Civil Emergency and other special assignment 1.pdf

Restricted, Non-sensitive Civil Emergency (CE) Activations & Other Special Assignment Diyana Binte Hashim SSN, DEPARTMENT OF EMERGENCY MEDICINE Introduction 1. What is Civil Emergency? 2. Identify the possible causes of a Civil Emergency (CE) activation. 3. Un...

Restricted, Non-sensitive Civil Emergency (CE) Activations & Other Special Assignment Diyana Binte Hashim SSN, DEPARTMENT OF EMERGENCY MEDICINE Introduction 1. What is Civil Emergency? 2. Identify the possible causes of a Civil Emergency (CE) activation. 3. Understand the process of a CE activation. 4. Understand the CE Special Assignment and their roles. 5. Understand other Special Assignments on daily shift area assignment. Restricted, Non-sensitive What is Civil Emergency? ✓ “an unforeseen combination of circumstances or the resulting consequences thereof within the geographic limits of a given jurisdiction that calls for immediate action or for which there is an urgent need for assistance or relief to protect the general citizenry” ✓ “a civil disorder, or a national or man-made calamity” ✓ “ a riot or unlawful assembly characterized by the use of actual force or violence or any threat to use force without the authority of law; or a natural disaster or human-made calamity, … resulting in the death or injury of persons or the destruction of property…” Restricted, Non-sensitive  Civil Emergency Department of Emergency Medicine (DEM) has been designated to deal with mass casualties resulting from unforeseen events such as ▪ Air Crash ▪ Chemical Disaster ▪ Collapse of High-Rise Building ▪ Ferry Mishap ▪ High-Rise Fire ▪ Mass Rapid Transit (MRT) Disaster ▪ Radiation Exposure Restricted, Non-sensitive  History 1950: Maria-Hertogh Riot Relocated 5 1954: National Service Ordinance Riot times over 1955: Hock Lee Bus Riot 60 years 1965: MacDonald House Bombing v Implement a Opening of the Opening of 10-Year Emergency Hotel New World SGH Medical Plan Department Collapse 1821 1926 1942-45 1951 1964 1977 1978 1986 First Japanese Sino-Malay Spyros Oil Tanker General Occupation Riots Explosion Hospital was build  Civil Emergency The Emergency Department is responsible to triage, treat and evacuate all casualties sent to Singapore General Hospital (SGH). DEM has put in place 3 level of response during events resulting in mass casualties. The plan will be activated depending on the estimated number of casualties expected to be brought to SGH. Definition Remarks Plan 50 20 to 50 casualties Only Dem and relevant departments are involved Plan 100 51 to 100 casualties Whole hospital is activated Plan 260 101 to 260 casualties or Whole hospital is activated more Restricted, Non-sensitive  Civil Emergency DEM will be activated by one of the following: ▪ Singapore Police Force ▪ Maritime Port Authority ▪ Civil Aviation Authority Singapore ▪ Singapore Civil Defence Force ▪ Singapore Armed Force Restricted, Non-sensitive  Phases of Operation Immediate Action Lead the CE activation Nurse Senior Doctor Clinician (M2,E2,C) Inform all Medical Officers (Mos) to review current patients Authenticate Message Activate CE Plan Activate any other level with/without Radiation Head of Dispersal Device (RDD) of response Department (HOD) Despatch DSMC and Inform CEO, CMB, COO, COO Field Medical Team (Ambulatory) Craft Activation Message Re-organise Activate Key Personnel Department and DEM staff Restricted, Non-sensitive Restricted, Non-sensitive  Phases of Operation Phase 1 Receive, triage, treat and evacuate casualties Report of casualties by the respective areas to the Ops room Reporting of casualty reports by DEM Ops room to SGH Campus Command Centre Logistic re-supply activities Phase 2 (Stand down) Consolidate reports Personnel recovery Replacement of equipment Restricted, Non-sensitive  Department Reorganization Area Location Purpose Duty NC Ops Room Level 3 Meeting Room ▪ DEM Command Post ▪ MOHCC and SGH Operation Centre until they are operational Tutorial Room Level 3 ▪ Recalled Staff reporting centre Ambulance Porch Level 2 ▪ CE Triage Area ▪ Hospital Decontamination Station (HDS) Resuscitation and Critical Care Level 2 ▪ P1 CE casualties Area Ambulatory Surgery Centre Level 2 ▪ P2 CE casualties (ASC) ▪ Radiation Isolation Room (RIR) [Room 3] Specialist Outpatient Clinic H Level 1 ▪ P3 CE casualties (Plan 100 and 260) Ambulatory Endoscopy Centre Level 1 ▪ Peacetime patients (AEC) (Plan 260) Medical Student lounge Level 3 Restricted, Non-sensitive ▪ HDS Coordination Centre  CE Triage Role Primary function is to provide rapid assessment for all incoming casualties prior to the arrival of the Medical Specialist Assign casualties according to priority (P1, P2, P3, P0) Label Triage Pack with coloured sticker (Red, Yellow, Green, Black) Co-ordinate all activities in the Triage Area Equipment Triage carts (consist of Triage Packets) Clipboards + pen + casualty report form Trolleys, wheelchairs Triage Signboards Restricted, Non-sensitive  Triage Personnel Staff Category Plan 50 Plan 100 Plan 260 Medical Specialist 1 2 2 Staff Nurse 2 2 2 Enrolled Nurse 0 1 2 PCA/HCA 9 11 13 Restricted, Non-sensitive  CE Triage Additional Information: There will be an assigned person from the Communication Information Bureau (CIB) who will be station at CE Triage Area Will take photos of casualty with their Y-Series registration number To enable public to identify the patient Restricted, Non-sensitive Restricted, Non-sensitive  Vehicle Recorder (VR) ▪ Record vehicle type and number on the “ Casualty Reception” form ▪ Record the number of casualties (P1, P2, P3, P0) and their time of arrival ▪ Hand over form to OPC Runner Restricted, Non-sensitive Restricted, Non-sensitive Priority 1 – Severe Cases (RED) ❑ Asphyxiating head, facial and chest injurie eg flail chest ❑ Major hemorrhage/ shock ❑ Cranial trauma with GCS 30% and inhalation injuries ❑ SLUDGE signs due to nerve agent requiring antidote Restricted, Non-sensitive  PRIORITY 1 AREA Personnel Plan 50 Plan 100 Plan 260 Staff Category ( 5 Teams ) ( 8 Teams ) ( 14 Teams ) Specialist Doctor 5 8 14 (Reg, AC, C) Medical Officer 5 5 14 Staff Nurse 15 24 42 (1 DEM, 2 NON-DEM) PCA/HCA 5 8 14 Restricted, Non-sensitive ▪ A GES surgeon will be Area IC ▪ Assist by 1 NC ▪ Allocate casualty to each team ▪ Anaesthesia, Plastics and Radiology will provide doctors to assist Restricted, Non-sensitive P1 PROCEDURES ❑ Only clinical procedures to resuscitate and stabilize will be performed ❑ Only essential laboratory and X-ray investigations to be done ✓ Plain X-ray ✓ GXM, blood gas ✓ Request for CT will be directed to P1 Area IC ❑ All documentations of injuries, procedures and investigations ordered to be documented on the downtime forms provided in the TRIAGE Pack ❑ Send stabilized patient to Operation Theater (OT) / Intensive Care Unit (ICU) accompanied by 1 MO + 1 Ward Nurse + 1 HCA/PCA ❑ Remaining team members to continue to treat next casualty  P1 Mass Casualty Trolley ❑Located at P-Corridor cupboard B1-B4 ❑2 sets of P1 Trolley ❑1 set can treat up to 10 casualties Restricted, Non-sensitive ❑Non-asphyxiating facial/thoracic trauma ❑Closed long bones fracture ❑