Disaster Medical Hospital Disaster Medical Hospital ControlControl

Adam Richards RN, BSNAdam Richards RN, BSNDirector of Emergency ServicesDirector of Emergency Services

Deaconess Medical CenterDeaconess Medical Center

Region 9 DMHC Implementation Region 9 DMHC Implementation ProcedureProcedure

““Disaster Medical Hospital Control will make Disaster Medical Hospital Control will make every effort to place patients initially at a every effort to place patients initially at a

facility most appropriately to care for them, facility most appropriately to care for them, and to avoid secondary transfer from and to avoid secondary transfer from

facility to facility if possible.”facility to facility if possible.”

The triggerThe trigger

Multiple ambulances Multiple ambulances dispatched to one incidentdispatched to one incident

multi-unit housing structure multi-unit housing structure firefire

MVC- multiple vehicles or MVC- multiple vehicles or Haz-Mat situationHaz-Mat situation

Public venue incidentPublic venue incident Aircraft incidentAircraft incident Explosion or building Explosion or building

collapsecollapse

The contactThe contact

From first responders: SFD, SVFD, SPDFrom first responders: SFD, SVFD, SPD Dispatch (AMR, CCC, SPD)Dispatch (AMR, CCC, SPD)

All Law Enforcement agenciesAll Law Enforcement agencies Incident CommandIncident Command

Local/Regional HospitalsLocal/Regional Hospitals Department of Emergency ManagementDepartment of Emergency Management

Public HealthPublic Health

The DecisionThe Decision

Does this exceed the capacity or create a Does this exceed the capacity or create a surge event for the immediate facilities surge event for the immediate facilities

affected?affected?1.1. Evaluate capacities locally/regionallyEvaluate capacities locally/regionally2.2. Initiate calls to nursing supervisors in Initiate calls to nursing supervisors in

local/regional hospitals to evaluate local/regional hospitals to evaluate capacitycapacity

3.3. Initiate a blue line informational update Initiate a blue line informational update on Ramses… an ALERT.on Ramses… an ALERT.

Start with the “ALERT”Start with the “ALERT”

Currently Region 9 is using RAMSES to Currently Region 9 is using RAMSES to create an alert for other hospitals.create an alert for other hospitals.

Simultaneously; phone calls to the Simultaneously; phone calls to the local/regionally affected hospitals will help local/regionally affected hospitals will help determine the need for full activation of the determine the need for full activation of the DMHCDMHC

The DMHC Alert Call Data SheetThe DMHC Alert Call Data Sheet

Decision to activate…Decision to activate…

Made by the Incident Command in Made by the Incident Command in conjunction with the DMHCconjunction with the DMHC

Based on the capacity of the locally affected Based on the capacity of the locally affected hospitalshospitals

Size of eventSize of eventNumber of patientsNumber of patients

The ACTIVATIONThe ACTIVATIONOnce the decision to activate has been Once the decision to activate has been

made then “Activation” will occur via the made then “Activation” will occur via the RAMSES system or WaTRAC.RAMSES system or WaTRAC.

Initiate an “All Call” on HEARInitiate an “All Call” on HEARContact the Poison Control Center if Haz Contact the Poison Control Center if Haz

Mat is involvedMat is involvedContact the Blood Bank (509)624-8591Contact the Blood Bank (509)624-8591 Initiate forward movement of patients Initiate forward movement of patients

““All Call” on HEARAll Call” on HEAR

““This is Deaconess Medical Center your This is Deaconess Medical Center your Disaster Medical Hospital Control calling Disaster Medical Hospital Control calling all regional hospitals. This is a (drill or all regional hospitals. This is a (drill or disaster). Do not use call letters until disaster). Do not use call letters until instructed to do so. (Briefly describe the instructed to do so. (Briefly describe the disaster/drill.) Please acknowledge as disaster/drill.) Please acknowledge as your facility is called.”your facility is called.”

DMHC needs during DisasterDMHC needs during Disaster

PatiencePatienceA response if a Disaster alert “all call” is A response if a Disaster alert “all call” is

initiated.initiated.An update on Ramses for bed availabilityAn update on Ramses for bed availabilityAn update if you are not able to raise a An update if you are not able to raise a

subspecialist for your hospital (i.e. subspecialist for your hospital (i.e. neurosurgery).neurosurgery).

Communication with DMHC if you are Communication with DMHC if you are exceeding your capacityexceeding your capacity

DMHC All Call Directory/LogDMHC All Call Directory/Log

CapacityCapacity

In a disaster situation when all hospitals In a disaster situation when all hospitals have exceeded their capacity, it is known have exceeded their capacity, it is known that DMHC will continue to send patients that DMHC will continue to send patients to them.to them.

MCI Patient Triage/Destination ListMCI Patient Triage/Destination List

What do we do?What do we do?

1.1. AlertAlert

2.2. ActivateActivate

3.3. Designate one person and a secretary if Designate one person and a secretary if possible to be stationed at the HEAR possible to be stationed at the HEAR Radio to initiate the “All Call.”Radio to initiate the “All Call.”

4.4. Connect with local/regional hospitals for Connect with local/regional hospitals for a quick inventory of resourcesa quick inventory of resources

5.5. Initiate Internal Disaster ProtocolInitiate Internal Disaster Protocol

Goals for DMHCGoals for DMHC

Have a yearly review of DMHC Have a yearly review of DMHC policy/procedurepolicy/procedure

For updates in policyFor updates in policy

Changes in capabilitiesChanges in capabilities

Educational purposes to stay currentEducational purposes to stay current

Hot Wash large scale incidentsHot Wash large scale incidentsTrain staff on off hoursTrain staff on off hours

Create education for all staff that do not work the Create education for all staff that do not work the customary day shifts where the majority of practice customary day shifts where the majority of practice takes place.takes place.