Hospitals disaster planning

Auf der Heide, E. (2002). Principles of hospital disaster planning. In D. E. Hogan J. L. Burstein (Eds.), Disaster medicine. Philadelphia Lippincott Williams Wilkins. 

Each position in HICS has a specific functional role that is described on a JAS. Each JAS includes functional role title what role title that position reports to the mission of the position and immediate, intermediate, and extended tasks. Figure 8.7 provides examples of functional role JAS. When developing a hospital disaster plan based on HICS, the manager should review established HICS JASs and adapt them to the organization. 

Williamson, C. R. (1994). Emergency preparedness A hospital disaster plan. Journal of Healthcare Protection Management, 10(2), 116-121. 

Children may be separated from their parents and family members if they are deemed to be contagious. If children are quarantined, parents may not be able to visit. Young children may experience separation anxiety and they may not respond to staff members. Nurses and health care professionals must be able to distinguish separation anxiety and fear of abandonment from a worsening neurologic status. Children who are quarantined require extra staff for their care because they cannot care for themselves, and their health condition must be closely monitored. Plans for the care of quarantined children and families must be included in community and hospital disaster planning. 

Diamond, J. and G.M. CiampaneUi. Integrated Emergency Management Hospital Disaster Planning, Topics in Emergency Medicine, 20 2, June 1998. 

Chemical incident planning should be integrated into standard hospital disaster plans and should have the direct involvement of emergency medical staff who will be expected to receive casualties with toxic trauma. 

There had been no emergency service planning for a chemical event, nor any emergency medical services special training. Equally there was no chemical hospital disaster plan. 

The management of casualties following toxic agent release must be integrated into hospital disaster plans, and appropriate equipment and training should be provided. 

A comprehensive disaster plan will account for the effective triage of patients (prioritization for care and transport of patients) and distribution of patients to hospitals (a coordinated, even distribution of patients to several hospitals as opposed to delivering most of the patients to the closest hospital). Review of previous disaster response efforts reveals that patients are frequently... 

Disaster planning must include a community mutual aid plan in the event that the hospital (s), nursing home(s), or other residential health care facility needs to be evacuated. Plans for evacuation of health care facilities must be realistic and achievable, and contain sufficient specific detail as to where patients will be relocated to and who will be there to care for them. Patient evacuation was a major challenge to disaster response efforts following Hurricane Katrina, and was hampered by the destruction of all major transportation routes in and out of the city. Pre-planning for the possibility of the need to evacuate entire health care facilities must address alternative modes of transportation and include adequate security measures (see Figure 1.4). 

Internal disaster plans should be integrated with the hospital s overall disaster preparedness protocol. Gaining should be mandatory for all personnel. As with other disaster plans, drills should be designed and routinely performed to ensure that all staff are adequately prepared (see chapter 6 for a detailed discussion of the management of internal disasters). 

Historically, nurses have responded quickly during public health emergencies. The events following 9/11 provide a case in point. Hospitals in and around New York City mobilized disaster teams, ready to receive casualties. In New York City, nurses saw the World Trade Center collapse and immediately reported to work (New York State Nurses Association, 2002). Around the state and in neighboring states nurses mobilized to receive casualties. This response was, in part, the routine disaster plan of every hospital in the New York City region, but above and beyond disaster plans, nurses went to work. Within hours the New York State Nurses Association was fielding calls from nurses across the country volunteering to help out in any way they could. 

Currently, the most common model for disaster response in the hospital sector is the Incident Command System (ICS) model (Federal Emergency Management Agency [FEMA], 2001). In 1992 the Hospital Emergency Incident Command System (HEICS) was first developed by the California Emergency Medical Services Authority and the San Mateo County Health Services Agency. It is important to remember that HEICS is not a disaster plan, but rather a model on which a plan can be developed. In 2006 the model was updated and it is now known as the Hospital Incident Command System (HlCS). The newer model of incident command for hospitals includes ... 

Encourage incorporation into the hospital-specific disaster plan of ABA-recommended triage plan for burn casualty mass disaster situations and provide outpatient care for nonintubated patients with burns covering <20% TBSA also, address issues of communication with families, psychological support needs, and media control. 

In a disaster or mass casualty situation, all hospitals may be called on to care for ill or injured children of varying degrees of symptom severity. Therefore, all hospital emergency departments need to be prepared to treat children likewise, pediatric hospitals must be prepared to treat injured or ill parents and adult family members. As part of their pediatric disaster planning, hospitals should anticipate a lack of prehospital triage establish protocols for care create pediatric antidote kits organize and store pediatric equipment in one setting and anticipate the need for extra personnel (Hohenhaus, 2005). 

Children are likely to be victims in natural disasters and public health emergencies. Health care professionals must be prepared to care for children in the prehospital, inpatient, and follow-up phases of disaster care. Children may experience long-term physical and psychosocial sequelae following a disaster appropriate follow-up will be indicated. Nurses and health care professionals must place a high priority on the needs of children in disasters or public health emergencies and incorporate these needs into their hospital and community disaster plans. 

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