Disaster Planning and Organization Dr. Eric Goedecke Asst. Professor of Emergency Medicine

Learning Objectives Steps of disaster planning Concepts in management planning and interventions Quetzaltenango, Guatemala, Noviembre

Steps of Disaster Planning Planning Resource assessment Risk and hazard analysis Quetzaltenango, Guatemala, Noviembre

Risk and Hazard Analysis Assessment of threats to the locality – Geographic – Building – Population cluster Children groups – Day care or schools – Summer camps – Field trips Quetzaltenango, Guatemala, Noviembre

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Risk and Hazard Analysis Environmental Hazards Weather – Tornados – Hurricanes Geographic – Earthquakes – Flood plains Quetzaltenango, Guatemala, Noviembre

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Risk and Hazard Analysis Man-made Hazards Chemicals – Production, storage and transport Biologic hazards Terrorism Transportation Hazards Materials Mass transit centers Quetzaltenango, Guatemala, Noviembre

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Resource Assessment Local resources – EMS – Police – Fire department – Cruz Rojas Volunteers – Rotary Club Children’s advocacy groups Quetzaltenango, Guatemala, Noviembre

Resource Assessment National – Cruz Rojas – FEMA – DMAT – National Police Agencies and unions – College of Physicians and Surgeons – Nurses Quetzaltenango, Guatemala, Noviembre

Quetzaltenango, Guatemala, Noviembre

Resource Needs Personnel – Pediatric specialists (if available) Equipment Supplies: water, food, blankets Shelter Suppliers with contact source – Back-up suppliers and contact sources Quetzaltenango, Guatemala, Noviembre

Quetzaltenango, Guatemala, Noviembre

Resource Needs Communications – Equipment and personnel – Telephone company/cell phones often overload – Ham radio / alternative methods Quetzaltenango, Guatemala, Noviembre

Resource Needs Transportation – Roads – Vehicles, public and private Maintaining access for emergency vehicles often problematic Quetzaltenango, Guatemala, Noviembre

Quetzaltenango, Guatemala, Noviembre

Quetzaltenango, Guatemala, Noviembre

Quetzaltenango, Guatemala, Noviembre

Planning is a Dynamic Process Plan before, during and after Contingency planning Continued revising Quetzaltenango, Guatemala, Noviembre

Plan Ahead Resource assessment – Be realistic about resources not already committed to the disaster – Know local limits When and how to call for outside resources – Scale of response Quetzaltenango, Guatemala, Noviembre

Plan Ahead Discuss with groups / individuals – Identify problems – Find options – Keep updated on response abilities Resources and personnel Vary by incident Quetzaltenango, Guatemala, Noviembre

Plan Ahead Involve all potential participants – Don’t overlook potential resources – Avoid improper assumptions Regular planning meetings – Risks of area – Unforeseen events Quetzaltenango, Guatemala, Noviembre

Planning Exercises Look for deficiencies Single components vs. multi-group – Moulage useful but complex – Inter-group cooperation Quetzaltenango, Guatemala, Noviembre

Quetzaltenango, Guatemala, Noviembre

Planning after Exercise Debriefing after exercise – Share information – Improve plan – Ensure dissemination of changes to plans Honest not defensive feedback from all Quetzaltenango, Guatemala, Noviembre

During the Disaster Constant revision of plan – New risks and resources – Loss of resources Flexibility – Alternate uses of resources – Alternate ways of transporting patient to resources or resources to patient Quetzaltenango, Guatemala, Noviembre

Quetzaltenango, Guatemala, Noviembre

Quetzaltenango, Guatemala, Noviembre

Incident Command System IncidentCommander Planning CommandStaff Finance LogisticsOperations Quetzaltenango, Guatemala, Noviembre

Incident Command System Identified central commander with limited scope of control – leave chain of command for smaller groups intact Unified command Modular system Expand as needed Quetzaltenango, Guatemala, Noviembre

Medical control - Decisions Disaster interventions differ from everyday – less information – more victims – different priorities Stress for responders “Greatest good to greatest number” – may not be optimal care for each person Triage/treatment protocols for children will help providers Quetzaltenango, Guatemala, Noviembre

Documentation Need to provide permanent record Transfer of information from field to base hospital Limit information – will lose some details Quetzaltenango, Guatemala, Noviembre

Documentation problems Data loss / inaccuracies Patient limitations - unable to obtain / convey accurate information Multicopy permanent record Deterioration of record Identifying the nameless victim Quetzaltenango, Guatemala, Noviembre

Documentation uses To track patient movements To reunite families Epidemiological studies Evaluation and post disaster critique Long term sequelae and resupply Quetzaltenango, Guatemala, Noviembre

Conclusion Planning – risk / hazard analysis – resource assessment – planning is a dynamic process Incident Command System Quetzaltenango, Guatemala, Noviembre

Quetzaltenango, Guatemala, Noviembre