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There are many types of disasters grouped into two different categories. Here in Arizona the populations concern is the Palo Verde Nuclear power plant. It is one of the largest in the US and could cause devastation across Arizona. This and others such as terrorism, fires, and any type of accident at the hands of man are considered manmade disasters. There have also been natural disasters that the world worries about that the people can do nothing about. Earthquakes along the San Andres fault, the tsunamis that follow, flooding and landslides, as well as volcanic eruptions are all things that communities, hospitals, and emergency personnel should be prepared for. Each plan for preparation can be so different because the situations can be unique, but having an overall understanding of the process can prepare for the overall emergency.
The basic plan
The first phase of having a preparedness plan is the planning phase. Without a plan nothing can be accomplished and chaos will ensue. Planning must focus on communication technique. With no communication plans can become scattered and disorganized. Ways to track patients, keep records and communicate with the community will ensure uniformity throughout emergencies. There are also several things that need to be prepared for during disaster. Often power outages, building damage and a large number of injuries and casualties may occur. Back-up power from generators need to be installed in areas of needed power. Alternate areas of triage and shelter need to be planned for in cases of building damages.
A way to treat patients in a timely, efficient manner need to be developed to ensure proper care of injured. If computer systems go down there needs to be an alternate way to document and access information that is used consistently throughout all divisions. Communication on what to do and expect must be a focus. Take hurricane Katrina for instance. People were confused, agitated and felt abandoned because of lack of communication between first responders, government agencies, and the community. With a plan comes practice. If citizens and personnel have a grasp of what is needed and expected the process is more effective and operations run smoother. Training is also a key component of planning. To enhance the preparedness of hospitals around the US, standards have been established and standing preparedness plans are in practice. The agencies that establish these standards include Joint Commission on Accreditation of Healthcare Organizations (JCAHO), Centers for Disease Control (CDC), and the American hospital Association (AHA).
With the coordination of many agencies, planning will be the basis of survival and treatment in all emergencies. In response to emergencies the responders must have a standard procedural response to abide by. With this basis response can be swift and universal. There should be a single entrance in and out of triage areas to allow for orderly flow of patients and staff, as well as decontamination if needed. There should be a hierarchy of command to monitor and direct the situation. A triage color coding system should be used to identify the treatment level of the wounded. Each color has a degree of treatment associated with it. The red tag indicates the highest level of treatment descending to yellow and then green. Black is the worst indicating death or impending death. This is a mass triaging system which is usually done outside of the treatment area. In the decontamination area, those that have a higher color would then be assessed again by the START system. This is based on respirations, perfusion, and LOC. Inside the triage, patients would get a thorough assessment and subsequent treatment.
No treatment other than life saving should be performed outside of a triage area. This type of response is to ensure rapid assessment and treatment in mass casualty situations. Recovery, often the longest and most expensive phase of disaster, is the last phase of the plan. It has many elements with multiple agencies involved. Focus should be made in regaining life back to its original state in aspects of community, economics, and emotional condition. Federal funds are available through many organization such as Federal Emergency Management Agency (FEMA) and the Red Cross. Housing for those displaced by disaster is primary in establishing a normalcy. Food and water can be compromised; therefore sources for supplies and routes for them to be delivered must be established. Hospitals may become overcrowded and transport to other locations may be necessary. The emotional strain of an emergency cause issues with PTSD and depression.
Support and counseling should be available for survivors and victims. Leadership will play a key element in recovery. There will be many volunteers and agencies involved that will need guidance from a group or person in charge of rebuilding. Overall, being able to assess and evaluate the recovery, to learn and plan for future emergencies will be the final step in recovery. The process of planning for an emergency situation is much like a nurses plan of care. Its composed of many phases that look at a situation that needs be fixed, and is a revolving assessment to make the situation better.
A nurse will assess, plan and treat a patient based on previous evidence based practice and then continually evaluate her results making a complete circle. This is similarly done in emergency preparedness. Through planning, prevention, treatment, recovery and evaluation one can save lives and reduce the effects financially and emotionally on the victims. Its a similar circle because our plan is constantly changing and molding based upon previous experiences and situations. The ultimate goal in emergency preparedness is to have a plan and be able to implement it in a way that will save lives.
Arizona Division of Emergency Management. (n.d.). Palo Verde Nuclear Generating Station. www.dem.azdema.gov/preparedness/paloverde.html.
FEMA. (n.d.). Natural Disasters. www.ready.gov/natural_disasters. FEMA. (n.d.). Recovering from Disaster.
Richter, Paul V. (6/1997). Hospital Disaster Preparedness: Meeting a requirement or preparing for the worst. www.burndisaster.com/HospitalDisasterPreparedness.pdf. Southeast Arizona Emergency Medical Services Council. (6/06). Disaster Triage. www.saems.net/Downloads?DISASTERTRIAGEProtocol606.pdf.
US Dept. of Health and Human Services. (1/12). Healthcare Preparedness Capabilities. www.phe.gov/preparedness/planning/hpp/reports/Documents/capabilities.pdf.