civil hospital karachi emergency plan

Civil Hospital Karachi Emergency PlanTo handle unusual situation, Mass causality, Disasters Dr. Ashfaq Ahmed Bhutto Additional Medical Superintendent

AcknowledgmentProfessor Saeeda HaiderProfessor of Anesthesia For developing the plan

Professor M. Saeed QuraishyProfessor of Surgery and Medical Superintendent For able guidance

Dr. Shakil MullickAdditional Medical superintendent OPD For assistance in developing the plan

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E_Plan Dr. Ashfaq Bhutto

About DisasterDisaster results in sudden surge drawing heavily on Hospital resources over and above routine Can be divided in two phaseso Phase-I: Multiple Causality incidento Limited additional resources required o Decision by on duty personnel o Information to MS CHK

o Phase II- Mass Causality Evento Full recall of all personnel required o Disaster plan activated o Incident commander take charge3 E_Plan Dr. Ashfaq Bhutto

GENERAL GUIDELINESDISASTER IS NO TIME TO START LEARNING YOUR ROLE, LEARN BEFORE IT OCCURSo Get to know and perform your pre-identified jobs proactively o A designated INCIDENT COMMANDER be responsible to implement this plan. o DISASTER RED ALERT will be conveyed through designated mobile phone

no. 0334-3515006o Please rush to the Civil Hospital as soon as you learn about emergency situationo READ THE EMERGENCY PLAN MANUAL

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INCIDENT COMMANDERDepending on the availability at zero hour the INCIDENT COMMANDER would be (In order of priority):1. 2. 3.

Medical Superintendent Additional Medical Superintendent (General) Deputy Medical Superintendent ON DUTYo The next arriving senior in order of priority will take over as Incident

commander. o Incident commander will be the Head of the Disaster Team and will oversee the total plan. o He can modify plan as and if required. o Takes charge of the Control Room5 E_Plan Dr. Ashfaq Bhutto

LOGISTICS INCHARGEo Additional Medical Superintendent General

Assisted byo Chief Nursing Superintendent (CNS) o Steward o Duty Supervisor of Nursing / Stewards

o Responsible for all Human and Material resources

mobilization

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TELE-COMMUNICATION DIRECTORDeputy Medical Superintendent IT Assisted by o In charge Telephone Exchangeo

Telephone Operator on Duty.

Responsible for all Tele-communication related jobs.

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Incident CommanderDMS on Duty AMS General MS AMS On Call

Administrative Arm

Clinical Management Arm

Patient Receiving Bay (PRB)Immediate Administrative / Clinical Responsibility to be shared by Reaches Control Room Phone: 99215740-5 Ext: 1131-1132

Informs

Casualty Medical Officer & Trauma Team according to Daily Order DUTIES

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Determine Triage Category Shift the patients safely to the correct Triage Zone Tagging the patient according to the Triage Zones

TRIAGE ZONESA= RED Treatment Side of A&E B=YELLOW Medical Side of A&E C = GREEN Surgical OPD D = BLACK Mortuary

Resident Doctors, mentioned below Resident Doctors, mentioned below Faculty Members according to Daily Order Faculty Members according to Daily Order

Resident Doctors, mentioned below Faculty Members according to Daily Order

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Continue

Incident CommanderDMS on Duty AMS General MS AMS On Call

Administrative Arm

Clinical Management Arm

Reaches Control Room Phone: 99215740-5 Ext: 1131-1132

Informs

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PATIENT RECEIVING BAYDesignated Areaso If number of victims Less than 15 within A & E o If number of victims More than 15 In between 2 Gates of A & E

and OPD Ground Future Plan Benazir Bhutto Shaheed Trauma Center underway

In chargeo Immediate In charge CMO, CCMO, AMS Casualty o Senior Faculty of the 2nd General Surgical Unit On Call o Patient Receiving Doctors

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PATIENT RECEIVING BAY contd.Immediate Steps to be takeno All RMO and all those doctors present in the hospital premises should

reach this area leaving a minimum number in their wards.o In charge of the area, Senior Registrar/Senior most RMO will be in charge

till the arrival of the Senior Faculty of the 2nd General Surgical Unit on call.

What jobs to doo The most senior doctor in the department will become the captain of team. o Triage all patients & shift them to the correct triage zone Red, Yellow,

Green & Black.o Write the main problem/diagnoses on the tag o Attach the tag to a limb securely13 E_Plan Dr. Ashfaq Bhutto

START - Simple Triage And Rapid Treatment Objective is to do RPM

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TRIAGE CATEGORIESCATEGORY TAG COLOUR CLASSIFICION TREATMENT SITE Resuscitate at Treatment side in A & E, immediately shifted to Theater Wait at Medical side of A & E and then ultimately shifted to Theater Treat at Surgical OPD Shifted to Mortuary

A

RED

Life in danger Immediate Care

B

YELLOW

Serious but life is not in danger immediately Second Priority in care Walking Wounded Third priority in care Dead on Arrival Confirmed by 2 doctors

C

GREEN

D15

BLACK


Area for Patients Triaged-A RedWhere is this areao Treatment side in A & E

Primary PurposeResuscitate the patient and immediately transport to theater

Administrative/Clinical Director of Area-A CMOo Technical Personnel RMO of Anaesthesia, General Surgery, Orthopaedics,

Neurosurgery, Paediatric surgery, Vascular Surgery, Facio-maxillry Surgery, ENT & Burns till the arrival of their respective Senior Faculty Members.o Senior Faculty of these specialties on arrival should decide on a Team Captain and work

accordingly.E_Plan Dr. Ashfaq Bhutto

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Area for Patients Triaged-A RedJob to be done here Clinical Job o Maintain ABCD RMO Anaesthesia o Provide Primary Trauma Care o Perform investigation o Ensure shifting to immediately as and where required Directors Job o Backward Triage to make space available for other patients. o Safe intra-hospital transport of patients to wards/operation theatre. o listing of patients and their outcome being treated in Area-A prior to shifting and forwarding to the information desk also. o Make assessable and toped up the Disaster store in A & E17 E_Plan Dr. Ashfaq Bhutto

Area for Patients Triaged-B YellowWhere is this areao Medical side in A & E

Primary PurposeResuscitate the patient, wait for availability of resources, support and ultimately transport to theater

Administrative/Clinical Director of Area-A CMOo Same as Red category

What Job to be done here Clinical Job o Same as Red category Directors Job o Same as Red category18 E_Plan Dr. Ashfaq Bhutto

Area for Patients Triaged-C GreenWhere is this areao At Surgical OPD

Primary PurposeTreat the patient, wait for availability of resources, support and ultimately admit or discharge

Who in In chargeAdministrative / Clinical Director CMO o Technical Personnel Resident doctors of not on-call medical wards, Paediatrics, Gynecology Units till the arrival of their Senior Faculty and In charge Surgical OPD.o

Jobs to be done here o Treat, admit or discharge as required and vacate premises for the Walking Wounded o Supervise - the Doctors to provide MINIMAL CARE o Keeps records and provide a Discharge slip to the patient for continued care.

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Area for Patients Triaged-D BlackWhere is this areao Mortuary

Immediate In charge Medical Legal Officer till the arrival of Police SurgeonJobs to be done hereo Must reconfirm death o Try to establish I.D and take photographs of the dead o Perform necessary Post-Mortem o Provide list of Dead to the Incident Commander, Liaison Director and Department of Health,

Govt. of Sindh.

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Surgical Operating facilitiesWho Is In chargeo Incident Commander / AMS OT

Clinical Responsibilitieso Senior/Junior Doctors of General Surgical Unit on Call, Anaesthesia Faculty,

Orthopaedic on Call Unit at least one Doctor of Neurosurgical Team

SOPo

Operating facilities should be made available by the INCIDENT COMMANDER according to the number of patients requiring surgery. PHASE-I : EMERGENCY OPERATION THEATRE PHASE-II: OPERATION THEATRE COMPLEX

o In case of opening of OT Complex. EOT will then manage only minor injuries and a

team dedicated to EOT should stay in EOT and perform resuscitation.o In case of predominantly ORTHOPAEDIC INJURIES, ORTHOPAEDIC THEATRE will

be opened.21 E_Plan Dr. Ashfaq Bhutto

Ancillary facilitieso Radiology o Blood bank o Laboratory o Medical store/Pharmacy

Remain functional around the clock These facilities will function under respective in charge

y

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SECURITYInchargeIncident Commander / AMS Security Jobs to be done As per SOP Given to the law enforcing agencieso Security beefed up at all gates. o Police / Rangers immediately take over the hospital in case of mass casualty. o Crowd to be discouraged into the Hospital premises or Triage / Patient Receiving Bay

areas.o All roads coming to the A & E should be cleared and for free movement of

Ambulances

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Thank You

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civil hospital karachi emergency plan

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