach will be two-pronged. Customs and Border Patrol (CBP) will use its targeting systems to identify travelers scheduled to travel from one of the three
affected countries into the United States, with a first U.S. port of entry other than Atlanta, New York Liberty, Dulles, John F. Kennedy International Airport or
Chicago O'Hare International Airport. CBP should get this information up to 72 hours in advance of the traveler’s scheduled departure and will communicate
directly with the booking air carrier to get the traveler rebooked with an entry into the U.S. through one of the five enhanced screening airports.
This guidance does not apply to Des Moines International Airport as they were not included in the list of the five airports above.
8. Special Instructions
The CDC will notify IDPH regarding Iowa-bound travelers. IDPH will notify the PCHD regarding travelers with a destination of Polk County for appropriate
monitoring. Travelers who have been in an affected country (Guinea, Liberia or Sierra Leone) in the previous 21 days with fever of 100.4 or higher with or
without Ebola symptoms will be deferred and not allowed to continue to travel. Travelers who have been in an affected country (Guinea, Liberia or Sierra
Leone) in the previous 21 days no known exposure will receive instructions on self-monitoring and a CARE Kit (with digital thermometer, thermometer
directions, health advisory, symptom card, symptom log, reminder card, list of state health department phone numbers).
9. Communications (radio and/or phone contact numbers needed for this assignment)
Name/Function
Radio: Freq./System/Channel Phone
Cell/Pager
Emergency Communications
Medical
Evacuation
10. Prepared by:
ASSIGNMENT LIST
Date/Time
Other
11. Reviewed by (PSC):
Page 4 of 23
Date/Time
12. Reviewed by (OSC):
Date/Time
Page
ICS 204-CG (Rev 04/04)
16
1. Incident Name
2. Operational Period (Date/Time)
From: 11/03/2014 06:00
Ebola 2014
3. Branch
4. Division/Group/Staging
Communication Group
Infrastructure Support
Name
5. Operations Personnel
Operations Section Chief:
To: 11/10/2014 06:00
Assignment List
ICS 204-CG
Affiliation
Contact # (s)
Scott Slater
Branch Director:
Division/Group Supervisor/STAM:
“X” indicates 204a attachment with additional instructions
6. Resources Assigned
Strike Team/Task Force/Resource
Identifier
Leader
Contact Info. #
# Of
Persons
Reporting Info/Notes/Remarks
7. Work Assignments
It is important for PSAPs to question callers and determine if anyone at the incident possibly has Ebola. This shall be communicated immediately to EMS
personnel before arrival. PSAPs shall review existing medical dispatch procedures and coordinate any changes with their EMS medical director and with their
local public health department.
8. Special Instructions
- PSAP call takers shall screen callers for symptoms and risk factors of Ebola. Callers will be asked if they, or someone at the incident, have fever of greater
than 100.4 degrees Fahrenheit, and if they have additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or
unexplained bleeding.
- If PSAP call takers suspect a caller is reporting symptoms of Ebola, they shall screen callers for risk factors within the past 3 weeks before onset of symptoms.
Risk factors include: Contact with blood or body fluids of a patient known to have or suspected to have Ebola;
- Residence in–or travel to–a country where an Ebola outbreak is occurring; or direct handling of bats or nonhuman primates from disease-endemic areas.
- If PSAP call takers have information alerting them to a person with possible Ebola, they shall make sure any first responders and EMS personnel are made
confidentially aware of the potential for Ebola before the responders arrive on scene.
9. Communications (radio and/or phone contact numbers needed for this assignment)
Name/Function
Radio: Freq./System/Channel Phone
Cell/Pager
Emergency Communications
Medical
Evacuation
10. Prepared by:
ASSIGNMENT LIST
Date/Time
Other
11. Reviewed by (PSC):
Page 5 of 23
Date/Time
12. Reviewed by (OSC):
Date/Time
Page
ICS 204-CG (Rev 04/04)
7
1. Incident Name
2. Operational Period (Date/Time)
From: 11/03/2014 06:00
Ebola 2014
3. Branch
4. Division/Group/Staging
Public Works/Eng Group
Infrastructure Support
Name
5. Operations Personnel
Operations Section Chief:
To: 11/10/2014 06:00
Assignment List
ICS 204-CG
Affiliation
Contact # (s)
Scott Slater
Branch Director:
Division/Group Supervisor/STAM:
“X” indicates 204a attachment with additional instructions
6. Resources Assigned
Strike Team/Task Force/Resource
Identifier
Leader
Contact Info. #
# Of
Persons
Reporting Info/Notes/Remarks
7. Work Assignments
Waste Management:
CDC guidance indicates that sanitary sewers are acceptable for patient bodily fluids. Royce Hammitt, the Wastewater Reclamation Authority Operations
Manager said that they will follow the CDC guidelines.
8. Special Instructions
9. Communications (radio and/or phone contact numbers needed for this assignment)
Name/Function
Radio: Freq./System/Channel Phone
Royce Hammit
(515) 323-8001
Cell/Pager
515-208-0641
Emergency Communications
Medical
Evacuation
10. Prepared by:
ASSIGNMENT LIST
Date/Time
Other
11. Reviewed by (PSC):
Page 6 of 23
Date/Time
12. Reviewed by (OSC):
Date/Time
Page
ICS 204-CG (Rev 04/04)
17
1. Incident Name
2. Operational Period (Date/Time)
From: 11/03/2014 06:00
Ebola 2014
3. Branch
4. Division/Group/Staging
Firefighting
Emergency Services
Name
5. Operations Personnel
Operations Section Chief:
To: 11/10/2014 06:00
Assignment List
ICS 204-CG
Affiliation
Contact # (s)
Scott Slater
Branch Director:
Division/Group Supervisor/STAM:
“X” indicates 204a attachment with additional instructions
6. Resources Assigned
Strike Team/Task Force/Resource
Identifier
Leader
Contact Info. #
# Of
Persons
Reporting Info/Notes/Remarks
7. Work Assignments
1.Address scene safety:
- If PSAP call takers advise that the patient is suspected of having Ebola, personnel shall put on the PPE appropriate for suspected cases of Ebola before
entering the scene. Please see the end of this IAP for updated guidelines on PPE.
- Keep the patient separated from other persons as much as possible.
- Use caution when approaching a patient with Ebola. Illness can cause delirium, with erratic behavior that can place personnel at risk of infection, e.g., flailing
or staggering.
8. Special Instructions
- Patients shall be asked if they, or someone at the incident, have fever of greater than 100.4 degrees Fahrenheit, and if they have additional symptoms such as
severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained bleeding.
- If a patients is reporting symptoms of Ebola, they should be questioned for risk factors within the past 3 weeks before onset of symptoms. Risk factors include:
Contact with blood or body fluids of a patient known to have or suspected to have Ebola;
- Residence in–or travel to–a country where an Ebola outbreak is occurring; or direct handling of bats or nonhuman primates from disease-endemic areas.
- Based on the presence of symptoms and risk factors, put on or continue to wear appropriate PPE and follow the scene safety guidelines for suspected case of
Ebola. The patient should be placed in a gown, mask and gloves according to the same PPE recommendations.
- If there are no risk factors, proceed with normal EMS care.
9. Communications (radio and/or phone contact numbers needed for this assignment)
Name/Function
Radio: Freq./System/Channel Phone
Cell/Pager
Emergency Communications
Medical
Evacuation
10. Prepared by:
ASSIGNMENT LIST
Date/Time
Other
11. Reviewed by (PSC):
Page 7 of 23
Date/Time
12. Reviewed by (OSC):
Date/Time
Page
ICS 204-CG (Rev 04/04)
8
1. Incident Name
2. Operational Period (Date/Time)
From: 11/03/2014 06:00
Ebola 2014
3. Branch
4. Division/Group/Staging
Public Hlth & Med Services 1
Emergency Services
Name
5. Operations Personnel
Operations Section Chief:
To: 11/10/2014 06:00
Assignment List
ICS 204-CG
Affiliation
Contact # (s)
Scott Slater
Branch Director:
Division/Group Supervisor/STAM:
“X” indicates 204a attachment with additional instructions
6. Resources Assigned
Strike Team/Task Force/Resource
Identifier
Leader
Contact Info. #
# Of
Persons
Reporting Info/Notes/Remarks
X
Public Health
7. Work Assignments
Medical Supplies Management & Distribution Task Force - Check local inventory of PPE for adequate supplies
Mass Prophylaxis Task Force - At this time, no vaccination is available for the Ebola Virus. Polk County Health Department has a Mass Prophylaxis plan should
a vaccine become available.
Medical Surge Task Force - Individual hospitals maintain medical surge plans that may be implemented as needed
Isolation & Quarantine Task Force - Polk County Health Department has an Isolation & Quarantine plan that may be implemented if necessary
Laboratory Testing Task Force - Iowa Department of Public Health and Polk County Public Health will coordinate any lab testing of suspected Ebola cases
Fatality Management Task Force - Polk County Emergency Management and the Polk County Medical Examiner have a fatality management plan that may be
implemented as needed
Disaster Mental Health Task Force - Polk County Emergency Management has a Disaster Mental Health plan that may be implemented as needed
Environmental Health Task Force - Polk County Emergency Management has a Environmental Health plan that may be implemented as needed
Responder Safety & Health Task Force - Maintain coordination and communication on safety and health issues between agencies and departments
8. Special Instructions
Epidemiological Surveillance & Investigations - If patient meets clinical and exposure criteria for high or low risk Contact IDPH immediately at 800-362-2736 or
515-323-4360. If patient meets the clinical and “no known exposure” criteria, order appropriate testing which may include continued use of infection control
measures until cause identified; Rule out more common infections, including influenza, malaria, and diarrheal pathogens; If no cause is identified and Ebola
infection is suspected, contact IDPH at 800-362-2736 or 515-323-4360 to discuss Ebola testing.
Use a U.S. Environmental Protection Agency (EPA)-registered hospital disinfectant with a label claim for a non-enveloped virus (e.g., norovirus, rotavirus,
adenovirus, poliovirus) to disinfect environmental surfaces in rooms of patients with suspected or confirmed Ebola virus infection. Although there are no
products with specific label claims against the Ebola virus, enveloped viruses such as Ebola are susceptible to a broad range of hospital disinfectants used to
disinfect hard, non-porous surfaces. In contrast, non-enveloped viruses are more resistant to disinfectants. As a precaution, selection of a disinfectant product
with a higher potency than what is normally required for an enveloped virus is being recommended at this time. EPA-registered hospital disinfectants with label
claims against non-enveloped viruses (e.g., norovirus, rotavirus, adenovirus, poliovirus) are broadly antiviral and capable of inactivating both enveloped and
non-enveloped viruses.
9. Communications (radio and/or phone contact numbers needed for this assignment)
Name/Function
Radio: Freq./System/Channel Phone
Cell/Pager
Emergency Communications
Medical
Evacuation
10. Prepared by:
ASSIGNMENT LIST
Date/Time
Other
11. Reviewed by (PSC):
Page 8 of 23
Date/Time
12. Reviewed by (OSC):
Date/Time
Page
ICS 204-CG (Rev 04/04)
9
1. Incident Name
2. Operational Period (Date/Time)
Ebola 2014
From: 11/03/2014 06:00
3. Branch
4. Division/Group
Emergency Services
Public Hlth & Med Services 1
5. Strike Team / Task Force/Resource (Identifier)
6. Leader
ASSIGNMENT LIST ATTACHMENT
ICS 204a-CG
To: 11/10/2014 06:00
7. Assignment Location
Public Health
8. Work Assignment Special Instructions, Special Equipment/Supplies Needed for Assignment, Special Environmental
Considerations, Special Site Specific Safety Considerations
Clinical presentation and level of exposure are taken into account when determining appropriate public health actions for individuals with potential Ebola
exposure, as follows.
Mandatory Quarantine: Asymptomatic individuals with high or low exposure risk will be placed under mandatory quarantine order in their home and monitored
by the Polk County Health Department. A Communicable Disease Nurse and/or designee will conduct visits twice daily to observe the individual taking their
temperature from outside the residence during the incubation period (21 days). Symptom review and other discussions will be conducted by phone while on
and off the premises as appropriate. Symptomatic individuals with high or low exposure risk will be placed under a mandatory quarantine in the hospital.
Self-Monitoring: Asymptomatic individuals with "No Known Exposure" will be required to self-monitor for fever and symptoms under a mandatory Submit to Self
Monitor Order and report to the Polk County Health Department. The individual will be evaluated and report their temperature and symptom status twice daily
during the incubation period (21 days). Individuals do not have movement restrictions as with quarantine but must refrain from using mass transportation,
including airplanes, trains, cruise ships, or busses, unless they receive written permission from the Iowa Department of Public Health/CDC prior to engaging in
such travel.
Approved Site Safety Plan Located at:
9. Other Attachments (as needed)
Map/Chart
10. Prepared by:
Weather Forecast/Tides/Currents
Date/Time
ASSIGNMENT LIST ATTACHMENT
11. Reviewed by (PSC):
Page 9 of 23
Date/Time
12. Reviewed by (OSC):
Date/Time
ICS 204a-CG (Rev 04/04)
Page
10
1. Incident Name
2. Operational Period (Date/Time)
From: 11/03/2014 06:00
Ebola 2014
3. Branch
4. Division/Group/Staging
Law Enforcement & Security
Emergency Services
Name
5. Operations Personnel
Operations Section Chief:
To: 11/10/2014 06:00
Assignment List
ICS 204-CG
Affiliation
Contact # (s)
Scott Slater
Branch Director:
Division/Group Supervisor/STAM:
“X” indicates 204a attachment with additional instructions
6. Resources Assigned
Strike Team/Task Force/Resource
Identifier
Leader
Contact Info. #
# Of
Persons
Reporting Info/Notes/Remarks
7. Work Assignments
Address scene safety:
- If PSAP call takers advise that the person is suspected of having Ebola, personnel shall put on the PPE appropriate for suspected cases of Ebola (before
entering the scene. Please see the end of this IAP for updated guidelines on PPE.
- Keep that person separated from other persons as much as possible.
- Use caution when approaching a patient with Ebola. Illness can cause delirium, with erratic behavior that can place personnel at risk of infection, e.g., flailing
or staggering.
- Correctional facilities should consider revising intake/booking procedures to include the questions below
8. Special Instructions
If you observe a person you suspect may be ill, you will ask if they, or someone at the incident, have fever of greater than 100.4 degrees Fahrenheit, and if they
have additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained bleeding.
- If a patients is reporting symptoms of Ebola, they shall be questioned for risk factors within the past 3 weeks before onset of symptoms. Risk factors include:
Contact with blood or body fluids of a patient known to have or suspected to have Ebola;
- Residence in–or travel to–a country where an Ebola outbreak is occurring; or direct handling of bats or nonhuman primates from disease-endemic areas.
- Based on the presence of symptoms and risk factors, put on or continue to wear appropriate PPE and follow the scene safety guidelines for suspected case of
Ebola. The patient should be placed in a gown, mask and gloves according to the same PPE recommendations.
- Request EMS response to the scene as appropriate
- If there are no risk factors, proceed with normal law enforcement duties.
9. Communications (radio and/or phone contact numbers needed for this assignment)
Name/Function
Radio: Freq./System/Channel Phone
Cell/Pager
Emergency Communications
Medical
Evacuation
10. Prepared by:
ASSIGNMENT LIST
Date/Time
Other
11. Reviewed by (PSC):
Page 10 of 23
Date/Time
12. Reviewed by (OSC):
Date/Time
Page
ICS 204-CG (Rev 04/04)
12
1. Incident Name
2. Operational Period (Date/Time)
From: 11/03/2014 06:00
Ebola 2014
3. Branch
4. Division/Group/Staging
Public Hlth & Med Services 2
Emergency Services
Name
5. Operations Personnel
Operations Section Chief:
To: 11/10/2014 06:00
Assignment List
ICS 204-CG
Affiliation
Contact # (s)
Scott Slater
Branch Director:
Division/Group Supervisor/STAM:
“X” indicates 204a attachment with additional instructions
6. Resources Assigned
Strike Team/Task Force/Resource
Identifier
Leader
Contact Info. #
# Of
Persons
Reporting Info/Notes/Remarks
X
Emergency Medical Services
7. Work Assignments
During patient assessment and management, EMS personnel shall consider the symptoms and risk factors of Ebola:
- All patients shall be assessed for symptoms of Ebola (fever of greater than 100.4 degrees Fahrenheit, and additional symptoms such as severe headache,
muscle pain, vomiting, diarrhea, abdominal pain, or unexplained hemorrhage). If the patient has symptoms of Ebola, then ask the patient about risk factors
within the past 3 weeks before the onset of symptoms.
- Based on the presence of symptoms and risk factors, put on or continue to wear appropriate PPE and follow the scene safety guidelines for suspected case of
Ebola. The patient should be placed in a gown, mask and gloves according to the same PPE recommendations.
- If there are no risk factors, proceed with normal EMS care.
8. Special Instructions
EMS personnel shall notify the receiving healthcare facility when transporting a suspected Ebola patient, so that appropriate infection control precautions may
be prepared prior to patient arrival. EMS personnel involved in the ground interfacility transfer of patients with suspected or confirmed Ebola should wear
recommended PPE. Please see the end of this IAP for updated guidelines on PPE.
9. Communications (radio and/or phone contact numbers needed for this assignment)
Name/Function
Radio: Freq./System/Channel Phone
Cell/Pager
Emergency Communications
Medical
Evacuation
10. Prepared by:
ASSIGNMENT LIST
Date/Time
Other
11. Reviewed by (PSC):
Page 11 of 23
Date/Time
12. Reviewed by (OSC):
Date/Time
Page
ICS 204-CG (Rev 04/04)
14
1. Incident Name
2. Operational Period (Date/Time)
Ebola 2014
From: 11/03/2014 06:00
3. Branch
4. Division/Group
Emergency Services
Public Hlth & Med Services 2
5. Strike Team / Task Force/Resource (Identifier)
6. Leader
ASSIGNMENT LIST ATTACHMENT
ICS 204a-CG
To: 11/10/2014 06:00
7. Assignment Location
Emergency Medical Services
8. Work Assignment Special Instructions, Special Equipment/Supplies Needed for Assignment, Special Environmental
Considerations, Special Site Specific Safety Considerations
- EMS crews should wear properly fitting PPE as identified in CDC guidance included at the end of this IAP.
- Number of EMS personnel/care providers should be kept to an absolute minimum.
- EMS crews shall call the destination hospital with a pre-arrival report and to receive directions for the transport and specific hospital arrival procedures.
- Air transport via rotary wing aircraft (helicopters) will NOT occur
- Suspect cases should NOT be transported to Iowa Lutheran Hospital, Methodist West Hospital, or Mercy West Lakes. Patients should instead be transported
to Broadlawns Medical Center, Iowa Methodist Hospital, Mercy Medical Center or the VA Medical Center (if they are a veteran).
- Upon arrival at destination hospitals, the ambulance should pull into the patient unloading area as normal. The EMS crew should STAND BY THEIR
AMBULANCE until a hospital staff member comes out to greet them and guide them to the appropriate room via the appropriate route. NOTE unloading the
ambulance may be delayed until the hospital is ready to receive the patient in the ED. Transfer of the patient to hospital staff will otherwise occur as normal.
- The ambulance will not be allowed to leave the garage until decontamination has occurred. The EMS crew is responsible for performing the decon in the
garage under the guidance and supervision of hospital staff, with materials provided by the hospital
- EMS PPE will be doffed under the direction and supervision of hospital staff. The used PPE will be left at the hospital for disposal.
- EMS crews should compile basic contact information for not only their own crews but other close contacts who may have been present at the time of patient
pick up. This will aid the health department in determining potential exposures.
- Rural ambulances and others that feel they are not prepared, equipped, or are uncomfortable with transporting suspect cases should instead contact Iowa
Methodist Hospital, Mercy Medical Center, or one of the private ambulance services for transport/ inter-hospital transfer.
- Limit activities, especially during transport, that can increase the risk of exposure to infectious material (e.g. airway management, cardiopulmonary
resuscitation, use of needles).
- Limit the use of needles and other sharps as much as possible. All needles and sharps should be handled with extreme care and disposed in puncture-proof,
sealed containers.
Approved Site Safety Plan Located at:
9. Other Attachments (as needed)
Map/Chart
10. Prepared by:
Weather Forecast/Tides/Currents
Date/Time
ASSIGNMENT LIST ATTACHMENT
11. Reviewed by (PSC):
Page 12 of 23
Date/Time
12. Reviewed by (OSC):
Date/Time
ICS 204a-CG (Rev 04/04)
Page
15
1. Incident Name
2. Operational Period (Date/Time)
From: 11/03/2014 06:00
Ebola 2014
3. Branch
4. Division/Group/Staging
Public Hlth & Med Services 3
Emergency Services
Name
5. Operations Personnel
Operations Section Chief:
To: 11/10/2014 06:00
Assignment List
ICS 204-CG
Affiliation
Contact # (s)
Scott Slater
Branch Director:
Division/Group Supervisor/STAM:
“X” indicates 204a attachment with additional instructions
6. Resources Assigned
Strike Team/Task Force/Resource
Identifier
Leader
Contact Info. #
# Of
Persons
Reporting Info/Notes/Remarks
Hospitals/Clinics
7. Work Assignments
The CDC will direct where a confirmed Ebola case will go, however hospitals should be prepared to house confirmed cases for up to 5 days until such transfer
can occur.
If clinics receive a phone with a suspect case and the screening questions indicate a strong likelihood of a case, DO NOT advise to come to the clinic. Instead,
EMS should be called to conduct the transport to Broadlawns Medical Center, Iowa Methodist Hospital, Mercy Medical Center or the VA Medical Center (if they
are a veteran).
Rural hospitals should not perform blood draws or other medical procedures beyond screening questions.
8. Special Instructions
9. Communications (radio and/or phone contact numbers needed for this assignment)
Name/Function
Radio: Freq./System/Channel Phone
Cell/Pager
Emergency Communications
Medical
Evacuation
10. Prepared by:
ASSIGNMENT LIST
Date/Time
Other
11. Reviewed by (PSC):
Page 13 of 23
Date/Time
12. Reviewed by (OSC):
Date/Time
Page
ICS 204-CG (Rev 04/04)
18
1. Incident Name
2. Operational Period (Date/Time)
From: 11/03/2014 06:00
Ebola 2014
3. Branch
4. Division/Group/Staging
Hazardous Materials
Emergency Services
Name
5. Operations Personnel
Operations Section Chief:
To: 11/10/2014 06:00
Assignment List
ICS 204-CG
Affiliation
Contact # (s)
Scott Slater
Branch Director:
Division/Group Supervisor/STAM:
“X” indicates 204a attachment with additional instructions
6. Resources Assigned
Strike Team/Task Force/Resource
Identifier
Leader
Contact Info. #
# Of
Persons
Reporting Info/Notes/Remarks
7. Work Assignments
The Ebola virus is a Category A infectious substance regulated by the U.S. Department of Transportation’s (DOT) Hazardous Materials Regulations (HMR, 49
C.F.R., Parts 171-180). Any item transported for disposal that is contaminated or suspected of being contaminated with a Category A infectious substance must
be packaged and transported in accordance with the HMR. This includes medical equipment, sharps, linens, and used health care products (such as soiled
absorbent pads or dressings, kidney-shaped emesis pans, portable toilets, used Personal Protection Equipment [e.g., gowns, masks, gloves, goggles, face
shields, respirators, booties] or byproducts of cleaning) contaminated or suspected of being contaminated with a Category A infectious substance.
8. Special Instructions
- Personnel performing cleaning and disinfection should wear the recommended PPE outlined at the end of this IAP.
- Patient-care surfaces (including stretchers, railings, medical equipment control panels, and adjacent flooring, walls and work surfaces) are likely to become
contaminated and should be cleaned and disinfected after transport. A blood spill or spill of other body fluid or substance (e.g., feces or vomit) should be
managed through removal of bulk spill matter, cleaning the site, and then disinfecting the site. For large spills, a chemical disinfectant with sufficient potency is
needed to overcome the tendency of proteins in blood and other body substances to neutralize the disinfectant’s active ingredient.
- An EPA-registered hospital disinfectant with label claims for viruses that share some technical similarities to Ebola (such as, norovirus, rotavirus, adenovirus,
poliovirus) and instructions for cleaning and decontaminating surfaces or objects soiled with blood or body fluids should be used according to those instructions.
After the bulk waste is wiped up, the surface should be disinfected as described in the bullet above. Contaminated reusable patient care equipment should be
placed in biohazard bags and labeled for cleaning and disinfection according to agency policies. Reusable equipment should be cleaned and disinfected
according to manufacturer's instructions by trained personnel wearing correct PPE. Avoid contamination of reusable porous surfaces that cannot be made
single use.
9. Communications (radio and/or phone contact numbers needed for this assignment)
Name/Function
Radio: Freq./System/Channel Phone
Cell/Pager
Emergency Communications
Medical
Evacuation
10. Prepared by:
ASSIGNMENT LIST
Date/Time
Other
11. Reviewed by (PSC):
Page 14 of 23
Date/Time
12. Reviewed by (OSC):
Date/Time
Page
ICS 204-CG (Rev 04/04)
11
1. Incident Name
2. Operational Period (Date/Time)
From: 11/03/2014 06:00
Ebola 2014
3. Branch
4. Division/Group/Staging
Public Information
Command Staff
Name
5. Operations Personnel
Operations Section Chief:
To: 11/10/2014 06:00
Assignment List
ICS 204-CG
Affiliation
Contact # (s)
Scott Slater
Branch Director:
Division/Group Supervisor/STAM:
“X” indicates 204a attachment with additional instructions
6. Resources Assigned
Strike Team/Task Force/Resource
Identifier
Leader
Contact Info. #
# Of
Persons
Reporting Info/Notes/Remarks
7. Work Assignments
Coordination between IDPH and Polk County Public Health. Public Health will send out relevant information to their partners as necessary.
Press conferences, Flash Reports, Situation Reports, Facebook and Twitter updates will be used for public information.
8. Special Instructions
Once there is a suspected case a Joint Information Center shall be established at Polk County Emergency Management Agency within the hour. The Joint
Information Center shall include representatives from Polk County Public Health, Iowa Department of Public Health, Polk County Emergency Management and
the EMS Agency and Hospital involved in the suspected case. The lead Public Information Officer will come from the Polk County Health Department.
For additional information on Joint Information Center procedures, please log into DLAN and click on Documentation>Reference Library>Polk County
Comprehensive Emergency Plan>ESF#15 Public Information.
9. Communications (radio and/or phone contact numbers needed for this assignment)
Name/Function
Radio: Freq./System/Channel Phone
Cell/Pager
Emergency Communications
Medical
Evacuation
10. Prepared by:
ASSIGNMENT LIST
Date/Time
Other
11. Reviewed by (PSC):
Page 15 of 23
Date/Time
12. Reviewed by (OSC):
Date/Time
Page
ICS 204-CG (Rev 04/04)
13
1. Incident Name
2. Operational Period (Date / Time)
Ebola 2014
From: 11/03/2014 06:00
COMMUNICATIONS LIST
To: 11/10/2014 06:00
ICS 205A-CG
3. Basic Local Communications Information
Assignment
Name
Method(s) of contact (radio frequency, phone, pager, cell #(s), etc.)
Johnston Schools
Susanne Richardson
susanne.richardson@johnston.k12.ia.us/971-1312
Johnston Schools
Susan Krebs
susan.krebs@johnston.k12.ia.us
Unity Point RN Epidemiologist
Carrie OBrien
515-241-6826
Polk County Health Department
Scott Slater
286-3752
Polk County Board of Superviso
Sarah Boese
664-7869
Polk County Medical Exam.
Amanda Luick
201-2275
Broadlawns
Karen Nichols
988-4160
DSM Schools
Amanda Lewis
451-3336
Pine Ridge Farms
Nicole Sams
608-3289
DMACC
Sandra Foster
964-6352
Iowa DPS
Alex Murphy
443-3014
Fraser Ambulance
James Morgan
460-8883
Mary Greeley Medical Center
Chris Perrin
perrinc@mcmc.com
Clive Fire Department
Brian Helland
BHelland@cityofclive.com
Unity Point
Julie Gibbons
241-5434
Unity Point
Kevin Daniels
241-8622
IDPH
Chris Galeazzi
Chris.galeazzi@idph.iowa.gov
IDPH
Anne Garvey
ann.garvey@idph.iowa.gov
DSM Register
Tony Lays
Safe Guard Iowa Partnership
Jesse Truax
jtruax@safeguardiowa.org
Safe Guard Iowa Partnership
Jami Haberl
jhaberl@safeguardiowa.org
Ankeny PD
Makai Echer
mecher@ankenyiowa.gov
DMACC
Ned Miller
nlmiller4@dmacc.edu
Unity Point
Scott Draper
Scott.Draper@unitypoint.org
Polk Co Court Administrator
Anne Sheeley
286-3184
Polk Co Public Works
Bob Rice
286-3705
Polk City PD
Dustin Bjornn
984-6565
Polk Co Medical Examiner
Dr. Schmunk
710-2852
Broadlawns ED
Steve Carter
282-2253
Des Moines Fire Dept
Dale Bunting
283-4929
4. Prepared by: (Communications Unit)
Date / Time
COMMUNICATIONS LIST
ICS 205a-CG (Rev. 07/04)
Page 16 of 23
Page
19
1. Incident Name
2. Operational Period (Date / Time)
Ebola 2014
From: 11/03/2014 06:00
COMMUNICATIONS LIST
To: 11/10/2014 06:00
ICS 205A-CG
3. Basic Local Communications Information
Assignment
Name
Method(s) of contact (radio frequency, phone, pager, cell #(s), etc.)
Polk County Attorney
Ralph Marasco
Ralph.marasco@polkcountyiowa.gov
DSM Public Schools
Marci Cordaro
242-7618
Polk County Sheriff Office
Tim Krum
208-4872
Westcom
Rob Dehnert
rob.dehnert@wdm.iowa.gov
Ankeny PD
Brian Huggins
289-5258
DSM Airport FD
Kevin Gill
573-424-1523
Drake University
Becky Anderson
210-1293
Urbandale FD
Scott Lyon
278-4172
Des Moines Fire
Jim Fox
283-4273
Des Moines Fire
Tony Sposeto
283-4172
Windsor Heights Fire
Christopher Criss
778-2772
MWA
Scott Nelson
710-1403
Polk County Health Depart
Rick Kozin
rick.kozin@polkcountyiowa.gov
Pleasant Hill Fire
Jamie Xayavong
Pleasanthillmedic@gmail.com
MidAmerican
Carol Ralston
clralston@midamerican.com
Mercy Hospital
Brenda McGraw
bmcgraw@mercydesmoines.org
Mercy Hospital
Jan Tippett
jtippett@mercydesmoines.org
Mercy Hospital
Gregg Lagan
glagan@mercydesmoines.org
Iowa Homeland Security
Steve Warren
steve.warren@iowa.gov
Warren County EM
Troy Bass
troyb@co.warren.ia.us
Unity Point
Katherine Hill
katherine.hill@unitypoint.org
Newton Fire
Rex H.
rexhnewtongov.org
Newton Fire
Joe Coen
joec@newtongov.org
Iowa Health Association
Art Spies
spiesd@ihaonline.org
Iowa Air National Guard
Cameron Stufflebeam
cameron.stufflebeam@ang.af.mil
Meredith Corporation
Katherine Reardon
katherine.reardon@meredith.com
Polk County Sheriff Comm
John Smith
john.smith@polkcountyiowa.gov
Polk County Sheriff Office
John Tayler
john.tayler@polkcountyiowa.gov
West Des Moines EMS
Mark Mc Culloch
Mark McCulloch@wdm.iowa.gov
West Des Moines EMS
David Edgar
dedgar@wdm.iowa.gov
Iowa Telecom
Pam Boat
pamboat@iowatelecom.net
4. Prepared by: (Communications Unit)
Date / Time
COMMUNICATIONS LIST
ICS 205a-CG (Rev. 07/04)
Page 17 of 23
Page
20
1. Incident Name
2. Operational Period (Date / Time)
Ebola 2014
From: 11/03/2014 06:00
COMMUNICATIONS LIST
To: 11/10/2014 06:00
ICS 205A-CG
3. Basic Local Communications Information
Assignment
Name
Method(s) of contact (radio frequency, phone, pager, cell #(s), etc.)
Marge Zondervain
margezondervain@gmail.com
Altoona Fire
Doug Richardson
drichardson@altoona-iowa.com
Polk County Sheriff Office
Vic Munoz
victor.munoz@polkcountyiowa.gov
Sean McAndrew
smcandrew83@gmail.com
Tristan Johnson
tgjohnson88@gmail.com
VA
Angela Blankership
angela.blankenship@va.gov
VA
Rebecca Jordan
rebecca.jordan2@va.gov
Marion County Public Health
Kim Dorn
kdorn@marionph.org
Marion County
Kim Pettyjohn
kpettyjohn@co.marion.ia.us
Polk County Sheriff Office
Mike Reasoner
michael.reasoner@polkcountyiowa.gov
VA
Corey Bakaler
corey.bakaler@va.gov
Urbandale Schools
Dan Stein
dstein@urbandale.org
Altoona Fire Department
Jerry Whetstone
jwhetstone@altoona-iowa.com
Justine Wyma
mjwyma@netins.net
PC Sheriffs office
Kevin Schneider
Kevin.Schneider@polkcountyiowa.gov
Story County Hospital
Jeff Gilchrist
jgilchrist@storymedical.org
Marion County Public Health
Teresa H.
thiggin@marionph.org 641-828-2238
Des Moines PD
Gaylord Houston
gmhouston@dmgov.org
Wellmark
Chris George
georgecj@wellmark.com
Ankeny Fire
Frank Prowant
fprowant@ankenyiowa.gov
Ankeny Fire
Dan Schellhase
dschellhase@ankenyiowa.gov
Dallas County EA
Barry Halling
dcema@dwx.com
Dean MCGhee
mcgheemtch@aol.com
Johnston Schools
Josh Morgan
jmorgan@johnston.k12.ia.us
United Way 211
Tim Schuh
tim.schuh@redcross.org
Des Moines Schools
Marci Cordaro
marci.cordaro@dmschools.org
Broadlawns
Jacalyn Bell
jbell@broadlawns.org
Dept Public Safety
Alex Murphy
amurphy@dps.state.ia.us
Ankeny Schools
Chad Bentzinger
chad.bentzinger@ankenyschools.org
LEPC Chair
Mary Jo Press
maryjo.press@kemin.com
4. Prepared by: (Communications Unit)
Date / Time
COMMUNICATIONS LIST
ICS 205a-CG (Rev. 07/04)
Page 18 of 23
Page
21
1. Incident Name
2. Operational Period (Date / Time)
Ebola 2014
From: 11/03/2014 06:00
COMMUNICATIONS LIST
To: 11/10/2014 06:00
ICS 205A-CG
3. Basic Local Communications Information
Assignment
Name
Method(s) of contact (radio frequency, phone, pager, cell #(s), etc.)
Des Moines Police Comm
Sandy Morris
skmorris@dmgov.org
Community Family Youth Svcs
Betty Devine
betty.devine@polkcountyiowa.gov
American Red Cross
Joe Solem
joe.solem@redcross.org
4. Prepared by: (Communications Unit)
Date / Time
COMMUNICATIONS LIST
ICS 205a-CG (Rev. 07/04)
Page 19 of 23
Page
22
Call Tree For Ebola2014.pdf
Continue Normal
Operations
911 Phone call or a call
from a clinic
Questions to ask:
1. Does the person have a
temperature of 100.4 or
greater?
If so ask the following
questions:
1. A severe headache
2. Muscle Pain
3. Vomiting
4. Diarrhea
5. Abdominal Pain
6. Unexplained Bleeding
Continue Normal
Operations
Dispatch EMS:
Alert EMS of a
Suspected Case of
Ebola
No
Yes
Further Questions to Suspected
ask:
Case
Within the last 3
weeks before the
onset of symptoms
have you:
1. Contact with blood
or bodily fluids of a
patient with or
suspected to have
Ebola
2. Residence in or
traveled to an area
with an outbreak of
Ebola is occurring. As
of 10/21/14: Guinea,
Liberia, and Sierra
Leone.
3. Direct handling of
bats or nonhuman
primates from disease
in endemic areas.
Non Suspect Case
Properly fitting PPE
to be donned per
CDC guidelines. With
supervision of a
trained observer
EMS to limit the
amount of
personnel exposed
to suspected case.
EMS assessment of
Patient per CDC
guidelines.
Suspected Case
Compile Basic
Contact
information of
close contacts
to patients and
EMS crew.
No Transport
to: Lutheran,
Methodist
West, and
Mercy West.
Hospital staff will
guide EMS staff to
the appropriate
room
EMS PPE will be
doffed under the
supervision of
hospital staff. The
PPE will be disposed
of by hospital
Pull into the garage.
EMS crew to stand
by ambulance until
the hospital staff
greet you. *This may
be delayed if
hospital is not ready.
EMS is responsible
for decontamination
of the ambulance
which will occur
under hospital
guidance. The
hospital will supply
the cleaning
materials.
Don suspected
patient with gown,
N95 mask, and
gloves.
Prior to transporting,
call the hospital with a
pre-arrival report and
for directions on arrival
procedures.
No air
transport via
rotary wing
aircraft
Page 20 of 23
Page 5
Guidance on PPE.pdf
CDC Guidance on Personal Protective Equipment To Be Used by Healthcare Workers
During Management of Patients with Ebola Virus Disease in U.S. Hospitals
Recommended Personal Protective Equipment





PAPR or N95 Respirator. If a NIOSH-certified PAPR and a NIOSH-certified fit-tested
disposable N95 respirator is used in facility protocols, ensure compliance with all
elements of the OSHA Respiratory Protection Standard, 29 CFR 1910.134, including fit
testing, medical evaluation, and training of the healthcare worker.
o N95 Respirator: Single-use (disposable) N95 respirator in combination with
single-use (disposable) surgical hood extending to shoulders and single-use
(disposable) full face shield.** If N95 respirators are used instead of PAPRs,
careful observation is required to ensure healthcare workers are not inadvertently
touching their faces under the face shield during patient care.
o PAPR: A PAPR with a full face shield, helmet, or headpiece. Any reusable
helmet or headpiece must be covered with a single-use (disposable) hood that
extends to the shoulders and fully covers the neck and is compatible with the
selected PAPR. The facility should follow manufacturer’s instructions for
decontamination of all reusable components and, based upon those instructions,
develop facility protocols that include the designation of responsible personnel
who assure that the equipment is appropriately reprocessed and that batteries are
fully charged before reuse.
 A PAPR with a self-contained filter and blower unit integrated inside the
helmet is preferred.
 A PAPR with external belt-mounted blower unit requires adjustment of
the sequence for donning and doffing, as described below.
Single-use (disposable) fluid-resistant or impermeable gown that extends to at least midcalf or coverall without integrated hood. Coveralls with or without integrated socks are
acceptable.
Consideration should be given to selecting gowns or coveralls with thumb hooks to
secure sleeves over inner glove. If gowns or coveralls with thumb hooks are not
available, personnel may consider taping the sleeve of the gown or coverall over the inner
glove to prevent potential skin exposure from separation between sleeve and inner glove
during activity. However, if taping is used, care must be taken to remove tape gently.
Experience in some facilities suggests that taping may increase risk by making the
doffing process more difficult and cumbersome.
Single-use (disposable) nitrile examination gloves with extended cuffs. Two pairs of
gloves should be worn. At a minimum, outer gloves should have extended cuffs.
Single-use (disposable), fluid-resistant or impermeable boot covers that extend to at least
mid-calf or single-use (disposable) shoe covers. Boot and shoe covers should allow for
ease of movement and not present a slip hazard to the worker.
o Single-use (disposable) fluid-resistant or impermeable shoe covers are acceptable
only if they will be used in combination with a coverall with integrated socks.
Single-use (disposable), fluid-resistant or impermeable apron that covers the torso to the
level of the mid-calf should be used if Ebola patients have vomiting or diarrhea. An apron
provides additional protection against exposure of the front of the body to body fluids or
Page 21 of 23
Page 3

excrement. If a PAPR will be worn, consider selecting an apron that ties behind the neck
to facilitate easier removal during the doffing procedure.
The CDC is also recommending an apron if vomiting, diarrhea occur.
For additional details including preparing for Donning and Doffing please go to this link:
http://www.cdc.gov/vhf/ebola/hcp/procedures-for-ppe.html
Page 22 of 23
Guidance on PPE.pdf
Page 4
Page 23 of 23