Disaster Planning and Organization Dr. Eric Goedecke Asst. Professor of Emergency Medicine.

Disaster Planning and Organization

Dr. Eric GoedeckeAsst. Professor of Emergency Medicine

Learning Objectives

• Steps of disaster planning• Concepts in management planning and

interventions

Quetzaltenango, Guatemala, Noviembre 2009. 2

Steps of Disaster Planning

• Planning• Resource assessment• Risk and hazard analysis


Risk and Hazard Analysis

• Assessment of threats to the locality– Geographic– Building– Population cluster

• Children groups– Day care or schools– Summer camps– Field trips



Environmental Hazards• Weather– Tornados– Hurricanes

• Geographic– Earthquakes– Flood plains


Quetzaltenango, Guatemala, Noviembre 2009.

Table 3.1 Selected natural disasters in Latin America and the Caribbean, 1970-1993.

Year Country Type of disaster

No. of reported

Estimated no. of affected people

1970 Peru Earthquake 67,000 3,139,000

1972 Nicaragua Earthquake 10,000 400,000

1974 Honduras Hurricane (Fifi)

7,000 15,000

1976 Guatemala Earthquake 23,000 1,200,000

1979 Dominica Hurricane (David)

38 81,000

1979 Dominican Republic Hurricane (Frederick)

1,400 1,200,000

1980 Haiti Hurricane (Allen)

220 330,000

1982 Mexico Volcanic Eruption

1,770 60,000

1985 Chile Earthquake 180 1,000,000

1985 Mexico Earthquake 10,000 60,000

1985 Colombia Volcanic Eruption

23,000 200,000

1986 El Salvador Earthquake 1,100 500,000

1987 Ecuador Earthquake 300 150,000

1987 Dominican Republic Hurricane (Emily)

3 50,000

1988 Brazil Flood 355 108,000

1988 Jamaica Hurricane (Gilbert)

45 500,000

1988 Mexico Hurricane (Gilbert)

225 200,000

1988 Nicaragua Hurricane (Joan)

116 185,000

1989 Antigua, Guadeloupe, Montserrat, Puerto Rico, St. Kitts and Nevis, U.S.A., U.S. Virgin Islands

Hurricane (Hugo)

56 220,000

1990 Peru Earthquake 21 130,000

1991 Costa Rica Earthquake 51 19,700

1992 Nicaragua Tsunami 116 13,500

1993 Honduras Tropical Storm (Gert)

103 11,000

Source: PAHO/WHO: OFDA/USAID; DHA/Geneva: Atlas Nacional de Riesgos de México.

7


Man-made Hazards• Chemicals– Production, storage and transport

• Biologic hazards• Terrorism

Transportation Hazards• Materials• Mass transit centers


Resource Assessment

• Local resources– EMS– Police– Fire department– Cruz Rojas

• Volunteers– Rotary Club

• Children’s advocacy groups


Resource Assessment

• National– Cruz Rojas– FEMA– DMAT – National Police

• Agencies and unions– College of Physicians and Surgeons– Nurses


www.fema.gov/areyouready


Resource Needs

• Personnel– Pediatric specialists (if available)

• Equipment

• Supplies: water, food, blankets

• Shelter

• Suppliers with contact source– Back-up suppliers and contact sources


Resource Needs

• Communications– Equipment and personnel

– Telephone company/cell phones often overload

– Ham radio / alternative methods


Resource Needs

• Transportation– Roads– Vehicles, public and private

• Maintaining access for emergency vehicles often problematic


Planning is a Dynamic Process

• Plan before, during and after• Contingency planning• Continued revising


Plan Ahead

• Resource assessment– Be realistic about resources not already committed to

the disaster

– Know local limits• When and how to call for outside resources

– Scale of response


Plan Ahead

• Discuss with groups / individuals– Identify problems– Find options– Keep updated on response abilities

• Resources and personnel• Vary by incident


Plan Ahead

• Involve all potential participants– Don’t overlook potential resources– Avoid improper assumptions

• Regular planning meetings– Risks of area– Unforeseen events


Planning Exercises

• Look for deficiencies• Single components vs. multi-group– Moulage useful but complex– Inter-group cooperation


Planning after Exercise

• Debriefing after exercise– Share information– Improve plan– Ensure dissemination of changes to plans

• Honest not defensive feedback from all


During the Disaster

• Constant revision of plan– New risks and resources– Loss of resources

• Flexibility– Alternate uses of resources– Alternate ways of transporting patient to resources or

resources to patient


Incident Command System

IncidentIncidentCommanderCommander

PlanningPlanning CommandCommandStaffStaff

FinanceFinance

LogisticsLogistics OperationsOperations


Incident Command System

• Identified central commander with limited scope of control– leave chain of command for smaller groups intact

• Unified command• Modular system• Expand as needed


Medical control - Decisions

• Disaster interventions differ from everyday– less information– more victims– different priorities

• Stress for responders• “Greatest good to greatest number”

– may not be optimal care for each person

• Triage/treatment protocols for childrenwill help providers


Documentation

• Need to provide permanent record• Transfer of information from field to base hospital• Limit information – will lose some details


Documentation problems

• Data loss / inaccuracies• Patient limitations - unable to obtain / convey

accurate information• Multicopy permanent record• Deterioration of record• Identifying the nameless victim


Documentation uses

• To track patient movements• To reunite families• Epidemiological studies• Evaluation and post disaster critique• Long term sequelae and resupply


Conclusion

• Planning– risk / hazard analysis– resource assessment– planning is a dynamic process

• Incident Command System


Disaster Planning and Organization Dr. Eric Goedecke Asst. Professor of Emergency Medicine.

Documents

Transcript of Disaster Planning and Organization Dr. Eric Goedecke Asst. Professor of Emergency Medicine.