POST DISASTER REPORT AND EVALUATION

4 May 2004

Hazel Turingan, MD

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 the 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, as was the incident that transpired last May 4, 2004 at around 6:30 am wherein a vehicular accident at Macapagal Highway resulted in an overwhelming number of physical injuries. Since Ospital ng Maynila is one of the nearest hospitals from the said accident, approximately thirteen patients were brought in at around 6:45 am. Such type of disaster is usually managed by a Department of Surgery or by surgeons.

A second year resident was manning the emergency room at that time. The rest of the team already went to the surgery ward to prepare for the Tuesday conference when the code was sounded.

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 worked in coordination and in concerted efforts with other departments in the hospital.

DISASTER RESPONSE TEAMS

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

Code Yellow - 2 teams were physically present to answer the code

Surgical consultant on duty was informed

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. Dr. Padolina assigned Dr. Turingan as the out-going Senior House Officer and as the designated representative of the hospital in coordination with Dr. Vidanes as the spokesperson just to give the general data on the incident.

GENERAL DISASTER CONTROL FLOW CHART

DECLARATION OF DISASTER

By any OMMC Surgery personnel (Dr. Aludino)

By OMMC Surgery Disaster Control Director (Dr. Turingan)

CALL FOR DISASTER RESPONSE TEAM

Team III, I

Code Yellow

ACTIVATION OF DEPARTMENTAL DISASTER PREPAREDNESS PLAN

1. On scene triage classification was done

2. Primary survey done

3. Charting of all patients given treatment at the ER.

Included were medication and treatment given.

II. PATIENT INFLUX DISASTER

The Surgery Resident on duty for that day declared the disaster. The departmental preparedness plan was then activated. The OMMC Surgery Disaster Control Director was then 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 (Trauma-ER).

Yellow - acute care classified as priority 2 (3/13)

Red - for critical care patients or classified as priority one (1/13 patients)

Disaster - Sudden Influx of patients in Surgery ER

Influx of patients came without prior notice

Types of Disaster Injury: Lacerations and abrasions

Multiple fractures

Head injuries

Blunt abdominal trauma

Checklist on essential steps followed in disaster control and management

Problems Identified:

Lack of resources (unavailability of sutures)

Delay in the paraclinical diagnostic procedures

Only one x-ray machine functioning at that time

All trauma patients had to wait in line, no prioritization was given on those tagged as red or yellow patients

General confusion of the E.R. nurses, as to what to do

New clerks and interns without briefing on disaster preparedness

NAMES OF PATIENTS TRIAGED AND MANAGED