This document discusses hospital disaster preparedness in India. It notes that hospitals play an important role in disaster response but most Indian hospitals have little knowledge of or preparation for disasters. It outlines some common internal and external disaster scenarios hospitals may face. The document then provides details on forming a disaster management team, preparing an emergency manual, establishing communication codes, staff roles and responsibilities, and conducting drills to evaluate response and identify areas for improvement. The goal is to better prepare healthcare organizations to effectively respond to disasters.

2. • “ Hospitals have always been an important link in the
chain of disaster response and are assuming even more
importance as advanced pre-hospital care capabilities lead
to improved survival-to-hospital rate”(Dara et al., 2005).
• Therefore, disaster preparedness in India must focus
heavily on organizations that provide healthcare.

3. Not a mandatory requirement
Most of the hospitals have less or no
knowledge and understanding of disaster
preparedness
Very few hospitals have proactively
responded
Accreditation is a boon

4. Difficulty in resource allocation
 Not a priority area for the hospital
management
Difficult to keep the training inputs
remembered
 Not a routine activity
Less trainers available
Theory not put in to practice

5.  Internal Disasters
 Fire
 Building collapse
 Bomb blast / Threat
 HAZMAT injury
 External Disasters
 Earth quake
 Bomb blast / Accidents
 Fire
 Tsunami / Flood / Cyclone
 Each requires different type of management

8. Disaster
Nsg.
Doc’s
Mainte
nance
Securit
y
PR
Mgt.
Lab /
Blood
bank
Pharmacy

9. Hospital
Govt
Other
HCOs
supplie
rs
Police
Media
Pt.
Relatives

10.  Formation of disaster management TEAM

 Preparing Emergency / Disaster management
MANUAL

11. Director / CEO / Medical Superintendent
RMO
Nursing Head
Administrator
PRO

12. Commanding
Officer
Security Maintenance Security
RMO N.S
Administrator Finance

13.  Code Blue - Cardiac arrest
 Code Red - Fire outbreak
 Code black - Mass causalities
 Code gold - Bomb threat

14.  Call the emergency number and declare the
code
 Eg. “Code RED in Operation Theater” (A110)
 The message is broadcasted in the PAS
 Specific calls made by the telephone operators
to respective teams
 Electricians and Fire rescue team– code RED
 ACLS team – Code BLUE

15.  Once the code is established, every employee shall
act according to the standard instruction given to
them
 Should not expect orders. Act automatically.

16. Disaster
Internal
Evacuation
External
Preparation

17. • Alert the command
• Evacuate patients and staff
• Mitigate the Emergency (Fire fighting etc)
• Inform Govt. sources
• Evaluate emergency response
• Initiate corrective actions

19.  Fire prevention methods
include
 Heat and/or smoke detectors
 Automatic fire sprinkler systems

20.  JEH conducts fire drills in
all areas of the hospital
including operation theater

 Conducted once in 4
months

22. EXIT routes should be
established,
All employees should
be aware to use the
route

24. • Alert the command
• Establish disaster status
• Set up Triage, Command, Communication centers
• Treat patients
• Coordinate with Govt. sources
• Evaluate emergency response & Initiate CA

25. Your disaster response job descriptions
Tell you
 What you are going to do
 When you are going to do it
 To whom you are going to report it after you
have done it.

26. Administrator - Operations
 Check completion of internal communication
 Ensure preparedness check is complete
 Command center ready
 Triage center ready
 Wards ready
 Ambulance ready
 Physicians in place
 Consumables secured
 Medicines secured
 Mobilize manpower and materials
 Report to command

27. Nursing Head
 Inform and gather nurses at designated wards
 Assign Triage nurses
 On order of the RMO discharge elective, pre-
operative patients and fit post operative patients
 Mobilize emergency medicines
 Ensure adequate supplies

28. Security
 To close all entries, and allow only patients,
relatives
 To allow press person after verifying their ID card
 To position securities at front and backside gates
 Report to command center

29. Pharmacy
 Supply pre-authorized quantities of medicine and
consumables to wards
 Contact suppliers and arrange additional drug
needs. Have list of drug suppliers that can provide
emergency supplies quickly
 Keep minimum supply of emergency drugs on
hand at all times.
 Pharmacy should remain open and have a runner to
deliver needed meds to areas.

30. Overall inchage of the incident
management
Group of decision makers
Supersedes routine line of
command

31. Prioritising patient admission
Resource optimisation
Maximize survival

32. Communicate with government agencies
Media management / Press releases, etc
Releasing information to anxious
relatives of victims

33. Most crucial aspect during disasters
Patients, relatives require
exceptional counseling during this
time
Pastors, chaplains, religious
personnel can be deployed

34. Stress level of staff is very high
Mentally and physically exhausted
Many might go to depression, if not
counseled

35. Observation Corrective action
The emergency medication was inadequate
Prepare a list of medicines
that is sufficient to treat 25
emergency patients
Coordination between teams were lacking
Conduct mock drills
frequently
Key personnel did not carry disaster action
cards, hence they did not know their roles
Conduct mock drills
frequently
In adequate training for doctors in triaging Conduct triage training
Telephonic message did not reached all the
listed personnel
Display the action card
near the telephone area

36. Training covers all employees once a
year
Mock drills are conducted once a year
Types of drills
 Table top drill
 Mock drill