DEM Mass Casualty Response Plan

Study Notes

A Civil Emergency is an unforeseen combination of circumstances or resulting consequences that require immediate action or urgent assistance to protect the general citizenry.
Possible causes of CE activation include air crash, chemical disaster, collapse of high-rise building, ferry mishap, high-rise fire, mass rapid transit (MRT) disaster, and radiation exposure.

The Department of Emergency Medicine (DEM) has a 3-level response plan for CE activations:
- Plan 50: 20-50 casualties, only DEM and relevant departments are involved.
- Plan 100: 51-100 casualties, whole hospital is activated.
- Plan 260: 101-260 casualties or more, whole hospital is activated.

Immediate Action:
- Lead CE activation.
- Inform all Medical Officers (MOs) to review current patients.
- Authenticate message.
Craft Activation:
- Re-organize department.
- Activate key personnel and DEM staff.

Primary function: rapid assessment and prioritization of incoming casualties.
Assign casualties according to priority (P1, P2, P3, P0).
Label Triage Pack with colored sticker (Red, Yellow, Green, Black).
Co-ordinate all activities in the Triage Area.
Personnel:
- Medical Specialist: 1 (Plan 50), 2 (Plan 100), 2 (Plan 260).
- Staff Nurse: 2 (Plan 50), 2 (Plan 100), 2 (Plan 260).
- Enrolled Nurse: 0 (Plan 50), 1 (Plan 100), 2 (Plan 260).
- PCA/HCA: 9 (Plan 50), 11 (Plan 100), 13 (Plan 260).
Equipment:
- Triage carts (consist of Triage Packets).
- Clipboards + pen + casualty report form.
- Trolleys, wheelchairs.
- Triage Signboards.

Only clinical procedures to resuscitate and stabilize will be performed.
Only essential laboratory and X-ray investigations to be done.
All documentations of injuries, procedures, and investigations ordered to be documented on the downtime forms provided in the TRIAGE Pack.
Send stabilized patients to Operation Theater (OT) / Intensive Care Unit (ICU) accompanied by 1 MO + 1 Ward Nurse + 1 HCA/PCA.