DISASTER

MANAGEMENT
MA. NEMIA L. LIZADA, M.D.,FPAFP,MPH
HEALTH SERVICES
ORGANIZATION
Role of Health Services
Main Concerns:
1.to ensure the survival & treatment of the
greatest number of disaster victims
2.to prevent & control epidemics, poisoning,
and/or other public health consequences
of disasters
Role of Health Services
Specific activities:
1. Triage & patient care at the disaster site
2. Transporting the patient to the hospital
3. Certifying that deaths have occurred &
removing bodies ( in collaboration with the
police)
4. Conveying health supplies & equipment, &
providing health care to evacuees in temporary
shelters and encampments
Staffing in Health Services
Organization
Chief medical officer in-charge Municipal
Health Officer

* In the absence of the MHO, the 1st

physician to reach the disaster site
assumes the duties of the CMO
Responsibilities of the CMO:
Organizing the chain of medical aid & triage
Transport of patients to hospitals
Identifying personnel requirements: vehicles,
equipments, & supplies and requesting
additional support when needed
Over-all supervision & representing health
services at operational base headquarters
Responsibilities (cont.)
Sanitation & over-all public health control
measures
Evaluation of records
Protection of health personnel& prescribed
decontamination in the event of a chemical
or nuclear disaster
General Planning Framework -
Components
1. A main plan which is inter-sectoral
2. A national agency responsible for
coordinating and implementing the plan
3. A planning committee designated by law
to formulate the functional health plan
General Planning Framework
(cont.)
4. An emergency coordination unit which reports directly to
the highest level of authority with the following duties:
a. Conducts planning process
b. Ensures plan update
c. Organizes simulation activities
d. Coordinates health-related relief operations in plan
activation
e. Takes health as focal point for inter-sectoral
coordination and tasking
Areas/Units Designated During
Disasters
1. Command post
2. Search and rescue unit
3. Area for triage and first aid
Command Post
- Can be existing buildings such as gyms,
warehouses, schools & the lobby of
public/private buildings
- Tents or temporary shelters (in the
absence of existing structures)
Command Post
4 Areas:
1. Reception and triage
2. Treatment of shock
3. General medical care
4. Place for patients awaiting evacuation
Search and Rescue Operations
- Composed of personnel properly trained in
first aid and organized to move
immediately to the disaster site
- Carry tags because they are expected to
perform initial triage
Search and Rescue Operations
Responsibilities:
Do limited surgery/or anesthesia, such as
performing amputation to free trapped
victims to increase their chances of
survival (emergency intensive care)
Relieve pain & anxiety of the injured,
making rescue easier & limiting
physiological damage caused by stress
Responsibilities (cont.)
Advise on the benefits, risks, & dangers of
the different rescue operations/options
Indicate order of how casualties must be
rescued/freed according to the medical
condition (presorting)
Provide emergency treatment to injured
colleagues in rescue teams
Triage and First Aid
Objective of triage personnel:
to relieve the suffering of as many people
as quickly as possible
Triage and First Aid
A necessary procedure when there is a
very large number of casualties
A continuing process
Is based more on benefits, not on
seriousness of injury
Guidelines for Effective Triage
1. Should attend to all injured victims of an
emergency at once
2. Should begin as soon as possible, in the chain
of medical aid, & should continue along the
chains whole stretch
3. Should be done by experienced doctors,
surgeons or those who have had regular &
long experience in emergency
care/traumatology
Guidelines for Effective Triage
(cont.)
4. Should have logical examination of
patients in the quickest possible time so
that everybody can benefit from it
5. Should end with proper categorization &
tagging of patients/casualties (color-
coding).
6. Once in the post, conditions must be
redefined according to categories
Identification of Patients -
Tagging/ Color-coding
A. Red Tag 1st priority for evacuation
1. breathing problems that cannot be treated
on site
2. cardiac arrest (witnessed)
3. appreciable loss of blood (> liter)
4. loss of consciousness
5. thoracic perforation or deep abdominal
injury/problems
Red Tag (cont.)
6. Certain serious fractures
a. pelvis
b. thorax
c. cervical vertebra
d. (-) pulse below site of
fracture/dislocation
e. severe concussion
f. burns
B. Green Tag 2nd priority evacuation
1. 2nd degree burns covering >30% of the
body
2. 3rd degree burns covering 10% of the body
3. burns complicated by major lesions to soft
tissue or minor fractures
4. 3rd degree burns involving hands, feet, face
but no breathing problems
5. moderate loss of blood (500-1000 cc)
6. dorsal lesions with or w/o injury to spinal
column
Green Tag (cont.)
7. conscious patients w/ craniocerebral damage w/ any of
the ff. signs:
a. secretion of spinal fluid
b. rapid increase in systolic presssure
c. projectile vomiting
d. changes in respiratory frequency
e. pulse below 60 bpm
f. swelling or bruising beneath the eyes
g. anisocoric pupils
h. collapse
i. weak or no motor response
j. weak reaction to sensory stimulation (profound stupor)
C. Yellow Tag 3rd priority
1. minor lesions
a. Minor fractures (fingers, teeth, etc)
b. Others, abrasions, contusions
c. Minor burns
c.1. 1st degree <20% of the body
excluding hands, feet, face
c.2. 2nd degree <15% of the body
c.3. 3rd degree < 2% of the body
Yellow tag (cont.)
2. Fatal injuries
a. 2nd & 3rd degree burns > 40% of the
body with death reasonably certain
b. a & other major lesions e.g., major
fractures, major craniocerebral lesions,
thoracic lesions, etc.
Yellow tag (cont.)/ fatal injuries
c. Cranial lesions w/ exposed brain
tissue, patient unconscious w/ major
fractures
d. Lesions of spinal column w/ absence
of sensitivity & movement
e. Patient > 60 years old w/ major
lesions
D. Black Tag
1. dead
2. without pulse or respiration over 20
minutes or whose injuries under
resuscitation impossible
Evacuation Procedures:
1. Not trapped or buried.
a. red
b. green
c. yellow
Evacuation procedures (cont.)
2. Trapped or buried
a. Red
b. Green
c. Yellow
d. Black, not trapped or buried
e. Black, trapped
Diagram
Evacuation
(shuttle)
Disaster site ---------------- RHU or ------------- Hospital with
(initial triage & District Hospital better facilities
1st aid) (cont. triage & (centers/regional/
treatment) provincial hosp.)
(patient admission
depending on case)
THANK YOU AND GOD BLESS!

HAPPY DINAGYANG !