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Disaster Management UCLA

Disaster Management Nursing 431

Robert Borja

on 13 July 2016

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Transcript of Disaster Management UCLA

Internal Disaster Triage Plan
Internal Code Triage
UCLA - Ronald Reagan Medical Center
Responsibilities Within The Departments
What's an External Code Triage?
Instructions are given over to the facilities departments through the email, overhead page system, emergency radio network, dept. intercom system, telephone and by runners.

HICS responders are informed about what is going on by the incident commander or. Once they are informed about the event they take the following actions:

1. Receive code triage activation notification via phone

2. Call the HICS code triage hotline and let them know the time of arrival to the medical center.

3. Then implement the jobs and activities that are required in their disaster plan.

This specific code is designed for disasters or emergencies that occur in the community external to the facility. This is created to ensure continuous care for the patients currently in the hospital as well as responding to the community needs. Staff members should anticipate and prepare for casualties coming to the medical center.
Wednesday, October 7, 2015
Vol XCIII, No. 311
What is a Disaster?
UCLA MC - Are They Disaster Ready?
A Disaster is an unexpected event that occurs causing serious disruption of the functioning and of a community or society.

It causes considerable amount of damage to people physically, mentally and emotionally.

The healthcare field specifically plays a vital role in disasters prevention, preparedness, response and recovery for the individual as well as for the public.

UCLA medical center has a department called Emergency Preparedness that develop and test responses to internal and external emergencies.
: is to create emergency and disaster response plans that can immediately function during and after a disaster.

Director, Medical Center
Director, Neuropsychiatric Hospital
Administrator-on-call, Triage Officers
Safety Officer/Safety Department Officer
Disaster Committee
Medical Staff Executive Committee
Department Heads
Hospital Incident Command System (HICS) Responders


Director, Medical Center
-Responsible for the Emergency Management Program
-Serves as Incident Commander during a declared disaster
Director, Neuropsychiatric Hospital
-Responsible for the NPH Emergency Management Program
-Serves as Incident Commander and Operations Chief
Admin-on-call, Triage Officers
-Consulted outside normal work hours
-Can declare a Code Triage disaster and activate EMP
Safety Officer/Safety Department Officer
-Acts on behalf of Medical Center Admin in their absence
Disaster Committee
-Oversight responbility
-Reviews Hazard Vulnerability Analysis
-Oversees drill planning
Medical Staff Executive Committee
-Reviews and approves EMP
Department Heads
-Leads appropriate response from staff to protect patients,
staff, visitors, and property
-Implement Department Disaster Plan
-Ensure patient safety and staff
-Assess areas, supplies, resources, staff
HICS Responders
-Notified via pager and directed to call Code Triage Hotline
for ETA.
-Perform duties in relation to command post and both
Medical and Neuropsychiatric Medical Center.
-Each responder has specific duties listed in their
job action sheets.

What is a Code Triage?
Code Triage
- The purpose of this is to establish a set of procedures that should be acted on when responding to an emergency or disaster.
For both
internal and external triage
UCLA uses the Hospital Incident command system (HICS) to design the facilities response and recover to disasters. During and after an emergency or disaster occurs the staff should make sure to protect themselves, other staff members, patients and visitors.
must be
ready to participate in things that are different than

their normal everyday duties
Internal Code Triage
This specific code triage is designed for disasters that may occur inside or next to the hospital’s facilities, which can affect patient care and the safety of the staff, patients and visitors.
Code is activated when the normal hospitals operations are interrupted due to a disaster or emergency. During an internal code triage all staff members are not supposed to go home even if their shift is over. Additionally certain departments go through their inventory of resources, supplies and staff members.

Plan Activation
- The only people that are allowed to call a code triage are:
Health system director
Chief medical officer
Chief operating officer
On call administrator
Nurse supervisor
Emergency dept. faculty
The physician on duty.

Articles by: Shoshana Levine, Veronica Hinze, Christy Wishingrad, Robert Borja & Brandon Ro
Internal Code Triage Cont.
Multi-Department Response System
: During this time the medical care unit leader or medical care director -
organize and direct the delivery of medical care in all areas of the hospital. They do this by prioritizing and assigning the doctors to go to where the care is being given. Their job also entails informing the incident commander of any issues with the medical staff.

Department heads
: They are notified by the incident commander and their duties entail:
1. Ensure the safety of the patients, staff and visitors
2. Assess the impact of the event and their ability to provide for the patients and give that information to the Command center.
3. Then implement the disaster plan
4. Follow the directions from the command center
5. Assess the area, supplies, staff, and resources and inform the command center.
6. Department heads sometimes are asked to work past their normal shift.

: On duty staff are notified about the emergency by an overhead page announcements, pager, email, phone, or verbally.
Once they are informed the staff member’s duties are to continue to listen to the announcements and directions.
They also need to provide safety, comfort and care for all patients, staff and visitors. Staff members also may be asked to work longer hours than normal.

: Off duty staff is notified about the emergency or disaster by telephone or pager.
Once they are notified they are to ensure protection and safety of their home and families.
They should also call the disaster hotline to get the status reports and updates.

Plan Activation
- Activation of an external triage code is done as soon as they are informed via hearing, radio systems, the media, or first responder agencies.
Instructions are given over through email, overhead page system, emergency radio network, intercom systems, telephones and runners.

- same as above in internal code triage

- same as above in internal code triage

Department heads
- same as above in internal code triage

- same as above in internal code triage

- same as above in internal code triage

External Triage at Work!
What Does This All Mean??
Interruption of Services
Failure of communication and/or IT system
Communications dept contacted if phone service (phone/pager) is disrupted
Contact MCCS to report failure of IT system
Initiate information systems downtime procedure

Alternate methods
of communication during communication failure or disruption
Utilize Essential Line Service (ELS) phones located at nursing stations
If ELS and phones are disabled, use disaster phone located in ICU conference room on each floor
If all phone systems are disabled, appoint runners to communicate to Hospital Incident Command Center
NEXTEL phones may be used

If computer systems are down, use information systems downtime procedures
Use ELS phones for critical communication functions or lab ordering
Appoint runners to communicate to Hospital Incident Command Center and/or areas essential for patient care
NEXTEL phones can also be used

Nurse Call
Notify Facilities if Nurse Call system fails
Identify most critical patients and deploy staff to monitor patients in hall between rooms
Contact Nursing Supervisor/Nursing Office if additional staffing is needed

Biomedical Equipment Failure
Contact clinical engineers

Authority and Responsibility
Communications With External Services
Fire Departments
Hazardous Material Spills Response Teams
Law Enforcement, and Dept of Health Services

Safety Officer
informs the Dept of Licensing and Policy of any kind of patient care that is affected and the Dept of Health Services is notified

Incident Commander

notifies, coordinates and communicates with off-site external agencies
May also delegate these tasks to other Command Posts or individuals

The following list represents events with their respecting external agencies:

Biohazardous Material Spill, Release or Exposure
Campus HazMat Spill Response Team
Fire Dept HazMat Spill Response Team

Bioterrorism Event
UCLA police/external law enforecement
Campus HazMat Response Team
Campus Transportation Services
Dept of Health Services

Bomb Threat/Suspicious Package
UCLA police

Chemical Spill, Release, or Exposure
Campus HazMat Spill Response Team
Fire Dept Hazardous Materials Spill Response Team

Chemical Terrorism Event
UCLA police/ external law

External agencies include:

STAFFING...What is it Good For?
: notified of emergency/disaster via overhead announcement, pager, email, etc.
Upon notification; 4 steps:
a) Listen to announcement/Directions
b) Perform Duties in Department Disaster Plan
c) Provide for Patients, Staff & Visitors
d) Work Longer than Normal Shift
e) Obtain Supplies Normally
: notified of internal emergency/disaster by telephone, pager, etc.
Upon notification, 2 steps:
a) Provide for Homes/Families
b) Call Disaster Hotline (310-206-3232)
Staff Reporting for Duty
: reporting to the Medical Center for duty should:
a) Wear Photo ID
b) Park in Designated Area
c) Report to Department
- If reporting during an extended, multi-day, event you may bring dependents for
whom care will be provided by the HICS Dependent Care Leader & Child Life Development
- HICS Psychological Support Leader, clinical social work, spiritual care & faculty
& staff from Neuropsychiatric Hospital provide psychological support & incident stress debriefing
during & after the event.
- All efforts will be made to identify & provide lodging for staff who are either working
extended shifts in support of the disaster response or are unable to return home due to damage,
We've got stacks of assignments!!
Identification of staff available to assist in a disaster at the department level is the responsibility of each department.
1 staff member to every 10 visitors to escort them down the stairs.
Here is a little video that will give you an idea of what is done during a disaster
Hospital Emergency Incident Command System
California Emergency Medical Services Authority. (2014). Emergency Medical Services Authority - Hospital Incident Command System - Main. Retrieved from http://www.emsa.ca.gov/disaster_medical_services_division_hospital_incident_command_system
California Hospital Association. (2011). Emergency Preparedness - preparing hospitals for disasters. Retrieved from http://www.calhospitalprepare.org/
Disaster Preparedness | American Red Cross | International Red Cross. (2015). Retrieved from http://www.redcross.org/what-we-do/international-services/disaster-preparedness
UCLA Health. (2007, November 5). UCLA Med Ctr Participates in Military Disaster Drill [Video file]. Retrieved from
Veenema, T. G. (2012). Disaster nursing and emergency preparedness for chemical, biological, and radiological terrorism and other hazards. New York: Springer Pub. Co.
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