States: Andhra Pradesh Assam Bihar Gujarat Madhya Pradesh Maharashtra Orissa Rajasthan Tripura West Bengal   Home  |  Checklists  |  Case studies  |  Volunteer    Search:   Checklist for health personnel Back to Disaster Checklist>>           Following steps/procedures are recommended for the health personnel:       Every hospital should follow The Guide to Health Management in Disaster. A special plan should be developed for facilities, equipment and staff of each hospital. Selected personnel can be deputed for training as nodal officers and officers-in-charge at the state and district level respectively         Hospital staff should be aware of damage-proof hospital rooms and buildings The safest rooms are likely to be     on the ground floor/open ground   in the centre of the building away from windows   with concrete ceilings         All personnel required for disaster management should work under the overall supervision and guidance of the district disaster manager         Personnel working within the district should come under the direction and control of the collector/civil surgeon         Radio communication should be established with emergency preparation centres, divisional commissioners, district control rooms and hospitals within the division         Department vehicles should be refuelled and parked in protected/safe areas       Top     Emergency medical equipment and drugs should be stocked before the onset of disaster. These can be categorised as:       Drugs For cuts, fractures, diarrhoea, water-borne diseases and dehydration (including Oral Rehydration Solution), burns and infections   For detoxification including breathing equipment   Tetanus toxoid (TT), analgesics and antibiotics         Equipment   Fissure material   Surgical dressings   Splints   Plastic rolls   Disposable needles and syringes   Local antiseptics   Gloves and masks         Every hospital should have standby generators         At least one kerosene powered refrigeration unit should be available to store vaccines         All ambulatory patients whose release does not pose a health risk should be discharged, and if possible, should be transported to their homes       Top     Candles, matches, lanterns and extra clothing should be provided for the comfort of patients         Surgical packs should be assembled and sterilised. A large number should be sterilised to last for four to five days. These sterilised packs should be stored in protective cabinets or boxes covered with polythene.         All valuable instruments, such as surgical tools, ophthalmoscopes, portable sterilisers, dental equipment, etc should be packed in protective covering and stored in damage-proof rooms         All immovable equipment, such as x-ray machines, should be protected with tarpaulins or polythene covers         All electrical equipment should be unplugged on receiving a disaster warning         ·All equipment needed for bone/cartilage fracture should be kept ready         Emergency supply of anaesthetic should be arranged on a daily basis         Hospital water storage tanks should be filled to capacity and the community encouraged to save water. Drinking water should be stored in clean containers.       Top     A special area of the hospital should be demarcated for receiving large numbers of causalities         Emergency admission procedures should be developed         Hospital administrators should     establish work schedules to ensure that adequate staff is available for in-patient's needs   organise in-house emergency medical teams to ensure that adequate staff is available round the clock to handle emergency causalities   set-up team of doctors, nurses and dressers for visiting disaster sites          RELIEF GUIDELINES         Health facility and treatment centres should be established at disaster sites         During the threat or existence of an epidemic, check posts and surveillance should be maintained at all railway junctions, state transport depots and all entry and exit points from the affected area         Transport should be arranged to transfer seriously injured patients from villages and peripheral hospitals to the general hospital. In case of blocked roads, arrangements should be made to establish helicopter contact.         Medical services should be co-ordinated by the district civil surgeon through the district control room and the site operation centre         Procedures should be clarified between     peripheral hospitals   private hospitals   blood banks   general hospital         Health services should be established at transit camps, relief camps and the affected villages         Emergency accommodation for auxiliary staff from outside the area should be planned in advance         Continuous monitoring should be done of epidemics, water and food quality, disposal of waste in transit and relief camps, feeding centres and affected villages         The local police, rescue groups and ambulance teams should be aware of resources available in each hospital         Security arrangements should be sought from district police authorities, to keep curious people from entering hospital area and protect staff from hostile actions       Top      TAGGING           Tagging is a process of prioritising transfer of injured, based on first hand assessment of the medical officer at the disaster site.     It is based on the medical criterion of chances of survival. The injured are classified into:     Cases that can await treatment   Cases that need to be taken to more appropriate medical units   Cases that have no chance of survival     Grouping is based on the benefit that the injured can derive from medical care and not on the seriousness of the injuries.     Whenever possible, tagging should be done concurrently with the identification of patients. Tagging involves attaching a tag to each patient, usually colour-coded to indicate a degree of injury and the priority for evacuation.           Red tag     Signifies that the patient has first priority for evacuation. Red-tagged patients need immediate care and fall into one of the following categories:     Breathing problems that cannot be treated at the site   Cardiac arrest   Appreciable loss of blood (more than a litre)   Loss of consciousness   Thoracic perforations or deep abdominal injuries   Certain serious fractures:     Pelvic   Thoracic   Fractures of the cervical vertebrae   Fractures or dislocation in which no pulse can be detected below the site of the fracture or dislocation   Severe concussion   Burns along with injury to the air passage       Top       Green tag     Signifies that the patient has second priority for evacuation. Such patients require care but the injuries are not life- threatening. They fall into the following categories:     Second degree burns covering more than 30 per cent of the body   Third degree burns covering 10 per cent of the body. The critical areas are hands, feet, face but there are no breathing problems   Burns complicated by major lesions to soft tissue, or minor fractures   Moderate loss of blood (500-1,000 ml)   Dorsal lesions, with or without injury to the spinal column   Conscious patients with significant mental confusion. They may have:     Secretion of spinal fluid through ear or nose   Rapid increase in systolic pressure   Projectile vomiting   Changes in respiratory frequency   Pulse below 60 ppm   Swelling or bruising beneath the eyes   Anisocoric pupils   Collapse   Weak or no motor response   Weak reaction to sensory stimulation       Top       Yellow tag     Signifies that the patient has third priority for evacuation. They fall into the following categories:     Minor lesions     Minor fractures i.e. fingers, teeth etc.   Other minor lesions, abrasions, contusions.   Minor burns:     Second degree burns covering less than 15 per cent of the body   Third degree burns covering less than two per cent of the body surface   First degree burns covering less than 20 per cent of the body, excluding hands, feet, and face           Fatal injuries     Burns with second and third degree over more than 40 per cent of the body, death being reasonably certain   Second and third degree burns over more than 40 per cent of the body; with other major lesions, as well as major fractures, major cerebral and thoracic lesions   Cranial lesion with brain tissue exposed, patients unconscious, lesions of the spinal column with absence of sensitivity and movement   Patients over 60 years with major lesions       Top       Black tag     Black tags are placed on the dead i.e. casualties with no pulse or respiration for more than 20 minutes, or whose injuries render resuscitation procedures impossible.   Evacuation procedures for tagged patients     Casualties not trapped or buried are to be evacuated in the following order:     Red-tag casualties   Green-tag casualties   Yellow-tag casualties         Casualties trapped or buried are be evacuated in the following order:     Red-tag casualties   Green-tag casualties   Yellow-tag casualties   Black-tag casualties   Trapped black-tag casualties             Top         ||   About InfoChange  |  About Norwegian Church Aid  |  Contact us  ||

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