Checklist for Internal Disaster

Internal disaster affects the hospital’s building and/or its occupants. For example, major fire in the building, earthquake, flood inside the hospital, bomb or terrorist threat inside hospital etc. In internal disaster safety of the people inside it and minimum damage to the property becomes the main objective. Here is the list of things that must be taken care of for combating internal disaster situations. (Also check emergency codes of hospital –  code blue, code pink and code red)

 

1. Availability of a disaster management committee / safety committeefor disaster preparedness plan
2. Identified and documented possible disaster situations that can affect the hospital
3. Infrastructural arrangement for withstanding and handling identified disasters should be in place, such as,
4. Fire safety installations for fire disasters
5. Earth quake resistant building if hospital is located in earthquake prone zone
6. Flood resistant building design if hospital located in flood prone area
7.     Installation of security devices such as CCTV, controlled access etc. in case hospital is located in an area which is prone to terrorist attack
8. For each disaster, when and how will it be declared, shall be determined
9. Documented plan of action to be followed in case of any of the identified disaster situation strikes the hospital
10. Plan for setting up of command centre and managing internal and external communication shall be in place
11. Role and responsibility of each staff during the disaster shall be defined and staff shall be aware about it
12. There should be a Fire-fighting team with trained members to combat fire situation in the hospital, till the time external help is reached
13. There should be an Evacuation team with trained members who will help other staff, patients and visitors to safely evacuate the building when required during the disaster.
14. Evacuation route shall be planned for each area that are occupied by people and displayed across the hospital
15. Arrangement and plan for evacuating bed ridden patients, patients in ICU and disabled patientsshall be available.
16. Emergency exits and routes shall be without obstacle and allow for free and quick movement
17. Space for collection of people during disaster shall be earmarked.
18. Mock-drills of each disaster situation shall be conducted and record of the same be maintained. Necessary change in plan and staff training shall be done based on mock drills performance
19. Hotline numbers of agencies whose help may be required during disaster shall be readily available. Such as Fire station, police station, district disaster management cell etc.
20. Back-up of important data of hospitals (such as patients’ medical data) shall be stored at a different location so that it can be retrieved if data is lost during disaster
21. Post-event analysis (after mock-drill and after actual disaster, if any) shall be done for making necessary improvements in the plan

 

 

External Disaster (Mass casualty situation)

A disaster that has occurred outside the hospital, such as bus/train accident, wide-spread food poisoning, epidemic, fire in a building, bomb blast etc. The hospital is the place where the victims of external disaster will be brought for medical care. Hence the objective of the hospital in external disaster is to handle mass casualty situation. Here are the things that hospitals must be prepared with

 

1. A working definition of mass casualty situation. This definition will help hospital staff and authority to understand when to declare mass casualty and put action in place
2. An identified person or team who will take charge in case of declaration of mass casualty
3. List of people (doctors, nurses and support staff) who will be called in case of mass casualty
4. Defined role and responsibility of each staff during mass casualty handling
5. Identified places that can be quickly converted to accommodate victims of external disaster

 

 

6. Defined process of triaging and place for each category of triage
7. Identified on-site morgue for temporarily keeping dead bodies
8. Dedicated store of medicine, consumable and other materials to be used only during mass casualty situations
9. Availability of ambulances for shifting of patients
10. Identified places (internally and externally) where patients will be shifted/referred after managing emergency care
11. Hotline numbers of other agencies and hospitals from whom help will be requested for augmenting resources
12. Identified place for handling people other than patients, such as media, relatives, officials etc.
13. Helpline numbers with identified person to respond to queries
14. Plan for handling internal and external communication
15. Plan and arrangement for quick record keeping
16. Standard treatment protocol for managing various types of emergency situations
17. Training of staff and mock-drills of handling mass casualties shall be conducted from time to time 19. Post-event analysis (after mock-drill and after actual mass casualty situation, if any) shall be done for making necessary improvements in the plan