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2014

Health Emergency Preparedness, Response and Recovery Plan

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Health Emergency Preparedness,


Response and Recovery Plan

Lung Center of the Philippines

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LUNG CENTER OF THE PHILIPPINES
EMERGENCY PREPAREDNESS, RESPONSE AND
RECOVERY PLAN

TABLE OF CONTENTS

I. Background 1
II. Plan Description 2
III. Goals and Objectives 3
IV. Planning Group 4
V. Management Structures 7
VI. Roles and Responsibilities 8
VII. Hospital Emergency Preparedness Plan 9
A. Hazards assessment 9
B. Vulnerabilities reduction 21
C. Capacity development 22
D. Fire emergency plan 30
VIII. Hospital Emergency Response Plan 36
A. Organization 36
B. System activation 37
C. Resource mobilization 38
D. Partnership 38
IX. Hospital Recovery and Reconstruction Plan 38
A. Damage assessment and needs analysis 38
B. Provision of services 38
C. Psychosocial support 39
D. Restoration of utilized/damaged resources and services 39
E. Planning Matrix 40
X. Annexes
A. Directory of contact persons 45
B. Hospital Map & Pre-emergency evacuation designated area 46
C. LCP Organizational Chart 47
D. Glossary 48
E. Risk assessment form for all hazard 53
F. Risk assessment form for highly infectious disease 76
G. Flow chart for referral of emerging and re-emerging respiratory

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disease 81
H. Protocols on the triage of emerging and re-emerging respiratory
disease
I. Advice form for home quarantine 83
J. Triage screening form 84
K. Protocols in response to trauma emergencies outside the hospital 85
L. Protocols in response to earthquake incident 86
M. Protocols in the conduct of fire drill 88
N. Protocols in response to fire incident 90
O. Protocols in the activation of HEICS 92
P. Incident Command System Organization 93
Q. Hospital policies, guidelines, protocols 110
R. Post Mission Report 117
S. Hospital Floor Plan 118
T. Metro Manila DOH Zoning Plan 122
U. Reference 123

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Health Emergency Preparedness, Response and Recovery Plan

I. Background
The Lung Center of the Philippines is a government owned and controlled
corporation and established through Presidential Decree No. 1823 on January
16, 1981, to address respiratory diseases which were already recognized as the
leading cause of illnesses and deaths in the country. Lung Center is situated in
the district of Diliman, Quezon City, Metro Manila, with 12 hectares of prime
property. On January 23, 1982, the portals of the institution were first opened to
the public. It has since provided tertiary level care services to around 30,000
problematic and difficult cases annually and admitted 6,000 patients per year; it
has a bed capacity of 250. Around 70% of these are service patients and 30%
are pay patients. It has a complementary manpower consisting of 65 Physicians,
177 Nurses, 98 Nursing Attendants, 1 Dentist, 6 nutritionist-dietician, 41 Medical
Technologist, 17 Radiology Technologist, 3 Social Workers, 2 Mechanical
Engineers, 1 Electrical Engineer, 3 Driver and 3 Security Guard. Janitorial,
Maintenance Engineering and other Clerks are under contractual status. With
regards to health statistics, the leading causes of mortality and morbidity are (1)
Malignant Neoplasm of Trachea, Bronchus and Lung; (2) Respiratory TB
(MDRTB, TB Bronchiectasis, PTB); (3) Chronic lower respiratory diseases
(COPD, Bronchial Asthma, Bronchiectasis); (4) Pneumonia; (5) remainder of
diseases of the respiratory system (Aspiration pneumonia, ARDS, Interstitial
Lung Diseases, Pneumothorax). Other Services include:
1. PHDU Programs:
a. DOTS
b. MDRTB
c. Sagip Baga
2. ER OPD Specialty Clinics
a. HEMS Program
b. Surgery, Asthma, COPD
c. Smoking Cessation, Pain Clinic
d. Cancer support, Oncology
3. Services Areas for In-Patients
a. OR, ER, PACU-SICU, MICU, STU, IMCU, Pediatrics, Sleep
Lab, SRS, Laboratory, X-ray (CT-Scan, Ultrasound), VATS,
Pharmacy
b. Dietary, Social Services, Linen, PPSD and General Services

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Health Emergency Preparedness, Response and Recovery Plan

All personnel have an annual medical check-up on their birth month.


Influenza and hepatitis are also given.

Lung Center focuses on the promotion of health of the majority of the Filipino
people and kept abreast with the technological advances in the field of medical
services.
But on that unfortunate event of May 18, 1998, Lung Center was gutted by
fire and 90 percent of its complex totally burned to the grounds including loss of
lives. Lung Center is in a state of shock for several years, affecting and
displacing hundreds of hospital personnel and patients.

The Lung Center suffered and tremendous reversals as a result of the 1998
fire, but its services, particularly to its numerous outpatients, never stopped. It
continued to give out-patient medical services even in a temporary field tents. Its
recovery took 2-4 years utmost, recalling gradually administrative and nursing
staff to manned small number of units. With the construction of the new building,
the design for safety focuses on multiple and easily accessible fire exits/ramps,
electronic fire/smoke detection and sprinkler system.

In the face of global threats to bio-terrorism and pandemic threats of


diseases, specifically Severe Acute Respiratory Syndrome (SARS), Avian H5N1
also known as Bird Flu and the Pandemic H1N1, Lung Center has risen up to the
challenge, that is why as early as 2004, the Center has put up its Isolation Units
and Bird Flu Facility, specifically made to confine highly infectious patients.

II. Plan Description

The Lung Center of the Philippines Health Emergency Preparedness,


Response and Recovery Plan defines the direction of the hospital in preparing for
effective and efficient response and recovery in any event of emergency or
disaster within its facilities and/or its catchment areas. The planning process
includes all-hazards preparedness, based on a comprehensive hazards
vulnerability analysis, in the response to an internal or external event.

Its processes are directed primarily in reducing morbidity and mortality, while
preserving basic community service. The hospitals function in basic community
service will be fulfilled by protecting the patients, visitors, staff, and facility while

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Health Emergency Preparedness, Response and Recovery Plan

maintaining services, providing care to victims, and providing coordination and


control with other agencies. The plan is intended to enhance the ability of a
hospital to implement preparedness, mitigation and business continuity activities.
The plan also includes the hospital incident management system that should
provide for the establishment of a hospital incident command system with
position description that identifies mission, functions, and responsibilities within
the incident response organizational structure.

The Recovery or Rehabilitation Plan contains the strategies and activities in


mainstreaming and/or restoring the facility and its services back to its prepared
position for any forthcoming eventuality.

III. Goals and Objectives

Goal:
To enhance the hospitals capacity for prompt and effective attendance to
the largest possible number of people requiring medical and health care in a
health emergency or disaster ultimately reducing mortality, morbidity and
disability and promoting their early recovery.

Objectives:
1. To provide policy for effective response to both internal and external
disaster situations that will affect the operation of the hospital and its staff,
visitors, patients and the community.
2. To identify the hospitals capability to handle mass casualty in all
scenarios.
3. To identify responsibilities of individuals and departments in a disaster
situation.
4. To identify Standard Operating Guidelines/Procedures, protocols for
emergency activities and responses.
5. To continuously improve risk reduction framework of the hospital.
6. To promote health emergency preparedness through networking, inter
hospital collaboration, technical assistance, training, public information,
advocacy, research and development.
7. To document best practices and lessons learned during simulation
exercises, emergencies and disasters.

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IV. Planning Group

Composition of the Lung Center Health Emergency Preparedness


Response and Recovery (HEPRR) Planning Group/Committee:

1. Executive Director

2. Deputy Director for Hospital Support Services

3. Deputy Director for Medical Services

4. Department Manager, Nursing

5. Finance Division

6. Property and Procurement Division

7. General Services Division

8. HEMS Coordinator and Asst. HEMS Coordinator

9. Representative from the Quezon City Disaster Coordinating Council

10. Representative from the Quezon City Medical Society Chapter

11. Representative from the Philippine National Red Cross, Quezon City
Chapter

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General functions of Planning Group:

A. Develops, reviews, update the Lung Center of the Philippines Health


Emergency Preparedness, Response and Recovery (HEPRR) Plan.

B. Gathers required information and gain commitment of key people and


organization.

C. Initiates testing of the plan for its functionality and adaptability to multi-
hazard situation.

D. Develop annual operational plan and other plans relevant to health


emergencies and disasters.

Specific functions:

1. Executive Director/Deputy Directors


a. Has the final authority for the implementation of the planning group.
b. Approves the plan provisions and all subsequent revisions.
c. Assures that adequate resources are available to support
emergency management activities.
d. Monitors the effectiveness of response activities during
emergencies and take actions to ensure that all appropriate
procedures are followed.
e. Assures continued compliance with the provisions of LCP policy on
emergency precautions and response.
2. Department Manager, Nursing
a. Ensures that all nursing staffs are trained in all aspect of health
emergency management and participates in the conduct of drills.
b. Ensures that all nursing units are adequately staffed and supplied.
c. Maintains and monitor the quality of nursing service being provided.
d. Ensures all nursing actions and decisions are documented.
e. Observes all nursing staff for signs of stress and inappropriate
behavior and report concerns to psychosocial personnel in-charge.
f. Ensures rotation of nursing personnel to prevent burnout.
g. Responsible to make necessary guidelines for volunteer nursing
staff.
h. Brief the Executive Director/Deputy Directors routinely on the status
of the hospital operations especially on the status of all patients,
problems encountered, resources needed.
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3. Finance and Budget Division, Head


a. Responsible for the monitoring of institution financial assets.
b. Approve incident financial status report relative to personnel,
supplies and miscellaneous expenses.
c. Updates the Executive Director/Deputy Directors and other unit
leaders pertinent to financial status.
4. Property and Procurement Division, Head
a. Responsible for the control, anticipation and provision of logistical
needs during emergencies and disaster.
b. Coordinate with companies regarding stock level, available supply
and equipment.
c. Coordinate frequently with the finance chief regarding monetary
assistance.
5. General Services Division, Head
a. Responsible for providing technical advice and assistance.
b. Responsible for maintaining safety and security for the hospital.
c. Responsible for the maintenance and provisions of transportation.
d. Responsible for communication need, sufficient potable water
supplies and uninterrupted electrical supplies.
6. HEMS Coordinator/Asst. Coordinator
a. Organizes hospital emergency response team.
b. Conducts regular fire/earthquake safety seminar
c. Conducts regular disaster drills whether it is a table top or actual
drill in the hospital.
d. Evaluate the conduct of drill and makes necessary
recommendations to the management.
e. Responsible for the training of the HEMS members and the
communities relative to health emergency management.
f. Coordinate other training program not being offered by the hospital
to ensure continued competence in emergency response.
g. Network with members of the Health Sector responding to
emergencies and disasters within hospitals catchment area and
the communities, as well as other agencies responding to
emergencies and disasters.
7. Representative from other society (PCCP, QC Disaster Coordinating
Council, PNRC, BFD)
a. Assist in the formulation of health related policies, guidelines and
procedures pertaining to community wide emergencies and
disasters.

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b. Provide medical and manpower assistance especially in mass


casualty situations.
c. Assist in the conducts trainings and seminars not being offered by
institution.
d. Provide assistance on the evaluation during the conduct of drills.

V. Management Structures

EMERGENCY COMMAND STRUCTURE

During an emergency, management structure is of prime importance as it shows


the specific chain of command, control and coordination. These management
structures show the flow of reporting, coordination and communication. The hospital in
responding to an incident at Code Blue alert now activates the Hospital Emergency
Incident Command System (HEICS) which involves and organizational shift to an
emergency mode. During an emergency/disaster, as the hospital is in an emergency
mode, other staff of the hospital may assume roles and functions as needed in an
emergency. The HEMS Coordinator may assume the role of the Incident Commander,
an operation head or a spokesman as deemed necessary by the hospital chief.

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The HEICS has basic personnel consisting of an Incident Commander, Operation


Officer, Planning Officer, Finance Officer and Logistic Officer; three other personnel
Security Officer, Liaison Officer and Public Information Officer serve as staff to the
Incident Commander and altogether compose the command staff.

These command structure may be revised according to the need of the facility
and available human resources. If the facility is not affected by the disaster, a
designated group shifts to an emergency/disaster mode for the HEICS, while the rest of
the staff conduct normal or regular hospital transaction/services.

If the hospital raises its alert status to Code Blue, normal office transactions are
suspended and the hospital is shifted to emergency/disaster mode.

VI. Roles and Responsibilities

Lung Center of the Philippines is primarily a responding hospital; it has


limitations as to its existing mandate with regards in receiving patients.

LUNG CENTER CAPABILITY RATING SHEET


SERVICES RATING Remarks
1. TCVS 1 Specialty
2. NEURO-SURGERY 2
3. ABDOMINAL 2
4. UROLOGY 2
5. EENT 2
6. MAXILLO-FACIAL 2
7. BURNS/PLASTIC SURGERY 3
8. ORTHOPEDIC 2
Legend:
Rated 1 - means that the hospital is capable of accepting all
cases of his specialty. A hospital Rated 1 is an end-
hospital that will not refuse patients unless the
situation makes admission extremely difficult or
impossible.
Rated 2 - means that the hospital is capable of handling sub-
specialty cases but has some limitations such as bed
capacity, equipment, etc, and cannot be expected to
offer definitive care. It may also mean there are not
enough full time consultants and residents available
on a 24 hour basis or that there is no training

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program and therefore no frontline personnel in this


specialty.
Rated 3 - means that the hospital is incapable of handling
cases of this sub-specialty beyond giving primary
care and resuscitation.

LCP main responsibilities in times of emergencies and disasters are:


1. Observe all the requirements and standards (hospital emergency plan,
HEICS, Code Alert, etc.) needed to respond to an internal or external
emergencies and disasters.
2. Ensure enhancement of their facilities to respond to the needs of the
communities especially during emergencies.
3. Provision of Mental Health and Psychosocial support to direct and indirect
victims including the responders.
4. Network with other hospitals in the area to optimize resources and
coordinate transferring of victims to the appropriate facility.
5. Report all health emergencies to the DOH-HEMS Operation Center, and
document all incidents reported.

VII. Hospital Emergency Preparedness Plan


A. Hazards assessment
1. Identification of all potential hazards inside and outside the vicinity
of the hospital.
Hospital Service Areas
Hazards Vulnerable Areas
1. Fire 1.1 General Services Area
1.2 Pathology Department
1.3 Radiology Department
1.4 Dietary Section
2. Earthquake 2.1 All infrastructures
2.2 Pathology
2.3 Radiology
2.4 Dietary
2.5 General Services

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3. Flood 3.1 Emergency Room


3.2 Out-Patient Department
3.3 General Services including Motorpool
3.4 St. Therese Unit
3.5 Dietary
3.6 Radiology
4. Typhoon 4.1 All 4th floor areas
4.2 All 3rd floor wards
5. Hazardous 5.1 Pathology Department
Material Spills 5.2 General Services including Motorpool

HAZARDS MAPS

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Legend: S Severity, F Frequency, E Extent, D Duration, M Manageability


Scoring: 1 Low and Easy, 2 Moderate, 3 Severe and Difficult

HAZARD SEVERITY FREQUENCY EXTENT DURATION MANAGEABILITY TOTAL


NATURAL
1. Typhoons 2 1 1 1 4 1
2. Floods 2 3 2 2 4 5
3.Earthquake 4 2 3 1 3 7

BIOLOGICAL
1. Dengue 3 1 1 3 5 3
2. Nosocomial 3 2 2 2 4 5
Infection
3. Water Borne 2 2 2 3 5 4
Dse.
4. Food 2 2 2 3 5 4
Poisoning
TECHNOLOGICAL
1.Radio-Nuclear 2 1 1 1 1 4
accident
2. chemical Spill 1 1 1 1 1 3
3. Hazardous 2 1 1 1 1 4
waste
4. Power Supply 2 1 2 2 5 2
Failure
5. Elevator 2 1 1 1 5 0
System Failure
6. HVAC Failure 2 1 1 1 5 0
7. Telecom. 2 1 2 2 5 2
failure
8. Fire 2 1 3 2 4 4
SOCIETAL
1.Bomb Threat 4 1 2 2 3 6
2. Hostage 3 1 2 2 3 5
Taking
3. Mass 2 1 1 1 4 1
Gathering
4. Bombing 3 1 3 3 3 7

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Health Emergency Preparedness, Response and Recovery Plan

2. Preventive strategies
a. Activities includes:
1) Continuous monitoring and updating of preparedness
capability in terms of policies, guidelines and
procedures.
2) Strengthening human resource capability by
encouraging continuous training.
3) Conduct a table top or an actual drill at least quarterly
or semi-annual.
4) Conduct post evaluation of the drill and make
appropriate recommendations for improvement
identifying what went wrong and what went right.
5) Team building among LCP-HEMS responders
b. Identifying resource requirements for all types of hazards.
1) Technical expertise on occupational safety, lectures
on first aid, basic life support, mass casualty handling
and incident command system.
2) Identifying alternative portable electric generators and
water pumps
3) Alternative source of electricity like solar power
devices.
4) Stockpiling of medicines and supplies.
5) Stockpiling of gasoline and diesel fuel for at least 5-10
days without compromising hospital safety.
6) Proper utilization of HEMS sub-allotted fund for
hospital capacity building activities.
7) Appropriate inclusion of specific supplies and
materials in annual procurement plan for proper
allocation and budgeting.
8) Networking with other government and private
agencies.
c. Assigning point person to monitor the different activities and
to source out any deficiencies in terms of resource
utilization.
1) General Services Chief as the Safety Officer in-
charge. Monitoring of all potential hazards and
vulnerable areas and take action immediately.

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2) HEMS Coordinator updating of hospital


preparedness, response and recovery plan
3) Asst. HEMS Coordinator in-charge for the
monitoring and training of all hospital staff on
emergency preparedness and response.
4) Infection Control Nurse monitoring of all potentially
infectious diseases through active surveillance
approach and reporting immediate concern to higher
authorities.

B. Vulnerabilities reduction
1. Vulnerable areas in times of emergencies and disasters.
a. Radiology Department
b. Pathology Department
c. General Services Division
2. All identified areas must be able to follow the guidelines in
assessing health facilities in responding to health emergency in
order to effectively reduce morbidity and mortality among its
personnel and clients. Vulnerability is categorized as:
a. Structural Related to the construction of the facility.
b. Non-Structural The non-structural elements of a building
include ceilings, windows, doors, mechanical, electrical,
plumbing equipment and installation.
c. Functional There are three aspects:
1) Deals with general physical lay-out of a facility,
including location, accessibility and distribution of
areas within the facility.
2) Individual services: medical (supplies and equipment)
and non-medical (utilities, transportation and
communication vital to continuous operation of
facility).
3) Public service and safety measures.
d. Human Resources Includes:
1) Organization of the health facility (e.g., emergency
planning group, subcommittees)
2) Inventory and mobilization of personnel
3) Preparedness activities for the personnel (e.g.,
hazards and vulnerability analysis, drills and training,

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C. Capacity development
1. Training
a. All ER personnel must attend the Basic Life Support Training
(BLS), Advance Cardiac Life Support Training (ACLS),
Pediatric Advance Life Support Training (PALS) and
Emergency Medical Responder Course (EMR)
b. All hospital personnel must attend the following training:
1) Basic Life Support Training
2) First Aide Course
3) Fire & Earthquake Seminar
4) Incident Command System and Mass Casualty
Management Seminar
c. All identified high risk area personnel must attend special
training to resolve any immediate threat to hospital
operations. This training shall include:
1) Hospital Emergency Awareness and Response
Training
2) Special handling of highly flammable substance
3) Fire suppressant training
4) Radiological emergency training
5) Use of special personnel protective equipment (PPE)
for biological hazards and hazardous materials.
6) Basic water sanitation training

2. Purchase of emergency equipments.


a. Purchase of at least 10 radio communication equipments.
1) Executive Director - 1
2) Deputy Directors 2
3) HEMS Coordinator 1
4) Head of Communication Section 1
5) Department Manager Nursing 1
6) Senior House Officer 1
7) ER 1
8) GSD Head 1
9) Security - 1
b. Purchase of at least 2 portable generators capable of
delivering 500KVA each
c. Purchase of alternate water pumps.

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d. Purchase of alternate solar power devices.


3. Provision of temporary shelters for patients and staffs.
a. Purchase of 10 tents that can accommodate at least 20
patients at a time.
b. Identify areas where to construct the field hospital (Please
see maps for the possible locations of tents)
c. Provisions of portalets (portable toilets).

4. Alarm Code and Alert Status.


a. Hospital Alarm Code
1) Code 98 Fire Incident
2) Code 55 Evacuation Alert
b. Medical Emergency Code Alert
1) Code 82 Adult Cardiac Arrest
2) Code 41 Pediatric Cardiac Arrest
c. Security Alert
1) Code 77 Internal Hospital Violence or potential
violence
d. Hospital Code Alert Level
Code Alert Level Conditions for adopting color code alert
a. Code White Strong possibility of a military operation within the
area, example: coup attempt.
Any planned mass action or demonstration within
the catchment area.
Forecast typhoons (Signal No. 2 up) the path of
which will affect the area.
National or local elections and other political
exercises.
National events, holidays, or celebrations in the
area with potential for MCI (Mass Casualty
Incident).
Any emergency with potentially 10-50 casualties
(deaths, injuries).
Any other hazards that may result in emergency.
Unconfirmed report of re-emerging diseases,
example: Avian Influenza, SARS, Pandemic H1NI
Human Resource First response team ready for dispatch to include
requirement for the following:
responding to the 2 doctors preferably Surgeon, Internist and
Code White Anesthesiologist.
2 Nurses
First Aider/EMR
Driver

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Second response team should be on call


The following should be available for immediate
treatment of incoming patients:
- General Surgeons
- Orthopedic Surgeons
- Anesthesiologist
- Internist
- O.R. Nurses
- Ophthalmologists
- Otorhinolaryngologists
- Infectious Specialists
Emergency service personnel, nursing personnel
and administrative personnel residing at the hospital
dormitory shall be placed on call status for
immediate mobilization.
Other requirements The Hospital Operations Center should be
for responding to activated. It should continuously report and
Code White coordinate with the DOH Central Operation Center.
Medicines and Supplies
- Ensures that emergency medicines (especially
for trauma needs) be made available at the
emergency room.
- Medicines and supplies in the operating rooms
should likewise be reviewed and increased to
meet sudden requirements.
- Other needs such as X-ray plates, laboratory
requirements, etc. should be made available
and not required to be purchased by victims.
- Personnel department to prepare for
mobilization of additional staff.
- Finance department to ensure availability of
funds in cases of emergency purchases and the
like.
- Logistics department to coordinate with possible
suppliers for additional requirements.
- Dietary department to open and meet the need
of the victims as well as the health personnel on
duty.
- Security force to institute measures and stricter
rules in the hospital.
- Activate Bird Flu Plan (Avian Influenza), SARS
Plan, Pandemic H1N1 Plan, etc.
- Enforce and monitor use of personnel (PPE) for
all health personnel.
- Triage system should be activated.

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b. Code Blue Any of the following conditions


- When 20-50 casualties (red tags) are suddenly
brought to the hospital.
- Any internal emergency/disaster in the hospital
which brings down their operating capacity (ex.
Vital areas) to 50% or which would require
evacuation of patients and setting up of a
Field Hospital.
- For conditions other than MCI, the influx of
patients is beyond the capacity of the hospital to
handle.
- Confirmed/documented report of re-emerging
diseases (SARS, Human to Human Avian
Influenza, Pandemic H1N1) within the
catchment area.

Human Resource HEMS Coordinator to be physically present at the


requirement for hospital.
responding to the On-scene Response Team
Code Blue Medical Officer in charge of the Emergency Room
All Medical Fellows should be present
Medical Officer in charge of the Operating Room
Surgical Team on duty for the day
Surgical Team on duty the previous day
Mental Health Personnel (if available)
All Anesthesia Fellow should be present
Toxicologist/Chemical Experts (if available)
Administrative Officer or designate
Nursing supervisor on duty
All OR nurses
Social workers
Dietary personnel
Officer in charge of supplies at the CSSR
The entire security force
Housekeeping personnel
Other requirements All those mentioned in Code White plus:
for responding to - Activate Hospital Emergency Incident
Code Blue Command System (HEICS).
- Other needs of victims apart from medicines
and supplies depending on the disasters should
as much as possible be made available
- The Executive Director of his designate should
make proper coordination with other hospitals
for networking and/or possible transfer of
patients.
- Incident Commander should assign a Safety

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Officer, Liaison Officer to coordinate with other


agencies, and Public Information Officer to
serve as the authorize spokesperson of the
hospital.
- Social Service section should prepare
assistance to victims in coordination with mental
health professionals of the hospital, if available,
and they should lead in providing information to
relatives of victims.
- Mortuary section should anticipate dead victims
brought to the hospital for proper care and
identification.
- The security team, in anticipation of possible
influx or patients, relatives, responders, police,
press, etc. should ensure smooth flow of traffic
inside the compound especially for the
ambulances.
- Should report regularly to HEMS Operation
Center and as much as possible have regular
press releases or briefings.

c. Code Red Any of the following conditions


- When more than 50 (red tags) casualties are
suddenly brought to the hospital.
- An emergency wherein the services of the
hospital is paralyzed since 50% of the
manpower are themselves victims of the
disaster.
- Hospital is structurally damaged requiring
evacuation and/or transfer of patients.
- Conditions requiring mandatory quarantine of
hospital and its personnel (ex., SARS, Avian
Infuenza, Pandemic H1N1); uncontrolled human
to human transmission of SARS/Avian Flu,
Pandemic H1N1 within the catchment area.

Human Resource All personnel enumerated under Code Blue
requirement for All medical personnel
responding to the All nurses
Code Red - All nursing attendants
- All administrative staff
- All housekeeping personnel

Other requirements All those mentioned in Code Blue plus:
for responding to - The Executive Director can cancel all types of
Code Red leave and can order all personnel to report to

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the hospital
- The Executive Director can temporarily stop all
elective admissions and surgeries and network
with other hospitals.
- The Executive Director should anticipate
request for additional manpower and specialists
not available in his hospital. He is further
authorize to accept medical volunteers and
other professional to augment the hospitals
manpower resources rather than transferring
patients based on some agreements.
- Networking with other hospitals for
augmentation of resources and transfer of
patients in special cases.
- Answer all queries of the media pertaining to
patients in the hospital.
- Anticipate evacuation and/or use of field
hospital; closure and/or quarantine of the
hospital.
- The Executive Director specifically be
concerned with safety and security, not only of
the patients but of the personnel as well.

c. Guidelines in implementing the Tri-Color Code Alert


1. The Hospital Code Alert shall be declared by the
Secretary of Health or by the Director of HEMS for
external emergencies.
2. The Medical Center Chief or the Hospital HEMS
Coordinator of the hospital shall declare the code alert
based on his assessment of the emergency within his
catchment area.
3. The Medical Center Chief shall automatically declare
a Code White Alert during national events and
activities especially with the potential of an MCI (Mass
Casualty Incident).
4. The alert level is raised, lowered or suspended by the
Secretary of Health, Director of HEMS for external
emergencies and national events.
5. The alert level status (raised, lowered or suspended)
within the hospital catchment area shall be the
responsibility of the Medical Center Chief or his
designates.

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d. Determining Priority for Case Management


1. Use of Color Tag for Prioritization of care
i. Categories
a. RED Immediate: Priority One (Life-
threatening Conditions). The condition is
life-threatening and the patient requires
immediate attention and transport. The
following conditions should be present
for a Mass Casualty Incident (MCI)
victim to be classified Priority One.
1) Obstruction or damage to airway.
2) Disturbance of breathing
respiration above 30/min.
3) Disturbance in circulation
capillary refill greater than 2
seconds or carotid pulse weak,
irregular or absent, radial pulse
absent.
4) Does not follow commands or
altered level of consciousness.
5) Need for life-saving measures
(BLS and ATLS) and urgent
hospital admission.
6) Victims whose injuries demand
definitive treatment in the hospital
but which treatment may be
delayed without prejudice to
ultimate recovery
b. YELLOW Urgent: Priority Two. Patient
has passed primary survey, but with
major system injury, may delay transport
to one hour. Any one of the following
conditions could place a victim into a
Priority Two Category:
1) Needs to be treated within one
hour; otherwise they will become
unstable.
2) Severe burns; burns involving
hands, feet or face (not including

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the respiratory tract); burns


complicated by major soft tissues
trauma.
3) Hospital admission is required.
4) Moderate blood loss; back
injuries; head injuries with a
normal level of consciousness.
c. GREEN Delayed: Priority Three. An
injury exists but treatment can be
delayed for four to six hours. Generally,
anyone who can walk (walking
wounded) to a designated area for
treatment will be a Priority Three. The
following injuries are examples:
1) Minor injuries not threatened by
airway, breathing and circulatory
instability
2) Minor fractures, minor soft tissue
injuries, minor burns.
3) May or may not be admitted.
d. BLACK or WHITE Dead: Last Priority.
Condition are the following:
1) Patient is dead.
2) Those who die awaiting
treatment, and those in cardiac
arrest following trauma.
Special Note: For Moslem communities, white
tag will be used for dead Moslems.

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2. The prescribe color tag is the ribbon for practical


reasons.

5. Commencing quarterly or semi-annual drills to different scenarios.


a. Table top Drill
b. Actual Drill

D. THE FIRE EMERGENCY PLAN

The main concern in any fire emergency plan is to:


1) Stop and prevent spread of fire
2) Evacuate patients/personnel, records and equipment.
3) Allay panic
4) Be able to render emergency treatment for various forms of
fire related injuries i.e., wound or inhalation injuries.

Every hospital personnel should be aware of the following


instructions in case of fire

1. General Instructions
a. Notification
1) Notify the telephone operator (local 444, 401 right
away the source of fire, exact location and possibly
the extent. Speak in a moderate tone of voice so that
the patient will not overhear and become frightened.
2) Notify the Charge Nurse who shall in turn notify the
Nursing Department Manager/Supervisor
3) Notify the Safety Committee and activate the Fire
Brigade
b. Evacuation strategies

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1) Removal/Evacuation of Patients
i. Do not move patients unless with specific
instruction from the safety officer.
ii. Move patients with utmost caution bring along
their charts and medications.
iii. When patients are moved out from the room,
close the doors and windows.
iv. Everyone should know the location of the exits
nearest to the room to be evacuated, the
location of the keys to the exits, or the exit to
be used, ensure that exits are free from any
obstruction.
v. Evacuation priorities shall be as follows
1. FIRST those nearest the source
of fire or posed with
greatest danger or those
farthest from safety
2. SECOND helpless patients, use
available stretcher. If
none, roll in top covers
and carry with help by
grasping blanket under the
patient.
3. THIRD wheelchairs patient, wrap
in blankets and wheel out
towards exit
4. FOURTH walking patients; wrap in
blanker and lead towards
exit.
c. Removal/Evacuation of Equipment/Instruments/Supplies
All equipments should have been color coded at the
time they were installed in the unit. Color codes are used for
priority of evacuation. Color tags should be luminous or
reflectors.
1) RED FIRST PRIORITY
Equipment that contains
flammable gases such as
Oxygen
Halothane, Nitrous Oxide, etc.

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Containers that contains


flammable liquids, such as
petroleum, gasoline, alcohol

2) GREEN SECOND PRIORITY


Equipments needed life
support especially of patients
already evacuated
Expensive equipments
3) YELLOW THIRD PRIORITY
All others
d. Stop the fire
1) What everyone should know
i. Location of the fire extinguisher in the unit.
How to operate them.
1. Pull the pin
2. Aim the extinguisher with nozzle
pointing at the base of the flames.
3. Squeeze the hand trigger as you hold
the extinguisher upright
4. Sweep the extinguisher from side to
side, covering the area/base of the
flames.

ii. Location of fire hydrants/hose/water source


iii. When and how to use wet blankets or rugs
when necessary. Place wet blankets under the
floor to keep out the smoke.

2) Turn-off at once all oxygen tanks in operations and


electrical devices
3) Close al doors and windows

e. Allay fear and panic


The greatest danger in hospital fires is panic caused by fear
or smoke. BE CALM! Fear and panic can do as much
damage as fire. Patients usually become aware of the
existence of fire. Reassure them that the alarm has been

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turned on and that the emergency plan has been activated.


DO NOT BECOME ALARMED YOURSELF.
2. Specific Instructions
a. Nursing Department Manager/Supervisor
1) Once notified by the Head Nurse/Charge Nurse and
once on the scene she shall assume responsibility
2) Keep someone on the telephone all the time for
further instructions and coordination and to relay
instructions.
3) She shall direct the removal of the patients when
authorized and shall do so according to priority.
4) She shall coordinate and give instructions to other
units or employees who have come to help.
5) She shall have a complete list of all patients in the
unit immediately and shall make all patients are
accounted for along with their charts and medications.
6) She makes sure that all EXITS are free from any
obstructions.
b. Other Departments
1) Radiology/Laboratories
i. Turn of all electrical machinery
ii. Remove patients
iii. Close doors and windows
iv. Report to the Command Post for instructions
2) Linen/Housekeeping
i. Turn off all electrical machinery
ii. Close doors and windows
iii. Assemble blankets, linens and gowns
iv. Remain alert at the telephone for instruction as
where to deliver
3) Operating Room
i. Turn off all gases, electrical machineries and
closed all tanks with combustible gases
ii. Close doors and windows
iii. Get ready for first aid or immediate wound care
4) Emergency Room/OPD
i. Turn off all gases, electrical machineries and
closed all tanks with combustible gases.
ii. Close doors and windows

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iii. Get ready for first aid or immediate wound care


5) Motorpool
i. Double check if all ambulances are all in
running conditions
ii. Double check ambulance equipments
iii. Awaits instruction from a staging
officer/transport supervisor
6) Dietary
i. Turn off gas and electrical machinery including
ventilation fans
ii. Close doors and windows
iii. Report to Command Post for any instructions
7) Engineering Section
i. Turn off air conditioning system and any other
equipment with blower fans
ii. Switch off all circuit breakers in the floor where
the fire is raging and those next or above it.
8) Communications (PABX (Switchboard Operators)
i. Upon receiving notice of fire, verify through the
engineering personnel, if positive call fire
department with telephone numbers 928-3974,
928-8363 or 117.
ii. Post a very conspicuous place in the
switchboard the telephone numbers of fire and
police department
iii. Meralco 531-1111
iv. Engineering and Maintenance section local
number 201 and 208
v. Call police and in-house security services
vi. Notify other key personnel in the Hospital
Emergency Plan
vii. Notify dormitory
viii. Call all hospital units
ix. Keep line open in unit where fire is located
x. Seek assistance from the Command Post to
assist in transmitting calls.
xi. Sound the alarm code for fire Code 98, if
instructed by higher authorities
9) Accounting and Billing Section

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i. Get all cash together in one receptacle


ii. Get all valuable from safe, gather all ledgers
and important books ready be removed
iii. Gather all accounts receivable cards ready to
be removed
iv. Keep track of file containing names and
accounts of patients in the hospital
10) Information Technology Section
i. Backs-up all the hospital transaction records
daily
11) Medical Records
i. Evacuate all hospital and patients records
accordingly
ii. Backs-up all hospital record accordingly
12) Security
i. Cordon the area.
ii. Assure safe passage of patients thru exits
iii. Prevent loss of personal property thru pilferage
and looting.
iv. Coordinate with fire and law enforcement
officer as soon as they arrive at the scene and
direct them to the Incident Commander.
c. Disaster Control Committee
As soon as the Hospital Emergency Plan has been
activated to Code Blue, the Incident Commander (Hospital
Director, Deputy Director, HEMS Coordinator, Senior House
Officer) is expected to coordinate the activity in a large as
scale.
1) He makes sure that the notice of fire has been
relayed to the fire station and police department.
2) Let other department know as to the progress of the
fire so they can prepare to remove other patients as
necessary or can assure patients that the fire has
been controlled.
3) Shall proceed with networking with other hospital if
necessary by first informing the Department of Health-
Operation Center of the status of the fire incident.
4) Shall monitor number of casualties and the extent of
injury

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5) Shall monitor the extent of the fire and water damage.


6) Makes sure that the Command Post is established as
well as the Treatment Area, Triage Area, Staging
Area as well.
7) Can direct as to where to send employees to help
where they are most needed.
8) Give orders for removal of patients when necessary
9) Maintains coordination with other member of the
emergency command structures and other key
hospital personnel.

VIII. Hospital Emergency Response Plan


A. Organization

EMERGENCY COMMAND STRUCTURE

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B. System activation and termination


1. Activation and termination of alarm status is designated to the
following:
a. Hospital Director
b. Deputy Director
c. HEMS Coordinator
d. Senior House Officer (after office hours)
2. The incident commander is always the hospital director or to his
duly designate personnel, on the other hand the officer of the day
or the senior house officer will act on the latters behalf after office
hours.
3. The incident commander will immediately form his command staff
as shown in the organizational structure. The roles and
responsibilities are shown on Annexes p. 91
4. With the declaration of the alert, the plan is activated. Depending
on the alert level status, corresponding human resource and other
requirements are mobilized.
5. Under Code Blue, the Hospital Emergency Incident Command
System (HEICS) is immediately established using the six-step
response.
a. Step 1 Assume command. The pre-assigned incident
commander must assume command based on the
emergency plan.
b. Step 2 Assess the situation. Assess magnitude of the
incident form sources like the DOH-Operation Center and
other reliable network.
c. Step 3 Identify critical areas. These include emergency
rooms, decontamination, triage, treatment, security, media,
etc.
d. Step 4 Activate of Identify the Operations Center.
Coordinate with DOH-HEMS Operation Center; assign staff
and ensure communication system is in place.
e. Step 5 Identify the Safety Officer. The Safety Officer is the
one to go around the compound to ensure safety of the staff,
the hospital, and the patients.
f. Step 6 Secure the hospital and critical areas. Identify area
for ambulances, points of ingress and egress.

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C. Resource mobilization
1. All resource mobilization will be decided by the incident commander
upon recommendation by his command staff
a. Purchases of necessary supplies and materials will be
decided by the command staff based on priorities.
b. Review of MOA with other agencies
2. Construction of field hospital in case one is needed for patients and
staff in the pre-designated area. (Please see Annexes B. Hospital
Map)
a. Tents must be constructed as soonest possible time to
prevent delays in providing hospital services.
b. This temporary shelter must be supplied with adequate
water and electricity
c. Portable toilets must be closely monitored by sanitary
inspector assigned.

D. Partnership through Memorandum of Agreement (MOA)


1. As part of DOH-HEMS network with other government hospital and
NGO within the catchment area
a. East Avenue Medical Center
b. National Kidney and Transplant Institute
c. Philippine Heart Center
d. Philippine Childrens Medical Center
e. Philippine National Red Cross, Quezon City Chapter
f. Bureau of Fire, Quezon City
2. Private hospital
3. Medical Societies
4. Drug Store (Mercury Drug, South Star Drug)
5. Medical supplies and equipment distributor
6. Media
IX. Hospital Recovery and Reconstruction Plan
A. Damage assessment and needs analysis
1. Depending of type of calamities, all structures must be check prior
to re-occupying the facilities.
2. All damaged structures must be checked by a structural engineer
and make necessary recommendation.
3. Damage assessment must be reported to the appropriate authority,
estimating the cost of damages to the facilities.

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4. All the incurred cost during response must be fully documented


indicating the name of patients seen, the services rendered and the
supplies and medications given.
5. Appropriate networking must be fully utilized not only for
augmentation purposes but for maximizing the special services
each medical center/hospital has to offer.
B. Provision of services
1. Hospital operation must continue to provide basic medical services.
2. Surveillance of the water and sanitation, food safety, emergent and
re-emergent endemic diseases and nutritional status.
C. Psychosocial support and recognition to personnel
1. Psychosocial support must be given to victims of calamity as well
as to the medical, nursing and support staff of the hospital.
2. There must be point person to monitor hospital staff that shows
signs of increasing anxiety and take immediate actions.
3. Awarding and recognition rites for responders
4. Provision of overtime compensation for responders.
5. Provision of assistance to hospital personnel who were also
affected by the calamity.
6. Re-training of hospital staff on technical and administrative
procedures.
D. Restoration of utilized/damaged resources and services
1. Evaluation, clean-up and/or repair of damages to the hospital
building/facilities/equipment.
2. Accounting and recording of available materials, medicines,
supplies and equipment.
3. Requisitioning and replenishment of utilized materials and logistics
4. Decontamination of areas, ambulance and equipment.

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X. Annexes
A. Directory of contact persons
Name Designation Contact No./s
Dr. Jose Luis J. Danguilan Executive Director 0917-8220690
Dr. Rey Desales Deputy Director for Hospital 0917-8376920
Support Services
Dr. Raoul Villarete Deputy Director for Medical 0919-7461807
Services
Dr. Jaime Mendoza Department Manager III, ER- 0916-3751974
Out Patient Department
Mrs. Elvira N. Baura Department Manager II, 0919-4452198
Nursing Service
Mr. Albilio Cano Department Manager II, 0917-8397185
Corporate Services
Dr. Benilda Galvez Infection Control Coordinator 0918-9158378
Mrs. Heminia Tolentino Infection Control Nurse 0921-2656355
Dr. David F. Geollegue HEMS Coordinator 0927-4407329
Mr. Gerardo I. Lirag Asst. HEMS Coordinator 0917-6106534
Ms. Angie Roxas Division Chief, Accounting 0928-5050758
and Budget
Mrs. Consolacion Balderosa Division Chief, Property and 0919-8202527
Procurement
Mrs. Carol Manduraoi Division Chief, Cashier 0917-6265248
Engr. Conrado Yangat Division Chief, GSD 0919-5877499
Engr. Boyet Panlaqui Asst Chief, GSD 0927-9794857
Ms. Heidi Basobas Division Chief, Pharmacy 0917-8962363
Mrs. Donnabelle Arcillo Chief, Social Service 0922-8247115

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B. Hospital Map

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C. LCP Organizational Chart

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D. Glossary

All-hazard An approach to emergency management based on the


recognition that there are common elements in the management of
responses to virtually all emergencies, and that by standardizing a
management system to address the common elements, greater
capacity is generated to address the unique characteristics of different
events
Burn-out syndrome A state of exhaustion, irritability and fatigue which
markedly decreases workers effectiveness and capability
Capacity/readiness An assessment of local capacity to respond to an
emergency (a risk modifier)
Casualty Victims both dead and injured, physically and/or
psychologically
Command post Form of site-level emergency operations center,
assembled as needed by the first agencies to respond to an event
Community Consist of people, property, services, livelihoods and
environment; a legally constituted administrative local government unit
of a country, e.g. municipality or district, that is small enough to be
able to indentify its own leaders (to make participation meaningful)
and large enough to control its resources, e.g., village, district, etc
Coordination Bringing together of organization and elements to ensure
effective counter-disaster response. It is primarily concerned with the
systematic acquisition and application of resources (organization,
manpower and equipment) in accordance with the requirements
imposed by the threat of impact of disaster.
Crisis A state brought about by adverse life experience wherein the
normal coping mechanism or problem solving is not working
Critical Incident Any event causing unusually strong overwhelming
emotional reactions which have the potential to interfere with work
during the event or thereafter in the majority of those exposed
Disaster Any actual threat to public safety and/or public health where
local government and the emergency services are unable to meet the
immediate needs of the community; and event in which the local
emergency management measures are insufficient to cope with a
hazard, whether due to lack of time, capacity or resources, resulting in
unacceptable levels of damage or numbers of casualties; an
emergency in which the local administrative authorities cannot cope

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with the impact of the scale of the hazard and therefore the event is
managed from outside of the affected communities; any major
emergency where response is also constrained by damage or
destruction to infrastructure (i.e., the lack of resources plus loss of
infrastructure overwhelms local capacity and event management from
outside the affected area is needed to direct and support local
response efforts
Disaster recovery The coordinated process of supporting disaster-
affected communities in the reconstruction of the physical
infrastructure and restoration of emotional, social, economic and
physical well-being
Donation Act of liberality whereby a foreign or local donor disposes
gratuitously of cash, goods or articles, including health and medical-
related items, to address unforeseen, impending, occurring or
experienced emergency and disaster situations, in favor of the
Government of the Philippines which accepts them
Donor All persons, countries or agencies that may contract and dispose
of cash, goods or articles, including health and medical-related items,
to address unforeseen, impending, occurring or experienced
emergency and disaster situations
Emergency Any situation in which there is imminent or actual disruption
or damage to communities, i.e., any actual threat to public health and
safety
Emergency management A management process that is applied to
deal with the actual or implied effects of hazards
Emergency operation center A place activated for the duration of an
emergency within which personnel responsible for planning,
organizing, acquiring and allocating resources and providing direction
and control can focus these activities on response to the emergency
Emergency preparedness An integrated program of long-term,
multisectoral development activities whose goal are the strengthening
of the overall capacity and capability of a country to ready to manage
efficiently
Hazard Any potential threat to public safety and/or public health; any
phenomenon which has the potential to cause disruption or damaged
to people, their property, their services or their environment. i.e., their
communities. The four classes of hazards are natural, technological,
biological and societal hazards.

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Health Emergency Management Sector An organization of agencies


with a health unit primarily devoted to and united to provide state-of-
the-art, appropriate and acceptable technical assistance and/or direct
services on health emergency preparedness and response to any
entity international or national
Incident Medical Commander The highest representative of the
Department of Health or Local Health Office as designated by the
city/town local executive (depending on the extent of the disaster) who
shall serve as the liaison officer of the Health Sector to the Command
Post headed by the Incident Commander. For regional disaster, it
should be headed by the highest representative from the DOH CHD.
Major emergency Any emergency where response is constrained by
insufficient resources to meet immediate needs
Mass casualty incident Any event resulting in a number of victims
large enough to disrupt the normal course of administrative,
emergency and health services
Mass casualty management Management of victims of a mass
casualty event to minimize loss of lives and disabilities
Mass Casualty Management System Groups of units, organizations
and sectors that work jointly through standard consensus procedures
to minimize disabilities and loss of life in a mass casualty event
through the efficient use of all existing resources
Medical controller A designated senior Department of Health Officer
appointed to assume the overall direction of the medical response to a
mass casualty incidents and disasters. Control is established from a
designated Operation Center, either in the Central Operations Center
or the Regional Operations Center
Mental health A state of well-being in which the individual realizes his or
her own abilities, can cope with the normal stresses of life, can work
productively and fruitfully, and is able to make a contribution to his or
her community
Networking An approach to broaden the resources available to a
person to achieve his personal and professional goals while
supporting others to achieve theirs
Preparedness Measures taken to strengthen the capacity of the
emergency services to respond in an emergency. Emergency
preparedness is done at all levels.

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Rapid health assessment The collection of subjective and objective


information to measure damaged and identify those basic needs of
the affected population that require immediate response
Risk Anticipated consequences of a specific hazards affecting a specific
community (at a specific time); the level of loss of damage that can be
predicted to result from a particular hazard affecting a particular place
at a particular time; probable consequences to public safety of a
community being exposed to a hazard (i.e., death, injury, disease,
disability, damage, destruction, displacement)
Type of hazard determines the kind of risk, e.g., floods cause few
deaths but earthquake cause many.
Vulnerabilities and capacity to respond determine how much risk is
in the community, i.e., how many deaths are likely, where they will
occur and the kind of people likely to be killed (e.g., old disabled)
Risk management A comprehensive strategy for reducing risk to public
safety be preventing exposure to hazards (target group hazards),
reducing vulnerabilities (target group elements of community), and
enhancing preparedness, i.e., response capacities (target group
response agencies); a strategy for identifying potential threats and
managing both the source of threats and their consequences
Strategic Deals with the concepts of relatively long term and big picture
in relation to the pattern or plan that integrates an organizations major
goals, policies and action sequences into a cohesive whole. Concept
is always relative what a local level of government sees as strategic
from their perspective is likely perceived as tactical from the
perspective of a more senior government.
Stress A state where ones coping mechanism is not enough to
maintain balance or equilibrium
Surge capacity The health care systems ability to rapidly expand
beyond normal services to meet the increased demand for qualified
personnel, medical care and public health in the event of large-scale
public emergencies or disasters (Agency for Healthcare Research and
Quality, USA, 2005)
Terrorism The premeditated use or threatened use of violence or
means of destruction perpetrated against innocent civilians or non-
combatants, or against civilian and government properties, usually
intended to influence an audience (Memorandum No, 21)
Triage The process of sorting victims needing immediate transport to
health facilities and those whose care can be prioritized.

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Vulnerabilities Factors that increase the risks arising from a specific


hazard in a specific community (risk modifiers)
Weapons of mass destruction Radiological, nuclear, biological or
chemical elements in nature used for large-scale damage to life and
property, usually by those perpetrating terrorist activities

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E. Risk Assessment Form

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F. Risk Assessment Form for Highly Infectious Diseases (SARS, Avian Flu-
H5N1, Pandemic Flu, H1N1, Mers-Cov, etc.)

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G. Flow chart for referral of highly infectious diseases (SARS, H5N1,


Pandemic Flu, H1N1, Mers-Cov, etc.)

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H. Protocols on the Triage of Emerging / Re-Emerging Respiratory Infections


(SARS, Avian Flu, Pandemic Flu, H1N1, MERS-Cov, etc.)

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I. Advice Form for Home Quarantine

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J. Triage Screening Form

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K. Protocols in response to trauma emergencies outside the hospital

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L. Protocols in Response to Earthquake Incident

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M. Protocols in the conduct of fire drill

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N. Protocols in Response to Fire Incident

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Health Emergency Preparedness, Response and Recovery Plan

O. Protocols in the Activation of the Hospital Emergency Incident Command


System (HEICS)

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P. Incident Command System Organization

JOB ACTION SHEETS


INCIDENT COMMANDER
(Field or Facility)
Mission Perform overall direction for the field and /or facility
operations and if needed, authorize evacuation.
Qualifications Must be an Emergency Manager for field; Hospital
Director for Facilities or his designate.
Preferably has experience in handling on-scene
Mass Casualty Incident for Field; has experience in
management situations for facilities.
Must possess good communication skills.
Must have leadership qualities.
Must be a good coordinator, must have good
command and control abilities.
Functions & Initiate the Incident Command System (ICS) by
Responsibilities assuming the role of the Incident Commander and
put any identification mark.
Designate a Command Post to include required
logistical needs.
Carefully assess the situation and the magnitude of
the casualties.
Secure the area, preventing entry of unauthorized
people and designate staging and transport area
for Field Operations.
Depending on the number of responders and the
magnitude of the emergency, fill up the
organization assignment list, the needed positions
relevant to the situation.
In major MCI, the following should be filled up:
Safety Officer, Liaison Officer, Public
Information Officer, Operations Manager, Triage
Officer, Treatment Officer, Staging Officer,
Transport Officer and Morgue Officer.
The Planning Officer, Logistic Officer and
Administrative Officer complements and

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completes the positions in severe MCI


necessitating the support of major agencies and
requiring long period of operations.
Announce an action plan meeting and identify the
general objective of the operations including
alternatives, and the incident communication plan.
Assign someone as Documentation Recorder/Aide.
Authorize resources as needed or requested by
managers.
Designate routine briefing with managers to receive
status report and update the action plan regarding
the continuance and termination of the action plan.
Communicate status to higher authority.
Approve media releases.
Identifications Proper signage (hard hat with mark of Incident
Commander or a vest)

SAFETY AND SECURITY OFFICER


Mission Monitor and have authority over the safety of rescue
operations and hazardous conditions. Organize and
enforce scene/facility protection and traffic security.
Qualifications Knowledgeable on safety precautions, procedures.
Preferably with various training in emergencies
relating to bombing, fire, hazardous, materials,
structural assessment, security procedures and
safety or responding personnel.
Has had an experience in emergencies and
disasters.
Good decision-making abilities.
Has sound knowledge in evacuation procedures.
Functions & Obtain appointment and briefing from the Incident
Responsibilities Commander.
Implement the emergency lockdown policy and
personnel identification policy.
Establish Security Command Post.
Remove unauthorized persons from restricted
areas.
Establish ambulance entry and exit route in

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cooperation with Transportation and Staging


Officer.
Secure the Command Post, Advance Medical Post,
Triage and Treatment Areas including the Morgue
Area and all other sensitive or strategic areas from
unauthorized access.
Full understand the importance of his roles
especially in the safety of the responders.
Secure and post non-entry signs around unsafe
areas.
Always alert to identify and report all hazards and
unsafe conditions to the Incident Commander.
Secure areas evacuated to and from, to limit
unauthorized personnel access.
Initiate contact with fire, police agencies through
the Liaison Officer, when necessary.
Advise the Incident Commander and others
immediately of any unsafe, hazardous or security-
related conditions.
Confer with Public Information Officer to establish
areas for media personnel.
Establish routine briefing with Incident Commander.
Provide vehicular and pedestrian traffic control.
Secure food, water, medical, and blood resources.
Document all actions and observations
Can order stoppage of operation if unsafe.
Identifications Use of any identification hat or vest.

PUBLIC INFORMATION OFFICER (PIO)


Mission Provide information to the public and the media.
Qualifications Knowledgeable on communication aspect
especially in collating relevant information needed
Knowledgeable in media handling.
Preferably with experience in emergencies and
disasters.
Preferably with understanding of Mass Casualty
Management.
Good communication skills and interpersonal

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relationships.
Sensitive on restriction in contents of news and
patient care activities.
Functions & Obtain appointment and briefing from the Incident
Responsibilities Commander.
Ensure that all news releases have the approval of
the Incident Commander.
Responsible for collating relevant information
needed to inform the public and for media.
Releases; obtain progress reports from respective
areas as appropriate.
Issue an initial incident information report to the
news media especially on the casualty status and
the actions being done.
Schedule press conferences on a regular basis.
Inform on-site media of the physical areas that they
have access to, and those which are restricted.
Coordinate with Safety and Security Officer.
Contact other scene agencies to coordinate
released information.
Direct calls from those who wish to volunteer to
Liaison Officer. Contact Operations to determine
request to be made to the public via the media.
Identifications Proper signage (hard hat with mark of Public
Information Officer or a vest)

LIAISON OFFICER
Mission Functions as incident contact person for
representatives from other agencies (government or
private).
Qualifications Preferably with experience in liaison procedures
and coordination.
Good or excellent public relation skills.
Preferably with understanding of Mass Casualty
Management.
Understand the bureaucracy and working
relationships of the different government as well as
private agencies responding to emergencies and

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disasters.
Good grasp of patient care and management in
mass casualty situation; informed on inter-hospital
emergency communication network, municipal
operation centers and/or province, region or
national as appropriate.
Knowledgeable on the inventory of resources
available in the area/country.
Understand municipal (provincial, regional,
national) organizational charts to determine
appropriate contacts and message routing.
Functions & Obtain appointment and briefing from the Incident
Responsibilities Commander.
In coordination with the Public Information Officer
should always be knowledgeable on the following:
The number of Immediate and Delayed
patients that can be received and treated
immediately (Patient Care Capacity); also the
status of all other victims, especially in mass
dead situations
Any current or anticipated shortage or
personnel, supplies, etc.
Number of patients transferred to hospitals.
Any resources which are requested by each
area (i.e., staff, equipment, supplies)
Establish contact with liaison counterparts of each
assisting and cooperating agency.
Keep appropriate agency Liaison Officers updated
on changes and development of response to
incident.
Request assistance and information as needed
through the different networks of government and
private organizations responding to emergencies
and disasters.
Respond to request and complaints from incident
personnel regarding inter-organization problems.
Prepare to assist Labor Pool with problems
encountered in the volunteer credentialing process.

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Identifications Use of any identification (hat or vest)


LOGISTIC SECTION CHIEF
Mission Organize and direct those associated with
maintenance of the physical environment, and
adequate levels of food, shelter, supplies and other
resources needed to support the objectives of the
incident.
Qualifications Preferably with experience in logistics
management.
Preferably with experience in emergencies and
disasters.
Understands the bureaucracy and working
relationships of the different units in government
especially in procurement and emergency
purchases.
Good grasp of procurement procedures;
knowledgeable in accessing supplies, medicines
and equipment needed during emergencies.
Good coordination with pharmaceuticals,
companies and suppliers and knowledgeable on
database of available resources in the market.
Functions & Obtain appointment and briefing from the Incident
Responsibilities Commander.
Establish Logistics Section Center in proximity to
the Command Post.
Brief all his staff on current situation; outline action
plan and designate time for next briefing.
Attend damage assessment meeting with Incident
Commander.
Coordinate with companies regarding stock level;
available supply and equipment.
Anticipate needed logistical requirements.
Obtain information and updates regularly; maintain
current status of all areas; communicate frequently
with Emergency Incident Commander.
Obtain needed supplies with assistance of the
Finance Section Chief and Liaison Unit Leader.
Identifications Proper signage (hat or vest).

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PLANNING SECTION CHIEF


Mission Organize and direct all aspects of Planning Section
operations. Ensure the distribution of critical
information/data. Compile scenario/resource
projections from all areas and effect long-range
planning. Document all activities.
Qualifications Preferably senior official with adequate knowledge
in planning and decision-making.
Have had experiences in emergencies and disaster
situations in addition to crises management.
Adequate knowledge of the government
bureaucracy and the role of the different
government entities responding to emergencies
and disasters..
Good coordination and networking skills.
Functions & Obtain appointment and briefing from the Incident
Responsibilities Commander; have regular updates as appropriate.
Brief members of the staff after meeting with
Incident Commander.
Provide for a Planning/Information Center.
Recruit a documentation aide from the Labor Pool.
Appoint Planning Unit Leaders, Situation Status
Leader, and Labor.
Pool and other appropriate positions as needed.
Ensure that all appropriate agencies are
represented in this section.
Ensure the formulation and documentation of an
incident-specific action plan. Distribute copies to
Incident Commander and all areas.
Call for projection reports (Action Plan) from the
Planning Unit Leaders for scenarios 4, 8, 24, and
48 hours from time of incident onset. Adjust time for
receiving projection reports as necessary.
Instruct staff to document/update status reports
from all areas for use in decision-making and for
reference in post-disaster evaluation and recovery

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assistance applications.
Schedule planning meetings to include Planning
Section Unit Leaders, Section Chiefs and the
Incident Commander for continued update of the
Action Plan.
Coordinate with the Liaison Officer and Labor
especially with regards to manpower requirements.
Identifications Proper signage (hat or vest).

FINANCE SECTION CHIEF


Mission Monitor the utilization of financial assets. Oversee the
acquisition of supplies and services necessary to carry
out the objective of the incident. Supervises the
documentation of expenditures relevant to the
emergency incident.
Qualifications Preferably a senior official with adequate
knowledge in financial management.
Had experiences in emergencies and disaster
situation
Adequate knowledge on the government
bureaucracy and the role of the different
government entities responding to emergencies
and disasters.
Good resource manager; knowledgeable on
tapping other resources.
Functions & Obtain appointment and briefing from the Incident
Responsibilities Commander.
Appoint members of his staff preferably the
following: Time Unit Leader, Procurement Unit
Leader, Claims Unit Leader, Cost Unit Leader and
other appropriate positions as he desires.
Establish a Financial Section Operation Center.
Ensure adequate documentation/recording
personnel. His station need not be within the area
of incident.
Confer with Unit Leaders after meeting with
Incident Commander and develop an action plan.
Approve a cost-to-date incident financial status

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report eight hours summarizing financial data


relative to personnel, supplies and miscellaneous
expenses.
Obtain briefings and updates from Incident
Commander as appropriate. Relate pertinent
financial status reports to appropriate chiefs and
unit leaders.
Schedule planning meetings to include Finance
Section Unit Leaders to discuss updating the
sections incident action plan and termination
procedures.
Identifications Proper signage (hat or vest).

OPERATIONS SECTION CHIEF


Mission Organize and direct aspects relating to the Operations.
Carry out directives of the Incident Commander.
Qualifications Knowledgeable on Operation Procedures;
understands well the organizational chart in MCI.
Preferably has experience in handling on-scene
Mass Casualty Incident with varied knowledge of all
types of operations (Search and Rescue, Fire,
Medical etc.)
Must be a crisis manager and with leadership skills.
Good communicator and can stand pressures.
Must know capabilities of people for proper
assignments.
Functions & Obtain appointment and briefing from the Incident
Responsibilities Commander.
Responsible for all specific sections of the
operations (ex. Medical, Search and Rescue, Fire
Suppression and others) depending on the incident
Establish Operations Section in the Command Post
preferably with the Incident Commander.
Brief all Operation Officers on current situation and
develop the sections initial plan.
Designate times for briefings and updates with all
Operations Officers to develop/update sections
action plan.

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Ensure that all areas are adequately staffed and


supplied.
Brief the Emergency Incident Commander routinely
on the status of the Operations Section especially
on the status of all patients, problems encountered,
resources needed, etc.
Ensure that all actions and decisions are
documented.
Observe all staff and personnel for signs of stress
and inappropriate behavior and report concerns to
Psychosocial Supervisor. Ensure rotation of all
personnel to prevent burnout among personnel.
Identifications Proper signage (hat or vest).

TREATMENT TEAM LEADER


Mission Responsible for the management of the Treatment
Area and assigning of responsible supervisor for
specific areas (RED, YELLOW and GREEN
subsections). Assure treatment of casualties according
to triage categories. Provide for a controlled patient
discharge and transfer to appropriate hospitals.
Qualifications Preferably a general
surgeon/trauma/emergency/anesthesia/family
medicine physician.
Knowledgeable on Mass Casualty Management
and the organization chart.
Should have on-scene experience in MCI;
knowledgeable on triaging and skilled in field care
and field operation.
Skilled in emergency procedures, especially in life
sustaining and stabilization of patients.
Good in personnel management, especially in
stress situations.
Functions & Receive appointment and briefing from the Incident
Responsibilities Commander, Operation Chief/Field Medical
Commander.
Organize the treatment area, assigning all
members to their specific assignments and

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responsibilities. In cases of WMD, treatment area


should be at the cold zone.
Appoint Unit Leaders for the following treatment
areas in pre-establish locations: Second Triage;
Immediate Treatment (RED); Delayed Treatment
(YELLOW); Minor Treatment (GREEN); Discharge.
Supervise the receiving of patient from the Initial
Triaging from the site, re-triage the victims and
institute measures to stabilize the victims; ensure
that all victims are continuously monitored.
Assess problems and treatment needs, and
customize the staffing and supplies in each area.
Receive, coordinate and forward request for
personnel and supplies to the Field Medical
Commander and/or Staging Officer.
Contact the Safety and Security Officer for any
security needs in the area.
Establish 2-way communication (radio or runner)
with Field Medical Commander, Triage, Transport
and Staging Officers.
Coordinate with Transport Officer, decide on the
order of transfer of victims, the mode of transport,
escort and place of transfer.
Document everything with regards to every
individual patient brought to the area using the
individual treatment form.
Regularly report to the Field Medical Commander.
Observe and assist any staff that exhibits signs of
stress and fatigue. Report any concerns to
Psychosocial Supervisor. Provide for staff rest
periods and relief.
Identifications Proper signage (hat or vest).

TRIAGE TEAM LEADER


(INITIAL)
Mission Sort casualties at the site according to priority of
injuries, and transfer (according to tagging priorities) to
the treatment area.

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Qualifications Any of the following:


Doctor of Medicine preferably trained in
emergency medical care and triaging.
Nurse, paramedic with appropriate training in
emergency, medical care and basic triaging.
Knowledgeable on mass casualty management and
has had experience in on-site mass casualty
incident; skilled in field care and field operations.
Functions & Receive appointment and briefing from the Field
Responsibilities Medical Commander or previously designated by
the Incident Commander.
Assess first the safety in entering the incident area;
note abnormalities in the surrounding, any
untoward manifestations of the victims and
approximate number of casualties and the type of
injuries.
Protect self by using the appropriate Personal
Protective Equipment (PPE)
In cases of WMD, ensure that decontamination is
present before entering the incident site.
Report first to authority and request for additional
help before proceeding to actual triaging.
Quickly brief members of the Triage Team and
assign areas for triaging.
Tag the appropriate color to every patient as
follows:
RED immediate stabilization necessary
YELLOW close monitoring, care can be
delayed
GREEN minor; delayed treatment or no
treatment
BLUE near or almost dead
BLACK - dead
Document important things to consider in the site
for purposes of evidence by use of camera, by
mapping or sketching, etc. especially in WMD.
Ask first all walking wounded to go to an identified
place.

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Provide and administer life sustaining support to


the patient in extreme cases (only for bleeding and
respiratory problems).
Bring patients to the Treatment Area accordingly to
priority.
Assess problem, triage treatment needs relative to
specific incident.
Identify a Morgue Manager and a Morgue Area for
black-coded victims.
Coordinate with Field Medical Commander and
Treatment Team Leader to report number and
types of casualties, including equipment needs.
Contact the Safety and Security Officer regarding
security and traffic flow needs in the Triage Area.
End his services once all patients are out of his
area and receive another assignment from the
Field Medical Commander.
Identifications Proper signage (hat or vest).

TRANSPORT GROUP SUPERVISOR


Mission Coordinate the transfer for patient received from the
Treatment Area to the appropriate hospitals.
Qualifications Preferably a paramedic, nurse or doctor with basic
training in Basic Life Support.
Experience and knowledgeable in Mass Casualty
Management.
Skilled in ambulance traffic control; skilled in radio
communications.
Sound knowledge of countrys transportations
resources.
Sound knowledge of access routes to health care
facilities.
Familiar with terrain, road maps, alternate routes.
Has sufficient knowledge in the return time of the
ambulance.
Functions & Receive appointment and briefing from the Incident
Responsibilities Commander/Field Medical Commander.
Establish immediately an ambulance loading zone,

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observing principles on way of traffic flow; identify


access routes and communicate traffic flow to
drivers.
Coordinate and supervise transport of victims from
the Treatment Area.
Ascertain all information relating to receiving
hospital (as to type of facility, bed availability,
hospital capability, contact ER medical officer, etc.).
Supervise all available ambulance drivers; assign
appropriate vehicle in accordance with status of
patients.
Receive request for transportation; Maintain a log
of the whereabouts of all vehicles under his control.
Ensure all patients transferred are tagged and with
their treatment form.
Brief ambulance crew as to the condition of the
patient, care required, access routes, traffic flow,
location of the receiving hospital and the
procedures in the endorsement of the patient.
Coordinate regularly with the Treatment Team
Leader/Staging Officer and report all patients
transferred and when the last person is
transported.
Document all activities in his area, including a
complete record of all patients.
Identifications Proper signage (hat or vest).

STAGING OFFICER
Mission Coordinate all resources arriving at the scene. For
manpower resources, referring them to appropriate
area of assignment. For transportation resources,
organizing them and dispatching them as required.
Qualifications At least a paramedic or an EMT.
Preferably with knowledge in Mass Casualty
Management and understand the organizational
chart.
Functions & Receive appointment and briefing from the Incident
Responsibilities Commander/Operation Section Chief.

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Identify suitable place for the Staging Area usually


away from the incident.
Organize, classify all transportation resources.
Coordinate with Transport Supervisor.
Dispatch appropriate vehicle as requested by
Transport Supervisor.
Coordinate with appropriate agencies with regards
to traffic flow and access routes within the site.
Direct all incoming responding teams to the Field
Medical Commander
Document all resources.
Identifications Any identification mark (hat or vest).

FIELD MEDICAL COMMANDER


Mission Organize, prioritize and assign officers under its
jurisdiction to areas where medical care is being
delivered. Advice the Operations Section
Chief/Incident Commander on issues related to
handling of the victims.
Qualifications Must be a Doctor of Medicine.
Must possess managerial skills in disaster.
Preferably with training and experience in MCI
management situations.
Knowledgeable in the hospital capability and
networking; having sound knowledge of countrys
health resources.
Skilled in pre-hospital care; skilled in radio
communications
Skilled in staff management; skilled in logistical
operations.
In the absence of the above the first who arrives at
the scene preferably on the of following:
Municipal Health Officer, City Health Officer,
any Emergency Health Physician
Emergency Critical Nurse (in the absence of an
MD)
Private MD with experience in emergency care
Can first assume the position and later endorse

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(face to face) providing an orderly transfer of


command to the next incoming qualified medical
personnel.
Functions & Receive appointment from the Incident
Responsibilities Commander/Operations Section Chief.
Identify the suitable site for the Advance Medical
Post and inform everybody.
Responsible for the different members of his team
(if not yet identified): Triage Officer, Treatment
Officer, Transport Officer, Mortuary Officer.
Responsible that all the needed medical resources
be mobilized and available.
Report and coordinate with the Operations/Incident
Commander; likewise attend meetings and press
conferences.
Ensure the welfare and safety of the medical team,
including relief and sustenance (decking,
scheduling, pullback, etc)
Conduct regular meetings with his designated
officers in the area.
Anticipate other concern and regularly confer with
the Operation Officer/Incident Commander.
Responsible that all the necessary recording of the
events be done and all required reports to all the
authorities be submitted on time.
Evaluate the whole activity and make the
necessary recommendations to improve future
responses.
Coordinate and regularly report to the Medical
Controller of the DOH Operation Center/Regional
Operation Center.
Identifications Proper signage (hat or vest).

MORGUE MANAGER
Mission Collect, protect and identify deceased patients.
Qualifications Doctor of Medicine aided by a social worker, a
psychosocial support officer.
For medico-legal cases forensic experts from the

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PNP Crime Laboratory or the National Bureau of


Investigation will be part of the team.
Functions & Receive appointment and briefing from the Triage
Responsibilities Officer/Field Medical Commander.
Identify and establish the Morgue Area; coordinate
with the Triage Officer and Treatment Officer.
Maintain master list of deceased patients with time
of arrival.
Assure that all personal belongings are kept with
deceased patients and are secured.
Assure that all deceased patients in Morgue Area
are covered, tagged and identified when possible.
Provide a system or procedures for identifying and
endorsing the body of the deceased to authorized
members of the family.
In medico legal cases consult with PNP and NBI
with regards to procedures necessary for proper
identification and for evidence collection and
preservation.
Keep Triage/Treatment Officers appraised of
number of deceased.
Contact the Safety and Security Officer for any
morgue security needs.
Arrange for frequent rest and recovery periods as
well as relief for staff.
Schedule meetings with the Psychological Support
Unit Leader to allow for staff debriefing.
Observe and assist any staff that exhibit signs of
stress or fatigue. Report any concerns to the
Treatment Area Supervisor.
Review and approve the area documenters
recording of actions/decisions in the Morgue Area.
Identifications Proper signage (hat or vest).

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Q. Hospital policies, guidelines, protocols, and other issuances relevant to


emergency or disaster management

1. Lung Center of the Philippines Policy on Health Emergency


and Disaster Management
a. General Objectives
The hospital prior to a health emergency event
undertakes development activities to enhance its capacity to
manage all types of hazard and systematically carry out
response to recovery, ensuring a better level of function in
health emergency management.

b. Legal Framework
DOH Administrative Order No. 6-B of 1999:
Institutionalization of a Health Emergency Preparedness and
Response Program within the Department of Health and
DOH Administrative Order No. 168 s 2004. It stated that all
hospital must have a working and updated health emergency
preparedness, response and recovery plan as a basic
requirement by the Bureau of Licensing of the Department of
Health.

c. Rationale
This aimed to promote health emergency
preparedness among the general public and strengthen
health sectors capability to respond to emergency and
disaster. The administrative order likewise gives advice and
policy directions regarding health emergencies. It embodies
the framework of Health Emergency Management (HEM).
HEM strategies, organizational structure, human resource
development, support systems and roles and responsibilities
of HEMS, DOH offices, and attached agencies, and other
health sector.

d. Statement of Policy
1) All hospital personnel must have a full knowledge and
understanding of the Hospital Health Emergency
Preparedness, Response and Recovery Plan

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Guidelines
a. Before a Health Emergency Preparedness Response
and Recovery can be perceived a reality, a planning
committee must be formed and must be supported by
a Center Order.
b. Members of the committee must be equally
represented to the different main section of the
organization and this must be headed by the
Executive Director or by the Deputy Director. The
members are:
i. Medical
ii. Nursing
iii. Pathology
iv. Radiology
v. Infection Control
vi. GSD
vii. Finance
viii. HEMS
ix. Representative from Medical Specialty Society,
PNRC and BFP
c. The committees function is as follows:
i. Review existing HEPRR plan and makes
necessary updates
ii. Review roles and responsibility of members of
the committee
iii. Assignment of major responsibilities within the
hospital for emergency prevention, preparedness
and response.
iv. Selecting priorities for the acquisition of
emergency supplies and medicines.
v. Initiates testing of the plan for its functionality
and adaptability to a multi hazards situations.

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d. The committee will meet Quarterly, first Tuesday of


the Week.
e. The committee chair will be responsible for the
dissemination of the hospital emergency plan.
f. The plan must be included in the orientation of newly
hired employees.
g. Orientation for all employees must be done gradually
with adequate testing, monitoring and evaluation.
2) All hospital personnel must attend the Basic Life Support
Training.
Guidelines:
a. Basic Life Support Training has two main courses
namely:
i. BLS for Healthcare Provider
ii. BLS for Lay Rescuer
b. Hospital personnel will be classified into Healthcare
Provider and Lay Rescuer
c. Personnel that are included in the medical services
are classified as healthcare provider, and on the other
hand personnel that are part of administrative section
are classified as lay rescuer.
d. BLS is a two-day course training whether participants
are healthcare or lay.
e. BLS trainers are all DOH certified and have
undergone DOH BLS Training of Trainer Course.
f. BLS training expenses are charged to the DOH-
HEMS sub-allotted funds.
g. The conduct of BLS training is done every last
Thursday and Friday of a month except January and
December.
h. All personnel must undergo medical screening prior to
the training.

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i. Personnel who are fit and failed to attend the course


will be rescheduled the next available month.
j. The BLS training program is in collaboration with the
Professional Education and Training Services and
LCP Health Emergency Management Staff.
k. BLS training program is also open to the public who
meet some basic requirements such as age limit,
medical conditions.
l. Participants from other Government agencies are free
of charge provided they must ask written permission
to the executive director of the hospital and available
slot are still open.
m. Reservation are entertain provided that five days prior
to the said training the fee must be settled otherwise
the slot will be given to others.

3) All hospital personnel must know the Hospital Emergency


Incident Command System and the basic on Mass
Casualty Management.
Guidelines
a. A lecture will provided by HEMS on Hospital
Emergency Incident Command System and on Mass
Casualty Management.
b. After the said conduct of series of lectures, a table top
exercise will be given to simulate an incident.
c. An actual drill may be given to test state of readiness
and understanding of the system.

4) All hospital personnel must participate in the conduct of


fire/earthquake seminar and drill.
Guidelines
a. Fire and Earthquake Seminar/Drill is a requirement for
one institution to operate legally.

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b. Fire and Earthquake Seminar/Drill is conducted by the


bureau of fire department semi-annually that is every
first week of June and November.
c. The seminar is a two day seminar with didactic lecture
on the first day and practical demonstrations on the
second day.
d. Failure to attend such seminar is an insubordination
of a direct order.
e. The actual drills are announced the next month after
the seminar.
f. The drills are the responsibility of the GSD in
coordination with the PETS and HEMS.
g. An honorarium will be given to the invited lecturer
other than the DOH personnel provided that the latter
must give his/her resume as per requirement by the
Commission on Audit.

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2. Lung Center of the Philippines Policy on Fire Safety


a. General Objectives
It is necessary that LUNG CENTER OF THE
PHILIPPINES should recognize and accept that fire and
foremost consideration and that functioning fire safety
system in building and structures should be ensured.
Preparedness of hospitals and other health facilities
must be put in place at all times.

b. Legal Framework
The design, construction and maintenance of
buildings, structures and facilities shall adhere to all
applicable provisions of the Fire Code of the Philippines.
Electrical systems, equipment and installation
mentioned in the Fire Code shall conform to the provisions of
the Philippine Electrical Code. Likewise, mechanical
systems, equipment and installation mentioned in the Fire
Code shall conform to the provisions of the Philippine
Mechanical Engineering Code.

c. Rationale
The built environment in hospitals and other health
facilities is becoming more complex as these institutions plan
and design their buildings and structures to response to the
demands of their growing bed capacity and service capability
and advance technology for quality healthcare services
delivery.
However with the continuing physical development in
hospitals and other healthcare facilities, comes the
corresponding responsibility of keeping the buildings and
structures properly maintained and safe especially against
man-made disasters.
Fire, which can be the most devastating but
preventable ma-made disaster to happen to hospitals and
other healthcare facilities, may result in loss of lives, loss of
essential equipments, damaged to infrastructures and
displacement of hospital employees. It can suspend
infrastructure projects, waste hard fought resources, and

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they make our citizens suffer unnecessarily through the long


rehabilitation or reconstruction period.

d. Policy
The management of the Lung Center of the
Philippines holds in high regards the safety, welfare and
health of its employee, patients, and other clients.
Accordingly, it is the policy of the institution to integrate
safety in every work stage and to promote and maintain a
good working environment to safety guards all personnel,
facilities and equipments.

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R. Post Mission Report

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S. Hospital Floor Plan

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T. Metro Manila DOH HEMS Zoning Plan for Emergency Response

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U. References

1. Guidelines on Hospital Health Emergency Management, 2nd Edition.


Department of Health-Health Emergency Management Staff. 2008.
2. Guidelines for Health Emergency Management, Operation Center, 2 nd
Edition. Department of Health-Health Emergency Management Staff.
2008.
3. Guidelines on Hospital Health Emergency Management for the
Centers for Health Development, 2nd Edition. Department of Health-
Health Emergency Management Staff. 2008.
4. Safe Hospitals in Emergencies and Disasters. Philippine Indicators,
2nd Edition. Department of Health-Health Emergency Management
Staff. 2009

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