1. Elsevier items and derived items © 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc. Chapter 12 Concepts of Emergency and Disaster Preparedness

2. Elsevier items and derived items © 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc. 2 Disaster  Disaster—an event in which illness or injuries exceed resource capabilities of a community or medical facility:  Violence  Illness outbreaks  Severe weather  Earthquakes  Avalanches  Fire

3. Elsevier items and derived items © 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc. 3 Multi-Casualty Events and Mass Casualty Events  Multi-Casualty Event—can be managed by a hospital using local resources.  Mass Casualty Event—local medical capabilities are overwhelmed and may require the collaboration of multiple agencies and health care facilities to handle the crisis.

4. Elsevier items and derived items © 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc. 4 Hurricane Katrina

5. Elsevier items and derived items © 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc. 5 Impact of Recent Disasters  Events of September 11, 2001  HAZMAT training  Emergency preparedness

6. Elsevier items and derived items © 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc. 6 Emergency Preparedness and Response

7. Elsevier items and derived items © 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc. 7 Emergency Preparedness and Response (Cont’d)  In mass casualty or disaster situations, a military form of triage is implemented with the overall goal of doing the greatest good for the greatest number of people.  Safety concerns for providers in the field.

8. Elsevier items and derived items © 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc. 8 Disaster Triage Tag System  Red Tag—emergent (class I) patients  Yellow Tag—patients who can wait a short time for care (class II)  Green Tag—nonurgent or “walking wounded” (class III)  Black Tag—patients who are expected to die or are dead (class IV)

9. Elsevier items and derived items © 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc. 9 Notification and Activation of Emergency Preparedness Plans  Radio or cellular communication between the ED and EMS providers at the scene  Media broadcast message via radio, television, or electronic announcements  DMAT team

10. Elsevier items and derived items © 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc. 10 Hospital Incident Command System  Common organizational model for disaster management  Roles formally structured under the hospital or long-term care facility incident commander with clear lines of authority and accountability for specific resources  Emergency Operations Center or Command Center  Hospital incident commander  Medical command physician  Triage officer

11. Elsevier items and derived items © 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc. 11 Role of Nursing in Hospital Incident Command System  Meet patient needs  Personal emergency preparedness plan  Personal readiness supplies or “go bag”

12. Elsevier items and derived items © 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc. 12 Basic Supplies for Personal Preparedness (3-Day Supply)

13. Elsevier items and derived items © 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc. 13 Event Resolution  Debriefing:  Critical incident stress debriefing  Administrative review  Psychosocial response of survivors to mass casualty events