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We Are Public Health - September 2016

We Are Public Health, September 2016

We Are Public Health

This story features the work of the Public Health Emergency Preparedness Unit at the Wyoming Department of Health. Photo courtesy of the CDC.

We are public health.
We strategically locate medical resources to support emergency response.

Of all the states in the US, the Wyoming Department of Health’s Public Health Emergency Preparedness Unit receives the least amount of federal funding.

But in a frontier state, responding to a widespread emergency or natural disaster can be challenging. Wyoming spans nearly 100,000 square miles, and the travel distances between residents and to more urban areas are vast. One county lacks a local hospital. To make matters worse, frequent road closures during the winter months can limit access to medical care. Seventeen of 23 counties have fewer than six residents per square mile.

Dense populations can present problems too. Tourist attractions, such as Yellowstone National Park, or events like the Sturgis Motorcycle Rally frequently bring a large influx of visitors to the state. During the peak tourist season, Yellowstone National Park brings in an average of approximately 2.5 million people per year—nearly five times the state’s population of residents.

“Given our existing resources and staffing levels, we knew we needed to find creative ways to increase our capacity for responding to public health emergencies,” said Sheryl Roub, Manager for the Public Health Preparedness Unit at the Wyoming Department of Health.

To address this issue, Wyoming’s Public Health Emergency Preparedness Unit worked with the Centers for Disease Control and Prevention (CDC) to acquire one of eighteen surplus Federal Medical Stations. These stations come with equipment and supplies for operating a temporary medical facility for 50 to 250 patients. On March 7, 2015, the organization became the first to obtain the medical equipment at no cost. Included was a cache of much needed items such as wheel chairs, walkers, stretchers, defibrillators, oxygen cylinders and tubing, beds, cribs, linens, personal hygiene items, baby supplies, and more.

Roub and her colleagues chose to break the 250-bed Federal Medical Station into five 50-bed units so they could be strategically placed around the state. They would store Wyoming Medical Stations in areas where it would be convenient for the stations to quickly “pop up,” enabling the state to provide medical support where it is needed the most. The five units will take some of the pressure off emergency rooms and hospitals by providing surge bed capacity for handling cases that are less acute. To date, one unit is deployed, two are configured and ready to go, and Roub and her colleagues are working to identify one more site for the last unit.

Choosing the right location to store the Wyoming Medical Stations was a pivotal piece in the preparedness puzzle. “It is important to hit that sweet spot between storing them where support is most needed, and co-locating it with as many available resources as possible,” said Roub.

To make the Wyoming Medical Stations operational, the site locations needed to be in close proximity to certain wrap-around services. These services include: a 12-person Wyoming Medical Station assembly group, food preparation services, potable water, physical security, laundry services, patient transportation, a secure pharmaceutical area and refrigerator, biomedical and standard waste removal, billeting services, and oxygen filling services.

There are other challenges, including the question of how to develop their staffing plan. “It’s one thing to have this wonderful resource in hand, but it is another thing to be able to put it into motion when the time calls for it, and that takes man power,” said Roub. “What makes it so tricky is trying to find the solutions to questions like ‘How do you pay for staffing?’ or ‘How do you cover staff liability?’”

Roub and her colleagues are currently exploring different staffing options, including having the National Guard staff the stations, contracting with an out-of-state vendor called BCFS in San Antonio, Texas to provide staffing services, and working with local public health nurses, law enforcement, fire fighters, emergency medical services, and volunteers.

As part of their education and outreach efforts, Roub and her colleagues are conducting trainings, calls, and webinars on how to set up and use the medical stations. In August, 2016, they were invited to attend the Annual Wyoming Trauma and EMS Conference, where they set up a mini version of their Wyoming Medical Station. “The single most important message we wanted to convey at the conference is that Wyoming Medical Stations are for low acuity patients and their job is to decompress emergency rooms,” said Roub. Dr. Dan O’Leary, the Career Epidemiology Field Officer for Wyoming was there to provide an overview of the mini station, and answer questions about where they will be located, how to get one set up in a county, and what the space requirements are for a station.

Next year—with the support of the Carbon County Emergency Manager, John Zieger—Roub and her colleagues plan to run a mock exercise using the Rawlins Wyoming Medical Station.