Disaster Preparedness Plan
Team I
Setting:
You are the Surgical Team I Captain (with 4 junior surgical residents and 3 surgical interns in his team) on duty at the OMMC Surgical ER.
1.1 scenario:
During office hours, you received a phone call transmitting a message that an explosion has occurred at the Pandacan Oil Depot and to expect a lot of victims being sent to OMMC.
I. DECLARATION OF DISASTER
Surgical Team I Captain will inform the Disaster Control Director (DCD), the DCD will declare the presence of a disaster.
Creation of an incident command
A Command Center will be set up to handle and coordinate all internal communications.
I. DECLARATION OF DISASTER
All departments evaluate their units and report immediately to the Command Center about the number of staff on duty, the availability of beds, operating rooms and the status of utilities.
All department heads or their designee can call as many of their employees as needed.
Incident Command Center: Surgery ER/Trauma
Assign a nurse to the communications system in the E.R
II. NOTIFICATION AND MOBILIZATION
Notification of
-Department Disaster Control Director
-Department Assistant Chair for Service
-Department Chair
-Senior House Officer on duty
-Hospital Director
II. NOTIFICATION AND MOBILIZATION
Mobilization and organization (task assignment and authorization) of surgical and parasurgical staff
-Surgical Team on Duty
-Surgical Team Pre-duty
-Surgical Team Post-duty
-Surgery Consultants
Specific specialty consultants (Plastic/Orthopedic/Neuro)
General surgery consultants
-Parasurgical staff – nurses
(Emergency Room, Operating Room, Surgery Ward)
II. NOTIFICATION AND MOBILIZATION
Evaluate the availability of operating rooms, including the number of scrub teams, and note the number of critical care beds available for trauma beds.
prepare for incoming casualties determining which standard hospital operations (e.g., elective surgeries, outpatient procedures) should cease and which should continue.
Mobilization and organization of other medical staff as indicated with task assignment and authorization
Mobilization of ancillary services (laboratory/blood bank, x-ray, pharmacy, etc)
III. CONTROL OF DISASTER
Triage
Treatment
Referrals
In the event of a Mass Casualty Incident, local acute care hospitals with emergency departments will be alerted as early as possible .
III. CONTROL OF DISASTERTriage
Treatment
Referrals
In the event of a Mass Casualty Incident, local acute care hospitals with emergency departments will be alerted as early as possible .
Traffic control
allow for movement of patients through corridors and staff movement throughout their areas.
egress routes for patients and staff provided for evacuation purposes.
elevators are manned and controlled
elevator usage prioritized
movement routes designated within the hospital and traffic flow charts prepared and posted.
arrangements made for both vehicular (Trauma) and people (ER) entrance to and exit from the hospital premises
Uninterrupted flow of ambulances and other vehicles to casualty sorting areas or emergency room entrances
III. CONTROL OF DISASTER
Patient log
Relatives Information Area
A "Visitor Control Center" will be set up in the front lobby. Families of casualties will be instructed to wait there until notified of patient's condition.
Normal visiting hours will be suspended during the disaster situation.
This "Visitor Control Center" should be away from the Emergency Department to minimize unwanted access to the relatives and friends of disaster victims?
III. CONTROL OF DISASTER
Press conference
Identify a designated area for the media and press briefings
designate an internal spokesperson as a media contact (Hospital Director)
IV. DECONGESTION AND POST-DISASTER RECONSTRUCTION
Make provision for the following during recovery:
Documentation,
Financial matters,
Inventory
Re-supply
IV. DECONGESTION AND POST-DISASTER RECONSTRUCTION
Record preservation
Cleanup
Hazard removal and cleanup
Garbage and waste disposal
Utility and equipment servicing
Physical plant restoration and renovation
Debriefing
Counseling services
1.2 scenario:
After office hours, you received a phone call transmitting a message that an explosion has occurred at the Pandacan Oil Depot and to expect a lot of victims being sent to OMMC.
I. DECLARATION OF DISASTER
The Surgical Team I Captain will declare the presence of a disaster, and will inform the Disaster Control Director (DCD)
Creation of an incident command
A Command Center will be set up to handle and coordinate all internal communications
I. DECLARATION OF DISASTERThe Surgical Team I Captain will declare the presence of a disaster, and will inform the Disaster Control Director (DCD)
Creation of an incident command
A Command Center will be set up to handle and coordinate all internal communications
All departments evaluate their units and report immediately to the Command Center about the number of staff on duty, the availability of beds, operating rooms and the status of utilities.
All department heads or their designee can call as many of their employees as needed.
Incident Command Center: Surgery ER/Trauma
Assign a nurse to the communications system in the E.R
II. NOTIFICATION AND MOBILIZATION
Notification of
-Department Disaster Control Director
-Department Assistant Chair for Service
-Department Chair
-Senior House Officer on duty
-Hospital Director
II. NOTIFICATION AND MOBILIZATION
Mobilization and organization (task assignment and authorization) of surgical and parasurgical staff
-Surgical Team on Duty
-Surgical Team Pre-duty
-Surgical Team Post-duty
-Surgery Consultants
Specific specialty consultants (Plastic/Orthopedic/Neuro)
General surgery consultants
-Parasurgical staff – nurses
(Emergency Room, Operating Room, Surgery Ward)
II. NOTIFICATION AND MOBILIZATION
Evaluate the availability of operating rooms, including the number of scrub teams, and note the number of critical care beds available for trauma beds.
prepare for incoming casualties determining which standard hospital operations should cease and which should continue.
Mobilization and organization of other medical staff as indicated with task assignment and authorization
Mobilization of ancillary services (laboratory/blood bank, x-ray, pharmacy, etc)
Triage
Treatment
Referrals
In the event of a Mass Casualty Incident, local acute care hospitals with emergency departments will be alerted as early as possible .
III. CONTROL OF DISASTER
Traffic control
allow for movement of patients through corridors and staff movement throughout their areas.
egress routes for patients and staff provided for evacuation purposes.
elevators are manned and controlled
elevator usage prioritized
movement routes designated within the hospital and traffic flow charts prepared and posted.
arrangements made for both vehicular (Trauma) and people (ER) entrance to and exit from the hospital premises
Uninterrupted flow of ambulances and other vehicles to casualty sorting areas or emergency room entrances
III. CONTROL OF DISASTER
Patient log
Relatives Information Area
A "Visitor Control Center" will be set up in the front lobby. Families of casualties will be instructed to wait there until notified of patient's condition.
Normal visiting hours will be suspended during the disaster situation.
This "Visitor Control Center" should be away from the Emergency Department to minimize unwanted access to the relatives and friends of disaster victims
III. CONTROL OF DISASTER
Press conference
Identify a designated area for the media and press briefings
designate an internal spokesperson as a media contact (Hospital Director/ Senior House Officer)
IV. DECONGESTION AND POST-DISASTER RECONSTRUCTION
Make provision for the following during recovery:
Documentation
Financial matters
Inventory
Re-supply
IV. DECONGESTION AND POST-DISASTER RECONSTRUCTION
Record preservation
Cleanup
Hazard removal and cleanup
Garbage and waste disposal
Utility and equipment servicing
Physical plant restoration and renovation
Debriefing
Counseling services
1.3 scenario:
During office hours, you received a phone call transmitting a message that an explosion has occurred at the Pandacan Oil Depot. You were asked to send an ambulance and a team of medical staff to help.
After informing the CDC of the situation, the CDC will create a Scene Response Team.
The CDC will be the Incident Commander.
Scene Response Team is composed of Team 1 surgical residents, interns, nurses, ambulance driver, and orderlies.
At the explosion site, a scene triage classification will be performed
Black – for non-salvageable patients
Green – for primary care patients or classified as priority three
Yellow – for acute care patients or classified as priority two
Red – for critical care patients or classified as priority one
determine priority in transportation to OMMC or any hospital
Render life-saving first-aid measures
Direct the proper transportation of the injured to OMMC or any designated hospital
Tag all patients given treatment at the scene
On each tag should be stated medication and treatment given
1.4 scenario:
After office hours, you received a phone call transmitting a message that an explosion has occurred at the Pandacan Oil Depot. You were asked to send an ambulance and a team of medical staff to help.
After informing the CDC of the situation, a Scene Response Team will be created
The Surgical Team Captain will act as the Incident Commander
Scene Response Team is composed of Team 1 surgical residents, interns, nurses, ambulance driver, and orderlies
At the explosion site, a scene triage classification will be performed
Black – for non-salvageable patients
Green – for primary care patients or classified as priority three
Yellow – for acute care patients or classified as priority two
Red – for critical care patients or classified as priority one
determine priority in transportation to OMMC or any hospital
Render life-saving first-aid measures
Direct the proper transportation of the injured to OMMC or any designated hospital
Tag all patients given treatment at the scene
On each tag should be stated medication and treatment given
1.5 scenario:
During office hours, you got a patient who got injured in an explosion at the Pandacan Oil Depot. You were told that there were a lot of victims. These victims might be brought to OMMC.
The Incident Commander is the Disaster Control Director.
Incident Commander is an agreed upon coordinator of services, stationed at Incident Command Post. This role should be predefined in local disaster plans.
The following functions would be:
Assess scene and set up incident command (unified command)
Consider additional resources (i.e. law enforcement, ambulances, rescue and heavy rescue units, haz-mat, automatic and mutual aid)
Plan and coordinate strategies for controlling resources and the overall incident at a single location command post
Assign sectors/divisions as required (i.e. safety, triage, treatment, decon., transport)
Notify area hospitals (Through dispatch, hospital common, individual channels, or cellular)
The Incident Commander is not allowed to operate.
The triage is the key to effective management of a sudden inflow of disaster casualties.
The principal objectives are:
To receive the disaster victims.
To make a rapid classification (not identification) of casualties and conduct them to appropriate treatment areas:
Black – for non-salvageable patients
Green – for primary care patients or classified as priority three
Yellow – for acute care patients or classified as priority two
Red – for critical care patients or classified as priority one
The Surgical Team Captain on duty may be assigned to do the triaging.
In the hospital disaster plan,there are 4 teams
Team A – Surgery and ENT( for acute care patients)
Team B – Medicine and Pedia (for critical care patients)
Team C – Family Medicine Green (for primary care patients)
Team D – Nurses
Surgical Residents – Team A may operate if necessary.
1.6 scenario:
After office hours, you got a patient who got injured in an explosion at the Pandacan Oil Depot. You were told that there were a lot of victims. These victims might be brought to OMMC.
The Incident Commander will be the Surgical Team Captain.
Incident Commander is an agreed upon coordinator of services, stationed at Incident Command Post. This role should be predefined in local disaster plans.
The following functions would be:
Assess scene and set up incident command (unified command)
Consider additional resources (i.e. law enforcement, ambulances, rescue and heavy rescue units, haz-mat, automatic and mutual aid)
Plan and coordinate strategies for controlling resources and the overall incident at a single location command post
Assign sectors/divisions as required (i.e. safety, triage, treatment, decon., transport)
Notify area hospitals (Through dispatch, hospital common, individual channels, or cellular)
The Incident Commander is not allowed to operate.
The triage is the key to effective management of a sudden inflow of disaster casualties.
The principal objectives are:
To receive the disaster victims.
To make a rapid classification (not identification) of casualties and conduct them to appropriate treatment areas:
Black – for non-salvageable patients
Green – for primary care patients or classified as priority three
Yellow – for acute care patients or classified as priority two
Red – for critical care patients or classified as priority one
The Surgical Team Captain on duty may be assigned to do the triaging.
In the hospital disaster plan,there are 4 teams
Team A – Surgery and ENT( for acute care patients)
Team B – Medicine and Pedia (for critical care patients)
Team C – Family Medicine Green (for primary care patients)
Team D – Nurses
Surgical Residents – Team A may operate if necessary.
Problem-solving and Decision-making:
As the Surgical Team Captain, after you are through solving each scenario, construct a table showing the basic similarities and differences, first, in the scenarios themselves and, second, in the steps you will undertake for all the scenarios.
Cluster A1 - Disaster Scenarios – Explosions / Fire
For Disaster Control Director/ Surgical Team Captain / Junior Surgical Residents
Scenario:
Ten victims from the Pandacan Oil Depot explosion are now arriving or have arrived in the OMMC Surgery ER.
Problem-solving and decision-making:
1. Who will serve as the incident commander?
The Incident Commander is the Disaster Control Director
What are his roles?
Incident Commander is an agreed upon coordinator of services, stationed at Incident Command Post. This role should be predefined in local disaster plans.
This is usually the Disaster Control Director or the Senior House Officer, with the following functions:
Assess scene and set up incident command (unified command)
Consider additional resources (i.e. law enforcement, ambulances, rescue and heavy rescue units, haz-mat, automatic and mutual aid)
What are his tasks?
Is he allowed to operate?
Plan and coordinate strategies for controlling resources and the overall incident at a single location command post.
Assign sectors/divisions as required (i.e. safety, triage, treatment, decon., transport)
Notify area hospitals (Through dispatch, hospital common, individual channels, or cellular)
The Incident Commander is not allowed to operate
2. A triage has to be done.
How do you go about doing this?
Who should be assigned to do the triaging?
A Triage has to be done:
Objectives
to receive the disaster victims
To make a rapid classification of casualties
Triage officer :
The Surgical Team Captain on duty may be assigned to do the triaging.
Any resident who is knowledgeable in classifying casualties rapidly with appropriate coding to facilitate and prioritize treatment.
2. A triage has to be done.
How is triaging done, place assignment and color coding?
Coding
Black – for non-salvageable patients
Green – for primary care patients
or classified as priority three
Yellow – for acute care patient
or classified as priority two
Red – for critical care patients
or classified as priority one
How is TRIAGING done?
- assign corresponding treatment area for the different codes
- classify patient rapidly as they come and give the corresponding codes
-conduct patients to corresponding areas
3. Who should do the treatment and operation if needed?
In the hospital disaster plan, there are 4 teams
Team A – Surgery and ENT( for acute care patients)
Team B – Medicine and Pedia (for critical care patients)
Team C – Family Medicine (for primary care patients)
Team D – Nurses
Surgical Residents – Team A may operate if necessary.
INTERNAL DISASTER- OR Explosion
During office hours, there was a big explosion in the operating room of the hospital. There were about 10 OR personnel (surgeons, anesthesiologists, nurses, nursing aides, and medical interns) who suffered from blast injuries. About 80% of the operating room was destroyed.
INTERNAL DISASTER
Problem-solving and Decision-making:
As the Surgical Team Captain, what will you do next after learning of the explosion. List the steps in an order of priority and give a brief description and explanation, if necessary, for each step.
Declaration of disaster
Notify disaster control director
Activation of department’s disaster preparedness plan
Creation of an incident command
Mobilization of surgical and parasurgical staff (task assignment)
Mobilization and organization of other medical staff as indicated
Mobilization of ancillary services as indicated
Control of disaster
Decongestion of post-disaster reconstruction
I. Declaration of disaster
By any OMMC Surgery personnel
By OMMC Surgery Disaster Control Director
In the scenario presented it was done by the Surgical Team I Captain
II. Activation of the department’s disaster preparedness plan
III. Creation of an incident command
A Command Center will be set up, with the Surgical Team I Captain as Incident Commander in the absence of the disaster control director, to handle and coordinate all internal communications.
All departments evaluate their units and report immediately to the Command Center about the number of staff on duty, the availability of beds, operating rooms and the status of utilities.
All department heads or their designee can call as many of their employees as needed.
Incident Command Center should be at the Surgery ER/Trauma building.
A nurse is assigned to the communications system in the E.R
Mobilization and organization (task assignment and authorization) of surgical and parasurgical staff
-Surgical Team on Duty
-Surgical Team Pre-duty
-Surgical Team Post-duty
-Surgery Consultants
Specific specialty consultants (Plastic/Orthopedic/Neuro)
General surgery consultants
-Parasurgical staff – nurses
Emergency Room
Operating Room
Surgery Ward
Evaluate the availability of operating rooms, including the number of scrub teams, and note the number of critical care beds available for trauma beds.
prepare for incoming casualties determining which standard hospital operations (e.g., elective surgeries, outpatient procedures) should cease and which should continue.
Mobilization and organization of other medical staff as indicated with task assignment and authorization
Mobilization of ancillary services (laboratory/blood bank, x-ray, pharmacy, etc)
IV. Notification and Mobilization
Notification of
-Department Disaster Control Director
-Department Assistant Chair for Service
-Department Chair
-Senior House Officer on duty
-Hospital Director
Internal Disaster –
OMMC Kitchen Fire
FOR SURGICAL TEAM CAPTAIN
You are an OMMC surgical resident assigned to Surgical Team I. You are the Team Captain on duty at the OMMC Surgery ER. You are NOT the Disaster Control Director. You have 4 junior surgical residents and 3 surgical interns in your team
After office hours, there was a big fire that occurred in the kitchen of the hospital and there were about 10 victims were reported to be brought to the OMMC Surgery ER.
PROBLEM-SOLVING AND DECISION-MAKING:
As the Surgical Team Captain, what will you do next after learning of the fire. List the steps in an order of priority and give a brief description and explanation, if necessary, for each step.
STEPS IN DISASTER MANAGEMENT
Declaration of disaster
Notify disaster control director
Activation of department’s disaster preparedness plan
Creation of an incident command
(scene response team)
Mobilization of surgical and parasurgical staff (task assignment)
Mobilization and organization of other medical staff as indicated
Mobilization of ancillary services as indicated
Control of disaster
Decongestion of post-disaster reconstruction
Disaster Scenarios
Sudden Influx Of Trauma Patients
FOR SURGICAL TEAM CAPTAIN
After office hours, there was a sudden influx of trauma patients with 4 needing stat exploratory laparotomy and about 10 needing suturing of lacerations in the Surgery ER.
What will you do?
PROBLEM-SOLVING AND DECISION-MAKING:
As the Surgical Team Captain, what will you do next after learning of the sudden influx of trauma patients. List the steps in an order of priority and give a brief description and explanation, if necessary, for each step.
STEPS IN DISASTER MANAGEMENT
Declaration of disaster
Notify disaster control director
Activation of department’s disaster preparedness plan
Creation of an incident command
(scene response team)
Mobilization of surgical and parasurgical staff (task assignment)
Mobilization and organization of other medical staff as indicated
Mobilization of ancillary services as indicated
Control of disaster
Decongestion of post-disaster reconstruction
WHAT IS THE TAGGING SYSTEM OF PATIENTS? MATCH THE COLORS TO THE TYPE OF PATIENTS.
Black – for non-salvageable patients
Green – for primary care patients or classified as priority three
Yellow – for acute care patients or classified as priority two
Red – for critical care patients or classified as priority one
*The Surgical Team Captain on duty may be assigned to do the triaging.
You are an OMMC surgical resident assigned to Surgical Team I. You are the Team Captain on duty at the OMMC Surgery ER. You are NOT the Disaster Control Director. You have 4 junior surgical residents and 3 surgical interns in your team
After office hours, there was a big fire that occurred in the kitchen of the hospital and there were about 10 victims were reported to be brought to the OMMC Surgery ER.
PROBLEM-SOLVING AND DECISION-MAKING:
As the Surgical Team Captain, what will you do next after learning of the fire. List the steps in an order of priority and give a brief description and explanation, if necessary, for each step.
STEPS IN DISASTER MANAGEMENT
Declaration of disaster
Notify disaster control director
Activation of department’s disaster preparedness plan
Creation of an incident command
(scene response team)
Mobilization of surgical and parasurgical staff (task assignment)
Mobilization and organization of other medical staff as indicated
Mobilization of ancillary services as indicated
Control of disaster
Decongestion of post-disaster reconstruction
Disaster Scenarios
Sudden Influx Of Trauma Patients
FOR SURGICAL TEAM CAPTAIN
After office hours, there was a sudden influx of trauma patients with 4 needing stat exploratory laparotomy and about 10 needing suturing of lacerations in the Surgery ER.
What will you do?
PROBLEM-SOLVING AND DECISION-MAKING:
As the Surgical Team Captain, what will you do next after learning of the sudden influx of trauma patients. List the steps in an order of priority and give a brief description and explanation, if necessary, for each step.
STEPS IN DISASTER MANAGEMENT
Declaration of disaster
Notify disaster control director
Activation of department’s disaster preparedness plan
Creation of an incident command
(scene response team)
Mobilization of surgical and parasurgical staff (task assignment)
Mobilization and organization of other medical staff as indicated
Mobilization of ancillary services as indicated
Control of disaster
Decongestion of post-disaster reconstruction
WHAT IS THE TAGGING SYSTEM OF PATIENTS? MATCH THE COLORS TO THE TYPE OF PATIENTS.
Black – for non-salvageable patients
Green – for primary care patients or classified as priority three
Yellow – for acute care patients or classified as priority two
Red – for critical care patients or classified as priority one
*The Surgical Team Captain on duty may be assigned to do the triaging.
1.. Patients needing primary care.- Green
2.. Patients needing acute care.- Yellow
3.. Patients needing critical care.- Red
4.. Dead patients.- Black
5.. Patients needing first priority care.- Red
6.. Patients needing second priority care.- Yellow
7.. Patients needing third priority care.- Green