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Health Management in Disaster

Dr. Zafrullah Khany Jasa, dr.SpAn.KNA

Any emergency that disrupts normal community function causing concern for the safety of its citizens including their lives and property.

“All-Hazards”
Man-made  Fires  Explosive devices  Firearms  Structural collapse  Transportation event  Air, Rail, Roadway, Water  Industrial HAZMAT  WMD – NBC events  Etc… Natural  Earthquake  Landslides  Avalanche  Volcano  Tornado  Hurricanes, floods  Fires  Meteors  Etc…

Disaster Response- ESF
1. Transportation 2. Communications 3. Public Works and Engineering 4. Firefighting 5. Emergency Management 6. Mass care, Housing and Human Services 7. Resource Support 8. Public Health and Medical Services

Emergency Support Functions (ESF)
9. Urban Search and Rescue 10. Hazardous Materials 11. Agriculture and Natural Resources 12. Energy 13. Public Safety and Security 14. Long-Term Recovery 15. Public Affairs

Plans must be simple and flexible. They should be made by the people who are going to execute them.”
george patton

Response

a. Notification b. Evacuation/extrication c. Search and rescue

d. Coordination
e. Immediate needs assessment f. Shelter/protection g. Implementing existing disaster plans

County Health Departments
Pre-hospital Outpatient Services Hospitals Pharmacies

Laboratories
Mortuary Services

Health Care System

Emergency Response Phase
1. Search and rescue 2. Emergency medical services

3. Immediate health service mobilization
4. Preliminary needs assessment

Indonesia
Respon terhadap becana:

SPGDT
Sistem Penanggulangan Gawat Darurat Terpadu

SPGDT / B (Sistem Penanggulangan Gawat Darurat Terpadu - Bencana
Evakuasi Medik (Medical) Tim Bencana Multi Disiplin Didaerah Bencana

X 4 RS Wilayah Rujukan

X 3 RS Propinsi

X 2 1 RS Puskes Kabupaten mas

X

Hansip

(PusKoDal (Pos (Pos Depan) (Pos Lapangan) Med) Belakang) Pusat Koodinasi Dan Pengendalian Medik Transportasi Komunikasi Pendanaan (SISTIM PENDUKUNG)

APA PASIEN GAWAT DARURAT ITU ?
Adalah pasien yang perlu pertolongan tepat, cermat, cepat untuk mencegah kematian / kecacatan Doktrin dasar : Time saving is life saving Waktu adalah nyawa Ukuran keberhasilan Response time Waktu tanggap

SIFAT DASAR PERTOLONGAN GAWAT DARURAT
1. Pertolongan harus tepat-cermat-cepat 2. Gawat darurat dapat terjadi kapan saja dimana saja pada siapa saja

3. Yang harus dikembangkan

adalah : Sistem pelayanan gawat darurat terpadu (SPGDT)

1. Jenis pasien gawat darurat yang diberi pertolongan (Trauma, bedah, medik, obstetrik, pediatrik)

2. Kerangka rujukan Puskesmas  RS Kelas C  RS Kelas A / B
3. Jenis SDM  Multi profesi (dokter, perawat)  Multi disiplin (berbasis dokter spesialis)  Multi sektor (kesehatan – non kesehatan)

FASILITAS IRD DAN ARUS PASIEN

Pra hospital Sistem ambulans

Ruang penerimaan Ruang triage Pulang Gawat darurat ringan

Ruang resusitasi

Ruang tindakan

(Diagnosis) Laboratorium radiologi

Pulang

Bank darah

Kamar bedah Ruang observasi intensive (ICU waktu pendek) Pulang Pasien gawat darurat berat

Ruang rawat inap

Ruang perawatan intensive (ICU)

Dr. Bedah Perdarahan trauma
SHOCK KARENA PERDARAHAN

Dr. Obgyn Perdarahan post partum 1 2 3
Resusitasi Stabilisasi Defenitif terapi awal Defenitif terapi akhir

Dr. Penyakit Dalam

Perdarahan G.I.

PEMBAGIAN PERAN DR. UMUM – DR.SPESIALIS

Priority Public Health Interventions


• • •

Water and sanitation Surveillance and Health Information Systems Nutrition Communicable disease control Immunization

KELOMPOK PENGUNGSI (CLUSTER)

KELOMPOK PENGUNGSI (CLUSTER)

KELOMPOK PENGUNGSI (CLUSTER)

POSKO
POSKO KESLAT KESEHATAN LAPANGAN

POSKO

HUBUNGAN RADIO MEDIK

PUSKESMAS

BANGSAL PERAWATAN DARURAT
BANGSAL PERAWATAN PERAWATAN DARURAT

SATLAK II

SATGAS KES II

RS. KLAS C

SATKORLAK I

SATGAS KES I

RS KLAS
A/B

BANGSAL PERAWATAN DARURAT

PUSDALSIS KESNAS RUJUKAN : 1. ALIH INFORMASI 2. ALIH PASIEN 3. ALIH ILMU 4. ALIH LOGISTIK (KONSULTASI) (KIRIM PASIEN) (PELATIHAN) (BANTUAN ALAT / OBAT)

Deadly Misconceptions
“It won’t happen here”
It won’t happen to me” “Someone else will take care of it”

Be Ware,..