Disaster management principles

Disaster management principles

1. Disaster M anagement Principles James Winton May 2016

2. Disaster Management Provide a framework of how disasters are managed Pre-hospital In Hospital MIMMS approach SCGH Emergency D epartment disaster plan 2015 ASM: Victims & Responders; Christchurch Earthquake — Prof. Mike Ardagh

3. What is a disaster? Disaster Event Threat actual or potential Extraordinary resources Coordination across services Classified by type Trauma vs Medical Natural vs Man-made Simple vs compound Compensated vs uncompensated

4. Disasters in Austalia natural Bushfires Cyclones Floods Drought Earthquake Heat wave Man Made Granville train Westgate bridge Kemspey bus Port Arthur Childers fire Eureka stockade Maritime Air accidents

5. Disaster M anagement in WA Governing body – DPMU All hazards approach C omprehensive approach (Prevention, Preparedness, Response, Recovery) All agencies (integrated) approach G raduated response C ommunity risk management P repared community

6. Phases of a major incident Preparation Response Recovery Both prehosptal and in hospital follow these phases A major incident in Perth may involve hospital based team as part of the coodinated prehospital response MIMMS course provides an approach to prehospital management

7. Pre-Hospital Response

8. Services involved Ambulance service Police service Fire services Urban search and rescue teams Local authorities – emergency services Health Organisation and coordination are crucial All hazards All service

9. Preparation for the scene Personal equipment Clothing/phone/torch/camera/map/rations Medical equipment Triage/First aid/advance life support/specialist equipment/transport equipment Communication equipment Radio/phone/other methods – runners, media, loud hailer

10. Scene management C – Command and control S – Safety C – Communication A – Assessment T – Triage T – Treatment T – Transport

11. Command and control zones

12. Casualty clearing post (CCP) Safe Large Sheltered Acessible Scene set up

13. Triage Disaster triage Dynamic process Priorities 1 – Immediate – RED 2 – Urgent – YELLOW 3 – Delayed – GREEN 4 – Expectant – BLACK/ BLUE Triage Sieve – at incident site Triage Sort – at casualty clearing post

14. Triage Sieve WALKING Priority 3 (Delayed) DEAD BREATHING When Airway opened RESPIRATORY RATE PRIORITY 1 (Immediate) PRIORITY 2 (Urgent) CAPILLARY REFILL Yes No No Yes < 10 or >29 10 - 29 < 2 sec > 2 sec

15. Triage sort Labels Visible/attachable

16. Triage Labels

17. Treatment What can be done What should be done Treatment at scene usually confined to A/B/C Priority is to get casualties away from the scene Triage takes priority to treatment

18. Transfer Organisation is imperative Treatment impacts on ability to transport Destination considerations Method of transport

19. Hospital Response

20. Hospital Plan SCGH response to an external disaster is “Code Brown” Each area has its specific subplan Do you know where it is? Details of the contents are available elsewhere

21. Preparation Have a plan Test the plan Locally Regionaly All agencies DPMU Hospital Emergotrain Meetings

22. Notification May come from different sources Ambulance Media Self presenters Hospital Emergency Control Group (ECG) DPMU – on call duty officer WebEOC Many theories and stories on how patients present

23. Preparation Surge capacity Clearing the ED Clearing the hospital Tiered response Department layout Locations Resources Clerical involvement

24. SCGH ED Mass Casualty layout

25. Response Staff allocated to triage prioritites Each priority has a team leader which liases with duty consultant Other staff may be utilised Duty surgeon Duty intensivist Duty radiologist Limit Xrays Limit operative treatment “Damage control”

26. Recovery Potentially huge undertaking Resumption of normal function Restocking Debriefing Reviewing Preparation Hours to days to weeks

27. Disaster M anagement Principles Planning Preparation Practice Prehospital response Hospital response MIMMS – www.mimms.org.au HMIMMS Thanks to Dr Roger Swift FACEM SCGH ED