Regional Resources

Regional Resources

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Crisis Standards of Care

Crisis Standards of Care

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WRAP-EM Pediatric Crisis Standards of Care Template version 2.0
 181 Downloads
 984.12 KB
 08-20-2023

Provides references and information to develop pediatric crisis standards of care (CSC). Also outlines triggers of CSC and legal considerations.

The Arizona Surge Line
 40 Downloads
 4 KB
 01-03-2024

The Arizona Surge Line was active for two years during the COVID-19 pandemic, facilitating the movement of nearly 10,000 patients with COVID-19 and load-leveling hospitals to postpone crisis standards of care in the state. With the end of the declared state of emergency in Arizona, the Arizona Surge Line ..

Should Covid Vaccination Status Be Used to Make Triage Decisions?
 40 Downloads
 4 KB
 01-03-2024

The relationships between each vaccine and interactions of different patient demographics or pre-existing diseases with resultant survival outcomes are undoubtedly complex and currently unknown. But if it is ethically questionable to apply vaccination status as a first-order consideration for critical care triage, might it be ethically defensible to use ..

Rapid Expert Consultation on Guiding Principles, Key Elements, Core Messages for CSC
 91 Downloads
 1.22 MB
 08-20-2023

This rapid expert consultation responds to a March 25 request to provide a rationale for the implementation of crisis standards of care (CSC) in response to the COVID-19 outbreak. Also discussed are the broad principles and core elements of CSC planning and implementation.

PICU in the MICU: how adult intensive care units can support pediatric care in public health emergencies
 36 Downloads
 4 KB
 01-03-2024

Care of pediatrics during a surge in adult facilities and considerations and strategies for care.

Network for Public Health Law Crisis Standards of Care: Legal Decision Factors
 192 Downloads
 221.02 KB
 08-20-2023

This memo identifies (1) factors or criteria generally interpreted or viewed as “unlawful” for purposes of Crisis Standards of Care (CSC) decision-making; and (2) remaining lawful bases for which CSC decisions may be made.

Navigating Legalities in Crisis Standards of Care
 52 Downloads
 4 KB
 01-03-2024

Solving the challenges of law and legal repercussions when CSC is invoked.

Guidance: State COVID-19 Emergency Declarations
 37 Downloads
 4 KB
 01-03-2024

State emergency declarations during COVID 19.

Ethically Navigating the Murky Waters of “Contingency Standards of Care"
 40 Downloads
 4 KB
 01-03-2024

Excellent article on the ethics around contingency and crisis standards from a historical perspective

CSC and COVID-19: What Did We Learn? How Do We Ensure Equity? What Should We Do?
 34 Downloads
 4 KB
 01-03-2024

The linked discussion paper focuses on hospital application of Crisis Standards of Care (CSC) and provides suggestions on revising CSC based on COVID-19 experiences.

Crisis Standards of Care—More Than Just a Thought Experiment?
 34 Downloads
 4 KB
 01-03-2024

Excellent article on the politics of CSC activation and involvement of government . Reviews triage and life saving care.

Crisis Standards of Care: Legal Decision Factors
 204 Downloads
 183.93 KB
 08-21-2023

Factors and criteria that may lawfully be used to determine CSC for specific patients in addition to factors that are unlawful to use.

Crisis Standards of Care: Guideline Table for Conventional, Contingency, and Crises Situations
 91 Downloads
 452.07 KB
 08-21-2023

Pediatric Crisis Standards of Care Reference Table for conventional, contingency and crisis care. Shows triggers, activation requirements and potential strategies.

Crisis Standards of Care - A Systems Framework for Catastrophic Disaster Response - Volume 1
 105 Downloads
 6.32 MB
 08-20-2023

Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response: Volume 1: Introduction and CSC Framework (2012)

Collaboration on Arizona Surge Line
 29 Downloads
 4 KB
 01-03-2024

To address the anticipated hospital surge due to the Covid-19 pandemic, a single statewide system was developed to expedite patient transfers and equitably distribute patients infected with SARS-CoV-2 across hospitals. The effort, featuring a 24/7 call line, was initiated by the Arizona Department of Health Services and collaboratively protocolized ..

COVID-19 and MIS-C

Pandemics

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WRAP-EM COVID-19 Vaccine for Children 5-11 Fact Sheet
 131 Downloads
 180.58 KB
 08-20-2023

COVID-19: WHAT PEDIATRICIANS AND PARENTS NEED TO KNOW ABOUT THE VACCINE FOR CHILDREN AGES 5-11

WA DOH Telepsychology
 123 Downloads
 390.13 KB
 08-20-2023

WA telepsychology definitions and guidelines

SAMHSA Tips For Social Distancing, Quarantine, and Isolation During An Infectious Disease Outbreak
 75 Downloads
 329.83 KB
 08-20-2023

Tips for social distancing, quarantine, and isolation during an infectious disease outbreak.

Rapid Expert Consultation on Guiding Principles, Key Elements, Core Messages for CSC
 91 Downloads
 1.22 MB
 08-20-2023

This rapid expert consultation responds to a March 25 request to provide a rationale for the implementation of crisis standards of care (CSC) in response to the COVID-19 outbreak. Also discussed are the broad principles and core elements of CSC planning and implementation.

PHE and pediatric mental health - TELE-BH
 82 Downloads
 4.98 MB
 05-03-2023

Slide deck on pediatric mental health and telemedicine in the PHE

Pediatric multisystem inflammatory syndrome temporally associated with COVID-19
 102 Downloads
 131.6 KB
 08-20-2023

This document is to raise awareness and gives management advice to clinicians and has been developed after expert review of the cases.

NYC Health Advisory 16 - Updated Reporting Requirements for MIS-C Associated with COVID-19
 69 Downloads
 1.09 MB
 08-20-2023

Reporting of MIS-C and clinical criteria

NV Infographic
 132 Downloads
 257 KB
 08-20-2023

Process for assessing, testing and reporting COVID cases in Nevada

NPHL Western Region Memo - Emergency Declarations Overview
 143 Downloads
 131.39 KB
 08-20-2023

Brief explanations of emergency declarations in response to COVID-19 at federal, state / tribal and local levels.

Crisis Standards of Care - A Systems Framework for Catastrophic Disaster Response - Volume 1
 105 Downloads
 6.32 MB
 08-20-2023

Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response: Volume 1: Introduction and CSC Framework (2012)

COVID-19 Vaccine Fact Sheet
 130 Downloads
 160.7 KB
 08-20-2023

COVID-19 FAQ – WHAT EVERYONE NEEDS TO KNOW ABOUT THE VACCINE

Coronavirus in Children Overview Zimmermann PedInfDisJ 2020
 114 Downloads
 663.42 KB
 08-20-2023

Review of COVID 19, diagnosis, treatment options and vaccines

Children’s Hospitals Caring for Adults During a Pandemic: Pragmatic Considerations and Approaches
 78 Downloads
 56.71 KB
 08-20-2023

Policymakers at pediatric facilities should think critically about their institution’s capacity to manage adults. Relationship building is imperative

CHA Pediatric Elective Surgery Guidance March 23 2020
 134 Downloads
 133.71 KB
 08-20-2023

Proposed guidance to limit non-time sensitive pediatric surgery and procedures, and to assist policymakers in the management of vital health care resources for children during a time of crisis.

Alameda Co. Health Advisory
 125 Downloads
 1.83 MB
 08-20-2023

Reviews actions of clinicians and reporting mechanisms needed for MIS-C

Provider Resources

Provider Resources

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WRAP-EM Pediatric Crisis Standards of Care Template version 2.0
 181 Downloads
 984.12 KB
 08-20-2023

Provides references and information to develop pediatric crisis standards of care (CSC). Also outlines triggers of CSC and legal considerations.

WRAP-EM Legal Guide Version 2023
 560 Downloads
 1.92 MB
 10-17-2023

A guide outlining legal and policy issues related to public health emergency declarations and healthcare response to disaster. Included are legal considerations from the COVID-19 pandemic, licensing, credentialing, and privileging, telehealth, idemnification, family reunification, data, etc.

WRAP-EM Kids In Crisis Initiative_Webinar Packet
 67 Downloads
 249.42 KB
 01-09-2024

This resource is a summary of the webinar agenda, speakers, and resources for the Kids in Crisis Initiative webinar.

University of Utah Burn Crisis Standards of Care App
 17 Downloads
 4 KB
 01-03-2024

This is a link to the University of Utah's Burn Crisis Standards of Care app that can be downloaded to a mobile device.

Triage by Resource Allocation for INpatients [TRAIN™]
 38 Downloads
 4 KB
 01-03-2024

The TRAIN® tool determines level of transport required for evacuation based on resource utilization. The tool aligns with local EMS protocols for transport type capabilities and expert opinion.

Preparedness Checklist for Pediatric Practices
 14 Downloads
 2.3 MB
 02-05-2024

This checklist, based on physicians' experiences in prior disasters, can help pediatricians take realistic, concrete steps to improve office preparedness.

PPN Navigating Potential Flu Antiviral Medication Shortages
 283 Downloads
 91.83 KB
 12-21-2022

This FAQ sheet provides resources and information on potential influenza antiviral medication shortages, specifically oseltamivir.

PICU in the MICU - How Adult ICUs Can Support Pediatric Care
 349 Downloads
 355.96 KB
 12-01-2022

This journal article is on COVID-19 pediatric intensive care unit (PICU) capacity and the use of adult intensive care units (ICUs) to potentially care for children.

Pediatric Preparedness Resource Kit
 27 Downloads
 4 KB
 01-03-2024

The American Academy of Pediatrics (AAP) developed The Pediatric Preparedness Resource Kit, which allows for pediatricians, public health leaders and other pediatric care providers to assess what is already happening in their community or state, and help determine what needs to be done before an emergency or disaster. The ..

OpenCriticalCare.org
 17 Downloads
 4 KB
 01-03-2024

OpenCriticalCare.org (beta) was launched in August 2020 as a repository for reliable, open-access critical care learning tools with relevance to resource-variable settings. In 2023, OCC has begun to transition from urgent content creation and dissemination for COVID19 and is now focusing on the creation of novel tools and content ..

Official Policy Statement: Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Units
 32 Downloads
 4 KB
 01-03-2024

The statement issued by multiple societies responds to requests for potentially inappropriate treatments in intensive care units. It provides guidance for clinicians to prevent and manage disputes with patients who have advanced critical illness.

Mass Critical Care Surge Response during COVID-19: Implementation of Contingency Strategies
 76 Downloads
 2.25 MB
 08-20-2023

This journal article proof proposes a subcommittee from the Task Force for Mass Critical Care offers interim evidence-informed operational strategies to assist hospitals and communities to plan for and respond to surge capacity demands from COVID-19.

Hazard Vulnerability Analysis & Metrics Score Card
 20 Downloads
 4 KB
 01-03-2024

A well-prepared emergency management system is essential for regions and communities to prepare and respond to disasters and other emergencies. Using tools such as the Pediatric Hazard Vulnerability Analysis and the Regional Metrics Score Card can help. This webpage includes Pediatric Hazard Vulnerability Analysis tools, a Regional Metrics Score Card, ..

Docs for Health
 18 Downloads
 4 KB
 01-03-2024

Cutting-edge screening tool focused on the patient’s current needs, not just historical data from the past six months. It can be used as the primary assessment or seamlessly integrated into existing screening processes, offering a dynamic approach to identify immediate social needs.

DASH - Disaster Available Supplies in Hospitals
 20 Downloads
 4 KB
 01-03-2024

Disaster Available Supplies in Hospitals (DASH) is an interactive tool that can help hospital emergency planners and supply chain staff estimate supplies that may need to be immediately available during various mass casualty incidents (MCI) and infectious disease emergencies based on hospital characteristics.

Curated Resources from National Pediatric Disaster Coalition
 320 Downloads
 84.94 KB
 11-22-2022

Links to resources related to pediatric surge resources as well as tools for Crisis Standards of Care (CSC), pediatric mental health, and cross training for adult providers.

CSC and COVID-19: What Did We Learn? How Do We Ensure Equity? What Should We Do?
 34 Downloads
 4 KB
 01-03-2024

The linked discussion paper focuses on hospital application of Crisis Standards of Care (CSC) and provides suggestions on revising CSC based on COVID-19 experiences.

Pediatric Surge Resources

Pediatric Surge Resources

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Curated Resources from National Pediatric Disaster Coalition
 320 Downloads
 84.94 KB
 11-22-2022

Links to resources related to pediatric surge resources as well as tools for Crisis Standards of Care (CSC), pediatric mental health, and cross training for adult providers.

MN DPH Pediatric Surge Toolkit
 7 Downloads
 4 KB
 02-05-2024

This link provides the pediatric surge toolkit and video introduction. It also offers assessment, planning, education, and response tools and templates.

NPDC Response to ASPR TRACIE PediSurge Resource Request
 135 Downloads
 57.59 KB
 11-22-2022

A response to California Hospital Association (CHA) Disaster Conference 2022 included pediatric presentations from PDCOEs and WRAP-EM. The document provides an overview of the presentation as well as links to resources

Pediatric Surge Recommendations and Resources 11.11.2022
 359 Downloads
 325.23 KB
 11-22-2022

The recommendations and resources below were compiled by pediatric experts from the Pediatric Pandemic Network, Gulf 7 – Pediatric Disaster Network, Region V for Kids, the Western Regional Alliance for Pediatric Emergency Medicine, and the Emergency Medical Services for Children Innovation and Improvement Center. These ideas and resources are ..

Pediatric Surge Resources List
 355 Downloads
 167.26 KB
 11-22-2022

Brief descriptions and links to pediatric surge resources developed by WRAP-EM and other entities.

Pediatric Surge Tools from PDCOEs 10-26-22
 657 Downloads
 631.58 KB
 11-22-2022

A presentation by WRAP-EM members outlining pediatric surge strategies and tools for staff, stuff, and space.

PICU in the MICU - How Adult ICUs Can Support Pediatric Care
 349 Downloads
 355.96 KB
 12-01-2022

This journal article is on COVID-19 pediatric intensive care unit (PICU) capacity and the use of adult intensive care units (ICUs) to potentially care for children.

WRAP-EM Hospital Reception Site Template
 152 Downloads
 1.22 MB
 08-20-2023

Provides a template to assist hospitals in developing a plan for Hospital Reception Sites for families in the case of a mass casualty incident or epidemic. These materials are based upon the national Hospital Incident Command System (HICS), with supplement positions and customized practices. The Hospital Reception Site falls ..

WRAP-EM JIT Quick Pediatric Reference Guide for Adult Healthcare Providers
 413 Downloads
 4.64 MB
 12-01-2022

Reference guide for adult healthcare providers treating pediatric patients. Includes clinical information for pediatric triage, vital signs, examinations, and assessments. 

Resources for Families

Resources for Families

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Campfire Burn Prevention
 37 Downloads
 187.07 KB
 01-09-2024

Prevention tips and initial treatment for campfire burn injury

CHLA How Families Can Prepare for Disasters
 24 Downloads
 4 KB
 11-13-2023

Produced by Children's Hospital of Los Angeles, this webpage provides families guidance for preparing for and responding to disasters. A key document on this site is the "Disaster Preparedness Activitie for Your Family" which is available in English, Arabic, Armenian, Chinese, Korean, and Spanish. It also provides guidance on ..

Clark County Preparedness Web Page
 19 Downloads
 4 KB
 01-08-2024

Preparedness tips and links to tips for families, children, seniors, and those with access and functional needs

Emergency Plan for Cancer Patients & Their Families
 4 KB
 02-19-2024

Disaster planning resources for people with mesothelioma and other types of cancer, their caregivers, and their families.

Fire Safety Checklist for Students
 40 Downloads
 01-08-2024

Student Fire Safety

Firework Safety
 39 Downloads
 287.92 KB
 01-09-2024

Prevention tips and treatment for firework injury

First Aid for Minor Burn Injuries
 37 Downloads
 462.41 KB
 01-08-2024

First Aid for minor burn injuries

Frostbite Prevention
 39 Downloads
 1.13 MB
 01-08-2024

Frostbite and Hypothermia prevention tip sheet

Gas Fireplace Safety
 44 Downloads
 304.93 KB
 01-09-2024

Guidance for how to keep children safe around gas fireplaces

Gasoline Safety
 39 Downloads
 219.48 KB
 01-09-2024

Prevention tips and treatment for gasoline fire injury

Juvenile Fire Setting Fact Sheet
 38 Downloads
 195.02 KB
 01-09-2024

Youth Firesetting prevention and education

NCTSN Talking to Children about War
 44 Downloads
 4 KB
 11-14-2023

The National Child Traumatic Stress Network (NCTSN) is a trusted resource for mental health guidance and information. On this webpage is "Talking to Children about War". This document offers information for caregivers on how to talk to children about war. It includes the potential impact and considerations when talking ..

Nevada DEM Kids Preparedness Page
 18 Downloads
 4 KB
 01-08-2024

This webpage provides disaster preparedness resources for kids K-12

Non fire cooking burns
 38 Downloads
 421.2 KB
 01-09-2024

Tip sheet on non fire burn injury prevention with data

Pediatric Scald Prevention
 41 Downloads
 210.69 KB
 01-09-2024

Prevention Tips and treatment for pediatric scald injury

Preparing Your Child for a Disaster
 21 Downloads
 4 KB
 12-04-2023

The County of Sonoma, CA has a dedicated page to Preparedness for the Whole Community - Access and Functional Needs. Within this page is "Preparing your child for a disaster." This customizable booklet addresses the specialized needs of children with autism that may present challenges for their families and ..

Preventing Dry Ice Burns
 41 Downloads
 3.68 MB
 01-09-2024

Tips on how to prevent and treat dry ice burns

SAMHSA Tips For Social Distancing, Quarantine, and Isolation During An Infectious Disease Outbreak
 75 Downloads
 329.83 KB
 08-20-2023

Tips for social distancing, quarantine, and isolation during an infectious disease outbreak.

Southern Nevada CERT
 21 Downloads
 4 KB
 01-08-2024

Link provides access to the Southern NV CERT Program to train families and communities in disaster preparedness

Tear Gas Fact Sheet
 134 Downloads
 162.78 KB
 08-20-2023

Brief overview of treating the impacts of exposure to tear gas.

UCSF Benioff Children's Hospital Family Emergency Evacuation Kit
 132 Downloads
 737.48 KB
 08-20-2023

A disaster planning guide for families focused on emergency evacuation.

UCSF Benioff Children's Hospital Kit de Evacuación de Emergencia Para La Familia
 89 Downloads
 1.46 MB
 08-20-2023

Kit de evacuación de emergencia para la familia. La preparación para una emergencia o desastre puede ser una tarea difícil y abrumadora. Planear con anticipación puede ayudarle a estar listo.

WRAP-EM COVID-19 Vaccine for Children 5-11 Fact Sheet
 131 Downloads
 180.58 KB
 08-20-2023

COVID-19: WHAT PEDIATRICIANS AND PARENTS NEED TO KNOW ABOUT THE VACCINE FOR CHILDREN AGES 5-11

Legal and Policy Guidance

Legal & Policy Guidance

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WRAP-EM Legal Resource Guide 2021
 140 Downloads
 2.06 MB
 08-20-2023

A detailed report addressing law and policy issues from the continued impacts of the COVID19 pandemic until July 9, 2021. The core objective of this guide is to produce a strategic assessment of legal or policy issues affecting the development of a regional model to enhance emergency pediatric disaster responses.

WRAP-EM Legal Guide Version 2023
 560 Downloads
 1.92 MB
 10-17-2023

A guide outlining legal and policy issues related to public health emergency declarations and healthcare response to disaster. Included are legal considerations from the COVID-19 pandemic, licensing, credentialing, and privileging, telehealth, idemnification, family reunification, data, etc.

Network for Public Law Region Memo - CSC Legal Factors
 22 Downloads
 221.02 KB
 08-31-2023

This document provides a list of factors/criteria viewed as both lawful and unlawful for CSC decision-making impacting patients. Developed after the COVID-19 pandemic.

Network for Public Health Law Crisis Standards of Care: Legal Decision Factors
 192 Downloads
 221.02 KB
 08-20-2023

This memo identifies (1) factors or criteria generally interpreted or viewed as “unlawful” for purposes of Crisis Standards of Care (CSC) decision-making; and (2) remaining lawful bases for which CSC decisions may be made.

ASU - Center for Public Health Law and Policy
 40 Downloads
 4 KB
 01-10-2024

The Arizona State University Center for Public Health Law and Policy provides regular of the Supreme Court Public Health Law Policy Updates. This site links to the most recent one.

WRAP-EM INITIATIVES

Telemedicine Focus Group

The Telemedicine Focus Group (TMFG) focuses on optimizing providers’ ability to deliver effective pediatric treatment across regional and state lines by developing resources and guidelines. The TMFG coordinates with hospitals and command centers to leverage telehealth programs into the larger context of crisis management and help stabilize emergency needs.

Mental Health Focus Group

The Mental Health Focus Group has a strong team of experts providing resources and programs. Their focus is on educating providers in triaging and assessing pediatric mental health needs during a disaster. In addition, the Mental Health Focus Group also focuses on care post-disaster considering that mental health often calls for long term and follow-up care, especially in adolescents.

Legal Resource Guide

Several focus groups have collaborated to develop a legal resource guide. The guide is intended to serve as a reference for emergency managers, administrators, and providers to successfully deliver care during a disaster. The core objective of this guide is to produce a strategic assessment of legal or policy issues affecting the development of a regional model to enhance emergency pediatric disaster responses.

Featured Resources and Announcements

Critical Global and Regional Announcements Shared by our WRAP-EM Community and Partners.

Resources for Community Crisis

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Radiation Surge Annex Pediatric Workshop

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On Tuesday, July 19, 2022, WRAP-EM hosted the Healthcare Coalition Radiation Surge Annex Pediatric Workshop. The purpose was to provide pediatric focused content for HCCs to include in their Radiation Surge Annexes. The content is also valuable for providers and facilities to view for education and planning purposes.

Pediatric Respiratory Care Resources

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WRAP-EM Subject Matter Experts with our partner networks have produced a 10-minute video, "Just-in-time Bronchiolitis Pearls and Pitfalls". It is intended to be a quick overview for providers with limited pediatric experience.

WRAP-EM has compiled a “just in time” basic clinical guidance for respiratory care of children for providers with limited pediatric experience, including High-Flow Nasal Cannula (HFNC) Protocols. Open Document

Resources for Global Crisis

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The Disaster Distress Helpline, 1-800-985-5990, is a 24/7, 365-day-a-year, national hotline dedicated to providing immediate crisis counseling for people who are experiencing emotional distress related to any natural or human-caused disaster. This toll-free, multilingual, and confidential crisis support service is available to all residents in the United States and its territories. 

www.samhsa.gov

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Talk To Someone Now. Share . Share on facebook Share on twitter Share with email. If you’re thinking about suicide, are worried about a friend or loved one, or would like emotional support, the Lifeline network is available 24/7 across the United States. Directory.

www.suicidepreventionlifeline.org

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Contact Poison Control right away if you suspect a poisoning. Help is available online with webPOISONCONTROL® or by phone at 1-800-222-1222. Both options are free, expert, and confidential.

https://www.poison.org/

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The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals in the United States.

https://988lifeline.org/

The Western Regional Alliance for Pediatric Emergency Management is supported by Award Number 6 U3REP190616-01-02 from the Office of the Assistant Secretary for Preparedness and Response (ASPR). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of ASPR or the Department of Health and Human Services.

© Copyright WRAP-EM, 2023

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