EHS 306 Disaster Management

Week 5 Practical : Natural Disaster

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Background
• Uses the principle of ‘Learning by Doing’ this educational tabletop
exercise is designed for training and testing preparedness for major
incidents and disasters
• Focus is on clinical and resource based decision making and time
management and utilising.
• This practical session has utilised Emergo train system as its
foundations for creation.

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What is involved?
• Magnetic symbols representing
• Patients
• Personnel
• Resources
• Moveable markers indicating priority and treatment
• Patient bank with various injuries
• Treatment times

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www.med.oita-u-ac.jp
Real time management
• Real time management is a major focus of this system
• A protocol has been developed to identify the time taken for various
clinical interventions (based on proficiency) and likely outcome
• Clinical interventions can occur at the site of the incident, the CCP,
ED, OT or ICU
• During intervention time, staff member is unable to treat other patients
• Available interventions have prescribed times
• Triage priority tags apply
 Immediate / Now
 Urgent / Soon
 Delayed / Later / Minor injuries
 Deceased

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Introducing “guber”

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Introducing, Guber Front = what you expect
to see from a distance
when approaching a
real victim. You can see
the position and major
injuries and also
identify if the patient is
able to communicate.

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Introducing, Guber

Back = information
you get when
examining the patient
closely. Relevant
findings are shown.

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How does it work….?

www.health.vic.gov.au

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How does it work….?
• Incident
• Site board set up in the prehospital environment
• Site board progresses
• Patient triage

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Incident Site

www.health.vic.gov.au

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 Incident Site

• Location
• Map of immediate environment
• Type of incident
• Injured and non-injured persons (Gubers may be positioned under
vehicles/buildings)
• Combating agency
• Triage sieve and transportation to CCP are the main activities from the
incident site
• Decisions made about treatment type and limitations
• Resources may need to be deployed for trapped patients

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Casualty Clearing Post

• Includes at least:
• Triage area
• Treatment areas

• Activities include:
• Triage sort
• Casualty management
• Transport priorities
• Ambulance and medical coordination

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Casualty Clearing Post

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 Transport Board

• Keeps track of
ambulance
resources and
controls real time
flow between the
incident site and
hospitals

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Emergency Department

• In the ED, the board is filled with existing patients

prior to the major incident patients arriving
• Often uses a sample day from one week prior so
as to create realistic setting
• Includes self presenters
• Staffing levels
• Other overflow levels of the department included

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EMERGO rules

• Exercise must progress in real time

• Designated times / delays for transportation and
interventions must be followed
• Communication by radio
• Follow directions of instructors and facilitators
• In the event of a real emergency, the statement
NO DUFF will be used

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Key Performance Indicators

• Was the disaster managed in a timely manner?

• Was disaster communication cascade activated?
• Chain of command utilised appropriately?
• Identification of resource requirements
• Appropriate utilisation of workforce?
• Patient flow managed?

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Let’s Practice

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Earthquake –
View as you approach the Scene

Unknown number of patients

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• METHANE?
• CSCATTT?

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Al Maktourn hospital - 10 mins Health city hospital 10 mins -
5 resus beds helicopter
15 Majors 2 Resus
25 Major beds
Local hospital 25 mins by land
4 Resus beds
5 Majors

Office
Hotel

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Back-up

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Triage

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Status?
Who needs to know?

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How do these patient’s priorities
alter once they are re-triaged?
Who is our Priority?

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Back-up

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Back-up

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Back-up

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Reference

Developed using the principles from: Emergo Train System:

https://www.emergotrain.com/products/ets-training-material

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