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Department of Surgery - Ospital ng Maynila Medical Center

Disaster Preparedness Plan

2003


Contents:


I. Philosophy

Conscious of our responsibility to have a preparedness to meet the needs of the patients and the community in disaster situations, we are committed to the development of a disaster preparedness plan at the Department of Surgery of Ospital ng Maynila Medical Center (OMMC Surgery). We endeavor to implement it in a concerted effort of all concerned and in cooperation with other OMMC departments and external emergency organizations.

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II. Objectives

The primary objective is to prepare the OMMC Surgery personnel for optimal performance during times of disaster. The aims are to prevent death and injuries to patients and hospital personnel; to avoid destruction to hospital properties; and to render medical services to the largest possible number of patients during a disaster.

The secondary objective is to make the OMMC Surgery personnel aware of the importance of the disaster preparedness plan, how it is executed, and the benefits it provides.

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III. Scope of OMMC Surgery Disaster Preparedness Plan

A. General Disaster Control Flow Chart

B. External Disaster Preparedness Plan

C. Internal Disaster Preparedness Plan

D. Response Teams' Disaster Preparedness Plan

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IV. Definition and Types of Disasters Faced by a Hospital and a Department of Surgery

Disaster is any event that overwhelms the person or a group of persons facing it. The overwhelming can be in terms of psychosocial impact, destruction of property, injuries to or diseases of human beings, and scarcity of resources.

Any event that is of a magnitude that overwhelms the administration of the hospital (or the department) is a disaster in the hospital (or the department).

Thus, a person in the hospital (or department) developing a cardiopulmonary arrest is a disaster.

If the influx of patients or injured victims into the hospital (or department) overwhelms the usually available personnel, supplies, and facilities, this too is a disaster.

A fire breaking out within the hospital (or department) is by itself a disaster. What more if persons and properties are lost as a result of the fire. A fire in the vicinity of the hospital  (or department) is also a disaster faced by the hospital administration (or department administration).

An earthquake, a flood, and a typhoon involving the hospital (or department) are also considered disasters.

An explosion within the hospital (or department) and a strike by hospital (or department) employees are likewise hospital (or department) disasters.

The following are basic disaster situations that any hospital (or department) may face and the primary responses required of them:

DISASTER SITUATION

PRIMARY HOSPITAL OR DEPARTMENT RESPONSE

INTERNAL DISASTERS
- Disasters within the hospital or department (fire, explosion, srikes, etc.)

-Evacuation of patients and personnel from threatened or affected areas

EXTERNAL DISASTERS
- Community disasters

-Expansion of usual hospital or department resources to care for sudden and tremendous influx of patients

DISASTER THREATS
- Either in the hospital (or department) or in the community (fire in the vicinity, impending typhoons, floods, bomb threats, etc.)

-Precautionary evacuation, either partial or total
-"Alert" notification to staff and outside cooperating agencies
-Preparation of reserve equipment and supplies

Thus, the types of disasters usually faced by a Department of Surgery are essentially the same as those faced by a hospital.  However, there are certain types of disasters that a Department of Surgery is especially concerned with just as there are disasters that other clinical departments are concerned with.  These are the disasters with victims whose conditions are usually managed by a Department of Surgery or by surgical specialists. A very common example is a disaster that results in overwhelming number of physical injuries.  Such type of disaster is usually managed by a Department of Surgery or by surgeons.

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V. Organizational Structure of OMMC Surgery Disaster Preparedness Plan

The whole Department of Surgery constitutes the disaster preparedness team or committee with the chair and assistant chair for service serving as coordinator and supervisor and the surgical residents, interns, and parasurgical staff assisted by the other surgical consultants as the implementors.

The Department of Surgery will work in coordination and in concerted efforts with other departments in the hospital as well as external emergency organizations.

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VI. OMMC Disaster Preparedness Committee

 A. Functions

1. To coordinate and collaborate in the preparation, organization, implementation, and regulation of the OMMC Surgery Disaster Preparedness Plan.

2. To develop procedures to orient and train new as well as old OMMC Surgery personnel in their disaster-related responsibilities so as to ensure a state of preparedness at all times.

3. To monitor the implementation of the plan and arrange for periodic drills and simulation exercises.

4. To periodically review and revise the provisions of the disaster preparedness plan as needs may dictate.

5. To appoint an annual disaster control director and an assistant director.

6. To assume general responsibility for the department's preparedness in the event of a disaster.

7. To relate the OMMC Surgery's Disaster Preparedness Plan to other OMMC departments, OMMC, and community disaster plans.

 

B. Composition

1. Department Chairperson

2. Assistant Chairperson for Service

3. All surgical residents

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VII. Disaster Control Director

 

A. Functions

1. Acts as the executive director of the OMMC Surgery Disaster Preparedness Plan.

2. Ensures that basic provisions of the plan are disseminated to all OMMC Surgery personnel and appropriate drills and exercises are scheduled.

3. Maintains liaison with OMMC administration, other OMMC departments, Philippine College of Surgeons, and other external agencies on matters of disaster preparedness. 

4. Takes necessary actions to ensure a safe and efficient operation of OMMC Surgery in an emergency.

5. Is responsible for the initiation and activation of the OMMC Surgery's Disaster Preparedness Plan.

 

B. Designation of OMMC Surgery Disaster Control Director

1. There will be annual designation of the OMMC Surgery Disaster Control Director and an Assistant Director by the OMMC Surgery Disaster Preparedness Committee.

2. The Assistant Disaster Control Director will take over in the absence of the Disaster Control Director.

3. A 5th year surgical resident will be designated as the Disaster Control Director and a 4th year surgical resident, as the assistant Disaster Control Director.

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VIII. Declaration of Disaster

Any OMMC Surgery personnel can declare the presence of a disaster once he discovers it but this has to be transmitted to the Disaster Control Director as soon as possible.

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IX. Disaster Response Teams

Depending on the type and extent of disaster, the following disaster response teams and codes are established as part of a disaster preparedness plan:

    Team I surgical residents and interns

    Team II surgical residents and interns

    Team III surgical residents and interns

    Code Red or Red Alert – all teams are physically present in the hospital

    Code Yellow or Yellow Alert – two teams are physically present in the hospital

    Code Green or Green Alert – all teams are on call

    Surgical consultants are called in as necessary.

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X. Orientation, Training, and Drills

1. All surgical residents will be oriented to the OMMC Surgery’s and hospital's Disaster Preparedness Plans.

2. There will be training and drills at least once a year (see  program).

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XI. Press Conference

Only the Hospital Director or her designated representative can give a press conference regarding disasters in the hospital and the Department Chair or his designated representative, regarding disasters in the department.

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XII. General Disaster Control Flow Chart

DECLARATION OF DISASTER

By any OMMC Surgery personnel

By OMMC Surgery Disaster Control Director

 

CALL FOR DISASTER RESPONSE TEAM

Team I, Team II, Team III

Code Red, Code Yellow, Code Green

 

ACTIVATION OF DEPARTMENTAL DISASTER PREPAREDNESS PLAN

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XIII. External Disaster Preparedness Plans

I. Disaster Outside the Hospital

The Scene Response Team will be formed by the Incident Commander of the hospital or OMMC Surgery. This team is composed of surgical residents, interns, nurses, ambulance driver, and orderlies. This team will respond when there is a call for such services.

The functions of the Team are:

1. To perform on scene triage classification and to determine priority in transportation to OMMC or any hospital.

2. To render life-saving first-aid measures.

3. To direct the proper transportation of the injured to OMMC or any designated hospital.

4. To tag all patients given treatment at the scene.

On each tag should be stated medication and treatment given.

 

II. Patient Influx Disaster

The OMMC Surgeon-on-duty at the Emergency Room can declare the disaster with the approval of the Team Captain on duty for the day.  The latter may call for the OMMC Surgery Disaster Response Teams. He may activate the departmental preparedness plan. The OMMC Surgery Disaster Control Director has to be notified.

The triage is the key to effective management of a sudden inflow of disaster casualties. The principal objectives are:

1. To receive the disaster victims.

2. 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

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XIV. Internal Disaster Preparedness Plans

I. Fires, Explosions, Earthquake, and Bomb Threats

Any hospital or deparment personnel may declare the presence of the disaster. The Disaster Control Director and the Hospital Director must be notified.

 

II. Strikes

The Hospital Director may declare strike as a disaster.

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XV. Response Teams' Disaster Preparedness Plan

Contact numbers of OMMC Surgery Staff

All residents

All consultants

Placed in ER, Chief Residents’ Office, Department’s Computer, Department’s e-group.

Easily retrievable

Updated every year

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XVI. Highlights of OMMC Disaster Preparedness Plan

A. Important personnel of hospital disaster preparedness committee to remember

Hospital Director – Overall Chairman

Chair of DEMS – Co-chair

Leopoldo E. Orantia, Jr. MD – vice-chair

Myrna Iglesia, RN – vice-chair

Senior House Officer on Duty – Incident Commander

Nurse Administrator on Duty – Co-incident Commander

 

B. 4 teams

            Team A – Surgery and ENT

            Team B – Medicine and Pedia

            Team C – Family Medicine

            Team D – Nurses

 

C. Surgical Residents – Team A (Acute Care Team)

First responder

Acute care

Field assessment

Stabilizes condition

Responsible for transport of victims

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XVII. Simulated Disaster Drills

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XVIII. Blueprint of Scenarios

          Surgical Team Captain on duty

Disaster Control Director

Junior Residents

 

During office hours

After office hours

 

External disaster

                        Fire / Explosions – burn / blast injuries

                        Vehicular accidents – blunt injuries

                        Felony / war – penetrating injuries

                         

Internal disaster

                        Fire / explosion – burn / blast injuries

                        Earthquake – blunt injuries

 

Disaster - Sudden Influx of patients in Surgery ER

 

Influx without prior notice

Influx with prior notice

            Telephone calls

            Estimate

 

Types of Disaster Injuries

 

Burn/blast injuries

Blunt injuries

Penetrating injuries

Assorted injuries

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XIX. Checklist of Essential Steps in Disaster Management

Checklist of Essential Steps in Disaster Management

            Done or not done

            Done properly or not

Declaration of disaster

Creation of an incident command

Notification and Mobilization

Notification of

Department Disaster Control Director

Department Assistant Chair for Service

Department Chair

Senior House Officer on duty

Hospital Director

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

General surgery consultants

Parasurgical staff – nurses

            Emergency Room

            Operating Room

            Surgery Ward

Mobilization and organization of other medical staff as indicated with task assignment and authorization

Mobilization of ancillary services (laboratory, x-ray, pharmacy, etc)

Control of disaster

Triage

Treatment

Referrals

Traffic control

Patient log

Relatives Information Area

Press conference

Decongestion and post-disaster reconstruction  

 

Checklist on essential steps in disaster control and management

Essential steps

Yes

No

Remarks

Declaration of disaster

 

 

 

Creation of an incident command

 

 

 

Notification and Mobilization

 

 

 

Notification of

Department Disaster Control Director

 

 

 

Department Assistant Chair for Service

 

 

 

Department Chair

 

 

 

Senior House Officer on duty

 

 

 

           Hospital Director

 

 

 

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

                      General surgery consultants

 

 

 

Parasurgical staff – nurses                

            Emergency Room

            Operating Room

                       Surgery Ward

 

 

 

Mobilization and organization of other medical staff as indicated with task assignment and authorization

 

 

 

Mobilization of ancillary services (laboratory, x-ray, pharmacy, etc)

 

 

 

Control of disaster

           Triage

 

 

 

 

Treatment

 

 

 

Referrals

 

 

 

Traffic control

 

 

 

Patient log

 

 

 

Relatives Information Area

 

 

 

Press conference

 

 

 

Decongestion and post-disaster reconstruction

 

 

 

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