1. DISASTER PREPAREDNESS

2.  Definition:  Any situation/event that overwhelms existing resources or ability to respond.

3.  Multi patient incident  event resulting in fewer than 10 casualties  Multi casualty incident  results in 100 or fewer casualties, strains facilities  Mass casualty incident  results in more than 100 casualties, overwhelms existing facilities

4.  Any situation that results in the health care facility becoming partially or totally inoperable

5. Assessment: 1. Loss of life 2. Physical injuries 3. Psychological trauma 4. Property damage 5. Environmental destruction 6. Economic/Business loss

6.  Disaster command center  Administrative operations center  Medical operations center  Nursing operations center

7.  Personnel operations center  OR operations center  Security operations center  ED operations center

8. RESPONSE  Confirm disaster activation response  ED operations center  Assignments of on-duty supervisor  Staff assignments  Evacuation of patients from ED  Secure environment  ED staffing considerations  Communication

9.  Disaster casualty patient coordination  Triage  Acuity assessment  Disaster tags  Registration log  Treatment area  All documentation on disaster packet  Tracking with disaster tags  Family

10. STRESS MANAGEMENT  Stress reducers  Assess staff during breaks or rounds  Educate staff regarding delayed stress reaction  Critical Incident Stress Debriefing.

11.  Support resources meeting demand  Institutional needs assessment  Critique—what worked, what needs improvement

12.  Rad ex  Radiation exposure  Chemical exposure  Biological agents  Viral agents  Toxin agents  Visual DX Resource

13.  Depends on dose  Symptoms-  Nausea, vomiting, or bloody diarrhea within 3 hours  Radiation safety officer  Decontamination of all patients  Safety of decontamination team

14.  Industrial or terrorist  Recognition of agent  PPE  Decontamination  Specific agents

15.  Occur naturally in environment  Types of biological agents  Bacteria: anthrax, plague, tularemia  Viruses: smallpox, ebola, VEE  Toxins: botulism, staphylococcal enterotoxin B, ricin

16.  Onset of signs and symptoms 7 – 10 days  Quarantine  Supportive therapy  No approved antiviral medication

17.  Botulism  Neurotoxin  Ricin  Blocks protein synthesis  Onset 8-24 hours  Staphylococcal enterotoxins  Sudden onset of high fever, headache, & chills in aerosol exposures

18. POLICY: All Union Hospital employees are to be familiar with their responsibilities and duties in the event of fire, internal disaster or external disaster. Participation in fire and disaster drills is required. PURPOSE: To ensure the efficient operation of services during a disaster; to ensure that all employees are familiar with, and able to perform their assigned tasks during a disaster, to ensure that all employees are familiar with the use of fire-fighting equipment and to ensure that the fire plan and internal and external disaster plans are current and effective.

19. 6. In the event of a real disaster, the Emergency Preparedness Team will initiate and direct action, evaluate the action and file a written report with the Safety and Security Department describing services provided in the disaster. 7. The Emergency Preparedness Team is responsible for reviewing and revising disaster plans as needed. 8. Department Directors are responsible for ensuring, and documenting, that all of their employees receive annual training on fire and disaster plans. NOTE: Reference department specific policies and procedures concerning Fire, Internal Disaster and External Disasters. PROCEDURE: 1. The organization maintains a Emergency Preparedness Team, composed of the Vice President of Human Resources, the Director of Safety, the Security Coordinator, Nursing Service Supervisors, Nursing representatives and Director of Public Relations. 2. The Emergency Preparedness Team is responsible for the fire and disaster plans and operation. 3. The Emergency Preparedness Team conducts rehearsals of realistic drills, involving all services, on the following time table: a. Disaster Plan - semi-annually b. Fire Drills - quarterly for each shift, with varied conditions 4. Patients are not evacuated during disaster drills. 5. The Emergency Preparedness Team will evaluate each drill and file a written report of each drill with the Safety and Security Department.