Kingdom of Saudi Arabia ‫المملكة العربية السعودية‬

Ministry of Health ‫وزارة الصحة‬

Directorate of Health Affairs-Najran ‫ نجران‬- ‫مديرية الشؤون الصحية‬
Maternity & Children’s Hospital ‫مستشفى الوالدة واألطقال‬
Disaster Management ‫إدارة الطوارئ‬

UNIT EVACUATION PROCESS CHECKLIST

Department: ……………………….. Unit Leader:…………………………
1 The unit’s Physician/senior nurse assumes the role of “Unit Leader.”
2 Unit Leader read and follow the “Unit Leader Job Action Sheet”.
3 Be briefed by the hospital “Evacuation Coordinator’’
4 the unit should continue to prepare its patients and staff for evacuation
if communication disrupted
5 All unit staff should gather to briefly discuss the situation and
communicate the response and evacuation plan
6 Visitors may stay with the patient, or may be directed to leave per the
direction of the Unit Leader
7 Unit staff should prepare patients by:
- Reassess each patient’s clinical status
- Review and minimize all active medications and clinical
interventions.
- Only essential medications and interventions should be
continued.
- Clinicians should include brief summary of patient’s treatment
plan and their own contact information to assist clinicians at the
receiving hospital.
- Give report to receiving clinicians at the receiving hospital
8 All nurses should complete one Patient Evacuation Form for each
patient and keep one copy with the patient when they leave the unit
- complete tracking form for patients “off the unit’’.
- if patients “off the unit’’, they may be transported to the
Assembly Point where they will re-join the unit
9 Unit leader complete the Evacuation Tracking Log and ensure an
accurate patient census for beds arrangement
10 Determine if evacuation operations will require additional staff or
equipment and communicate the needs
11 Patients’ families should be notified and provided a status update
12 The Unit Leader should direct the staff nurses to package patients for
transport.
- This includes packaging medications, essential medical
equipment, and supplies the patient will need during transport as
well as essential belongings
- Assume that patients may be in transit for as long as 12 hours
13 The Unit Leader should communicate with floor coordinator and
transport coordinator to learn the order of unit evacuations and ensure
patient safety.
14 A clinical staff member will accompany the first transported patient(s)
to ensure that the Assembly Point has at least one medical worker can

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 Kingdom of Saudi Arabia ‫المملكة العربية السعودية‬
Ministry of Health ‫وزارة الصحة‬
Directorate of Health Affairs-Najran ‫ نجران‬- ‫مديرية الشؤون الصحية‬
Maternity & Children’s Hospital ‫مستشفى الوالدة واألطقال‬
Disaster Management ‫إدارة الطوارئ‬

begin to provide medical care for patients.

15 Other clinical staff members may accompany patients provide
appropriate medical monitoring
- Unit Leader and Floor Coordinator will travel to the Assembly
Point to oversee care at Assembly Point.
16 In the Assembly Point, in order to retrieve additional patients, identify
which patients can be moved from stretchers and chairs
17 - only the minimum required care interventions should be
continued.
- All the critical supplies needed will be transported to AP by the
responsible department.

18 Infection control precautions should not be cohorted in one area in the

Assembly Point, however, patients on airborne precautions may be
segregated or cohorted by the Unit with patients with the same
diagnosis (e.g. TB with TB, Varicella with Varicella)
19 In the Staging Area, patients should be loaded onto the first available
vehicle with the appropriate clinical capabilities to safely transport them
to their transfer destination.
- Ambulances without higher clinical capabilities can be
permitted to take higher acuity patients if hospital nurses or
physicians travel with the patients.

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 Kingdom of Saudi Arabia ‫المملكة العربية السعودية‬
Ministry of Health ‫وزارة الصحة‬
Directorate of Health Affairs-Najran ‫ نجران‬- ‫مديرية الشؤون الصحية‬
Maternity & Children’s Hospital ‫مستشفى الوالدة واألطقال‬
Disaster Management ‫إدارة الطوارئ‬

SAMPLE PATIENT EVACUATION TRACKING LOG

Directions for Unit Leader: Unit Name: _______________________________

1. Review patients with staff and record information. Unit Leader: _________________
2. As soon as form is completed, FAX to hospital
Emergency Operations Center. Pager/Cell Phone: __________________________

SECTION

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 Kingdom of Saudi Arabia
Ministry of Health
Directorate of Health Affairs-Najran
Maternity & Children’s Hospital
Disaster Management
‫المملكة العربية السعودية‬
‫وزارة الصحة‬
‫ نجران‬- ‫مديرية الشؤون الصحية‬
‫مستشفى الوالدة واألطقال‬
‫إدارة الطوارئ‬
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