Informed Epidemic Preparedness Exercise - 2017

Apollo Health City Jubilee Hills

ExerciseDate 2nd November 2017,Thursday

ExerciseTime 14:00hrs to 16:00hrs (60 minutesduration)

Exercise Coordinators Dr. ImronSubhan

Dr.SyedNabi

Assessors Dr.Ratna Rao

Dr.RatnamaniDr.Subba
Reddy Dr.Ravikiran
Ms.Soma Das

Scenario A group of 6 people from Tanzania with history of fever arrive atApollo.
Patient 1 – 32/M with fever with severe headache & cough (goes to ER)
Patient 2 – 30/M unconscious patient with high grade fever (brought to ER)
Patient 3 – 22/M with fever with fever & pain abdomen (goes to surgery OPD)
Patient 4 – 30/M with mild fever (goes directly to family clinic)
Patient 5 – 31/M with mildfever (goes directly to internal medicine OPD)
Patient 6 – 23/M with mild fever (goes directly to infectious disease OPD)

Exercise will begin at 14:00hrs when 2 patients will be brought into the ER, one on a stretcher and
other in a wheelchair. At the same time 4 patients will walk into the four OPDS (1 into each OPD).
The coordinators will ensure that the patients (all actors) reach the locations and act appropriately.

The assessors will follow the patients and note down events as they happen with the patients. They
will ask relevant questions to the reception staff, doctors, nurses, lab personnel and any healthcare
workers taking care of the patients.

Exercise will end at 16:00hrs.

EPIDEMIC DRILL REPORT

List of Actors

Patient Actor Name Location

1 Mr. Raveen ER
2 No Actor.Manikin used ER
3 Mr. Jitesh Surgery OPD
4 Mr. Binson Family clinic
5 Mr. Jaggu Internal Medicine OPD
6 Mr. Subramanyam Infectious Disease OPD

Timeline of Events

Time Event Comments / Issues

14:30hrs Epidemic exercise started.
.
14:30 Patient 2 triaged and moved into the ER isolation N95 masks and PPE were used
room. Resuscitation started. Patient 1 triaged and by all ER staff to resuscitate
isolated in ER consultation room. unconscious patient.
Endotracheal intubation done
Dr. Rajib Paul(Internal medicine consultant on under full isolation. Used
duty) informed about the patient. consumables discarded as per
protocol.
14:40 Medical superintendent informed about high risk
patient in ER.

ER receives call from Surgey OPD (Dr. Ramesh)

to receive infectious patient.

14:43 Dr.Ratna Rao (Head of Infection Control

Committee) informed about the cases.

14:45 Dr. Ravikiran (Infectious disease consultant) Patients were assessed and
informed about the cases. diagnosed in the OPDs and
were isolated appropriately.
Patient 4 and Patient 5 brought into the ER. Moved Both were given masks to
to ER consultation room. Accompanied by cover themselves prior to
executives. transfer.

14:55 Patient 3 and Patient 6 arrived into the ER. Triaged Patients could not find the
and moved to ER consultation room. consultants, hence were
directed to go to the ER by the
Dr.Subba Reddy (Head of ICU) informed about reception staff. Consultants
 transfer of unconscious patient to MICU 1 isolation
room.
Dr. Ravikiranarrived in the ER and began
assessment of patients.
were unavailable as it was not
their appointment time.
Patients were appropriately
directed to reach ER for triage
& assessment.

PCR form received from ambulance EMT.

15:00 Patient 2 resuscitated and transferred to MICU 1 Adequate PPE and N95 masks
isolation room. were available for ER staff to
use. Pharmacy had adequate
Patients 1, 3, 4, 5, 6 undergo assessment and stock of medicines for OP
consultation by Dr.Ravikiran and are prescribed prescription.
OP treatment.

15:30 Disposition Disposition of patients was

Patient 1 – Referred to Govt. Isolation hospital appropriate.
Patient 2 – Admitted to MICU 1 isolation
Patient 3 – Referred to Govt. Isolation hospital
Patient 4 – Home quarantine
Patient 5 – Home quarantine
Patient 6 – Home quarantine

Disinfection of ambulance, ER consultation room

and ER isolation room was done.

15:45 Exercise ends

Recommendations

1) More isolation rooms to be identified to accommodate larger number ofpatients.

2) N95 masks to be made available for reception staff during anepidemic.
3) Ambulance to follow cleaning protocol after transporting infectiouspatients.
4) Next exercise to be conducted tentatively in Feb2018.

Dr. ImronSubhan
2ndNov 2017