Guidelines for Hospital Emergency Preparedness Planning

1 United NationsInternational Strategy for Disaster ReductionFrom the People of JapanEUROPEAN COMMISSIONH umanitarian AidGUIDELINES FOR Hospital EMERGENCYPREPAREDNESS Planning GOI-UNDP DRM Programme(2002-2008)lR;e o t;rslR;e o t;rsGovernment of IndialR;e o t;rslR;e o t;rsFor more information, contact:National Disaster Management DivisionMinistry of Home AffairsGovernment of India, North Block, New : -91-11-2094019 Fax: -91-11-2093750 Webstie: for Hospital Emergencies Preparedness PlanningPREFPREFPREFPREFPREFAAAAACECECEC ECEThe GoI-UNDP Disaster Risk Management Programme is a national initiative to reduce vulnerabilities ofcommunities in some of the most hazard prone districts of India (169 districts and 17 states). The Programme aimsto contribute to the social and economic development goals of the National and State Governments, enablingthem to minimize losses to development gains and to reduce their vulnerability to natural disasters.

2 UrbanEarthquake vulnerability Reduction Project (UEVRP), a sub-component of the DRM Programme, essentially aims atstrengthening capacities of communities, urban local bodies and administration in mitigation, Preparedness andresponse in 38 cities in India. These cities have been chosen on the criteria of being located in Seismic Zones III, IVor V, with more than half a million and Hospital systems are the most critical units of the Emergency Support Function. Guidelines fordeveloping Hospital Emergency Management Plan intends to support the hospitals to formulate their own allhazard Emergency plans in accordance with their manpower and infrastructural resources that will meet thedemands of medical care more effectively during document would guide in developing integrated Hospital Plans that are consistent with the city or communitydisaster management plans. Emphasis is laid on strengthening the functioning, coordination and response for anenhanced pre- Hospital and Hospital care.

3 It is ensured that these Guidelines are in accordance with the NationalDisaster Management Guidelines for Medical Preparedness and Mass Casualty Management brought out byNational Disaster Management Authority (NDMA).The first chapter provides an overview of Disaster Management, concepts of Hospital Emergency Planning , andissues of coordination and networking both for pre- Hospital and Hospital care. The second chapter covers theprinciples and the steps involved in Hospital Planning . The third chapter presents the templates for developingthe actual plan for different levels of health facilities from secondary to tertiary and the teaching hospitals. Vitalinventories, tables and charts, job cards etc. form a part of the for Hospital Emergencies Preparedness PlanningACKNOWLEDGEMENTSACKNOWLEDGEMENTS ACKNOWLEDGEMENTSACKNOWLEDGEMENTSACKNOWLE DGEMENTSWe wish to thank the consultant Dr. Amit Gupta, Assistant Professor of Surgery, All India Institute ofMedical Sciences (AIIMS), New Delhi for his Assistant support in formulating the Guidelines fordeveloping Hospital Emergency Management Plan.

4 We would like to acknowledge World Health Organization, India Country Office for their contributionsto the document in addition to sharing international protocols and standards on various topics in wish to thank the Core committee members formed under National Disaster ManagementAuthority (NDMA), Government of India for the Guidelines on Medical Preparedness and Mass CasualtyManagement, the principles of which have been largely followed for developing the Guidelines forHospital Emergency Management would like to thank Dr Deepa Prasad, Disaster Management Unit, UNDP, for technical supportfrom time to time and her close association with Dr. Gupta in formulating the word of thanks is also due to Ms. Ranjini Mukherjee, Mr. Sushil Chaudhary and Ms. Shafali RajoraDisaster Management Unit, UNDP, for coordinating all necessary activities and field visits that facilitatedin the timely development of the senior officials of Ministry of Home Affairs had providd continuous encouragement to the DRMteam involved in the preparation of this document We thank them for this Analyst & office in ChargeDisaster Management UnitUnited Nations Development Programme.

5 India4 LIST OF ABBRELIST OF ABBRELIST OF ABBRELIST OF ABBRELIST OF ABBREVIAVIAVIAVIAVIATIONSTIONSTIONSTIONS TIONSANS/DNSA ssistant Nursing Superintendent /Deputy Nursing SuperintendentBDOB lock Development OfficerCHCC ommunity Health CenterCMOC hief Medical OfficerCMSC hief Medical SuperintendentCSSDC entral Stores and Supply DepotCTComputerised TomographyCUGC lose User GroupDM CycleDisaster Management CycleEDEmergency DepartmentEOCE mergency Operations CenterHAZMATH azardous MaterialHDUHigh Dependency UnitICUI ntensive Care UnitICIncident CommanderI/CIn-ChargeICDSI ntegrated Child Development ServicesHEICSH ospital Emergency Incident Command systemHODHead of DepartmentHSCH ospital Surgical CapacityHTCH ospital Treatment CapacityMCIMass Casualty IncidentMICUM edical Intensive Care unitMLCM edico Legal CaseMOMedical OfficerMO I/CMedical Officer In ChargeMRDM edical Records DepartmentNGONon Governmental OrganizationOPDOut Patient DepartmentOTOperation TheaterOTAO peration Theater AssistantPHCP rimary Health CenterPWDP ublic Works DepartmentPROP ublic Relations OfficerQRMTsQuick Response Medical Teams5 Guidlines for Hospital Emergencies Preparedness PAGE & DisastersHospitals & DisastersHospitals & DisastersHospitals & DisastersHospitals & Disasters7 - What are disasters?

6 What are disasters? What are disasters? What are disasters? What are disasters? WWWWW hahahahahat is t is t is t is t is rrrrriskiskiskiskisk ? ? ? ? ? How can we reduce the risk? How can we reduce the risk? How can we reduce the risk? How can we reduce the risk? How can we reduce the risk? Disaster Management Disaster Management Disaster Management Disaster Management Disaster Management Role of Hospitals in Disasters/Mass casualty Role of Hospitals in Disasters/Mass casualty Role of Hospitals in Disasters/Mass casualty Role of Hospitals in Disasters/Mass casualty Role of Hospitals in Disasters/Mass casualty What constitutes a disaster for a Hospital ? What constitutes a disaster for a Hospital ? What constitutes a disaster for a Hospital ? What constitutes a disaster for a Hospital ? What constitutes a disaster for a Hospital ? Why have Emergency plans for hospitals?

7 Why have Emergency plans for hospitals? Why have Emergency plans for hospitals? Why have Emergency plans for hospitals? Why have Emergency plans for hospitals? Should smaller hospitals also have Emergency plans? Should smaller hospitals also have Emergency plans? Should smaller hospitals also have Emergency plans? Should smaller hospitals also have Emergency plans? Should smaller hospitals also have Emergency plans? is Hospital networking? is Hospital networking? is Hospital networking? is Hospital networking? is Hospital networking? Levels of Hospital Role of District Medical Role of District Medical Role of District Medical Role of District Medical Role of District Medical Suggested flow of patient in Organization of Health Delivery in Disaster/ Emergency Organization of Health Delivery in Disaster/ Emergency Organization of Health Delivery in Disaster/ Emergency Organization of Health Delivery in Disaster/ Emergency Organization of Health Delivery in Disaster/ Emergency important considerations for making your Hospital Emergency planSome important considerations for making your Hospital Emergency planSome important considerations for making your Hospital Emergency planSome important considerations for making your Hospital Emergency planSome important considerations for making your Hospital Emergency plan17 - Aim of Hospital disaster management Aim of Hospital disaster management Aim of Hospital

8 Disaster management Aim of Hospital disaster management Aim of Hospital disaster management Objectives and goals of Hospital disaster Objectives and goals of Hospital disaster Objectives and goals of Hospital disaster Objectives and goals of Hospital disaster Objectives and goals of Hospital disaster Principles of a Hospital disaster Principles of a Hospital disaster Principles of a Hospital disaster Principles of a Hospital disaster Principles of a Hospital disaster How to proceed for making Emergency plan for your Hospital ? How to proceed for making Emergency plan for your Hospital ? How to proceed for making Emergency plan for your Hospital ? How to proceed for making Emergency plan for your Hospital ? How to proceed for making Emergency plan for your Hospital ? Pre-disaster Planning Disaster Management Centre command The jobs Plan activation of different areas of the Disaster beds/ how to increase bed capacity in emergencies?

9 Planning of public information and Planning for Logistic planningi. Communications planningii. Transportation planningiii. Store planningiv. Personnel planningv. Financial Operations Planning Essencial Medical and non medical staff education Triage Activation of nursing staff Activation of ancillary services Activation of support Phase of staff education and Phase of Disaster Post disaster Emergency / Disaster Plans For HospitalsModel Emergency / Disaster Plans For HospitalsModel Emergency / Disaster Plans For HospitalsModel Emergency / Disaster Plans For HospitalsModel Emergency / Disaster Plans For Hospitals29 - General contents of the disaster Sample disaster plan for a community health center level Sample disaster manual for district level Sample disaster manual for a university/ teaching - 80 Annexure AScales for pre- Hospital facilities according to populationAnnexure BEquipment for a First Aid Party (Equipment for Casualty Services)

10 Annexure CMedical Stores & Equipment for First Aid PostsAnnexure DMedical Stores and Equipment for a Mobile Surgical UnitAnnexure EHospital Emergency Incident Command System (HEICS) Organizational Chart fully operationalAnnexure FHospital Emergency Incident Command System (HEICS)Annexure GHospital Emergency Incident Command System (HEICS)Annexure HSample Job CardsAnnexure ISample In Hospital Triage Protocol in DisastersAnnexure JHospital Evacuation Plans and Guidelines according to international best practicesAnnexure KSample stock inventory for disaster storesAnnexure LGuidelines for availability of knowledge, skills and resources for trauma management at different levelsof careReferencesReferencesReferencesRefere ncesReferences817 Guidlines for Hospital Emergencies Preparedness has been traditionally vulnerable to natural disasters onaccount of its unique geo-climatic conditions. Floods, droughts,cyclones, earthquakes and landslides are regular also witnessed a hitherto new natural calamity in the formof Indian Ocean Tsunami in 2004.