Documente Academic
Documente Profesional
Documente Cultură
disaster
Dr Ahmad bin Hashim
Jabatan Kecemasan dan Trauma
Hospital Queen Elizabeth
Kota Kinabalu
Definition of Disaster
when the destructive effects of natural or man-made
forces overwhelm the ability of a given area or
community to meet the demand for health care.
~American College of Emergency Physicians~
Natural
Earthquakes
Tsunamis
Hurricanes / Typhoons
Landslides
Infectious disease
outbreaks
Volcanic eruptions
Man - Made
Wars
Bombs
Chemical spills
Famine
Technological
Tactical
Hybrid disaster
Mix of natural and man made
disaster:
a) Tsunami and radiation
b) Typhoon and crash plane
Tips.
Survival skills is the key element for victims
Elemental needs of the human person
Aim to survive until help arrives (days / weeks /
never)
Community Resilience
Principle for responders doing the most for
the most
Limited resources requires responders to provide
assistance to those with a good chance of survival
Best available treatment may not be sending the
patient to the hospital
Elemental care is vital
Mass-Casualty Incidents
Smaller scale
Much more common
Within capability to respond and handle
adequately provided
1. Ability to mobilise and augment
resources within a specified time frame
2. Ability to coordinate efforts with other
responding agencies
3. Ability to communicate with all other
parties
4. Ability to function within a pre-defined
cross-agency comprehensive system
Disaster Preparedness
Always-be-ready concept
Anytime anywhere
Activation and Response phases
In any mass casualty or disaster, the role of the
responding hospital include
Primary ambulance response
Disaster triage
Control of Medical Operations at site of incident
On-scene management
Transfer decisions
Hospital activation
Receiving of in-coming patients
Perancangan Kontigensi
Di dalam proses mitigasi dan persediaan untuk kemungkinan sesuatu
kejadian bencana, aspek-aspek berikut perlu ditangani:
Analisis situasi
Analisis dan penilaian risiko
Komunikasi risiko
Kawalan bahaya dan strategi pencegahan
Penilaian kapasiti
Penubuhan kapasiti:
pembangunan sumber
matrik sumber
Plan respons kecemasan (ERP)
Perkembangan kemahiran dan latihan : latihan table top dan
simulasi fizikal
Komunikasi risiko
Ini merujuk kepada proses, kaedah dan teknik
untuk menyakinkan individu-individu, kumpulan,
komuniti atau pertubuhan-pertubuhan negeri atau
rantau untuk mengambil langkah siap-sedia
menghadapi ancaman itu.
Ia memerlukan keimbangan dari segi motivasi dan
kepercayaan.
Hasil yang diharapkan timbul dari komunikasi
tersebut adalah penyampaian maklumat dan
pertukaran pengetahuan dan persepsi.
Ini akan mempengaruhi sikap, peruntukan sumber
dan membuat keputusan.
999
Bomba
Telefonis Hospital
KEJADIAN
Pemanggil
Polis
JPA 3
Bulan
Sabit
(Yg menjaga/on-call)
St John
NGOs
Isytihar Yellow
Alert
Pengarah Hospital
Koordinator Pengurusan
Timbalan Pengarah Perubatan
Hospital
Amaran Palsu
Stand Down
(Berakhir Amaran
Bencana)
Koordinator Klinikal
Ketua Jabatan
Kecemasan
Polis/ Kepastian Bencana
Laporan ke KKM
Pegawai Perhubungan
Kepada Agensi Luar
PENGARAH HOSPITAL
Penyediaan makanan
untuk mangsa
Persiapan Operasi
Pusat Gerakan Bencana Hospital
Aktifkan Perkhidmatan
Sokongan Hospital
Disaster Plan
2 main phases
Emergency and Ambulance
activation phase/ site Management
Hospital Activation phase
3-stage Alert system
Yellow Alert
Red Alert
Green stand-down
Medical Operations
Incident Command System
Field Operations
Hospital Activation Phase
Stand-down and Recovery Phase
Lessons learnt
S-S-S-S-S
S
S
S
S
S
Safety
Scene Size-Up
Send Information
Set-up
START
MKN
Directive
20
PRESS
Medical
Base
Incident Area
High Risk Zone
COMMAND CENTRE
Family &
Relative
(TACTICS ZONE)
Fire Base
Station
Ambulance HQ
Transportation
STRATEGY ZONE
On Scene
Commander
POLICE
Medical
Incident
Commander
Forward Field
Commander
WORK MATRIX
ZON
KUNING
OSC
(POLIS)
PKTK
M.E.L.O
QUARTER
MASTER
OMC
BOMBA
SAR
MEDICAL
BASE
M.E.S.A.R.O
SAR
CRITICAL
HOSPITAL
S.CRITICAL
JPAM
N.CRITICAL
BOMBA
(SAR)
DEAD
COMMAND POST
F.F.C. BOMBA
RESCUER
SAR
Tea
ZON MERAH
Most effective
Internationally recognized Color codes
Defines severity of injury and also defines urgency of
transport
Useful to incorporate ID codes here
SAVE Triage
Used when treating multiple patients and
there is a delay in accessing definitive
management
3 categories of patients:
Will die regardless of how much care is
received
Will live whether or not they receive
care
Will benefit from field interventions
Mobilization
Human resources
Equipment
Ambulances
Activation
Command structure
Communications and Alert systems
Inventory preparedness
Check current inventory
Stock-up / prepare to re-stock ambulance teams
Re-designation
Redefine treatment areas and traffic flows
Separate area for non-event related patients
QUESTION
?
Terima
Kasih