HelloThe experience I had working with you previously was very wonderful, and I would like to work with you again since you have a bit of background in what I do.This time, I should use PowerPoint to develop a presentation that addresses the suggestions I made during my research. It was confusing for me since there were no guides for this program! Thus, I created one, but it wasn’t what my supervisors wanted, below are some of their comments so you can figure out what they tried to clarify.If you still do not know how to do that, please let me know so I can ask them.
Here are some questions that I got on the program:
– Can you clarify who is the target audience for this? – How does this address the recommendations you have set up?- How are you presenting the strengths and areas of improvement to them?- This may be different products. I like your first one to review in general EM and hazards.- The other areas you have identified seem to need a different type of product. It might be a protocol for communications for example or a need list to resolve- I would think the communications protocol would be a separate document, a specific audience.- Who have you assessed as needing to make these changes in communications? Educational Program on Disaster
Preparedness and Evacuation at King
Abdulaziz Specialist Hospital (KASH)
Amal Alwushayh
Agenda
• Purpose & Objectives
• Disaster Definition
• Hospital Disasters Classification
• Emergency Management Phases
• Emergency Management Steps
• Hospital Incident Command System
• Roles & Responsibilities
• Emergency Codes & Alerts
• Evacuation
Purpose and Objectives
• Purpose:
This presentation aims to educate the hospital staff at KASH to respond more effectively to disasters.
• Objectives:
1- To follow an organized plan during emergencies
2- To protect patients, visitors, and staff during disasters
3- To decrease the risk of emergencies in the hospital
4- To perform an effective and safe evacuation during disasters
Definition of a Disaster
• A sudden, unplanned event that makes it difficult, or impossible for a facility to
carry out essential activities. During a disaster, the needed resources are greater
than those available
• A hospital disaster is an event in which the demand for health services from the
event or existing patients, exceeds the ability of the to provide those services.
• A disaster can occur at any level – local, state, regional, country or multiple
countries.
Classification of Hospital Disasters
• Internal Disasters – events that result in loss of resources used for regular
activities.
Examples: fire, smoke, fumes, loss of utilities, worker strikes, release of chemicals
or radiation, hostage situations, or bomb threats
• External Disasters – events that occur in the community outside the
hospital that may affect the facility’s ability to carry out regular activities.
Examples: hurricanes, tornados, floods, storms, earthquakes, plane crashes, power
outages, terrorist attacks, and riots.
Emergency Management
• Hospitals must be prepared to respond to a wide range of
emergencies. These events may include natural disasters, terrorist
attacks or any other situation that dramatically increases the number
of patients who come to the facility needing treatment.
• Hospital emergency preparedness helps to reduce the impact of
emergencies and disasters while continuing to provide essential dayto-day services.
Emergency Management Phases
Disaster Impact
Response
Preparedness
Recovery
▪ Post-Disaster
▪ Pre-Disaster
Mitigation
Emergency Management Phases
1- Response – address the immediate effects of the emergency
ex. Transferring of Patients to Alternate Site
2- Recovery – actions taken to restore normal operations
ex. Clean-up operations
3- Mitigation – lesson or eliminate the impact
ex. Back-up generator, Planning for likely events.
4- Preparedness – activities aimed at avoiding or intervening to stop an emergency from
occurring
ex. Examining the facility for potential dangers and correcting
Five steps to Emergency Management
1. know
the risks
2. Build
the team
3. Prepare
the plans
4. Test the
plans
5. Update
everyone
The Emergency Management Plan
should be:
• Easy to understand.
• Functional, flexible, and adaptive.
• Consider various views.
• Written and updated annually.
• Comprehensive, All-Hazard.
• Education and Training.
• Adhere to existing standards, requirements.
• Include outside agencies.
The Emergency Management Plan
should describe:
• Responsibilities
• Command & coordination mechanism
• Management structures
• Resource management
• Information management and communication
• Training and exercises
The Hospital Incident Command System
Roles & Responsibilities
• It is important everyone knows their role and responsibilities
during an emergency situation.
• This will prevent any confusion that could potentially lead to
increased property damage or employee injuries.
• Roles and responsibilities should be clearly defined within the
hospital’s Disaster/Emergency Action Plan.
Roles & Responsibilities
(Incident Command)
• Incident Command
• Identify the scope of the incident and problems associated with it.
• Determine the overall strategy for incident
o Order and deploy necessary resources
o Develop an organizational structure for incident
• Responsible for overall accountability
• Activating the IMS Command Staff positions
o Information, Liaison, Safety
Roles & Responsibilities
(Operations Section)
• Operations Chief
• Deploy, direct and coordinate the tactical resources
• Establishing and supervising a staging area used for
controlling resource deployment
• May establish other elements of ICS as needed
o Branches, Divisions, Groups, Sectors
• Task forces, strike teams
Roles & Responsibilities
(Planning Section)
•
Planning Section used in complex incidents such as natural and man-made disasters
•
Primary mission is to assist the Incident Commander in managing the emergency
o Gather, analyze, and record information to be used in decisions made by the IC
•
Planning section reports directly to the IC
•
Supervise and coordinate the activities of the Resource unit (Re/Stat)
•
Supervise and coordinate the activities of the Situation Status unit (Sit/Stat)
•
Establish a Documentation Unit
o All resources assigned must be tracked
•
Control and maintain all records
•
Manage the Command Post
Roles & Responsibilities
(Logistics Section)
• Develop a long-term support system due to complexity
and scope of certain incidents
• May supply critical support areas with:
o Communications equipment
o Supplies; building materials, clothing,
o Equipment
o Fuel and repairs
Roles & Responsibilities
(Finance/Administration Section)
• Required in agencies that have a specific need for financial services
o Procurement of supplies and resources within and outside the organization
o Analyze and manage the legal risk for incident
o Document for compensation and claims of injury
o Document all financial costs of incident
o Document for possible cost recovery of services and/or supplies
o Obtain any documentation relating to cost recovery of staffing hours
Basic Responsibilities
• Police
o Scene security
o Evacuation
o Traffic and crowd control
o Ranking officers at EOC, Staging
o Lead appropriate investigations
Basic Responsibilities
• Fire Department
o Fire Suppression and prevention
o Emergency Medical Service
o Rescue, recovery and transportation of sick and injured
o Hazmat mitigation
o Activate CISD, MAST programs
o Provide Command at EOC
o Rehabilitation of personnel
o Pre-established mutual aid listings
Basic Responsibilities
• Public Works
o Immediate clearance of streets, alleys, bridges
o Clearance and maintenance of storm and sanitary sewers
o Delivery of water
o Maintenance of emergency vehicles
o Senior member at EOC
o Refueling needs
o Provide for mass transportation for evacuation
Basic Responsibilities
• ESDA – Emergency Services
o Duties defined by scope of group
o Activate area assistance when directed
o Representative at EOC
o Coordinate volunteer efforts
Emergency Codes
&
Emergency Alerts
• Code RED – Fire
Purpose
Communicate a risk and mobilize a response to protect patients, families,
visitors, staff, physicians and property in the event of smoke and/or fire.
Action:
Follow the RACE and PASS.
Be able to locate the following in your department/unit:
• Nearest extinguishers and pull alarm boxes.
• Evacuation plan and two exit routes in your assigned area.
• Code White – Bomb Threat
Purpose
To facilitate the notification of a bomb or threat of a bomb (suspicious
package).
Action:
Take all reports of a bomb seriously.
Keep caller on line, and obtain as much information as possible.
Complete the Bomb Threat Form.
Contact Security.
• Code BLUE – Cardiopulmonary Arrest
Purpose:
Communicate a risk and mobilize the immediate arrival of
emergency equipment and specialized personnel to an adult or
child whose heart or respiration has stopped.
Action:
Call hospital operator to announce the specific code and location.
• Code Silver – Person with a Weapon/ Hostage
Purpose
Initiated when there is an individual in possession of a weapon
or one who has taken hostages.
Action:
Clear area to avoid others being endangered.
Call security to report the situation.
Report as much information as possible.
• Code Pink – Infant or Child Abduction
Purpose
Code Pink should be initiated when an infant or child is missing or abducted.
Action:
Notify Security immediately.
Give as much information as possible.
Secure all exits.
A search of the building and grounds will be conducted by designated
individuals.
• Code ORANGE – Hazardous Material Spill or Release
Purpose
To initiate prompt response in the event of a hazardous material spill or release ensuring the
proper disposal of material.
Action:
Incidental Spills:
Emergency Spill:
•
Trained users clean up small spills using
the appropriate personal protective
equipment and decontamination materials.
•
Spills that may present a hazard to
people, the environment, or the effects
are unknown.
•
These spills represent NO hazard to
trained employees or the environment.
•
Isolate the spill (evacuate).
•
Deny entry to others and notify the
supervisor.
•
Contact the Safety Officer.
•
Materials must be appropriately disposed
of, and Environmental Service should be
contacted for secondary cleanup.
• Code Gray – Sever Weather
Purpose
Initiated when unsafe weather conditions exist in the area.
Action:
Close blinds, drapes, and unit doors.
Reassure patients and visitors.
Move patients from rooms to hallways.
Cover non-ambulatory patients with blankets to avoid injury from debris.
• Code Yellow – External Disaster
Purpose
Communicate occurrence of a catastrophic event and provide a mechanism to allow
the healthcare facility to respond to the external emergency situation.
Action:
If at work, return to department.
Complete assigned duties.
If at home, report as instructed.
Implement department disaster plan.
Perform employee call-back procedures when instructed to do so or when additional
staffing is required.
Follow your facility instructions.
Complete the disaster evaluation form.
• Code Brown – Utility Failure
(Heating, Ventilation, and Air Conditioning, Medical Gas System,
Natural Gas System, and Electrical Elevators)
Purpose
Communicate a risk and mobilize a response to protect the safety and well-being of individuals in the
event of a utility failure.
Action:
Call Maintenance.
Be careful around leaking steam.
If you suspect a natural gas leak, do not turn on lights, electrical appliances,
or other sources of ignition; open all windows.
Be aware of electrical hazards.
Do not use frayed/broken power cords.
The use of extension cords is prohibited.
• CODE “NAME” CLEAR
Purpose
When the code situation has been addressed or resolved, the
hospital operator may page the “code name” and then announce
“clear” to indicate the emergency situation has ended.
– Example: Code Red Clear
Evacuation
• Emergency evacuation is the urgent, immediate egress or escape of
people from an area with a life-threatening condition, such as a fire.
• The aim of the evacuation process is to save lives by moving people
from the location of the fire to a safer location.
• Evacuation procedures must be organized and fast.
• A plan and training are necessary to perform fast and effective
evacuation.
Evacuation Maps
• Evacuation maps must be prepared for each
floor and distributed on the hospital’s walls.
• Emergency exits, evacuation paths, and “YOU
ARE HERE” must be illustrated to indicate the
viewer’s current position.
Evacuation’s Stages
1. Firstly, evacuation occurs in the room where there is a disaster.
2. Secondly, evacuation occurs in surrounding rooms if the
disaster affects them.
3. If needed, total evacuation of the hospital may be ordered by
the central control unit.
Total Evacuation
• In cases of severe disaster, total evacuation is necessary for people’s safety.
• Employees must participate in the evacuation process by organizing it and helping
patients.
• Emergency staff and employees must be aware of each person’s responsibilities,
including not letting anyone to enter the location of the disaster.
• All the employees are responsible for patients’ safety, and this can be reached by
practicing on evacuation, being aware of the evacuation path, and knowing how to
activate the disaster alarms.
Total Evacuation
• Coordination is required between the hospital sectors to ensure the
effectiveness and safety of the evacuation process.
• When there is an order of total evacuation, all the hospital will be evacuated,
including patients who can not move.
• Each floor is evacuated horizontally, and then all the hospital is evacuated
vertically (from high floors to the ground floor).
• Total evacuation is about following the evacuation map and emergency
exits.
Evacuation Procedure
• Patients who need assistance must be identified,
supported, and helped during the evacuation
procedure.
• Don’t evacuate patients if the disaster is away and
there is no official order of evacuation in your area.
How to Evacuate Patients?
• Firstly, patients who are close to the disaster/crisis are evacuated.
• Patients who can move should be evacuated by giving them the
instructions, two employees will be supervisors of their movement
(one employee on the front and one on the back).
• Patients who can not move are evacuated by wheelchairs and
stretchers, or even holding when necessary
• Taking patient’s records during evacuation is recommended.
How to Evacuate Patients?
• Morbidly obese patients are moved to a safe place such as a room
away from the disaster to get ready for evacuation.
• Patients who are on ventilators must be transported with ventilators (if
ventilators are supported with batterie) or moving them to the closest
hospital.
• All patients and visitors must be moved from the hospital to a safe
location identified by the safety managers.
Evacuation, Lifting and Moving Techniques
• When patients who can’t move must be evacuated, please call emergencies for
help, or ask for assistance from professionals around you if you can’t perform
the evacuation by yourself.
• Important lifting and moving techniques:
o Do not harm the patient
o Move the patient’s body as one unit
o Use proper moving and lifting techniques
o Make movements at the level of the patient’s body
Evacuation, Lifting and Moving Techniques
Depending on their situation, you
can move patients from beds to:
1. Stretchers
2. Wheelchairs
Key Information for an Organized Evacuation
• Follow the evacuation plan and map
• Do not panic, and try to keep the patients calm
• The evacuation should be horizontal in each floor, then a vertical
evacuation (from higher floors to lower floors) will happen
• Guide patients and visitors to emergency exits
• Guide patients for the safe area
References
•
NIMS components – guidance and Tools. FEMA.gov. (n.d.). https://www.fema.gov/emergency-managers/nims/components
•
Hospital evacuation decision guide. AHRQ. (n.d.). https://www.ahrq.gov/research/shuttered/hospevac4.html
•
Joint Commission International (2021). JCI Accreditation Standards for Hospitals, 7th Edition Draft Standards for Field Review:
Proposed New Standards and Requirements
•
Forms. Ministry of Health. (n.d.). https://www.moh.gov.sg/forms
•
Saudi Central Board for Accreditation of Healthcare Institutions (CBAHI). (2016). National hospital standards. (3rd version).
Saudi Central Board for Accreditation of Healthcare Institutions.
•
Hospital evacuation decision guide. AHRQ. (n.d.). https://www.ahrq.gov/research/shuttered/hospevac4.html
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