Disaster Management KSUMC Zohair Al Aseri. MD, FCEM

Disaster Management KSUMC Zohair Al Aseri. MD, FCEM

Disaster Management KSUMC Zohair Al Aseri. MD, FCEM (UK). FRCPC (EM&CCM). Consultant, Departments of Emergency Medicine & Critical Care. Chairman, Department of Emergency Medicine Director, Disaster Management Master Program. College of Medicine King Saud University Hospitals.

Riyadh, KSA Email: [email protected] Fax: +966(11)467-2529 Tel: +966(11)467-0544 Definition of a Medical Disaster When the destructive effects of a natural or manmade forces overwhelm the

ability of a given area or community to meet the demands for health care Hospital Emergency Incident Command System (HEICS) & Emergency (Disaster) Operations Plan (EOP)

serve as an important emergency . management foundation for our institute Basic Features of ICS

Common terminology Modular organization Management by objectives Reliance on an Incident Action Plan (IAP) Chain of command and unity of command Unified Command

Manageable span of control ICS Management Organization Management system not an organizational chart The ICS organization does NOT correlate to the administrative structure of the agency Normal roles may not be assumed in ICS ICS Management Functions

INCIDENT COMMANDER LIAISON OFFICER SAFETY OFFICER

PUBLIC INFORMATION OFFICER OPERATIONS SECTION PLANNING SECTION

LOGISTICS SECTION FINANCE/ADMIN. SECTION Emergency (Disaster) Operations Plan (EOP) Intended to explain in a clear and concise

manner the critical components HICS as well as the suggested manner for using the accompanying materials. Two types of emergencies that may impact on this hospital Internal Emergencies involve only the hospital and its capabilities that may be reduced.

External Emergencies will usually be sited outside the hospital and the hospitals capabilities may remain intact. Basic components of EOP: 1)Mitigation: find ways to reduce the devastating effects of disaster BEFORE it occurs.

2)Preparedness / Planning 3)Response 4)Recovery / Debriefing 3 temporal phases of injury event Prevent Event Post event

Description of Disaster PICE- Potential Injury Creating Event PICE- Prefixes A B C

Static Controlled Local Dynamic

Disruptive Regional Paralytic National International

PICE PICE Stage Need for Status of outside help outside help 0

None Inactive I Small Alert

II Medium Standby III

Large Dispatch CTAS Triage level I

II III IV Time to MD Imm 15

ediat min e Fractile Response 98% 95% 90% 85% 80% 30 60

min min V 120 min Admission Rate 7040- 20- 10- 090% 70% 40% 20% 10% Impact Zone

Injured & non-injured victims Triage Zone Dead & Uninjured Treatment Transport

Transport Staging Area Hospital or Health Care Area MOI 1. Primary Mechanisms

2. Secondary Mechanisms 3. Tertiary Mechanisms Forces Involved

Examples Impact Acceleration Deceleration Crush Penetration Thermal Electrical

Victim thrown into a wall by a tornado Blast wave in explosion Sudden stop in plane crash Victims trapped in collapsed structures Projectiles powered by wind, explosion Burns from fires after earthquake Lightning strikes in storm

Asphyxiation Inhalation (i.e. toxins) Shock Exposure Metabolic Associated victim specific disorders Victims trapped in enclosed spaces

After hazardous materials spill Secondary to trauma from 1 MOI Victims unable to access shelter Lack of fresh water Diabetics unable to access food or medications Nutrition Infection

Renal failure Cancer Psychological Lack of access or spoiled food Untreated injuries, limited antibiotics Consequence of crush syndromes Consequences of radiation exposure Reaction to life-changing events

Basic components of EOP: In the Preparedness / Planning part Activation / Notification (when + how) Facility protection (especially for terrorism disasters) Decontamination Staging area Evacuation plans Families care

Expansion of services and alternative care sites Supplies and Logistics Resources (Inventory of hospital resources) Personnel (Fan-out, methods of mobilization) Phone #, contacts, etc. Basic components of EOP: In the Preparedness / Planning part Staff education and Training Exercises

Command and Control Incident Command System Incident Commander Operations Section with Subdivisions Planning Section (collect and disseminate infos) Logistic Section (provide materials) Finance Section Who does what. Structure.

Chain of command. Coordination and Communication Media Phases of Disaster Response 1. Activation 1. Notification 2. Organization of command post 2. Implementation

1. Search and rescue 2. Triage, stabilization and transport 3. Definitive management of scene hazards and victims 3. Recovery 1. Withdrawal from scene 2. Return to normal operations 3. Debriefing

HOSPITAL EMERGENCY STATUS Whenever the internal or external emergency plan is activated, the hospital will be considered to be in EMERGENCY STATUS with specific command responsibilities to facilitate resource allocation. ICS Command Staff

The Command Staff include: Public Information Officer Safety Officer Liaison Officer Transfer of Command Moves the responsibility for incident command from one Incident Commander to another

Must include a transfer of command briefing Oral Written Both oral and written Direct Telephone Number 1)467 1362 2)467 1372

3)469 1763 Fax 469 1764 Debrief At the conclusion of the event, a formal debrief and counseling sessions should be made available for all staff. The Psychiatry Department will coordinate this after the emergency is over.

Thank YOU

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