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ID
12-508-1142
Name
Palliative Care Team
Status
Published
Version
1.8
Updated
11/19/2019 11:39:13 AM
Original Release
03/14/2008
Last Major Release
11/19/2019
Description
The Palliative Care Team provides holistic palliative care for the critically, chronically, and terminally ill, or for injured persons in medical facilities, hospice, alternative care sites, and home care settings. After a mass casualty incident, this capability can support victims not expected to survive by minimizing suffering and facilitating patient-family end-of-life interactions.
Resource Category
Medical and Public Health
Primary Core Capability
Public Health, Healthcare, and Emergency Medical Services
Secondary Core Capability
 
Resource Kind
Team
Overall Function
The Palliative Care Team provides a range of services in a variety of settings, noted above. This team: 1. Provides end-of-life medical services, comfort, specialty pain management and support, including hydration and nutrition 2. Provides specialty pain management, other symptom control, and psychological/behavioral health guidance for patients 3. Provides guidance, training, and psychological support to caregivers, to help them adapt to the current situation 4. Supports family members and other loved ones, including through end-of-life and bereavement counseling 5. Provides support and training to the patient, family members, and other loved ones 6. Assists the patient, family, and staff with difficult medical decisions and identification of treatment options 7. Serves as a professional resource on palliative care guidelines and parameters
Composition and Ordering Specifications
1. Discuss logistics for deploying this team, such as working conditions, length of deployment, security, lodging, transportation, and meals, prior to deployment 2. Responding personnel have the clinical knowledge and skill to function in the clinical area as the incident demands 3. Requestor orders a Healthcare Resource Coordination Team to supplement clinical staff and support administrative, communications, team transportation, housing, clerical (medical records), security/safety, supply, and medical equipment maintenance and repair needs 4. Staffing requests consider patient census, patient acuity, and the types of skilled interventions necessary 5. Requestor verifies the existence of potentially hazardous conditions 6. To ensure that staff, equipment, and supplies fit the need, requests for assistance define the clinical area, specify required specialty services, and give an accurate mission assignment, including the expected practice setting 7. Requestor orders a Physician Assistant or a Nurse Practitioner to augment this team's capabilities 8. Requestor identifies who this team will coordinate with, such as coroner’s office, appropriate Emergency Support Functions (ESP), or hospital network 9. Requestor and provider discuss needed capabilities: a. Type 1 teams have supplies and personnel to establish Palliative Care Team services within an alternate care facility b. Type 2 teams provide staff augmentation within established facilities and use the facility's supplies, medications, and equipment 10. Requestor agrees to accept all credentials of provider's team members, allowing supplied team to function in existing facilities
Supporting Core Capabilities
None
Components
Component Notes  
MINIMUM PERSONNEL PER TEAMNot Specified
Component Types
Type Attribute
Type 117
Type 210
MANAGEMENT AND OVERSIGHT PERSONNEL PER TEAMNot Specified
Component Types
Type Attribute
Type 1Same as Type 2
Type 21 – National Incident Management System (NIMS) Type 1 Medical Team Leader
SUPPORT PERSONNEL PER TEAM1. Teams have operational competence in palliative care protocols and in working with an existing palliative care team. 2. NIMS Type 2 Registered Nurses have certifications in palliative care.
Component Types
Type Attribute
Type 1Same as Type 2, PLUS: 1 – NIMS Type 1 Pharmacist 1 – NIMS Type 1 Dietitian/Nutritionist 1 – NIMS Type 1 or 2 Behavioral Health Specialist 1 - NIMS Behavioral Health Chaplaincy Specialist 1 – NIMS Type 2 Registered Nurse 2 – NIMS Type 3 Registered Nurse
Type 21 – NIMS Type 1 Medical Officer 1 – NIMS Type 1 Social Worker 1 – NIMS Type 2 Registered Nurse 2 – NIMS Type 3 Registered Nurse 4 – NIMS Type 1 Patient Care Technician
Medical Supplies Per Team1. Requestor orders equipment per team or per team member. 2. For Type 2 teams, requestor orders equipment based on the facility a team will deploy to.
Component Types
Type Attribute
Type 1Specialized palliative care and hospice medical equipment, supplies, and medications to operate in an alternative care site or healthcare facility without established palliative or hospice care services, including: 1. Pain medication/administration 2. Wound care 3. Hospice kits
Type 2Not Specified
Personal Protective Equipment (PPE) Equipment Per Team MemberThe following standards address PPE: Occupational Safety and Health Administration (OSHA) 29 Code of Federal Regulations (CFR) Part 1910.134: Respiratory Protection and OSHA 29 CFR Part 1910.1030: Bloodborne Pathogens.
Component Types
Type Attribute
Type 1Same as Type 2
Type 2Personal Protective Equipment (PPE) is mission specific and may vary by work environment, including: 1. Protective footwear 2. Protective clothing for skin exposure 3. Eye and ear protection 4. Respirators 5. Gloves 6. Masks
Communications Equipment Per Team MemberConsider alternate forms of communications, such as satellite phones, based on the mission assignment and team needs.
Component Types
Type Attribute
Type 1Same as Type 2
Type 21. Two-way portable radio 2. Cell phone
721
Notes
References
Reference
FEMA, NIMS 508: Healthcare Resource Coordination Team
FEMA, NIMS 509: Medical Team Leader
FEMA, NIMS 509: Medical Officer
FEMA, NIMS 509: Behavioral Health Specialist
FEMA, NIMS 509: Dietitian/Nutritionist
FEMA, NIMS 509: Patient Care Technician
FEMA, NIMS 509: Pharmacist
FEMA, NIMS 509: Registered Nurse
FEMA, NIMS 509: Social Worker
FEMA, NIMS 509: Behavioral Health Chaplaincy Specialist
FEMA, National Incident Management System (NIMS), October 2017
Occupational Safety and Health Administration (OSHA) 29 Code of Federal Regulations (CFR) Part 1910.134: Respiratory Protection, latest edition adopted
OSHA 29 CFR Part 1910.1030: Bloodborne Pathogens, latest edition adopted