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<p><strong>You Are Here:</strong> <span class="crumb_link"><a href="/" class="crumb_link">AHRQ Archive Home</a> &gt; <a href="/prep/" class="crumb_link">Public Health Preparedness Archive</a> &gt; <a href="index.html" class="crumb_link">Disaster Alternate Care Facility Selection Tool</a> &gt; <a href="dacfrep.htm" class="crumb_link">Disaster Alternate Care Facilities: Selection and Operation</a> &gt; Tables 4-5</span></p>
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<td height="30px"><span class="title"><a name="h1" id="h1"></a>Disaster Alternate Care Facility Selection Tool </span></td>
</tr>
<tr>
<td><div id="centerContent"><p><strong>Public Health Emergency Preparedness</strong></p> <div class="headnote">
<p>This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.</p>
<!-- <p>Now this resource is supported by the <a href="http://emergency.cdc.gov/">Centers for Disease Control and Prevention</a> (CDC).</p> -->
<p>This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: <a href="https://info.ahrq.gov/">https://info.ahrq.gov</a>. Let us know the nature of the problem, the Web address of what you want, and your contact information. </p>
<p>Please go to <a href="https://www.ahrq.gov/">www.ahrq.gov</a> for current information.</p></div>
<h3><a name="tab4" id="tab4"></a>Table 4. Level I: Hospital Augmentation/Limited ACF Cache (50 Patients)</h3>
<table border="1" cellpadding="5" cellspacing="0" width="70%">
<tr align="center">
<th scope="col" width="40%">Item</th>
<th scope="col" width="10%">Number</th>
<th scope="col" width="10%">Cost Each Item</th>
<th scope="col" width="10%">Total</th>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Disaster/surge capacity trailer</td>
<td>1</td>
<td>10,000</td>
<td>10,000</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Patient cots</td>
<td>45</td>
<td>50</td>
<td>2250</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Patient cots, with wheels, collapsible</td>
<td>10</td>
<td>250</td>
<td>2500</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Linens - Sheets (2 per patient + extras)</td>
<td>150</td>
<td>4.56</td>
<td>684</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Linens - Blankets</td>
<td>75</td>
<td>13.5</td>
<td>1012.50</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Linens - Pillows (disposable - case of 15)</td>
<td>4</td>
<td>43.2</td>
<td>172.80</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Linens - Pillow cases</td>
<td>100</td>
<td>1.14</td>
<td>114</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">N95 masks (case of 210)</td>
<td>1</td>
<td>98</td>
<td>98</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Gloves - Latex Free Exam - small (case of 1000)</td>
<td>1</td>
<td>36</td>
<td>36</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Gloves - Latex Free Exam - medium (case of 1000)</td>
<td>1</td>
<td>36</td>
<td>36</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Gloves - Latex Free Exam - large (case of 1000</td>
<td>1</td>
<td>38.34</td>
<td>38.34</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Gloves - Powder Free Exam - small (case of 1000)</td>
<td>1</td>
<td>37.55</td>
<td>37.55</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Gloves - Powder Free Exam - medium (case of 1000)</td>
<td>1</td>
<td>37.55</td>
<td>37.55</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Gloves - Powder Free Exam - large (case of 1000)</td>
<td>1</td>
<td>39</td>
<td>39</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Gowns ( for staff - splash resistant - case of 12)</td>
<td>10</td>
<td>39</td>
<td>390</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Bag-valve-mask respirators</td>
<td>10</td>
<td>11</td>
<td>110</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Blood pressure cuffs (manual)</td>
<td>5</td>
<td>40</td>
<td>200</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">Stethoscopes</td>
<td>10</td>
<td>35</td>
<td>350</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left">IV Poles</td>
<td>25</td>
<td>60</td>
<td>1500</td>
</tr>
<tr valign="middle" align="center">
<td scope="row" align="left"><strong>TOTAL EQUIPMENT COSTS</strong></td>
<td colspan="3"><strong>$19,605.74</strong></td>
</tr>
</table>
<p class="size2"><a href="dacfrepch4.htm#tab4">Return to Document</a></p>
<br />
<h3><a name="tab5" id="tab5"></a>Table 5. Level II Regional ACF Cache (500 Patients)</h3>
<table border="1" cellpadding="5" cellspacing="0" width="70%">
<tr align="center">
<th scope="col" width="30%">Product Name<a href="#notet5a"><sup>a</sup></a><sup>, <a href="#notet5b">b</a></sup></th>
<th scope="col" width="40%">Description<sup><a href="#notet5c">c</a></sup></th>
</tr>
<tr>
<td scope="row">Applicator, cotton tipped</td>
<td>sterile, cotton-tipped, wood shaft; 5 yr shelf life</td>
</tr>
<tr>
<td scope="row">Bag Holder</td>
<td>rectangular aluminum</td>
</tr>
<tr>
<td scope="row">Bag Valve-Mask (adult)</td>
<td>Disposable</td>
</tr>
<tr>
<td scope="row">Bag Valve-Mask (infant)</td>
<td>Disposable</td>
</tr>
<tr>
<td scope="row">Bag, Disposable</td>
<td>Plastic, drawstring, 33 gal.</td>
</tr>
<tr>
<td scope="row">Bag, Disposable, Biohazard</td>
<td>disposable, 2 ml, red, 33 gallon</td>
</tr>
<tr>
<td scope="row">Batteries, AA</td>
<td>for flashlights</td>
</tr>
<tr>
<td scope="row">Bedpan</td>
<td>pontoon type, plastic</td>
</tr>
<tr>
<td scope="row">Bedpan, Fracture </td>
<td>Plastic, female, mauve</td>
</tr>
<tr>
<td scope="row">Blanket, Flannel</td>
<td>&nbsp;</td>
</tr>
<tr>
<td scope="row">Blanket, infant</td>
<td>white, cotton</td>
</tr>
<tr>
<td scope="row">Blanket, thermal</td>
<td>WHI2.2 lb 48</td>
</tr>
<tr>
<td scope="row">Blood Pressure Unit</td>
<td>Aneroid, Adult, L/F</td>
</tr>
<tr>
<td scope="row">Blood Pressure Unit</td>
<td>Aneroid, Child, L/F</td>
</tr>
<tr>
<td scope="row">Brief, Adult</td>
<td>Trimline, Medium, 8/12'sF</td>
</tr>
<tr>
<td scope="row">Bungy Cords</td>
<td>20 piece assortment</td>
</tr>
<tr>
<td scope="row">Chair, Folding</td>
<td>Poly</td>
</tr>
<tr>
<td scope="row">Clip Boards</td>
<td>brown clipboard</td>
</tr>
<tr>
<td scope="row">Cots, Portable </td>
<td>Collapsible deluxe aluminum military cot</td>
</tr>
<tr>
<td scope="row">Cots, Portable 500 lb rated</td>
<td>600 Denier nylon PVC-back poly on aluminum frame</td>
</tr>
<tr>
<td scope="row">Crib, Peds, Portable </td>
<td>single drop rail</td>
</tr>
<tr>
<td scope="row">Diapers, disposable</td>
<td>Baby, Cloth-Like CVR</td>
</tr>
<tr>
<td scope="row">Disinfectants/detergent</td>
<td>Meritz Plus, 32 oz.</td>
</tr>
<tr>
<td scope="row">Emesis Basin</td>
<td>&nbsp;</td>
</tr>
<tr>
<td scope="row">Form, General Medicine</td>
<td>&nbsp;</td>
</tr>
<tr>
<td scope="row">Form, Laboratory, Diagnostic </td>
<td>&nbsp;</td>
</tr>
<tr>
<td scope="row">Form, Registration, English</td>
<td>&nbsp;</td>
</tr>
<tr>
<td scope="row">Form, Registration, Spanish</td>
<td>&nbsp;</td>
</tr>
<tr>
<td scope="row">Gate, Child</td>
<td>Superyard XT Gate by Northgate Industries</td>
</tr>
<tr>
<td scope="row">Gloves</td>
<td>Medium, powder free, chloroprene</td>
</tr>
<tr>
<td scope="row">Gloves</td>
<td>Large, powder free, chloroprene</td>
</tr>
<tr>
<td scope="row">Gown, Patient, disposable</td>
<td>Adult, tissue/poly-tissue, blue; 2 yr shelf life</td>
</tr>
<tr>
<td scope="row">Gown, Patient, disposable</td>
<td>Pediatric, poly, white</td>
</tr>
<tr>
<td scope="row">Gown, Provider</td>
<td>MEDIUM, DuPont ProVent, Open back</td>
</tr>
<tr>
<td scope="row">Gown, Provider</td>
<td>LARGE, DuPont ProVent, Open back</td>
</tr>
<tr>
<td scope="row">Hamper Bag</td>
<td>drawcord, p/c natural</td>
</tr>
<tr>
<td scope="row">Hamper, Linen (soiled)</td>
<td>Rectangular stnd w/o lid</td>
</tr>
<tr>
<td scope="row">Hand Cleaner (waterless)</td>
<td>Epi-Clenz, 4 oz 70% ethyl</td>
</tr>
<tr>
<td scope="row">ID Band, Insert</td>
<td>Adult, vinyl, Blue</td>
</tr>
<tr>
<td scope="row">ID Band, pediatric</td>
<td>vinyl, snap, pink</td>
</tr>
<tr>
<td scope="row">IV Set</td>
<td>15DR/ML, LL,NO</td>
</tr>
<tr>
<td scope="row">Light, Flashlight</td>
<td>VersaBrite II, 8000 cp</td>
</tr>
<tr>
<td scope="row">Light, Headlamp</td>
<td>Trident halogen w/cloth strap</td>
</tr>
<tr>
<td scope="row">Mask, N-95 particulate respirators</td>
<td>Resp, 8211 N95, Cool Flw</td>
</tr>
<tr>
<td scope="row">Mask, Oxygen, Adult</td>
<td>Medium concent w/7'</td>
</tr>
<tr>
<td scope="row">Mask, Oxygen, Pediatric</td>
<td>Medium concen, 7'TB</td>
</tr>
<tr>
<td scope="row">Mat, Child</td>
<td>Mahar flat rest mat/2" foam (10 yr warranty)</td>
</tr>
<tr>
<td scope="row">Mattress, Portable Crib</td>
<td>Kolcraft, 2.5" thick, nonallergenic</td>
</tr>
<tr>
<td scope="row">Mattress Underpad, Crib</td>
<td>Polymer, Deluxe</td>
</tr>
<tr>
<td scope="row">Name Badge &amp; Holder, plastic clip-on</td>
<td>inkjet/laserjet, 100/box</td>
</tr>
<tr>
<td scope="row">Notepads</td>
<td>White, 100 pages</td>
</tr>
<tr>
<td scope="row">Pack, Ice</td>
<td>Cold Compress</td>
</tr>
<tr>
<td scope="row">Pack, Warm</td>
<td>Solar-Pack</td>
</tr>
<tr>
<td scope="row">Penlight, disposable</td>
<td>6 /pk</td>
</tr>
<tr>
<td scope="row">Pens, Standard </td>
<td>Bic Clic Stick</td>
</tr>
<tr>
<td scope="row">Pillowcase, disposable</td>
<td>Tissue/Poly, White</td>
</tr>
<tr>
<td scope="row">Pillows, disposable</td>
<td>Protect a Med Cot Pillow, blue</td>
</tr>
<tr>
<td scope="row">Pole, IV</td>
<td>4 caster, 2 hook</td>
</tr>
<tr>
<td scope="row">Scissors, Lister bandage</td>
<td>5 1/2"</td>
</tr>
<tr>
<td scope="row">Screen, Privacy, 3-panel</td>
<td>folding, w/casters, flame retardant</td>
</tr>
<tr>
<td scope="row">Sharps Containers, Biohazard </td>
<td>2 gal. Red</td>
</tr>
<tr>
<td scope="row">Sheets, Stretcher</td>
<td>Tissue/Poly, Blue</td>
</tr>
<tr>
<td scope="row">Soap, Liquid</td>
<td>Protection Plus Antimicrobial</td>
</tr>
<tr>
<td scope="row">Spectacles, Eye Protective </td>
<td>clear, wraparound, poly</td>
</tr>
<tr>
<td scope="row">Stethoscope, dual head</td>
<td>black, 5 yr shelf life</td>
</tr>
<tr>
<td scope="row">Storage container</td>
<td>clear plastic, attached top</td>
</tr>
<tr>
<td scope="row">Stretcher, Folding</td>
<td>Ferno Model 12</td>
</tr>
<tr>
<td scope="row">Stretcher, w/Wheels</td>
<td>Ferno Model 11</td>
</tr>
<tr>
<td scope="row">Table, Folding </td>
<td>Gray</td>
</tr>
<tr>
<td scope="row">Tape, Cloth</td>
<td>Cloth</td>
</tr>
<tr>
<td scope="row">Tape, Duct </td>
<td>&nbsp;</td>
</tr>
<tr>
<td scope="row">Thermometer, Disposable Strips</td>
<td>Nextemp 1 use thermometer; 5 yr shelf life</td>
</tr>
<tr>
<td scope="row">Tongue depressor</td>
<td>&nbsp;</td>
</tr>
<tr>
<td scope="row">Tourniquet</td>
<td>latex free</td>
</tr>
<tr>
<td scope="row">Urinal, male</td>
<td>w/Hill-Rom Compatible Handle</td>
</tr>
</table>
<p class="size2"><sup><a name="notet5a" id="notet5a"></a>a</sup> The inclusion of product brand names is for identification and illustrative purposes only and does not imply any type of endorsement or specific recommendation.<br />
<sup><a name="notet5b" id="notet5b"></a>b</sup> Quantities must take into consideration both the length of time the site will be in use (before re-supply can occur) and the purpose of the site.<br />
<sup><a name="notet5c" id="notet5c"></a>c</sup> For storage purposes, calculate the overall space needed based on the size of boxes or containers the items will be stored in.</p>
<p class="size2"><a href="dacfrepch4.htm#tab5">Return to Document</a></p>
<div class="footnote">
<p> The information on this page is archived and provided for reference purposes only.</p></div>
<p>&nbsp;</p>
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