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CBR Disaster Management

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CBR Disaster Management

  1. 1. Dr Stephanie Schlueter/ Dr Deanne Chiu CME 20th March 2014 Sir Charles Gairdner Hospital Emergency Procedures CODE: CBR PPE
  2. 2. Outline • Case presentation • Brief review of the response of SCGH ED to a CBR incident • Demonstrate PPE required for a CBR response • Practice Donning & Doffing
  3. 3. Case 0810 hrs: RED Phone rings “ This is T.S. from the Department of Health: Canisters containing unknown substances have been detonated at Fraser Restaurant during the CHOGM morning breakfast meeting. Expect Mass Casualties Symptoms range from D&V to full cardiac arrest “ Outline your approach
  4. 4. Emergency Department Process Code Brown/ CBR Phases: 1. Notification 2. Preparation 3. Receival 1. Recovery
  5. 5. Emergency Department Process Code Brown/ CBR Phase 1- Notification • Official phone call • Name, Title and telephone number of caller • Major incident declared or only potential • Exact location of the incident • Type of incident • Hazards • Access to site • Number & type of casualties & expected arrival times • Emergency services (present & required) “ METHANE ”
  6. 6. Emergency Department Process Code Brown/ CBR • Confirmation • DPMU/State Health coordinator • Log onto WEBEOC- http://myeoc.health.gov.au/eoc7 • Activation • Dial “55”- activate Code Brown • Request to speak to Hospital Health Coordinator • Switch will activate Emergency Response Team (ERT) and Emergency Control Group (ECG) • Code CBR announced over PA system
  7. 7. Emergency Department Process Code CBR Objectives: – Modify workflow and resources – Provide the greatest benefit for the most number of casualties – To provide a Hospital Response Team (HRT) +/- Health Commander if requested – To return to a normal working environment as soon as possible – To attend to welfare of relatives of patients and staff
  8. 8. Emergency Department Process Code CBR Phase 2- Preparation • Meet with Emergency Response Team • Review Code CBR Plans & Equipment • Hospital Lockdown • Brief ED staff • Command and Communication • Action Cards • Prepare space • Decanting ED safely • Rearrangement of geographic function • Teleconference • Expand Resources • Staff • Hospital • Equipment
  9. 9. Donning PPE- CBR • One Piece Positive Pressure Coverall • Inner Butyl Gloves • Pipe • GIAT PAPR - Respirator C420 • Belt Assembly • 2 Filter Cartridges per unit • Lithium Battery
  10. 10. Before you get started • Response Briefing - Know what you are going to do! • Change into scrubs • Drink 2 glass of water • Go to the toilet • Have your vital signs taken by the Safety Officer
  11. 11. PPE Heat Load Generation - Body temperature rises 1.5 times as fast. - Heart rate increases 80 per cent. - Endurance times are reduced by 60 per cent. - Weight loss is 40 per cent higher. - Perspiration evaporation is halved
  12. 12. Heat related illness • Warning signs will include: • Changes in gait (staggering), • Changes in speech (slurring) • Changes in behaviour (erratic) Many of these difficult to monitor in PPE – this makes observation by “buddy” and use of a safety officer important.
  13. 13. PPE Hazards • Impaired visibility • Impaired mobility • Impaired communication • Sensory Impairment • Psychological stresses (such as claustrophobia).
  14. 14. OHS- Requirements • Maximum work time in PPE 30 minutes • Minimum rest time 30 minutes • Rest area If any person is injured/unwell/feeling faint: • Sit down where you are • CODE WORD: NO DUFF • All participants to stop what they are doing & await further instructions • Exercise Controller to assess injured; and announces if exercise resumes if safe to do so
  15. 15. Doffing • Always self decontaminate in the suit first • The suit and PAPR are waterproof • Undo your boots and unzip the suit to your waist • Undo your PAPR belt • Remove your arms from the sleeves and lift your head off - Try to touch the inside of the suit only • Step out of the suit • Continue decontaminating
  16. 16. QUESTIONS
  17. 17. Summary • Challenging & overwhelming situation • Be familiar with the Emergency Procedures Manual • Regular practice of Donning & Doffing for medical staff is essential • Your safety 1st !!! • Participate in any Disaster Exercise & MIMMS course
  18. 18. References 1. MIMMS Handbook, 2nd Edition 2. SCGH – CODE CBR , Emergency Procedures Manual, July 2009 3. Emergency Management Australia Victoria DoH Health Services Personal Protective Equipment and Decontamination Hospital Staff Training Course Presenters Guide A special thanks to • Simone Thurkle (SDN) • Gaby Hutchinson (SDN • Emma Kubale (SDN) for their time, experience and materials in preparation of this exercise.