Disaster Preparedness Program

Department of Surgery

Ospital ng Maynila Medical Center

May, 2003 / January, 2006

rjoson2001@yahoo.com

The OMMC Surgery Disaster Preparedness Program was established on May 15, 2003, when the Department Disaster Preparedness Plan was presented and approved and the Simulated Disaster Drills were done.

The OMMC Surgery Disaster Preparedness Plan was formulated in consideration of the OMMC Disaster Preparedness Plan. Dr. Leo Orantia, the vice-chair of the OMMC Disaster Preparedness Committee was present.

The 2003 members of the OMMC Surgery Disaster Preparedness Committee:

Dr. Reynaldo Joson – Department Chair

Dr. Harry Go – Department Assistant Chair for Service

All surgical residents

2003 Department Disaster Control Director – Dr. Alex Deveza

2003 Assistant Department Disaster Control Director – Dr. Red Roque

Goal in disaster management – save as many patients as possible with as little complaints as possible!

2006

The OMMC Surgery Disaster Preparedness Plan is being reviewed every January since 2003. Latest review was done on January 19, 2006. Dr. Leo Orantia, the vice-chair of the OMMC Disaster Preparedness Committee was again present in the 2006 review.

The 2006 members of the OMMC Surgery Disaster Preparedness Committee:

Dr. Reynaldo Joson – Department Chair

Dr. Adrian Yu – Department Assistant Chair for Service

All surgical residents

2006 Department Disaster Control Director – Dr. Cecile Leyson

2006 Assistant Department Disaster Control Director – Dr. Rick Mujer

Goal in disaster management – save as many victims and as much properties as possible!

Disaster Preparedness Program

Memo [May 4, 2003]

Development and Institutionalization of Department Disaster Preparedness Program in OMMC Surgery

Blueprint of OMMC Surgery Disaster Preparedness Program

OMMC Surgery Disaster Preparedness Plan – 2003 / 2006

Content of 2006 Poster of OMMC Surgery Disaster Preparedness Plan (Overview and Checklist)

Simulated Disaster Drills

Year	Date	Scenarios	Outcome	Improvements/ Resolutions
2003	May 15, 2003	2003 Scenarios Surgical Team Captain on duty Disaster Control Director Junior Residents During office hours After office hours External disaster Fire / Explosions – burn / blast injuries Vehicular accidents – blunt injuries Felony / war – penetrating injuries Internal disaster Fire / explosion – burn / blast injuries (Earthquake – blunt injuries) Disaster - sudden influx of patients in Surgery ER Influx without prior notice Influx with prior notice Telephone calls Estimate Types of disaster injuries Burn/blast injuries Blunt injuries Penetrating injuries Assorted injuries	Results of Drills – Output of Team I Team II Team III Disaster Control Director	Triage Officer – 2^nd year surgery resident Color Tagging – Pentel pens · Patients’ Log Relatives Information Area (lobby or away from Surgery ER) Incident Command must have a runner and a messenger Assistant Department Disaster Control Officer for 2003 – Dr. Red Roque Incident Commander authorized to make any decision during disasters Always get help from Hospital Director for maximal mobilization of all hospital units and material needs Goal in disaster management – save as many patients as possible with as little complaints as possible Contact numbers of all surgical staff, hospital administration, major referral hospitals, and external agencies in the Surgery ER and Surgery Office.
2004	Jan. 29, 04	Same as above	Results of Drills – Output of Team I Team II Team III Disaster Control Director	Patient Management Problem initiated
2005	Jan. 20, 05	Same as above	Results of Drills – Output of Team I Team II Team III Disaster Control Director Powerpoint Presentation 2006	Create also DPP in case of hospital fire, gas poisoning, terrorist attack, and bomb attacks. Create a network with other hospital. Have actual simulation drills. Have a concrete definition for non-salvageable patients. Must have identifying uniforms for the teams in case of a disaster.
2006	Jan. 19, 06	Same as above	Results of Drills – Output of Team I Team II Team III Disaster Control Director	Use of ribbons as tags Color tagging rather than color “coding” Implement tagging on sudden influx of patients (do not use black ribbon unless certain of unsalvageable; use 1, 2, 3 in same color to prioritize; maximum simultaneous major operations is three (3) only. Emphasis on post-disaster evaluation and reporting

Philosophy

Conscious of our responsibility to have a preparedness to meet the needs of the patients and the community in disaster situations, we are committed to the development of a disaster preparedness plan at the Department of Surgery of Ospital ng Maynila Medical Center (OMMC Surgery). We endeavor to implement it in a concerted effort of all concerned and in cooperation with other OMMC departments and external emergency organizations.

Objectives

The primary objective is to prepare the OMMC Surgery personnel for optimal performance during times of disaster. The aims are to prevent death and injuries to patients and hospital personnel; to avoid destruction to hospital properties; and to render medical services to the largest possible number of patients during a disaster.

The secondary objective is to make the OMMC Surgery personnel aware of the importance of the disaster preparedness plan, how it is executed, and the benefits it provides.

Scope of OMMC Surgery Disaster Preparedness Plan

A. General Disaster Control Flow Chart

B. External Disaster Preparedness Plan

C. Internal Disaster Preparedness Plan

D. Response Teams' Disaster Preparedness Plan

Definition and Types of Disaster Faced by a Hospital and a Department of Surgery

Disaster is any event that overwhelms the person or a group of persons facing it. The overwhelming can be in terms of psychosocial impact, destruction of property, injuries to or diseases of human beings, and scarcity of resources.

Any event that is of a magnitude that overwhelms the administration of the hospital (or the department) is a disaster in the hospital (or the department).

Triage and Color Tagging

Red – for critical care patients or classified as priority one (Immediate Tx)

Yellow – for acute care patients or classified as priority two (Delayed)

Green – for primary care patients or classified as priority three (Minimal)

Black – for non-salvageable patients (Expectant)

Disaster Response Teams

Depending on the type and extent of disaster, the following disaster response teams and codes are established as part of a disaster preparedness plan:

Team I surgical residents and interns

Team II surgical residents and interns

Team III surgical residents and interns

Code Red or Red Alert – all teams are physically present in the hospital

Code Yellow or Yellow Alert – two teams are physically present in the hospital

Code Green or Green Alert – all teams are on call

Surgical consultants are called in as necessary.

Forms

Patients’ Log

Checklists

Checklist on essential steps in disaster control and management

Essential steps	Yes	No	Remarks
Declaration of disaster
Creation of an incident command
Notification of Department Disaster Control Director
Department Assistant Chair for Service
Department Chair
Senior House Officer on duty
Hospital Director
Mobilization and organization (task assignment and authorization) of surgical and parasurgical staff
Surgical Team on Duty Surgical Team Pre-duty Surgical Team Post-duty
Surgery Consultants Specific specialty consultants General surgery consultants
Parasurgical staff – nurses Emergency Room Operating Room Surgery Ward
Mobilization and organization of other medical staff as indicated with task assignment and authorization
Mobilization of ancillary services (laboratory, x-ray, pharmacy, etc)
Control of disaster Triage
Treatment
Referrals
Traffic control
Patient log
Relatives Information Area
Press conference
Decongestion and post-disaster reconstruction
Post-disaster evaluation and reporting

Evaluation of OMMC Surgery Disaster Preparedness Program

	2003	2004	2005	2006
There is a written department disaster preparedness plan (ddpp).	yes	yes	yes	yes
There is a structured ddpp.	yes	yes	yes	yes
The ddpp is disseminated to all surgical residents and to least the assistant chair for service.	Mar 15, 03	Jan 29, 04	Jan 20, 05	Jan 19, 06
The ddpp is being used in real disasters or simulated disasters (at least once a year).	Mar 15, 03	Jan 29, 04	Jan 20, 05	Jan 19, 06
The ddpp is being evaluated at least after each real disaster and updated thereafter (at least once every 2 years).	Done	Jan 29, 04	Jan 20, 05	Jan 19, 06