Management and Organizational Behavior in Healthcare

Ch6aa: Disaster and Crisis

Dr. Ali Rawabdeh, Ph.D

Associate Professor of Health Planning and Management,
Department of Public Administrative Sciences
Faculty of Economics and Administration
Yarmouk University
1st Semester, 2016-2017
Disaster and Crisis

Planning and Management

Planning and Preparing
Logistical Planning
• Federal
• State
• City
• District
• Staff
• Students
• Parents
• Volunteers
• Others
Emergency Preparedness
Emergency situations
can occur at any time,
any place, any where

They can be man made

or natural

They may involve a

single individual or large
populations

They may do minimal or

massive damage
 Basic Emergency Guidelines
Size up the situation
Day
Time
Type of occupancy
Type of construction
Weather
Hazards
Size of area
Number of people
Do not try to rescue anyone unless it is safe for you!
Do not add to the problem by becoming a victim too.
Know your Staff
First Aid/CPR cards –
who has them, who should?
Health restrictions - physical
restrictions or disabilities
Medication concerns – daily, 3 day
supply?
Travelling staff –
personnel and schedules
Parent volunteers
Other concerns
 Safety Concerns
Be part of the solution, not part of the
problem.
Always work in pairs.
Wear protective shoes; keep appropriate
walking shoes with your emergency kit.
Communicate regularly with a partner,
group, leader, and people being rescued.
Review escape plans with staff.
Measures to Ensure Safety
Review District
Bulletins and
Guidelines

Plan for the

unexpected – think
about possible
alternative plans.

Take all practice drills

seriously.
Step One: Triage

Triage is divided into two major

areas
• Psychological Triage
• Medical Triage
 Psychological Triage
Is complex and involves several basic aspects:

The rapid identification of victims in possible

emotional distress.
Establishing priorities for the care of potential
victims.

Psychological triage will be covered later in the Training.

Medical Triage
Medical triage involves
two basic
components:
The identification of
victims at greatest
risk for early death.
Establishing priorities
for the care of large
numbers of victims
START will be used
to evaluate victims
 START Goals
Simple
Rapid
No special skills required
No specific diagnosis
Stabilization provided
Easy to learn and teach
START
(Simple Triage and Rapid Treatment)

What is START?
The START plan is a simple step-
by-step triage and treatment
method to be used by the first
rescuers responding to a mass
casualty incident.
It allows the first responders to
identify victims at greatest risk
for early death.
To provide basic stabilization
maneuvers.
Who Can Use START?
START …
was specifically
designed for basic
emergency personnel.
Other groups may
choose to use START
as the first step in
their triage systems.
START Basics
RPM
Respirations
Perfusion
Mental Status
Where do I start?
 Triage Tag

• is an identification tag used in a multi casualty

incident to prioritize victims for care, (triage).
• is a tag to attach to the victim, with four colored
code strips to prioritized care.
 The Four TRIAGE TAG Colors

Green Strip Minor – bottom strip

-Injuries managed by first aid only
-No hospital care needed at the moment
Yellow Strip Delayed – second from the bottom
-Needs hospital care, but not immediate
Red Strip Immediate – third form the bottom
-Needs emergency care now
-Should receive attention before all others
Black Strip Deceased – fourth from the bottom
-Dead or non-salvageable, No CPR is done
 What do I do first?
Respirations/Ventilation
• Nothing – open airway, still no
breathing, tag black Deceased and
• BLACK
move to the next victim.

• If person starts to breath, tag red

• RED Immediate.
• Respirations 30/minute or higher,
tag red Immediate.
• Respirations under 30/minute, go to
the next step – Perfusion.
Perfusion
Capillary blanch refill test:

Color should return to lips

or nail beds within 2
seconds, if so go to Mental
Status.

If longer than 2 seconds,

tag red Immediate.

Remember - Control Bleeding

 What if the lights are out?
The Radial Pulse may be used in
reduced lighting

If…
• Not palpable, tag red
immediate
• If palpable, go to
Mental Status

Remember - Control Bleeding

Mental Status
Altered mental status,
tag red - Immediate.

Normal mental status,

tag yellow - Delayed.
 Let the Search Begin…
Search Systematically

Never search alone!

Take the proper supplies, equipment, and keys
Select team members according to physical abilities
Never enter a building /room without notifying the command
center first.
When entering a building/room, place a piece of tape on the
door forming the first half of an X - /
Use a consistent systematically room check
When the building/room is clear, complete the X

The Search Team will search first, then become part of the Rescue
Team
Basic Search Equipment
Boxes – one for each search team to store their equipment in
Hard Hats/ Gloves/ Goggles/ Vests/ Backpacks/ Dust Masks/ Whistles/ Maps – one set
per member
Walkie Talkie – at least one per team
Metatags/Triage tags/3x5 cards with safety pins – to tag victims
Clipboards/ pencils/ pens/ markers
Log Sheets – to record victims location and condition
Flashlights – at least one per team, change batteries annually
Masking Tape – to mark doors, people, or ???
Crowbar – to pry open doors and windows, one per team
Light weight rope – to string between team members, rope off an area, secure tents, or ???
START guidelines and Basic Vital Sign Guidelines
Additional Equipment – any items the teem feels is necessary

Remember to store in an easily accessible central location

Steps After Initial TRIAGE

Establish first aid station

Start initial first aid
Reassess the “walking
wounded” and those
previously TRIAGED
 Establishing the 1st Aid Station
Generally divided into four smaller stations

1. Triage/Communication Center – organizes,

records, receives, and directs 1st Aid and rescue
services.
2. Green Station – Minor, treat and release
3. Yellow Station – Delayed, needs hospital care, but
can wait.
4. Red Station – Immediate, needs emergency care
now. Should receive attention first.

Any victim tagged with Black goes directly to

the morgue.
Rescue Team
• Rescue members meet at the
1st Aid station
• The Search Team will join the
Rescue Team, once they have
completed their search
• Each team consists of 2 – 4
members
• Take appropriate equipment -
Stretchers, 1st Aid kits, etc.

No one goes anywhere alone

Questions?
Closing Comments