Zohair%20Al%20Aseri.%20MD,%20FCEM%20(UK).%20FRCPC%20(EM

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Disaster Management KSUMC
Zohair Al Aseri. MD, FCEM (UK). FRCPC
(EMCCM). Consultant, Departments of Emergency
Medicine Critical Care. Chairman, Department of
Emergency Medicine Director, Disaster Management
Master Program. College of MedicineKing Saud
University Hospitals. Riyadh, KSA Email
zalaseri_at_ksu.edu.saFax 966(11)467-2529 Tel
966(11)467-0544
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Definition of a Medical Disaster
When the destructive effects of a natural or
manmade forces overwhelm the ability of a given
area or community to meet the demands for health
care
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Hospital Emergency Incident Command System
(HEICS) Emergency (Disaster) Operations Plan
(EOP) serve as an important emergency
management foundation for our institute.
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Basic Features of ICS

• Common terminology
• Modular organization
• Management by objectives
• Reliance on an Incident Action Plan (IAP)
• Chain of command and unity of command
• Unified Command
• Manageable span of control

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ICS Management Organization

• Management system not an organizational chart
• The ICS organization does NOT correlate to the
  administrative structure of the agency
• Normal roles may not be assumed in ICS

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ICS Management Functions
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Emergency (Disaster) Operations Plan (EOP)
Intended to explain in a clear and concise manner
the critical components HICS as well as the
suggested manner for using the accompanying
materials.
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• Two types of emergencies that may impact on this
  hospital
• Internal Emergencies involve only the hospital
  and its capabilities that may be reduced.
• External Emergencies will usually be sited
  outside the hospital and the hospitals
  capabilities may remain intact.

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Basic components of EOP
1)Mitigation find ways to reduce the devastating
effects of disaster BEFORE it occurs. 2)Preparedn
ess / Planning 3)Response 4)Recovery /
Debriefing
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3 temporal phases of injury event

• Prevent
• Event
• Post event

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Description of Disaster

• PICE- Potential Injury Creating Event

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PICE- Prefixes
A B C
Static Controlled Local
Dynamic Disruptive Regional
Paralytic National
International
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PICE
PICE Stage Need for outside help Status of outside help
0 None Inactive
I Small Alert
II Medium Standby
III Large Dispatch
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CTAS
Triage level I II III IV V
Time to MD Immediate 15 min 30 min 60 min 120 min
Fractile Response 98 95 90 85 80
Admission Rate 70-90 40-70 20-40 10-20 0-10
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Impact Zone
Injured non-injured victims
Triage Zone
Dead Uninjured
Treatment
Transport
Hospital or Health Care Area
Transport Staging Area
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MOI Forces Involved Examples
1. Primary Mechanisms Impact Acceleration Deceleration Crush Penetration Thermal Electrical Victim thrown into a wall by a tornado Blast wave in explosion Sudden stop in plane crash Victims trapped in collapsed structures Projectiles powered by wind, explosion Burns from fires after earthquake Lightning strikes in storm
2. Secondary Mechanisms Asphyxiation Inhalation (i.e. toxins) Shock Exposure Metabolic Associated victim specific disorders Victims trapped in enclosed spaces After hazardous materials spill Secondary to trauma from 1 MOI Victims unable to access shelter Lack of fresh water Diabetics unable to access food or medications
3. Tertiary Mechanisms Nutrition Infection Renal failure Cancer Psychological Lack of access or spoiled food Untreated injuries, limited antibiotics Consequence of crush syndromes Consequences of radiation exposure Reaction to life-changing events
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Basic components of EOP
In the Preparedness / Planning part Activation /
Notification (when how) Facility protection
(especially for terrorism disasters) Decontaminati
on Staging area Evacuation plans Families
care Expansion of services and alternative care
sites Supplies and Logistics Resources (Inventory
of hospital resources) Personnel (Fan-out,
methods of mobilization) Phone , contacts, etc.
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Basic components of EOP
In the Preparedness / Planning part Staff
education and Training Exercises Command and
Control Incident Command System Incident
Commander Operations Section with
Subdivisions Planning Section (collect and
disseminate infos) Logistic Section (provide
materials) Finance Section Who does
what. Structure. Chain of command. Coordination
and Communication Media
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Phases of Disaster Response

1. Activation
2. Notification
3. Organization of command post
4. Implementation
5. Search and rescue
6. Triage, stabilization and transport
7. Definitive management of scene hazards and
   victims
8. Recovery
9. Withdrawal from scene
10. Return to normal operations
11. Debriefing

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HOSPITAL EMERGENCY STATUS
Whenever the internal or external emergency plan
is activated, the hospital will be considered to
be in EMERGENCY STATUS with specific command
responsibilities to facilitate resource
allocation.
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ICS Command Staff

• The Command Staff include
• Public Information Officer
• Safety Officer
• Liaison Officer

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Transfer of Command

• Moves the responsibility for incident command
  from one Incident Commander to another
• Must include a transfer of command briefing
• Oral
• Written
• Both oral and written

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• Direct Telephone Number
• 467 1362
• 467 1372
• 469 1763
• Fax [phone]

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Debrief
At the conclusion of the event, a formal debrief
and counseling sessions should be made available
for all staff. The Psychiatry Department will
coordinate this after the emergency is over.
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Thank YOU
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