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: zalaseri@ksu. edu. sa 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 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 hospital’s 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 Stage 0 Need for Status of outside help None Inactive I Small Alert II Medium Standby III Large Dispatch

CTAS Triage level I Time to MD Imm 15 30 60 120 ediat min min e 98% 95% 90% 85% 80% Fractile Response II IV V Admission Rate 7040 - 20 - 10 - 090% 70% 40% 20% 10%

Impact Zone Injured & non-injured victims Triage Zone Dead & Uninjured Treatment 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 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 INCIDENT COMMANDER LIAISON OFFICER PUBLIC INFORMATION OFFICER SAFETY 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 ? ? ?