MAJOR ACCIDENT

HAZARD CONTROL
IN
INDUSTRY
MAJOR ACCIDENT HAZARD CONTROL IN INDUSTRY

 Medical response in an emergency has to be well planned and organised

so that in case of major emergencies victims can be managed medically
in the best possible manner and without any delay.
 It is statutory requirement of the occupier of any hazardous industry to
have an emergency medical preparedness plan.
 Preparedness:- It covers all actions taken with a view to organizing and
facilitating timely and effective rescue, relief and rehabilitation.
 Prevention :- It means the formulation and implementation of long term
policies and measures to mitigate the impact.
 EMERGENCY MANAGEMENT

Emergency management is a comprehensive system setup to address and

handle natural and manmade hazards. It has four parts :-

1. PREVENTION/MITIGATION

2. PREPAREDNESS

3. RESPONSE

4. RECOVERY
 MEDICAL ORGANIZATION FOR EMERGENCIES

The most important factor in the relationship between the prognosis of victims
and the interval of time elapsing between sustaining the injuries are the
availability of medical care. This later period is called the “DELAY-TIME or
REACTION TIME or RESPONSE TIME”

The emergency medical responses aimed at in reducing the “DELAY-TIME”.

The medical organization for getting the proper responses in emergency

(industrial major accidents) has mainly three components:-

1. Organization at Site (On-Site Emergency)

2. Transportation of Victims (Communication)
3. Organization in the Hospital (Off Site Emergency Plan)
 ORGANISATION AT SITE (ON-SITE EMERGENCY)

Medical organisation is needed at site for the purpose of :

1. Early Identification
2. Elimination of Human Error Risk Factors due to physiological and
pathological causes.
3. Planning and executing the rescue operation.
4. Effective First Aid Management.
5. Training for minimising the after effects of major accident.
6. Constitution of “TRAUMA TEAM” for rescue and First-Aid Operations.
EFFECTIVENESS OF ON-SITE MEDICAL ORGANIZATION DEPENDS ON :

1. Capability of the personnel.

2. Availability of TRAUMA TEAM.
3. Plan of action to receive the victims.
4. Their codification
5. Their first aid treatment.
6. Transportation.
 FUNCTION OF TRAUMA TEAM :

1. To reduce delay time or reaction time.

2. Prevention of respiratory failure and administration of oxygen.
3. Control of bleeding.
4. Replacement of suitable fluid for loss of blood.
5. Treatment of shock.
6. Replacement of suitable pain killers.
7. Supportive treatment for cardiac, respirator and other systems.
8. Splinting and immobilization in case of fractures.
9. To keep the body warm with blankets and to protect open wounds with
suitable sterile dressing.
10. Moral support to the injured
11. Maintenance of medical records.
12. Dead body, if any, is to be identified and dealt in the appropriate
manner.
13. Distribution to the injured to referral.
ACTION PLAN :-

1. Employees should be trained first aid and be available at short notice

to take part in the rescue operation.
2. Periodical mock drill should be conducted so that each one knows his
exact role and responsibility.
3. Liaison with nearby reference hospital.
4. All employees should have had their blood grouped and routine
immunization carried out.
5. A mutual-aid-scheme should be worked out in case of a industrial
complexes.
6. A system of “TRIAGE” is to be adopted to classified the victims into
different groups depending upon the severity of the injury and
urgency of transportation.
 TRIAGE SYSTEM

This process is used to sort out patients into categories of priority for
care and transport, based on the severity of injuries and medical
emergencies.

1. Category I – RED TAG – FIRST PRIORITY

2. Category II – BLUE TAG – SECOND PRIORITY

3. Category III – YELLOW TAG – THIRD PRIORITY

4. Category IV – GREEN TAG – FOURTH PRIORITY

5. Category V – BLACK TAG – LEAST PRIORITY

 HIGHEST PRIORITY

Victim is seriously injured, required immediate hospitalisation in

the referral centre with life supporting equipment during
transportation

Examples:-

1. Respiratory Arrest, Airway Obstruction and severe breathing

difficulties.
2. Cardiac Arrest.
3. Uncontrolled Severe Bleeding.
4. Severe Head Injuries.
5. Open Chest wounds.
6. Open abdominal wounds.
7. Severe Shock.
8. Burns involving the respiratory tract.
9. Severe medical problems including heart attack, stroke,
heatstroke, poisoning and abnormal childbirth.
10. Unconsciousness.
 SECOND PRIORITY

Victim is seriously injured, required immediate hospitalization

in the referral centre without any life supporting equipment
during transportation.

Examples:-

1. Severe Burns.
2. Injuries to the spine.
3. Moderate Bleeding.
4. Conscious patients with head injuries.
5. Multiple fractures.
 LOWEST PRORITY

The Victim is injured required only first aid treatment and

allows to go home.

Examples:-

1. Minor Bleeding.
2. Minor fractures and minor soft tissue injuries.
3. Moderate and minor burns.
4. Obvious mortal wounds where survival is not expected.
5. Obvious Death.
 TRANSPORTATION OF VICTIMS (COMMUNICATION)

The transportation and allocation of victims to the hospitals need to be

organized. The medical care rendered during transportation minimizes and
induces complications. Net working and round the clock readiness should be
the essential feature of ambulance services. For this co-ordination between
concerned agencies is necessary. Helper of the ambulance driver should have
trained in first aid and CPR.
ORGANIZATION IN THE HOSPITAL (OFF SITE
EMERGENCY PLAN)

Primary requirement for drawing plans for the hospitals to cope with
emergencies arising out of major accidents is the identification of the victims,
codification, distribution and early medical management should be there. The
time period should be also so arranged that the initiation of each segment of
the plan is made in the least possible time.
 CRASH TEAM

 A well planned and optimum medical response helps the victim in a

great way. The chances of survival and reducing the complication
increase with this. The availability of crash team adds to the efficiency of
such organization.
 The team consists of one surgeon, one anaesthetist, one medical
specialist, one or two theatre sisters, one casualty sister with other
supporting paramedical staffs.