Running head: MASS CASUALITY EMERGENCY PREPAREDNESS DISASTER PLA
Mass Causality Emergency Preparedness Disaster Plan
Kimberly Johnson
Columbus State University
Professional Clinical Nursing RN II
4292
Dr. E. Frander
June 15, 2013
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MASS CASUALITY EMERGENCY PREPAREDNESS DISASTER PLA
ANNEX C (Mass Causality Management/External Disaster) to Emergency Preparedness Center
1. Reference: Basic Plan.
2. Time Zone: Basic Plan.
3. Situation: Basic Plan.
4. Mission: Basic Plan.
5. Execution.
a. Concept of operation. This plan establishes procedures to be implemented to
expand hospital capabilities in support of mass casualties.
b.
Tasks.
1. Staff activities given specific tasking in the EOP will perform all assigned
missions.
2. All other activities not specifically tasked will prepare to assist the effort in
any way possible.
3. Coordinating Instructions: See Basic Plan.
c. Security Support. This will be accomplished in accordance with the Mass
Casualty Plan.
6. Service Support: Basic Plan.
7. Command and Signal: See Basic Plan.
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MASS CASUALITY EMERGENCY PREPAREDNESS DISASTER PLA
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APPENDIX I (Patient Classification) to Emergency Preparedness Center (Mass
Casualty Management/External Disaster) to EOP
1. Situation-Basic Plan.
2. Mission- To classify casualties in a manner, which establishes priority of care and
ease of routing to the area where this care will be provided.
3. Execution.
a. Triage will be accomplished outside the ER. Minimal patients will be sent to
the Front Lobby of the Hospital for treatment with the drop-off point being the
Main Hospital Entrance. Delayed patients will be transported to the MedicalSurgical Unit for observation and appropriate care. Immediate patients will be
transferred immediately to the Pre-Op Holding area after receiving life-saving
procedures until transfers to OR, ICU, etc., as injuries dictate. Expand ER to
Acute Care Clinic and/or Central Triage waiting are for appropriate
management (Walker, 2011, p. C-1-1). The casualty flow will be followed
using the DIME pneumatic and will be listed as follows:
(D) DELAYED- Yellow (Medical-Surgical-Overflow to MBU)
(I) IMMEDIATE- Red (Emergency Room)
(M) MINIMAL- Green (Front Lobby)
(E) BLACK- Expectant (Basement of the Hospital)
b.
Expectant will only be used when the chief of the triage station, in
consultation with the EOC, has diagnosed little hope of recovery and available
resources are limited. This category should be used only if resources are limited.
MASS CASUALITY EMERGENCY PREPAREDNESS DISASTER PLA
When this occurs, expectant patients will be transferred to the Basement of the
Hospital.
c. Tasks- Presorting teams, when utilized, will mark patient’s classification on the
Field Medical Card or equivalent as follows: M-minimal, I-immediate, D-delayed, and Eexpectant (only when decision is given to use this category) (",”)
4. Service Support- Basic Plan.
5. Command and Signal- Basic Plan.
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MASS CASUALITY EMERGENCY PREPAREDNESS DISASTER PLA
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APPENDIX 2 (Reception, Triage, and Patient Flow within the Hospital) to EPC (Mass Casualty
Management/External Disaster) to EOP
1. Situation: Basic.
2. Mission: The Triage Area and Emergency medicine provides for rapid evaluation of each
casualty upon arrival at this hospital, determines the need for immediate life-saving
treatment, dispatches patient to the appropriate area to receive care, and provides
classification of patients of EOP (Walker, 2011, p. C-2-1).
3. Execution:
a. Concept of Operations: The triage function will be performed by up to three medical
teams: (1) Prehospital- on-site evaluation; (2) Triage Team- triage patients on arrival
to EPC with Minimal patients being dropped-off at the Main Hospital Entrance; and
(3) Emergency Treatment Team- provide ACLS/ATLS care in Emergency Room;
triage patients for surgical priority. The Incident Commander evaluation of the
disaster will determine the extent of the utilization of these teams (Walker, 2011, p.
C-2-1).
b. Tasks:
1. Prehospital Team: The initial responders will be EMS staff (EMT’s and
Paramedics), who will make an assessment of the site, relay the information to the
Emergency Department, and initiate on-site triage, ATLS/ACLS treatment, and
patient evacuation. Chief EMS or representative will remain on scene to join
Unified Command, be in contact with EOC/ER, and serve as eyes for the EOC
(Walker, 2011, p. C-2-1).
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2. Hospital Triage Team: The senior Emergency Medicine physician on duty will
serve as the Triage Officer. The Lead Triage Officer will assume control of the
EPC triage area. He/she will set up the initial triage site at EPC, supervise triage,
and coordinate with the Chief, Emergency Medicine, on the movement of
immediate patients to the ER for treatment. The Triage Team will perform the
following functions:
a. Evaluate all arriving patients and classify them as Immediate, Minimal,
Delayed, or Expectant. Mark patient’s classifications on Field Medical Card,
(I-immediate, D-delayed, M-minimal, and E-expectant) and attach to patient.
b. Initiate transfer of immediate patients to the ER.
c. Direct delayed to Medical-Surgical (overflow to MBU) and minimal patients
to the EPC.
d. Direct litter teams in movement of expectant patients to the Basement of the
Hospital.
e. Chief of Registration will ensure Registration representative is present with
trauma packets, ensuring patient tracking.
3. Emergency Treatment Area: The Chief, Emergency Medicine, will have direct
overall supervision of the Emergency Service. In the event of his/her absence, the
Assistant Chief will assume his responsibilities. The Chief, Emergency Medicine,
will designate the number of Emergency Treatment Teams needed to provide
immediate resuscitation and stabilization of patients transferred from the Triage
Area. In coordination with the Chief, and the CNO, the Chief of Emergency
Medicine, will request physicians and other medical staff as needed from the
MASS CASUALITY EMERGENCY PREPAREDNESS DISASTER PLA
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Physicians Labor Pool. The Chief, Emergency Medicine, will also coordinate
with the Chief, Department of Surgery, or his/her designated representative, on
triage and movement (gurneys and litters) of patients requiring immediate surgery
from the Emergency Room to the OR, or appropriate holding areas. Patients
treated and stabilized in the ER who does not require surgery will be moved to
designated wards (Walker, 2011, p. C-2-2).
a. The Emergency Treatment Teams will:
1. Consist of two physicians (if possible, one surgeon), one nurse, and one or
more medics, The Chief, Emergency Medicine, in conjunction with the
Chief, General Surgery, will contact the Provider Pool for specialists as
needed.
2. Provide resuscitation, and stabilizing treatment to all immediate patients
sent from the triage area.
3. Coordinate with Chief, Emergency Medicine, on disposition of patients.
b. Director of, Emergency Medicine, will be responsible for the coordination of
emergency supplies for the Emergency Service. He will communicate with
Logistics and CMS on supply status and needs.
c. Registration personnel will provide the patients with a number, log patients
into systems, and help maintain patient accountability.
d. Incident command will provide, from the Labor Pool:
1. Litter teams to transport patients.
2. Interior guides.
3. Traffic/crowd control.
MASS CASUALITY EMERGENCY PREPAREDNESS DISASTER PLA
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4. Runners, as requested.
4. Delayed care areas will be the responsibility of Chief of Emergency Medicine. One
physician from Emergency Medicine is required to oversee area and two physicians from
Specialty Services are required to attend delayed patients.
5. Minimal care areas will be the responsibility of the Chief Nursing Officer.
6. Expectant area will be the responsibility of the Chief CNO, and Interns are responsible
for care.
8. Chief, Emergency Medical Services (Ambulance Services), will:
a. Coordinate patient evacuation with land and air transportation.
b. Maintain equipment for Hospital triage area.
c. Provide personnel and equipment for on-site triage.
d. Provide ambulance services for patient transport.
e. Notify the EOC when all patients have been transported and no more casualties are
anticipated.
4. Service Support: Basic Plan.
5. Command and Signal:
1. Signal: Basic Plan.
2. Command: The Head Nurse of Incident Command is Chief, Emergency Medicine, or
his/her designated representative.
After having a local EMT review my Disaster Plan, her suggestions were to:
1. Ensure that a recall list is available to ensure adequate staffing, organization and
local officials have been notified i.e.: Local Police Department
MASS CASUALITY EMERGENCY PREPAREDNESS DISASTER PLA
2. Be sure that staff is aware of Emergency Disaster Plan with appropriate Policies
and Procedures.
3. She stated that staff communication is very important with understanding the
Standard Operative Procedures and communicating with Incident Command as
necessary.
She suggests that overall, the Emergency Disaster Preparedness Plan is appropriate for
the type of Casualty Disaster and the instructions are straight forward with no confusion or
questions as to what should take place in the event of a disaster.
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MASS CASUALITY EMERGENCY PREPAREDNESS DISASTER PLA
References
Emergency Preparedness and Response. (). Retrieved from
http://www.emergency.cdc.gov/preparedness/
Walker, L. (2011). Disaster Preparedness. Retrieved from
https://srmc-portal.amedd.army.mil/mtf/ftbenning/default.aspx
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