scholarly journals (A108) Hospital Disaster Planning: The Structured Approach

2011 ◽  
Vol 26 (S1) ◽  
pp. s30-s30
Author(s):  
G.E.A. Khalifa
Keyword(s):  
Emergency Preparedness ◽  
Disaster Preparedness ◽  
Disaster Response ◽  
Emergency Services ◽  
Disaster Planning ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Disaster Plan ◽  
Preparedness Plan ◽  
Hospital Disaster Preparedness

BackgroundDisasters and incidents with hundreds, thousands, or tens of thousands of casualties are not generally addressed in hospital disaster plans. Nevertheless, they may occur, and recent disasters around the globe suggest that it would be prudent for hospitals to improve their preparedness for a mass casualty incident. Disaster, large or small, natural or man-made can strike in many ways and can put the hospital services in danger. Hospitals, because of their emergency services and 24 hour a day operation, will be seen by the public as a vital resource for diagnosis, treatment, and follow up for both physical and psychological care.ObjectivesDevelop a hospital-based disaster and emergency preparedness plan. Consider how a disaster may pose various challenges to hospital disaster response. Formulate a disaster plan for different medical facility response. Assess the need for further changes in existing plans.MethodsThe author uses literature review and his own experience to develop step-by-step logistic approach to hospital disaster planning. The author presents a model for hospital disaster preparedness that produces a living document that contains guidelines for review, testing, education, training and update. The model provides the method to develop the base plan, functional annexes and hazard specific annexes.

scholarly journals Hospital Disaster Preparedness in Switzerland Over a Decade: A National Survey

2018 ◽  
Vol 13 (03) ◽  
pp. 433-439
Author(s):  
Simone Dell’Era ◽  
Olivier Hugli ◽  
Fabrice Dami
Keyword(s):  
Public Health ◽  
Health Care ◽  
Disaster Preparedness ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Disaster Medicine ◽  
Disaster Plan ◽  
Root Cause ◽  
Swiss Health ◽  
Hospital Disaster Preparedness

ABSTRACTObjectiveThe present study aimed to provide a comprehensive assessment of Swiss hospital disaster preparedness in 2016 compared with the 2006 data.MethodsA questionnaire was addressed in 2016 to all heads responsible for Swiss emergency departments (EDs).ResultsOf the 107 hospitals included, 83 (78%) returned the survey. Overall, 76 (92%) hospitals had a plan in case of a mass casualty incident, and 76 (93%) in case of an accident within the hospital itself. There was a lack in preparedness for specific situations: less than a third of hospitals had a specific plan for nuclear/radiological, biological, chemical, and burns (NRBC+B) patients: nuclear/radiological (14; 18%), biological (25; 31%), chemical (27; 34%), and burns (15; 49%), and 48 (61%) of EDs had a decontamination area. Less than a quarter of hospitals had specific plans for the most vulnerable populations during disasters, such as seniors (12; 15%) and children (19; 24%).ConclusionsThe rate of hospitals with a disaster plan has increased since 2006, reaching a level of 92%. The Swiss health care system remains vulnerable to specific threats like NRBC. The lack of national legislation and funds aimed at fostering hospitals’ preparedness to disasters may be the root cause to explain the vulnerability of Swiss hospitals regarding disaster medicine. (Disaster Med Public Health Preparedness. 2019;13:433-439)

Developing a Hospital Disaster Preparedness Plan for Mass Casualty Incidents: Lessons Learned From the Downtown Beirut Bombing

2017 ◽  
Vol 12 (3) ◽  
pp. 379-385 ◽  
Author(s):  
Mazen El Sayed ◽  
Ali F. Chami ◽  
Eveline Hitti
Keyword(s):  
Disaster Preparedness ◽  
Disaster Response ◽  
Hospital Staff ◽  
Mass Casualty ◽  
Lessons Learned ◽  
Mass Casualty Incidents ◽  
Preparedness Plan ◽  
Security Issues ◽  
Response System ◽  
General Response

AbstractMass casualty incidents (MCIs) are becoming more frequent worldwide, especially in the Middle East where violence in Syria has spilled over to many neighboring countries. Lebanon lacks a coordinated prehospital response system to deal with MCIs; therefore, hospital preparedness plans are essential to deal with the surge of casualties. This report describes our experience in dealing with an MCI involving a car bomb in an urban area of downtown Beirut, Lebanon. It uses general response principles to propose a simplified response model for hospitals to use during MCIs. A summary of the debriefings following the event was developed and an analysis was performed with the aim of modifying our hospital’s existing disaster preparedness plan. Casualties’ arrival to our emergency department (ED), the performance of our hospital staff during the event, communication, and the coordination of resources, in addition to the response of the different departments, were examined. In dealing with MCIs, hospital plans should focus on triage area, patient registration and tracking, communication, resource coordination, essential staff functions, as well as on security issues and crowd control. Hospitals in other countries that lack a coordinated prehospital disaster response system can use the principles described here to improve their hospital’s resilience and response to MCIs. (Disaster Med Public Health Preparedness. 2018; 12: 379–385)

scholarly journals Use of Moulage in Multi-Disciplinary Mass Casualty Incident (MCI) Training: Cost-Effective Tool or an Expectation?

2019 ◽  
Vol 34 (s1) ◽  
pp. s19-s19
Author(s):  
Sasha Rihter ◽  
Veronica Coppersmith
Keyword(s):  
Emergency Medicine ◽  
Training Session ◽  
Cost Effective ◽  
Disaster Planning ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Emergency Physicians ◽  
Disaster Plan ◽  
Before And After ◽  
Training Cost

Introduction:A 2018 poll by the American College of Emergency Physicians shows 93% of surveyed doctors believe their emergency department is not fully prepared for patient surge capacity in the event of a natural or man-made disaster. While an emergency disaster plan is activated during any incident where resources are overwhelmed, many US emergency physicians today think of a mass casualty incident (MCI) as the inciting event. To better prepare our communities, an MCI simulation took place in Chicago 2018 with participation from local and federal representatives. Included were Chicago fire, police, and emergency medical services agencies, emergency medicine physicians, resident participants, and medical student volunteer victims.Aim:The study’s aim was to determine whether resource intensive moulage was an expected component or a beneficial adjunct, if moulage-based training would improve physician preparedness, and if such a training would increase the likelihood of future involvement in local disaster preparations. Analysis was performed on pre- and post-training surveys completed by participants. By reviewing the benefits versus cost, future MCI simulation planners can efficiently use their funds to achieve training goals.Methods:Thirty-two emergency medicine physicians were surveyed before and after a five-hour training session on October 20, 2018, which included 89 moulage victims. Twenty-four after-event surveys were completed. All completed surveys were utilized in data analysis.Results:Of polled participants, a 68% improvement in general preparedness was achieved. While only 19% of participants cited current involvement in their facility’s disaster planning in pre-event survey, the likelihood of involvement after training was 8.2/10. Overall, the importance of moulage an essential component to such trainings remained constant.Discussion:Moulage is an expected and crucial element to MCI training and should be incorporated as extensively as resources allow. MCI trainings improve physician preparedness and potentially increase physician involvement in disaster planning at home institutions.

Mass-casualty Response to the Kiss Nightclub in Santa Maria, Brazil

2014 ◽  
Vol 30 (1) ◽  
pp. 93-96 ◽  
Author(s):  
Silvana T. Dal Ponte ◽  
Carlos F. D. Dornelles ◽  
Bonnie Arquilla ◽  
Christina Bloem ◽  
Patricia Roblin
Keyword(s):  
Disaster Preparedness ◽  
Disaster Response ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
The State ◽  
Capital City ◽  
Smoke Inhalation ◽  
Publication Type ◽  
Incident Command ◽  
Santa Maria

AbstractOn January 27, 2013, a fire at the Kiss Nightclub in Santa Maria, Brazil led to a mass-casualty incident affecting hundreds of college students. A total of 234 people died on scene, 145 were hospitalized, and another 623 people received treatment throughout the first week following the incident.1 Eight of the hospitalized people later died.1 The Military Police were the first on scene, followed by the state fire department, and then the municipal Mobile Prehospital Assistance (SAMU) ambulances. The number of victims was not communicated clearly to the various units arriving on scene, leading to insufficient rescue personnel and equipment. Incident command was established on scene, but the rescuers and police were still unable to control the chaos of multiple bystanders attempting to assist in the rescue efforts. The Municipal Sports Center (CDM) was designated as the location for dead bodies, where victim identification and communication with families occurred, as well as forensic evaluation, which determined the primary cause of death to be asphyxia. A command center was established at the Hospital de Caridade Astrogildo de Azevedo (HCAA) in Santa Maria to direct where patients should be admitted, recruit staff, and procure additional supplies, as needed. The victims suffered primarily from smoke inhalation and many required endotracheal intubation and mechanical ventilation. There was a shortage of ventilators; therefore, some had to be borrowed from local hospitals, neighboring cities, and distant areas in the state. A total of 54 patients1 were transferred to hospitals in the capital city of Porto Alegre (Brazil). The main issues with the response to the fire were scene control and communication. Areas for improvement were identified, namely the establishment of a disaster-response plan, as well as regularly scheduled training in disaster preparedness/response. These activities are the first steps to improving mass-casualty responses.Dal PonteST, DornellesCFD, ArquillaB, BloemC, RoblinP. Mass-casualty response to the Kiss Nightclub in Santa Maria, Brazil. Prehosp Disaster Med. 2015;30(1):1-4.

scholarly journals Planning for the Use of Imaging in Mass Casualty Incidents

2019 ◽  
Vol 34 (s1) ◽  
pp. s159-s159
Author(s):  
Deborah Starkey ◽  
Denise Elliott
Keyword(s):  
Disaster Preparedness ◽  
Disaster Planning ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Lessons Learned ◽  
Mass Casualty Incidents ◽  
Challenging Situation ◽  
Mass Fatality Incidents ◽  
Forensic Radiography ◽  
Mass Fatality

Introduction:A mass casualty incident presents a challenging situation in any health care setting. The value of preparation and planning for mass casualty incidents has been widely reported in the literature. The benefit of imaging, in particular, forensic radiography, in these situations is also reported. Despite this, the inclusion of detailed planning on the use of forensic radiography is an observed gap in disaster preparedness documentation.Aim:To identify the role of forensic radiography in mass casualty incidents and to explore the degree of inclusion of forensic radiography in publicly available disaster planning documents.Methods:An extended literature review was undertaken to identify examples of forensic radiography in mass casualty incidents, and to determine the degree of inclusion of forensic radiography in publicly available disaster planning documents. Where included, the activity undertaken by forensic radiography was reviewed in relation to the detail of the planning information.Results:Limited results were identified of disaster planning documents containing detail of the role or planned activity for forensic radiography.Discussion:While published accounts of situation debriefing and lessons learned from past mass casualty incidents provide evidence for integration into future planning activities, limited reports were identified with the inclusion of forensic radiography. This presentation provides an overview of the roles of forensic radiography in mass casualty incidents. The specific inclusion of planning for the use of imaging in mass fatality incidents is recommended.

scholarly journals LO094: Mass casualty incident training for rural Canadian municipalities: a mobile education unit initiative

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S62-S63
Author(s):  
F. Besserer ◽  
M. Hogan ◽  
T. Oliver ◽  
J. Froh
Keyword(s):  
Disaster Preparedness ◽  
Flipped Classroom ◽  
National Level ◽  
Pilot Project ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Disaster Plan ◽  
Mobile Education

Introduction / Innovation Concept: The Shock Trauma Air Rescue Society (STARS®) is a charitable, non-profit organization that is dedicated to providing a safe, rapid, highly specialized emergency medical transport system for the critically ill and injured. The STARS® Mobile Education Unit (MEU) is comprised of a high fidelity simulation suite that mimics a hospital emergency room, installed in a specially equipped motorhome (SEM) that can wirelessly operate a high fidelity human mannequin. The MEU provides an excellent opportunity to combine continuing medical education for resuscitation and MCI management. At present, no formal MCI education process exists in Saskatchewan. Curriculum, Tool, or Material: The Saskatchewan STARS® MEU delivers a phased MCI education initiative to rural and regional centers within the province. The educational initiative is sub-divided into three stages: 1. pre-exercise knowledge translation using a flipped classroom approach, 2. on-site tabletop exercise (TTX) and, 3. high-fidelity simulation session with a review of MCI management principles . Sites perform a Hazard Vulnerability Analysis (HVA) following stage 2 and the highest identified site-specific risks are utilized during the development of the simulated scenarios for stage 3. During stage 2, participants also complete a pre and post-exercise survey. The survey evaluates the educational component, the tabletop exercise component and the perceived pre and post tabletop exercise competencies for the management of MCI. In the pilot project, two regional sites completed the tabletop exercise. The pre-exercise survey evaluated perceived MCI and disaster preparedness for the region. Only 8% and 25% of participants at each site respectively, reported that their disaster plan had been trialed in tabletop, full exercise or real activation within the past three years. Participants strongly agreed that the tabletop exercise was a valuable experience (86% and 88% respectively). More robust data will become available as the initiative transitions out of the pilot stage to formal operations. Conclusion: A formal MCI training program implemented through the STARS® MEU for rural Saskatchewan municipalities enables participants and their organizations to both review and enhance their current emergency management plans. This initiative will aim to establish a foundation for future collaboration at the provincial and national level for rural MCI training and preparedness.

scholarly journals Disaster Preparedness and Management in Pakistan: A Systematic Review

2019 ◽  
Vol 34 (s1) ◽  
pp. s122-s122 ◽  
Author(s):  
Sana Shahbaz
Keyword(s):  
Disaster Management ◽  
Disaster Preparedness ◽  
Urban Areas ◽  
Hospital Management ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Mass Shootings ◽  
Politically Motivated Violence ◽  
Almost All ◽  
Hospital Disaster Preparedness

Introduction:Since its inception about 66 years ago, Pakistan has experienced a variety of both natural and man-made disasters like earthquakes in 2005 and 2015 and widespread flooding in 2010. Pakistan has also experienced a range of politically motivated violence, bombings in urban areas, as well as mass shootings. Such events generate a large number of casualties. To minimize the loss of life, well-coordinated prehospital and in-hospital response to disasters is required.Aim:To identify all the existing peer-reviewed medical literature on prehospital and in-hospital disaster preparedness and management in Pakistan.Methods:The search was conducted using PubMed and Hollis plus search engines in accordance with the PRISMA guidelines. The articles selected included articles on both natural and man-made disasters, and their subsequent prehospital and in hospital management. The following search terms and keywords were used while searching PubMed: mass casualty incident preparedness and management Karachi, mass casualty incident preparedness, disaster preparedness Karachi, and disaster management Karachi. To search Hollis plus, we used the terms: mass casualty incident preparedness and management Pakistan, mass casualty incident Pakistan, mass casualty incident preparedness and management Karachi, and disaster preparedness Karachi. We selected only peer-reviewed articles for a literature search and review.Results:The reviewed articles show a lack of data regarding disaster management in Pakistan. Almost all the articles unanimously state the scarcity of planned prehospital and in-hospital management related to both man-made as well as natural disasters. There is a need for planned and coordinated efforts for disaster management in Pakistan.

National survey of institutional pediatric disaster preparedness

2018 ◽  
Vol 13 (3) ◽  
pp. 153-160 ◽  
Author(s):  
Timothy M. Ketterhagen, MD ◽  
Deanna L. Dahl-Grove, MD ◽  
Michele R. McKee, MD
Keyword(s):  
Disaster Preparedness ◽  
Pediatric Patients ◽  
Disaster Planning ◽  
The United States ◽  
Simulated Patients ◽  
Disaster Plan ◽  
Preparedness Plan ◽  
Healthcare Needs ◽  
Demographic Patterns ◽  
Survey Responses

Objective: Describe institutional disaster preparations focusing upon the strategies to address pediatric patients in disaster preparedness.Design: Descriptive study using survey methodology.Setting: Hospitals that provide emergency care to pediatric patients throughout the United States.Participants: Survey responses were solicited from hospital personnel that are familiar with the disaster preparedness plan at their institution.Interventions: None.Main outcome measures: Describe how pediatric patients are included in institutional disaster preparedness plans. The presence of a pediatric-specific lead, policies and procedures, and geographic/demographic patterns are also a focus.Results: The survey was distributed to 120 hospitals throughout the United States and responses were received from 29 states. Overall response rate was 58 percent, with 53 percent of the surveys fully completed. Sixty-three percent of hospitals had an individual responsible for pediatric-specific disaster planning and 78 percent specifically addressed the care of pediatric patients (16 yo) in their disaster plan. The hospitals with an individual designated for pediatric disaster planning were more likely to have a disaster plan that specifically addresses the care of pediatric patients (90 percent vs 56 percent; p = 0.015), to represent children with special healthcare needs as simulated patients in disaster exercises (73 percent vs 22 percent; p = 0.003), and to include pediatric decontamination procedures in disaster exercises (78 percent vs 35 percent; p = 0.008) than hospitals without a designated pediatric disaster planner.Conclusion: The majority of hospitals surveyed incorporate pediatric patients into their disaster preparedness plan. Those hospitals with an individual designated for pediatric disaster planning were more likely to specifically address the care of pediatric patients in their institutional disaster plan.

scholarly journals (P1-54) Healthcare Worker's Perception towards Individual and Institution Disaster Preparedness

2011 ◽  
Vol 26 (S1) ◽  
pp. s116-s116
Author(s):  
G.H. Lim
Keyword(s):  
Family Support ◽  
Emergency Preparedness ◽  
Disaster Preparedness ◽  
Disaster Response ◽  
Healthcare Workers ◽  
Health Workers ◽  
Response Training ◽  
The Family ◽  
Training Opportunities ◽  
H1n1 Outbreak

Background and AimDisaster and MCI events are occurrences that healthcare institutions must be prepared to respond to at all times. The events of September 11 2001 have rekindled our attention to this aspect of preparedness amongst our healthcare institutions. In Singapore, the SARS experience in 2003 and the recent H1N1 outbreak have thrust emergency preparedness further into the limelight. While priorities had been re-calibrated, we feel that we still lack far behind in our level of preparedness. This study is conducted to understand the perception of our healthcare workers towards their individual and the institution preparedness towards a disaster incident.MethodA questionnaire survey was done for this study for the doctors, nurses and allied health workers in our hospital. Questions measuring perception of disaster preparedness for themselves, their colleagues and that of the institution were asked. This was done using a 5-point likert scale.ResultsThe study was conducted over a 2-month period from 1st August 2010 till 30th September 2010. 1534 healthcare workers participated in the study. 75.3% felt that the institution is ready to respond to a disaster incident; but only 36.4% felt that they were ready. 12.6% had previous experience in disaster response. They were more likely to be ready to respond to future incidents (p = 0.00). Factors that influenced perception of readiness included leadership (p = 0.00), disaster drills (p = 0.02), access to disaster plans (p = 0.04), family support. 80.7% were willing to participate in future disaster incident response training. 74.5% felt that being able to respond to a disaster incident constitute part of their professional competency. However, only 31% of the respondents agreed that disaster response training was readily available and only 27.8% knew where to go to look for these training opportunities.ConclusionThere is an urgent need to train the healthcare workers to enhance their capability to respond to a disaster incident. While they have confidence in the institutions capability they were not sure of their own capability. Training opportunities should be made more accessible. We should also do more to harvest the family support that these worker value in order for them to be able to perform their roles in a disaster incident.

scholarly journals Simple Emergency Triage (SET) – the new perspective on mass casualty incident triage

2020 ◽  
Vol 7 (2) ◽  
pp. 120-123
Author(s):  
Jerzy Jaskuła ◽  
Marek Siuta
Keyword(s):  
Personal Experience ◽  
Emergency Services ◽  
Statistical Data ◽  
First Aid ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Starting Point ◽  
Analysis And Synthesis ◽  
The Subject ◽  
New Perspective

The aim: Incidents with large number of casualties present a major challenge for the emergency services. Incident witnesses are always the first on scene. Authors aim at giving them an algorithm arranging the widely known first aid rules in such way, that the number of potential fatalities before the services’ arrival may be decreased. Material and methods: The authors’ main aim was creating an algorithm for mass casualty incident action, comprising elements not exceeding first aid skill level. Proceedings have been systematized, which led to creation of mass casualty incident algorithm. The analysis was based on the subject matter literature, legal acts and regulations, statistical data and author’s personal experience. Results: The analysis and synthesis of data from various sources allowed for the creation of Simple Emergency Triage (SET) algorithm. It has been proven – on theoretical level – that introducing an organized way of proceeding in mass casualty incident on the first aid level is justified. Conclusions: The SET algorithm presented in the article is of an implemental character. It may be a supplement to basic first aid skills. Algorithm may also be the starting point for further empirical research aimed at verifying its effectiveness.

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