Harbor:Disaster plan - Revision history

Kwilhelm at 03:43, 3 February 2022

2022-02-03T03:43:20Z

@@ Line 1: / Line 1: @@
-==Disaster Plan & Equipment (EOP)==
+==ED Emergency Operations Plan (EOP)==
-* '''ACTIVATING'''
+<big>'''ED EOP Activation Triggers'''</big> <br>
-** Triggers:
-*** 5 ADULT or 3 PED critical (red triage/TTA1) arriving within 30 min period (from single separate incidents!)
+Triggers for activation of the ED Emergency Operations Plan (EOP) include the following (numbers refer to
-*** 10 or more critical/urgent (red/yellow triage,TTA1/TTA2/ED Trauma)
+potential patients). The ED '''should not wait''' for patients to arrive before activating the ED EOP and/or the
-*** ED discretion – (potential for extensive decontamination, need to deploy HERT for extended period, leaving ED with decreased staffing, etc)
+Hospital’s Code Triage Plan:<br>
-*** Hospital administration initiates (EMS notification, active shooter)
 ** ED Command Post - AED Acute Side A Nursing Station.

Bchap23: /* Disaster Plan & Equipment */

2021-11-15T22:42:48Z

Disaster Plan & Equipment

← Older revision		Revision as of 22:42, 15 November 2021
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	== Disaster Plan & Equipment==		==Disaster Plan & Equipment (EOP)==
	* '''ACTIVATING'''		* '''ACTIVATING'''
	** Triggers:		** Triggers:

Bchap23: /* Disaster Plan & Equipment */

2021-11-15T22:41:10Z

Disaster Plan & Equipment

@@ Line 40: / Line 40: @@
-TRIAGE
+* TRIAGE
-•	Will occur at the Pedestrian Spine & Ambulance Entrance.
+* DECONTAMINATION
-•	If there is a security threat to the hospital, all patients will be routed to the Ambulance Entrance.
+** All ED physicians have been trained in use of Level C PPE (PAPRs) at Harbor-UCLA and may be called upon to perform decontamination.
-•	In a “slow going” disaster, START Triage may be used. However, for a limited notice MCI, the Purple Attending (or another senior physician) should stand in the ambulance bay and use clinical judgement and/or START Triage to designate patients as “Immediate”, “Delayed” or “Minor” based on clinical presentation and nature of injuries.
+** For events with < 20 patients, decon should be performed in the '''fixed shower outside the Ambulance bay (access with an NA-7 key)'''
-•	Patients may be labeled with a colored Triage bracelet, and then sent to the appropriate treatment area or waiting area.
+** Refer to the ED EOP binder for additional information.
-DECONTAMINATION
+* PATIENT TRACKING/REGISTRATION/RECORD KEEPING
-•	All ED physicians have been trained in use of Level C PPE (PAPRs) at Harbor-UCLA and may be called upon to perform decontamination.
+* ADMITTING PATIENTS TO THE HOSPITAL
-•	For events with < 20 patients, decon should be performed in the fixed shower outside the Ambulance bay (access with an NA-7 key).
+** '''During a Hospital “Code Triage” activation'''
-•	Refer to the ED EOP binder for additional information.
+*** ED Attendings should request the names of, and Spectra Link numbers assigned to, the Medicine Hospitalist, Pediatric Hospitalist, Trauma Attending and OB/Gyn Attending.
+* SUPPLIES & STAFFING
-PATIENT CARE AREAS & ED BED ASSIGNMENTS
+** '''Disaster Key should be retrieved by the OCN from the Pyxis in SE-1J25, listed as “*Keys, ER disaster keys” '''
+** Disaster vests, binders, forms and checklists are found in the shelves next to the AED Clerk desk
-•	Immediate Unit:  Trauma Bays (if no beds available, care can be initiated in Trauma hallway or in an AED room until bed available). Patients MUST be moved out of this area immediately after evaluation.
+** Disaster medical supplies, including gurneys, wheelchairs, linens, etc, or stored in various areas. An inventory list is in the ED EOP Binder.
 For the detailed plan:

Bchap23: /* Disaster Plan & Equipment */

2021-11-15T22:27:10Z

Disaster Plan & Equipment

← Older revision		Revision as of 22:27, 15 November 2021
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	== Disaster Plan & Equipment==		== Disaster Plan & Equipment==
	ACTIVATING		* '''ACTIVATING'''
			** Triggers:
			*** 5 ADULT or 3 PED critical (red triage/TTA1) arriving within 30 min period (from single separate incidents!)
			*** 10 or more critical/urgent (red/yellow triage,TTA1/TTA2/ED Trauma)
			*** ED discretion – (potential for extensive decontamination, need to deploy HERT for extended period, leaving ED with decreased staffing, etc)
			*** Hospital administration initiates (EMS notification, active shooter)

	~~Triggers:~~		** ED Command Post - AED Acute Side A Nursing Station.
	~~• 5 ADULT or 3 PED critical (red triage/TTA1) arriving within 30 min period (from single separate incidents!)~~		*** ED Nurse Leader - '''OCN - assign roles/responsibilities'''
	~~• 10 or more critical/urgent (red/yellow triage,TTA1/TTA2/~~ED ~~Trauma)~~		*** Physicians usually treat not lead
	• ED ~~discretion – (potential for extensive decontamination, need to deploy HERT for extended period, leaving ED with decreased staffing, etc)~~
	~~• Hospital administration initiates (EMS notification, active shooter)~~

	~~ED Command Post~~ - ~~AED Acute Side A Nursing Station.~~		** '''Physician-specific roles include''':
	~~ED Nurse~~ Leader ~~(OCN) - assign roles/responsibilities.~~		*** Immediate Unit Leader – Purple Attending
	Physicians ~~usually treat not lead~~		*** Delayed Unit Leader – Green Attending
			*** Pediatrics Unit Leader – PED Attending
			*** Physicians may be reorganized to other Units as needed.

	~~Physician~~-~~specific roles include:~~		** FOR PHYSICIANS
	~~• Immediate Unit Leader –~~ Purple Attending		*** “MCI alert” or “Code Triage” –
	• Delayed ~~Unit Leader – Green Attending~~		**** Attendings - report to the radio room or AED A-side for briefing
	~~• Pediatrics Unit Leader – PED Attending~~		**** Residents - report to the Trauma Bays to receive patients
			**** '''Purple Attending'''
			***** Go with the AED Charge/ Trauma nurses to clear all possible rooms,
			***** “Post” at the ambulance entrance -triage to either Trauma (“Immediate”) or AED (“Delayed”).
			***** '''You will need to triage, often together with the Trauma Attending''':
			****** 1) initial evaluation space (Immediate, Delayed, or Minor)
			****** 2) priority for CT scanner
			****** 3) ability to move out of a Trauma Bay to another room after initial evaluation and stabilization
			****** 4) priority to OR /Admission
			****** These triages, and re-triages, will need to be performed in an ongoing fashion until the emergency has ended.

	~~Physicians may be reorganized to other Units as needed.~~		* DECOMPRESSING THE ED
			** If the EOP is activated, physicians in the ED and Gold Unit must review their current patients and designate each in the “MD Comments” column of Cerner as:
			*** Chair – patient may be seated in a chair and discharged if bed is required emergently
	~~FOR PHYSICIANS~~		*** Admit – patient requires admission and can be moved to an inpatient bed as soon as available
			*** Stay – patient must remain in a monitored bed and is not sufficiently stabilized/evaluated to be admitted
	~~• “MCI alert” or “Code Triage” –~~		** These designations should be adjusted as patient condition/evaluation progresses, at least every 2 to 4 hours until the disaster event is over and normal functions resume.
	~~o Attendings - report to the radio room or AED A-side for briefing~~
	~~o Residents - report to the Trauma Bays to receive patients~~
	~~o Purple Attending –~~
	~~ Go with the AED Charge/ Trauma nurses to clear all possible rooms,~~
	~~ “Post” at the ambulance entrance -triage to either Trauma (“Immediate”) or AED (“Delayed”).~~
	• You will need to triage, often together with the Trauma Attending: 1) initial evaluation space (Immediate, Delayed, or Minor), 2) priority for CT scanner, 3) ability to move out of a Trauma Bay to another room after initial evaluation and stabilization, 4) priority to OR /Admission. These triages, and retriages, will need to be performed in an ongoing fashion until the emergency has ended.


	DECOMPRESSING THE ED

	If the EOP is activated, physicians in the ED and Gold Unit must review their current patients and designate each in the “MD Comments” column of Cerner as:
	• Chair – patient may be seated in a chair and discharged if bed is required emergently
	• Admit – patient requires admission and can be moved to an inpatient bed as soon as available
	• Stay – patient must remain in a monitored bed and is not sufficiently stabilized/evaluated to be admitted

	These designations should be adjusted as patient condition/evaluation progresses, at least every 2 to 4 hours until the disaster event is over and normal functions resume.

PetersonMike123: /* Disaster Plan & Equipment */ Update Plan

2019-11-20T20:35:30Z

Disaster Plan & Equipment: Update Plan

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 == Disaster Plan & Equipment==
 ACTIVATING
@@ Line 115: / Line 96: @@
 •	Disaster vests, binders, forms and checklists are found in the shelves next to the AED Clerk desk
 •	Disaster medical supplies, including gurneys, wheelchairs, linens, etc, or stored in various areas. An inventory list is in the ED EOP Binder.
 ==Disaster Triage==

PetersonMike123: /* General Instructions */

2019-11-20T20:29:21Z

General Instructions

Show changes

SSchlesinger2: /* Disaster Plan & Equipment */

2019-03-20T21:39:16Z

Disaster Plan & Equipment

← Older revision		Revision as of 21:39, 20 March 2019
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	*For information on the hospital-wide "Code Triage" disaster plan, and links to the HICS forms that should be used during a Code Triage event, follow the "Code Triage" Quick Link on the Harbor-UCLA intranet homepage.		*For information on the hospital-wide "Code Triage" disaster plan, and links to the HICS forms that should be used during a Code Triage event, follow the "Code Triage" Quick Link on the Harbor-UCLA intranet homepage.

	*Internal disaster: disruption impedes ~~the ED or~~ patient care services to the extent that the care of additional patients may be jeopardized		*Internal disaster: disruption within the hospital impedes patient care services to the extent that the safe care of additional patients may be jeopardized
	** DEM Attending & Overall Charge RN & Hospital AOD will make decisions on closure to internal disaster		** DEM Attending & Overall Charge RN & Hospital AOD will make decisions on closure to internal disaster
	** The '''MAC must be notified''' and made aware of the rationale for requesting temporary diversion and the name of the AOD authorizing the diversion		** The '''MAC must be notified''' and made aware of the rationale for requesting temporary diversion and the name of the AOD authorizing the diversion

SSchlesinger2: /* Disaster Plan & Equipment */

2019-03-20T21:37:14Z

Disaster Plan & Equipment

← Older revision		Revision as of 21:37, 20 March 2019
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	== Disaster Plan & Equipment==		== Disaster Plan & Equipment==
	*Detailed Instructions are in the '''Harbor-UCLA DEM Emergency Operations Plan''' Binder on the shelves next to the clerk's desk in the AED A-side.		*Detailed Instructions are in the '''Harbor-UCLA DEM Emergency Operations Plan''' Binder on the shelves next to the clerk's desk in the AED A-side.
			*For information on the hospital-wide "Code Triage" disaster plan, and links to the HICS forms that should be used during a Code Triage event, follow the "Code Triage" Quick Link on the Harbor-UCLA intranet homepage.

	*Internal disaster: disruption impedes the ED or patient care services to the extent that the care of additional patients may be jeopardized		*Internal disaster: disruption impedes the ED or patient care services to the extent that the care of additional patients may be jeopardized
	** DEM Attending & Overall Charge RN & Hospital AOD will make decisions on closure to internal disaster		** DEM Attending & Overall Charge RN & Hospital AOD will make decisions on closure to internal disaster

Bchap23: /* Disaster Plan & Equipment */

2019-03-14T20:13:41Z

Disaster Plan & Equipment

← Older revision		Revision as of 20:13, 14 March 2019
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	== Disaster Plan & Equipment==		== Disaster Plan & Equipment==
			*Detailed Instructions are in the '''Harbor-UCLA DEM Emergency Operations Plan''' Binder on the shelves next to the clerk's desk in the AED A-side.
	*Internal disaster: disruption impedes the ED or patient care services to the extent that the care of additional patients may be jeopardized		*Internal disaster: disruption impedes the ED or patient care services to the extent that the care of additional patients may be jeopardized
	* DEM Attending & Overall Charge RN & Hospital AOD will make decisions on closure to internal disaster		** DEM Attending & Overall Charge RN & Hospital AOD will make decisions on closure to internal disaster
	* The '''MAC must be notified''' and made aware of the rationale for requesting temporary diversion and the name of the AOD authorizing the diversion		** The '''MAC must be notified''' and made aware of the rationale for requesting temporary diversion and the name of the AOD authorizing the diversion
	*~~Detailed Instructions are in the '''Harbor-UCLA DEM Emergency Operations Plan''' Binder on the shelves next to the clerk's desk in the AED A-side.~~		** Criteria for Internal Disaster:
			*** Power outage impacting patient care, which is unable to be supported by emergency generators
	* Criteria for Internal Disaster:		*** Critical infrastructure systems failure impacting patient care, which is unable to be supported by emergency back-up procedures
	** Power outage impacting patient care, which is unable to be supported by emergency generators		*** Bomb threat, explosion, active shooter
	** Critical infrastructure systems failure impacting patient care, which is unable to be supported by emergency back-up procedures		*** Fire
	** Bomb threat, explosion, active shooter		*** Flooding
	** Fire		*** Water disruption or contamination
	** Flooding		*** Hazardous materials contamination in patient care areas
	** Water disruption or contamination		*** Other: Approval from EMS Agency through the MAC must occur prior to closure for Internal Disaster if rationale is anything other than what has been described
	** Hazardous materials contamination in patient care areas
	** Other: Approval from EMS Agency through the MAC must occur prior to closure for Internal Disaster if rationale is anything other than what has been described

	==General Instructions==		==General Instructions==

Bchap23: /* Disaster Plan & Equipment */

2019-03-14T20:07:15Z

Disaster Plan & Equipment

@@ Line 1: / Line 1: @@
 == Disaster Plan & Equipment==
-Detailed Instructions are in the '''Harbor-UCLA DEM Emergency Operations Plan''' Binder on the shelves next to the clerk's desk in the AAED A-side.
+*Internal disaster: disruption impedes the ED or patient care services to the extent that the care of additional patients may be jeopardized
 ==General Instructions==