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JOFRED M.

MARTINEZ, RN

1. Identify the necessary components of an emergency operations plan. 2. Discuss how triage in a disaster differs from triage in an emergency. 3. Develop a plan of care for a patient experiencing shortterm or long-term psychological effects after a disaster. 4. Evaluate the different levels of personal protection and decontamination procedures that may be necessary during an event involving mass casualties or weapons of mass destruction.

5. Describe isolation precautions necessary for bioterrorism agents. 6. Identify the differences among the various chemical agents used in terrorist events, their effects, and the decontamination and treatment procedures that are necessary. 7. Determine the injuries associated with varying levels of radiation or chemical exposure and the associated decontamination processes.

1. LEVEL I: Local emergency response personnel and organizations can contain and effectively manage the disaster and its aftermath. 2. LEVEL II: Regional efforts and aid from surrounding communities are sufficient to manage the effects of the disaster. 3. LEVEL III: Local and regional assets are overwhelmed; statewide or federal assistance is required. Control centers, and other local volunteer organizations.

The Incident Command System (ICS) is a management tool for organizing personnel, facilities, equipment, and communication for any emergency situation. Under this structure, one person is designated as incident commander. This person must be continuously informed of all activities and informed about any deviation from the established plan.

1. ACTIVATION RESPONSE: The EOP activation response of a health care facility should define where, how, and when the response is initiated. 2. INTERNAL / EXTERNAL COMMUNICATION PLAN: Communication is critical for all parties involved, including communication to and from the pre-hospital arena 3. PLAN FOR COORDINATED PATIENT CARE: A response is planned for coordinated patient care into and out of the facility, including transfers to other facilities.

4. SECURITY PLANS: A coordinated security plan involving facility and community agencies is key to the control of an otherwise chaotic situation. 5. IDENTIFICATION OF EXTERNAL RESOURCES: External resources are identified, including local, state, and federal resources and information about how to activate these resources. 6. PEOPLE MANAGEMENT AND TRAFFIC FLOW: People management includes strategies to manage the patients, the public, the media, and personnel.

7. DATA MANAGEMENT STRATEGY: A data management plan for every aspect of the disaster will save time at every step. 8. DEACTIVATION RESPONSE: Deactivation of the response is as important as activation; resources should not be overused. 9. POST-INCIDENT RESPONSE: Often facilities see increased volumes of patients up to 3 months after an incident.

10. PLAN FOR PRACTICE DRILLS: Practice drills that include community participation allow for troubleshooting any issues before a real-life incident occurs. 11. ANTICIPATED RESOURCES: Food and water must be available for staff, families, and others who may be at the facility for an extended period. 12. MASS CASUALTY INCIDENT PLANNING: MCI planning includes such issues as mass fatality and morgue readiness.

13. EDUCATIONAL PLAN FOR ALL OF THE ABOVE: A strong educational plan for all personnel regarding each step of the plan allows for improved readiness and additional input for fine-tuning of the EOP.

1. RATIONING CARE 2. FUTILE THERAPY 3. CONSENT 4. DUTY 5. CONFIDENTIALITY 6. RESUSCITATION 7. ASSISTED SUICIDE

1. 2. 3. 4. 5. 6. 7.

DEPRESSION ANXIETY SOMATIZATION POSTTRAUMATIC STRESS DISORDER SUBSTANCE ABUSE INTERPERSONAL CONFLICTS IMPAIRED PERFORMANCE

The following are some general principles of awareness that should raise suspicion: 1. Beware of an unusual increase in the number of people seeking care for fever or respiratory or gastrointestinal complaints. 2. Take note of an unusual illness for the time of year. Clusters of patients from a single location should raise suspicion. 3. Clusters can be from a specific geographical location, such as a city, or from a single sporting or entertainment event.

The following are some general principles of awareness that should raise suspicion: 4. A large number of rapidly fatal cases should raise suspicion, especially when death occurs within 72 hours after hospital admission. 5. Any increase in disease incidence in a normally healthy population should also raise suspicion. These cases should be reported to the state health department