Harbor:Disaster plan

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Disaster Plan & Equipment

  • Detailed Instructions are in the Harbor-UCLA DEM Emergency Operations Plan Binder on the shelves next to the clerk's desk in the AED A-side.
  • For information on the hospital-wide "Code Triage" disaster plan, and links to the HICS forms that should be used during a Code Triage event, follow the "Code Triage" Quick Link on the Harbor-UCLA intranet homepage.
  • Internal disaster: disruption within the hospital impedes patient care services to the extent that the safe care of additional patients may be jeopardized
    • DEM Attending & Overall Charge RN & Hospital AOD will make decisions on closure to internal disaster
    • The MAC must be notified and made aware of the rationale for requesting temporary diversion and the name of the AOD authorizing the diversion
    • Criteria for Internal Disaster:
      •  Power outage impacting patient care, which is unable to be supported by emergency generators
      •  Critical infrastructure systems failure impacting patient care, which is unable to be supported by emergency back-up procedures
      •  Bomb threat, explosion, active shooter
      •  Fire
      •  Flooding
      •  Water disruption or contamination
      •  Hazardous materials contamination in patient care areas
      •  Other: Approval from EMS Agency through the MAC must occur prior to closure for Internal Disaster if rationale is anything other than what has been described

General Instructions

  • Everbridge System notification for callbacks if at home - Call to clerk's phone to report if available and receive assignment.
  • Activate the DEM Emergency Operations Plan (EOP) based on info from EMS/Reddinet: Criteria:
    • 5 or more "Immediate/Red" patients,
    • 10 or more "Immediate/Red" or "Delayed/Yellow" patients from the same incident.
    • Multiple patients arriving from incident involving Hazmat exposure.
    • Directive from hospital administration, via activation of Hospital Code Triage.
  • Step-by-step instructions for activating the ED EOP are located in the "Checklist: Activating the ED EOP" document posted behind each console in the Base Station Radio Room, and in the ED EOP binder by the AED Clerk's desk.
  • The ED Nurse Manager, or Overall Charge Nurse on weekends/evenings, assumes the role of ED/Casualty Care Unit Leader, and coordinates all role assignments and/or other activity in the ED during the Disaster period.
  • The DEM Organizational Chart contains all ED roles during a disaster event.
  • Roles that may be assigned to physicians include: Immediate Unit Leader (Purple Attending), Delayed Unit Leader (Green Attending), Minor Unit Leader (Fast Track NP or MD), Pediatric Unit Leader (PED Attending), Triage Unit Leader (Screening MD or NP), Decon Unit Leader (Any Decon-Trained MD/NP/RN).

Disaster Triage

ADULT AND YOUNG ADULT Triage Category Definitions

  • Minor - Ambulates without assistance OR minor lower extremity injury
  • Expectant - No spontaneous breathing after airway positioned
  • Immediate
    • Apnea responds to positioning
    • RR >30
    • No palpable Radial Pulse/Cap refill > 2sec
    • AMS
  • Delayed - Needs gurney but not immediate

CHILD Triage Category Definitions

  • Minor - Ambulates without assistance OR minor lower extremity injury
  • Expectant - No spontaneous breathing after airway positioned and 5 rescue breaths
  • Immediate
    • Apnea responds to positioning or rescue breaths
    • RR <15 or >45
    • No palpable Radial Pulse/Cap refill > 2sec
    • Posturing or unresponsive
  • Delayed - Needs gurney but not immediate

Supplies

  • Airway Cart –
  • Atropine - use ED supplies first- Mark I antidote stock in basement - requires MAC approval (see Code Triage Manual for Phone number)
  • Cones - Triage Color Coded - Wheelchair Storage Closet
  • Decon Team Supplies (PAPRs, Level C PPE) - Storage Closet under Helipad
  • Decon Trailer - Trailer Lot
  • Disaster Cart - Central Supply and Linen Room SE BF09 - keys on big ring in Command Post (1L1) cupboard
  • Disaster Packets/Clipboards - Shelving unit next to clerk's desk, AED A-side
  • Disaster Tags - (Pedestrian spine storage by Router desk)
  • Dosimeters - Radiation Safety Office Building N32
  • Geiger Counters
    • 3 in ED Charge Nurses Office
    • 6 in Radiation Safety Office Building N32
  • Gurneys, disaster – Trailer #3 - Give keys to housekeeping - they will open trailer and assemble gurneys
  • Keys - AAED Pyxis (SE 1J25)
    • For instructions see disaster manual
  • Privacy Kits for Patients - Decon Trailer
  • Signs - Triage Station - Wheelchair Storage Closet
  • Trailers 1-5 - keys in Pyxis AAED
  • Additional Vests - Wheelchair Storage Closet
  • Wheelchairs - (SE1A04) - NA7 Key

Dir OPS 9/14/16

See Also

References