Shell Gresik Terminal - Trading & Supply

PT. Shell Indonesia

Local Operating Procedure

011-HSE-L203E-03
Medical Emergency Response Procedure

Author:
Terminal Compliance Lead Harman Prasongko

Approved:
Terminal Manager Agung Purwanto

Printed versions of the documents are for reference only and are subject to change at any time. It is the
responsibility of all users to verify the printed version against the electronic copy.
Medical Emergency Response Procedure Dept Code : HSE
Shell Gresik Terminal 011-HSE-L203E-03 Revision No.3
Date: April 2018 Page 2 of 17

Revision Record
Document Name : Emergency Response Module for Medical Emergency Scenarios

             
Rev Responsible Person
Date Description of Change
No.

0 17/04/2018 Harman Prasongko Initial Release

Updating scenarios as per

1 18/08/2018 Harman Prasongko
ER Management review

2 21/08/2018 Harman Prasongko  Update per review from

Health Team

3 05/01/2019 Agung Purwanto Update personnel

4 19/02/2019 Agung Purwanto Update Pandemic Scenario

   
5  
   

This document shall be reviewed three years after the last amendment date written above.
Next Review: 05/01/21

Distribution List
Doddy S. Muntaha, Facilities Manager
Harman Prasongko, Terminal Operations Support Lead
Iip Sufriza, T&S Indonesia HSSE Advisor
Dr. Lusiana Sanjaya, Indonesia Health manager
Andrea Rubiana, OH Physician Indonesia
Nuraini Weers, OH Nurse Indonesia
Sapto Nugroho, OH Nurse Indonesia
Andri Meiyanto, Terminal Ops Spv – Gresik
Medical Emergency Response Procedure Dept Code : HSE
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1.0 BACKGROUND

The medical emergency response procedure is made to give a clear guidance to

response toward incident which resulted in personnel injury, to prevent the escalation of
the injury into a life-threatening situation.

As per the HSSE & SP Control framework, the emergency response procedure specific
to the medical scenario has to be able to demonstrate several key actions:
1. First aid treatment including defibrillation by a Designated First Aider within 4
minutes.
2. Assessment and stabilization by a medical emergency professional within 1 hour
3. Admission to and care at the nearest local hospital within 4 hours
4. Referral to an appropriate specialist hospital (casualty specific)

It is important to the Incident Commander and Emergency Response Team (including

the First Aider Personnel) to understand above requirement to ensure the right response
and treatment to the injured personnel to prevent the escalation of the injury into a life-
threatening situation as well as to prevent escalation resulted by wrong response
management.

Below is the list of Credible Scenario for Medical Emergencies

1. Medical emergency at jetty
2. Medical emergency at terminal
3. Response to wound and bleeding
4. Response to muscles and bones (traumatic) injury
5. Response to burn injury
6. Response to loss of consciousness / shock
7. Response to animal bite / sting
8. Response to pandemic / virus outbreak

Below is the list of Largest Credible Scenario for Medical Emergencies

1. Multiple Casualties

The medical emergency response Emergencies at Terminal procedure is shown on the

flow diagram (in Bahasa).

Responden Pertama yang mengidentifikasi Korban NOMOR YANG BISA

 Buat penilaian awal DIHUBUNGI
 Mengamankan area sekitar ---------------------------------------------
 Hubungi First Aider yang ditunjuk TERMINAL CONTROL ROOM
 Informasikan ke Supervisor Telp: 031-3930772
031-3930773
 Menemani korban hingga First Aider tiba di tempat kejadian
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RADIO CHANNEL 2
First Aider tiba di tempat Korban RADIO CHANNEL 1 (pada saat
 Memeriksa Korban operasional Kapal)
 Memberikan pertolongan awal ---------------------------------------------
 Menilai apakah perlu aktivasi Tier 2-3 TEAM FIRST AIDER
 Jika YA, hubungi Remote Medical Support untuk meminta  Luke Kusmandari
bantuan dari Rumah Sakit Tier 2 (RS. Semen Gresik) dengan  Team Operator Terminal
menggunakan Laporan Darurat Medis terlampir ---------------------------------------------
REMOTE MEDICAL SUPPORT
GLOBAL ASSISTANCE &
Medical Emergency HEALTHCARE
Report.pdf Cibis Nine Office Tower, Ground
 Informasikan ke Terminal Manager Floor
Jl. TB Simatupang No. 2, Cilandak
 Menemani korban hingga team RS Semen Gresik tiba di
Pasar Minggu, Jakarta 12560
tempat kejadian
ALARM CENTER /
EMERGENCY CALL:
Profesional Tier 2 tiba di tempat Korban
+62 21 299 78999
 Memberikan perawatan dan pengobatan
 Membawa korban ke RS Semen Gresik P : +62 21 299 78988
 Menilai apakah evakuasi medis Tier 3 diperlukan F : +62 21 299 78 956
 Jika YA, informasikan ke Terminal Manager E : nurse@global-assistance.net
 Evakuasi korban cidera ke Rumah Sakit Tier 3 (RS. Premier W : fullertonhealth.com
Surabaya) ---------------------------------------------
RUMAH SAKIT TIER 2
RS. Semen Gresik
Nomor Penting Jl. RA Kartini No.280, Gresik
 Agung Purwanto (Terminal Manager) 61111
+628111553477 Telp: 031-3971818 (ER)
 Andri Meiyanto (Head Warden) 031-3987840 Ext 6154 (ER)
08119622116 031-3987841 (Hunting)
 Luke Kusmandari (First Aider)
081333133147 ---------------------------------------------
 Iip Sufriza (HSSE Advisor) RUMAH SAKIT TIER 3
08118490957 RS. Premier Surabaya
 Dr. Lusiana Sanjaya (Health Manager) Jl. Nginden Intan Barat Blok B,
08118694501 Surabaya 60118
Telp: 031-5993211

2.0 LOCATION ADDRESS

Shell Gresik Terminal - Gresik, Indonesia

Kawasan Industri Maspion, Jalan Beta Blok E-07, Manyar, Gresik
Telepon: 031-3930772, 031-3930773

3.0 MEDICAL EVACUATION ROUTE

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3.1 Terminal to RS Semen Gresik

Thru public road with fair condition and take around 20-30 minutes.
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3.2 RS Semen Gresik to RS Premier Surabaya
Thru public and toll road with good condition and take around 50-60 minutes.
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4. FIRST SURVEY BY FIRST AIDER

The first survey or screening steps is defined as DRCAB. This needs to be done by the
trained first aider before providing first aid measures to the victims.

The steps include:

D – Danger
Make sure the environment around the victim is safe for the first aider to perform the first aid
measures.

R – Response
Check victim consciousness by tapping into the victim’s shoulders and calling the name.
If the victim is conscious, they will response and let them know that the as the first aider, we
will help them.
If no response, victim will remain still. Call medical service provider asap; in a while, first aider
shall check the victim’s breath by checking the chest / abdominal movements for around 5 –
10 minutes.

C-Compression
If the victim is not breathing or had a gasping, perform chest compression.

A-Airway
Open the victim’s airway

B-Breathing
Perform breathing assistant for the victim
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5. PROCEDURE FOR POSSIBLE CREDIBLE SCENARIO

Medical Emergency at Jetty

No Mitigating Steps Remarks

1 Upon activation of terminal emergency response team, personnel on
site give clear information regarding the situations to the Incident
commander.
2 Inform the victim condition to supervisor on duty. (Consciousness,
injury/wound, etc.), upon receive emergencies information supervisor
on duty inform the terminal manager.
3 Terminal manager activate medical ER team and instruct the medical
officer for first aider team deployment.
4 After activation of Medical ER, the first aider on duty response the
activation and proceed to emergency site and immediately treat the
victim.
5 Terminal manager call the SMT first aider team to give prompt first
aid treatment to the victim.
First aider shall conduct assessment and look for victim symptoms.

In case heart attack signs are observed, first aider to conduct Appendix 1 -
minimum aid response to heart attack victims which also include the How to use
use of AED device. Only authorized first aider trained to use the AED AED
device is permissioned to conduct this response, until further medical
support arrived. Since the jetty area classified as Zone 1 & Zone 2
area, Gas test shall be conducted to ensure the area is free from gas Appendix 2 -
when using the AED device. Treating Heat
Exhaustion,
In case heat exhaustion or heat stroke signs are observed, Heat Stroke &
Perform first aid measures refer to attached document Hypothermia
6 First aider treats the victim and provides information to incident
controller regarding the severity of victim’s injury.
7 First aiders evacuate the victim to the medical evacuation point (SMT
office Post 3 approximately 750 meters from jetty head) and stand by
until medical assistance arrived.
8 In case the victim couldn’t be evacuated to the medical evacuation
point, the medical assistance (ambulance) can be deployed to jetty
head post 4 through jetty trestle, all operations in jetty 4 should be
suspended if necessary
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Medical Emergency at Terminal

No Mitigating Steps Remarks

1 Upon notice the injured personnel, inform supervisor on duty or
manager by portable radio regarding the medical emergencies.
2 Terminal manager activate medical ER team and instruct the
medical officer for first aider team deployment.
3 Safely stop on going operation related with the emergencies.
4 Incase further extent of emergencies (fire, toxic vapor release, etc.)
evacuate the victim to safe place.
5 Upon activation of terminal emergency response team, personnel
on site give clear information regarding the situations to the Incident
commander.
6 Inform the victim condition to supervisor on duty. (Consciousness,
injury/wound, etc.), upon receive emergencies information
supervisor on duty inform the terminal manager.
7 After activation of Medical ER, the first aider on duty response the
activation and proceed to emergency site and immediately treat the
victim.

In case heart attack signs are observed, first aider to conduct Appendix 1 -
minimum aid response to heart attack victims which also include the How to use
use of AED device. Only authorized first aider trained to use the AED
AED device is permissioned to conduct this response, until further
medical support arrived. If the response required to be conducted at
Zone 1 & Zone 2 area, Gas test shall be conducted to ensure the Appendix 2 -
area is free from gas when using the AED device. Treating Heat
Exhaustion,
In case heat exhaustion or heat stroke signs are observed, Heat Stroke &
Perform first aid measures refer to attached document Hypothermia
8 Ask historian to contact medical assistance from local hospital,
ambulance, SOS, etc. based on the information from first aider
regarding the severity of the victim.
9 First aider treats the victim and provides information to medical
officer & incident controller regarding the severity of victim’s injury.
10 First aiders evacuate the victim to the medical evacuation point
(office lobby) and stand by until medical assistance/ambulance
arrived.
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Response to Wound and Bleeding

No Mitigating Steps Remarks

1 Upon activation of terminal emergency response team, personnel on
site give clear information regarding the situations to the Incident
commander.
2 Inform the victim condition to supervisor on duty. (Consciousness,
injury/wound, etc.), upon receive emergencies information supervisor
on duty inform the terminal manager.
3 Terminal manager activate medical ER team and instruct the medical
officer for first aider team deployment.
4 After activation of Medical ER, the first aider on duty response the
activation and proceed to emergency site and immediately treat the
victim.
5 First Aider conduct the first screening by applying DRCAB steps
mentioned at the chapter 4
6 The first aider provides the first aid measures to treat wound and Appendix 3 -
bleeding, referring into the attached document Treating
Wound &
Bleeding
7 In case the victims condition requires tier 2 support, contact the
hospital and ambulance service for evacuation to Tier 2 medical
support
8 Accompany the victim until ambulance arrives
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Response to Muscles and Bones (Traumatic) Injury

Applicable to Sprain, Strain, Dislocation and Fracture

No Mitigating Steps Remarks

1 Upon activation of terminal emergency response team, personnel on
site give clear information regarding the situations to the Incident
commander.
2 Inform the victim condition to supervisor on duty. (Consciousness,
injury/wound, etc.), upon receive emergencies information supervisor
on duty inform the terminal manager.
3 Terminal manager activate medical ER team and instruct the medical
officer for first aider team deployment.
4 After activation of Medical ER, the first aider on duty response the
activation and proceed to emergency site and immediately treat the
victim.
5 First Aider conduct the first screening by applying DRCAB steps
mentioned at the chapter 4
6 The first aider provides the first aid measures for fracture injury, Appendix 4 -
referring into the attached document Treating
Muscles and
Bones Injury
7 In case the victims condition requires tier 2 support, contact the
hospital and ambulance service for evacuation to Tier 2 medical
support
8 Accompany the victim until ambulance arrives
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Response to Burn Injury

Applicable for light, heavy and serious burn

No Mitigating Steps Remarks

1 Upon activation of terminal emergency response team, personnel on
site give clear information regarding the situations to the Incident
commander.
2 Inform the victim condition to supervisor on duty. (Consciousness,
injury/wound, etc.), upon receive emergencies information supervisor
on duty inform the terminal manager.
3 Terminal manager activate medical ER team and instruct the medical
officer for first aider team deployment.
4 After activation of Medical ER, the first aider on duty response the
activation and proceed to emergency site and immediately treat the
victim.
5 First Aider conduct the first screening by applying DRCAB steps
mentioned at the chapter 4
6 The first aider provides the first aid measures for burn injury, referring Appendix 5 -
into the attached document Treating Burn
Injury
7 In case the victims condition requires tier 2 support, contact the
hospital and ambulance service for evacuation to Tier 2 medical
support
8 Accompany the victim until ambulance arrives
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Response to Loss of Consciousness / Shock

No Mitigating Steps Remarks

1 Upon activation of terminal emergency response team, personnel on
site give clear information regarding the situations to the Incident
commander.
2 Inform the victim condition to supervisor on duty. (Consciousness,
injury/wound, etc.), upon receive emergencies information supervisor
on duty inform the terminal manager.
3 Terminal manager activate medical ER team and instruct the medical
officer for first aider team deployment.
4 After activation of Medical ER, the first aider on duty response the
activation and proceed to emergency site and immediately treat the
victim.
5 First Aider conduct the first screening by applying DRCAB steps
mentioned at the chapter 4
6 The first aider provides the first aid measures for loss of Appendix 6 -
consciousness / shock injury, referring into the attached document Treating Loss
Consciousnes
s & Shock
7 In case the victims condition requires tier 2 support, contact the
hospital and ambulance service for evacuation to Tier 2 medical
support
8 Accompany the victim until ambulance arrives
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Response to Animal Bite / Sting

Applicable to rabies-carrier animal bite, insect & arthropoda bite/sting and snake bite.

No Mitigating Steps Remarks

1 Upon activation of terminal emergency response team, personnel on
site give clear information regarding the situations to the Incident
commander.
2 Inform the victim condition to supervisor on duty. (Consciousness,
injury/wound, etc.), upon receive emergencies information supervisor
on duty inform the terminal manager.
3 Terminal manager activate medical ER team and instruct the medical
officer for first aider team deployment.
4 After activation of Medical ER, the first aider on duty response the
activation and proceed to emergency site and immediately treat the
victim.
5 First Aider conduct the first screening by applying DRCAB steps
mentioned at the chapter 4
6 The first aider provides the first aid measures for animal bite/sting, Appendix 7 -
referring into the attached document Treating Bite
and Sting
7 In case the victims condition requires tier 2 support, contact the
hospital and ambulance service for evacuation to Tier 2 medical
support
8 Accompany the victim until ambulance arrives

Response to Pandemic / Virus Outbreak

Applicable to Influenza – Various Applicable Types e.g. Avian Flu, SARS, MERS-CoV,
Diphtheria, Measles, Rubeola, novel Corona Virus (Covid-19)

To follow ID Pandemic Preparedness PIP as attached at Appendix 8, and Indonesia Guideline

for Boarding Vessel Coronavirus that have been prepared by Shell Health as attached at
Appendix 9
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6. PROCEDURE FOR WORST CREDIBLE SCENARIO

Multiple Casualties – Maximum 2 Personnel Injured

No Mitigating Steps Remarks

1 Upon notice the injured personnel and multiple casualties were
observed, inform supervisor on duty or manager by portable radio
2 Safely stop on going operation related with the emergencies.
3 Incase further extent of emergencies (fire, toxic vapor release, etc.)
evacuate the victim to safe place.
4 Upon activation of terminal emergency response team, personnel on
site give clear information regarding the situations to the Incident
commander.
5 Inform the victim condition to supervisor on duty. (Consciousness,
injury/wound, etc.), upon receive emergencies information supervisor
on duty inform the terminal manager.
6 Terminal manager activate medical ER team and instruct the medical Dispatch 2
officer for first aider team deployment. First Aider
personnel
7 First aider provides treatments to the victims and stay with them until
further medical support is arrived on scene .
8 Ask historian to contact medical assistance from local hospital, Will need
ambulance, SOS, etc. based on the information from first aider more than 1
regarding the severity of the victim. ambulance
for rescue.
9 First aider treats the victim and provides information to medical officer
& incident controller regarding the severity of victim’s injury.
10 First aiders evacuate the victim to the medical evacuation point (office
lobby) and stand by until medical assistance/ambulance arrived.

In case Multiple Casualties (more than 2 personnel injured), medical response from Tier 2
Hospitals shall be immediately dispatched to the Terminal. First Aider to assess the victims and
provide necessary first aid measures.

Terminal is capable to provide up to 4 First Aider at the day shift and 2 at the night shift.

APPENDIX
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Appendix 1 – How to use AED

Appendix 2 – Treating Heat Exhaustion, Heat Stroke & Hypothermia

Appendix 3 – Treating Wound & Bleeding

203 Appendix 3 -
Treating Wound & Bleeding.pdf

Appendix 4 – Treating Muscles and Bones Injury

Appendix 5 – Treating Burn Injury

Appendix 6 – Treating Loss Consciousness & Shock

Appendix 7 – Treating Bite and Sting

Appendix 8 – ID Pandemic Preparedness PIP

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Appendix 9 – Indonesia Guideline for Boarding Vessel Coronavirus Ver 2.01