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DISASTERS
A disaster is any situation that threatens to overwhelm the
ability of local resources to cope, including:
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Trauma disasters, such as major road traffic accidents |
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Natural
disasters, such as hurricanes, earthquakes and floods |
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Public
health disasters, such as water contamination or the outbreak
of a virulent disease |
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War
and civil disorder. |
Each
country should have a national disaster plan, but it is the
responsibility of the district hospital to plan and prepare
for disaster situations at the local level. Disaster planning
requires consultation and discussion to develop a realistic
plan, made in advance, that anticipates a time when it will
be too late to plan.
Disaster planning involves the following steps.
| 1 |
Identify
situations that could potentially overwhelm a district hospital. |
| 2 |
Identify
the staff and resources required to cope with each kind
of disaster situation, including equipment, materials, drugs
and blood. |
| 3 |
Meet
with representatives of all hospital departments and staff
groups who would be involved, including medical, nursing,
paramedical, laboratory and blood bank staff, ambulance
attendants and support staff to discuss their role in managing
a major emergency. |
| 4 |
Liaise
with other services and authorities, such as the Ministry
of Health, local government, fire service, police, army,
non-governmental organizations and aid and relief agencies. |
| 5 |
Develop
a disaster plan to cope with each situation and communicate
this to all members of staff. |
It is impossible to anticipate every situation, but a disaster
plan should include:
| 1 |
Designating
a senior person to be team leader |
| 2 |
Defining
the roles and responsibilities of each member of staff |
| 3 |
Establishing
disaster management protocols |
| 4 |
Setting
up systems for:
– Identification of key personnel
– Communication within the hospital
– Calling in extra staff, if required
– Obtaining additional supplies, if required
– Triage
– Communicating patients’ triage level and medical
need
– Transportation of patients to other hospitals, if
possible |
| 5 |
Mapping
evacuation priorities and designating evacuation facilities |
| 6 |
Identifying
training needs, including disaster management and trauma
triage, and training staff |
| 7 |
Practising
the management of disaster scenarios, including handling
the arrival of a large number of patients at the same time |
| 8 |
Establishing
a system for communication with other services, authorities
and agencies and the media. |
In
the event of a local disaster, such as a major road traffic
accident involving many persons, systems will then be in place.
These will help the staff on duty to deal with a sudden and
dramatic increase in need for services and to summon help to
deal with such a situation.
It is vital to develop a written disaster plan if your hospital
does not yet have one. Inform staff about the plan and keep
copies of it in busy areas of the hospital. Ensure that it is
reviewed regularly and that staff practise implementing it using
different scenarios so that any problems can be identified and
resolved before a real disaster occurs.
Triage
Triage is a system of making a rapid assessment of each patient
and assigning a priority rating on the basis of clinical need
and urgency. The goal of triage is to do the greatest good for
the greatest number. People who are in greatest need should
therefore be treated first. It is not helpful to spend huge
amounts of time and resources on individuals whose needs exceed
the services available, especially if this is at the expense
of other patients who could be helped with the skills and resources
available locally.
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