EMERGENCY RESPON

DI RS

MUJIADI. S.Kep.Ns., M.KKK

 WHAT IS EMERGENCY ?
• ANYBODY
• ANYWHERE
• ANYTIME

A serious situation or occurrance that develops suddenly and

expectedly and needs immediate response for life and limb savin

Quick Response
Time saving is life and limb saving
( Human Right )

Individual Problem
 WHAT IS DISASTER ?
• ANYBODY
• ANYWHERE
World Health Organization• ANYTIME

ANY OCCURANCE THAT CAUSES DAMAGE , ECOLOGICAL-

DISRUPTION , LOSS OF HUMAN LIFE OR DETERIORATION
OF HEALTH AND HEALTH SERVICES ON A SCALE SUFFI –
CIENT TO WARRANT AN EXTRAORDINARY - RESPONSE
FROM OUTSIDE THE AFFECTIVE COMMUNITY OR AREA .

• Damage
• Ecological Disruption
NEED EXTRA ORDINARY
• Loss Of Human Life RESPONSE
• Deterioration Of Health And Health Services
HARM TO :
• People
• Communities
• Countries
HUMANITARIAN PROBLEMS
KEWASPADAAN BENCANA
DI RUMAH SAKIT PENTING
Agar fungsi rumah sakit apabila terjadi
bencana tidak terganggu dan dapat segera
diatasi

Sehingga aktivitas dapat berjalan

kembali
TUJUAN KEWASPADAAN
BENCANA
Untuk kesamaan pola pikir dan pola tindakan

Sebagai acuan petugas terkait dalam menghadapi

kemungkinan terjadinya bencana di lingkungan
rumah sakit
Mengapa perlu kewaspadaan
bencana ?

Bencana tidak dapat diduga kapan terjadi

dan berapa jumlah korbannya

Lingkungan RS
• Banyak pasien
dan keluarganya Usaha-usaha
Pencegahan
• Banyak petugas
• Banyak alat-alat
kesehatan
 KERANGKA KONSEPTUAL PERENCANAAN TANGGAP DARURAT RS
( BAGAIMANA MENGEMBANGKAN INTERAKSI POSITIF MASY – LING – HAZARD )

MASY RS LINGK RS
KAP Nakes RS  K3 • Pedoman Tanggap Darurat
• Design Bangunan RS
interaksi • Alat 2 Emerjensi
•Tanggap Darurat positif
• Pencegahan Gadar •Kebijakan K3 RS
• Mitigasi •Infrastruktur K3 RS

HAZARD

RISIKO K 3 RS :  Hazard Mapping

* Natural
* Technological
* Social Origin

PEMBERDAYAAN MASYARAKAT RS UNTUK P1 , P2 DAN P3

K3 RS
 POLA PIKIR

KAJIAN K3 RS P1 , P2 DAN
•Beban K P3
•Kemampuan K •KAP K3 RS
•Kapasitas K •Lingk K
•WHAT •Hazard
•WHO K3 RS
WHY HOW WHAT NEXT
•WHEN
•WHERE • PERENCANAAN
•HOW MUCH •Medicine TECHNOLOGY • PELAKSANAAN
•Non Medicine • PENILIAN GADAR RS

•Potensi bhy MULTI

DISCIPLINES Interaksi
•Prosedur kerja • MEDIS Positif
•Lingkungan kerja RS • TEKNIK
• GIZI
Nakes RS STATUS KESiagaan OPTIMAL
• FARMASIST Lingkungan petugas RS
• SANITASI Dan
•KEAMANAN
•SDM
Hazard

IDENTIFIKASI MASALAH K3 RS PROBLEM SOLVING

Usaha-usaha Pencegahan dan
Penanggulangan Bahaya Kebakaran

 Tindakan Preventif
 Tindakan Represif
 Tindakan Rehabilitasi (Evakuasi)
 Tindakan Preventif
Dilakukan sebelum terjadi kebakaran

 Mengadakan pendidikan dan pelatihan

 Pengadaan sarana pemadam kebakaran
 Pengadaan sarana penyelamatan
 Pengawasan peralatan mudah terbakar
 Pemahaman tempat titik rawan kebakaran
 Tindakan Represif
Usaha dilakukan pada saat terjadi
kebakaran
Untuk mengurangi kerugian akibat kebakaran

USAHA PEMADAMAN MEMBERIKAN

KEBAKARAN INFORMASI

• Penggunaan peralatan Pemberitahuan kepada

pemadam petugas (berkordinasi)
• Penggunaan alat •Pertolongan penyelamatan
penunjang jiwa
• Mencegah meluasnya Pelaksanaan evakuasi
kebakaran
Tindakan Rehabilitasi (Evakuasi)
Usaha dilakukan setelah terjadi kebakaran

Tentukan tempat evakuasi

• Menyelidiki penyebab kebakaran

• Membuat laporan kejadian
• Membuat program yang lebih
efektif
PENCEGAHAN BENCANA
1. Identifikasi titik rawan bencana
2. Deteksi dini asap kebakaran
3. Memperkecil dampak bencana
-Perencanaan penanganan bencana
-Koordinasi
4. Penyelenggaraan pelatihan keterampilan
petugas
5. Pengawasan perilaku semua orang yang ada di
lingkungan kerja
6. Penyediaan alat pemadam sederhana: selimut,
pasir, karung
7. Penyediaan alat pemadam lanjutan: APAR,
Hydrant.
JENIS BENCANA
1. KEBAKARAN
2. GANGGUAN TIDAK BERFUNGSINYA
SUPPLY AIR DAN LISTRIK
3. TIDAK BERFUNGSINYA ALAT
KOMUNIKASI
4. ANCAMAN BOM
5. ANCAMAN KERUSUHAN YANG MENJALAR
DI LINGKUNGAN RUMAH SAKIT
6. BANJIR
ALAT MEDIK DAN NON MEDIK YANG MUDAH
MENIMBULKAN KEBAKARAN
1. INKUBATOR
Ada hiter/pemanas, sistem kontrol alat, perputaran kipas,
komponen listrik
2. SENTRIFUGE
Timbul gesekan, sistem mekanik  keausan, perputaran
motor, komponen listrik
3. STERILISATOR
Ada hiter, media air dan tegangan listrik, komponen listrik
 bocor/rembesan
4. ALAT PEMASAK AIR
Ada elemen/pemanas/tercelup air  kehabisan air 
panas tinggi  timbul asap/api
5. KIPAS ANGIN
Ada gulungan kawat listrik, keausan mekanik, kabel dan
steker rusak

SEMUA ALAT YANG MENGGUNAKAN MOTOR LISTRIK

DAN HITER
ALAT-ALAT YANG MUDAH MELEDAK
1. TABUNG OKSIGEN
2. TABUNG LPG
3. TABUNG/BOTOL BAHAN KIMIA
4. INSTALASI GAS (GAS OKSIGEN
SENTRAL)

BERTEKANAN TINGGI  SAMBUNGAN2 

BOK (BELOKAN2) PIPA  TERKENA
BENTURAN BENDA KERAS  KEBOCORAN
RUANGAN RAWAN KEBAKARAN
1. R. DAPUR  aktivitas api

2. R. GUDANG  selalu tertutup  pengap

3. R. LAB  bahan2 kimia

4. R. MESIN  bahan bakar mesin (oli,

solar)

5. R. SENTRAL GAS MEDIS  bahan2 gas mudah

terbakar

6. R. PANEL LISTRIK  bahan bertegangan listrik

7. R. GARDU LISTRIK bahan bertegangan listrik

BILA TERJADI KEBAKARAN

 TIDAK PANIK
 PENYELAMATAN DIRI
 PENERAPAN TEORI K3

KENALI DENAH GEDUNG

KENALI PINTU DARURAT
BEBASKAN TANGGA MENUJU
PINTU DARURAT

JANGAN MENGGUNAKAN LIFT

Lantai atas…………………
Bahaya jatuh………………
Petir ?
Adakah kesepakatan
dgn lantai I bila
terjadi kebakaran
pintu ini segera
dibuka?
Petunjuk Pintu
Keluar Pintu Keluar
Darurat belum ada
 Peningkatan Ketahanan dan Kemandirian
Petugas Terhadap KEWASPADAAN BENCANA
- RS

100 % Teratasi
KONDISI
TIM K3 RS
AMAN
Sebagian
Teratasi
Pember dayaan
Petugas RS
Tak
Teratasi

• Adm / Mgt
Manajemen RS • Human Resource
•S&E
• Finance
 Bahaya X Kerentanan
Risiko
= Kapasitas

Kerentanan : kemungkinan kena bahaya

Kapasitas : kemampuan mengatasi masalah
Risiko dapat diperkecil bila kapasitas
diperbesar, dengan meningkatkan
kemampuan penanggulangan
 Level of
Development
Masyarakat yg disiapkan

Potential
Disaster

Masyarakat tdk
disiapkan

Time

Efek bencana thd masyarakat

APA YANG DIMAKSUD DGN TANGGAP DARURAT K3 - RS

Upaya K3 berkelanjutan yang bertujuan untuk

menjamin interaksi positif antara KAP petugas
RS , lingkungan dan hazard RS untuk mencegah
dan menanggulangi secara efektif dan efisien
berbagai masalah gadar K3 – RS , sehingga
menjamin berlangsungnya pelayanan &
keselamatan kerja di RS

Meningkatkan
Ketahanan
Dan Kemandirian
petugas RS
Jumlah kematihan

300

200
Tanpa peringayan

100
Dengan peringatan 90 minutes , atau lebih

Population
10 100 1000 10000 At Risk

Kematian dalam kaitan dengan kegagalan tanggul

dan peristiwa banjir ekstrim dengan dan tanpa
memperingatkan sistem
Prinsip-Prinsip
1. Software
• Pengorganisasian level RS-Unit Kerja
• Job descripsi & job distribusi , pos jab dlm org fgs
• Sistem komando pengendalian & kewenangan
• Tatalaksana aktivasi-koordinasi, pengendalian
sistem unit kerja & RS
• Tatalaksana koordinasi teknis antar instalasi
• Tim pendukung tak langsung
• Tim medis
 2. Hardware
a. Perangkat keras level lokal unit kerja
( early warning, early respon )
b. Perangkat keras level RS
c. sistem komunikasi pendukung
↓
Menggunakan apa?
simpan Nomor penting
IPS
Pamtib ( Posko )
Sanitasi
Sistem informasi/ komunikasi
• Alarm sistem
• Ruang kontrol
• Alat komunikasi
• Nomor-nomor penting
• Siapa pelaksana
• Apa yang disampaikan ( notasi)
 3. Brainware
• Pelatihan : pemahaman sistem, tata kerja, alasan
kebutuhan alat
• Skill pelaksana teknis ( mengoperasikan alat)
• Skill teamwork
( antar pimpinan, antara pimpinan unit kerja dan
pelaksana teknis )
• Kemampuan inovasi-adaptasi
Kembangkan pula cara mulai dari yg
sederhana/se- mudah mungkin agar tiap orang
dapat berkontribusi sekecil apapun bentuknya
dalam kondisi darurat
TINDAKAN LANJUT SETEMPAT :
-Kapan penetapan saat evakuasi
-Pembagian tugas evakuator
-Urutan prioritas yang dievakuasi
-Jalur evakuasi, tempat evakuasi
-Cara evakuasi, KOMUNIKASI
- Area / lokasi evakuasi ?
Organisasi Kead Darurat RS

Komandan RS

Komandan
Bencana

Managemen Medical
Support Support
Aktivasi sistem Organisasi
tanggap darurat
Informasi Kead Bencana

Komandan Bencana

KOMANDAN
LANTAI

Aktivasi sistem Tidak perlu

Aktivasi sistem

Aktivasi Posko

Evaluasi proses
penanggulangan
 ORGANISASI KEADAAN
DARURAT ( OKD ) Unit Kerja
Organisasi tanggap darurat unit kerja

DISASTER CHIEF

DEPUTY DISASTER CHIEF

Komandan REGU FIRE Regu Penunjang

Lantai BANTUAN OFFICER -Tim Medis
LUAR -Sat Pol PP
REGU -Teknik / BAS
EVAKUASI -Farmasi
REGU -Perlengkapan
REGU PENYELAMAT PEMADAN -Administrasi
DOKUMEN LANTAI -Gizi
-Dll
REGU PENYELAMAT
PERALATAN MEDIS
 SCOPE OF AUDIT
A. Assessment on “ Life Safety
Code ”
•building construction
•fire protection systems
•fire detection systems
•emergency power and back-up
power systems
•chemical storage and handling
•ingress and egress routes
•special operations  oxygen
usage
B. Evacuation plan
• emergency management
organization
• notification procedures
• portable medical equipment
• medical supplies • emergency response
capabilities
- response personnel
- reponse equipment
- transportation
- ambulances
- trucks
- buses
- helicopters
 CHECKLIST AUDIT
NFPA 101
PHYSICAL REQUIREMENTS CHECKLIST

Yes No NA
1. Building structure fire resistance
A. Containment
1. Compartmentization
a. Are shafts and vertical openings in the
building protected per the provisions in
NFPA 101 chapter 6-2?

B. Resistance
1. Do the following components meet the rating /
requirements of NFPA 101 chapter 6-2-4?
a. Structural system ratings?
b. Floor / ceiling ratings?
c. Roof / ceiling ratings?
d. Wall assembly ratings?
e. Occupancy separation ratings?
f. Opening protection?
g. Fire dampers?
h. Smoke dampers?
2. How are penetrations through fire related
components protected?
 Yes No NA
2. Detection systems
A. Which of the following systems does the building have?
1. Smoke detectors?
2. Heat detectors?
3. Flame detectors?
4. Annunciator panels?

B. Where are the systems used (located?)

C. How/where do the systems alarm when they detect fire?

D. Are these systems provided with emergency power?

E. Are these systems inspected and maintained per NFPA

recommendations?
 Yes No NA
3. Sprinklers

A. Where are the sprinklers located?

B. Is the sprinklers system equipped with:

1. Flow alarms?
2. Main?
3. Branch lines?
4. Where does the alarm sound?

C. Are the sprinklers supply valves open and secure?

D. What pressure is maintained in the sprinkler system?

E. Is the system tested / maintained per NFPA

recommendations?
 Yes No NA
4. Standpipes

A. What type of standpipe system is used?

(Class, how many risers etc.)
1. Wet?
2. Dry?
3. Hose cabinets?

B. What size connections are provided?

C. Where are the FD connections / hose-reels located?

D. Is the system tested / maintained per NFPA

recommendations?
 Yes No NA
5. Fire pumps

A. What types and sizes of fire pumps are installed?

B. Where are the fire pumps located?

C. Is there a diesel driver on any of the fire pumps?

1. If yes, how large is the fuel tank?
2. How many hrs of operation?

D. Is the system tested / maintained per NFPA

recommendations?
 Yes No NA
6. Fire Water Supply

A. How many hours of fire is available?

B. Is the fire water supply dedicated for only firewater?

C. Is there an indication of low level in the water supply?

D. Where does make-up water come from?

At what rate?

E. Is there a secondary supply?

If yes, describe rate available, etc..
 Yes No NA
7. Portable fire extinguishers

A. What type and where are portable fire extinguishers

used?

B. Are the fire extinguishers located with a maximum

travel distance of from any occupied space?

C. Is the system tested / maintained per NFPA 101?

 Yes No NA
9. Exit Stairs

A. What is the enclosure rating?

B. What is the exit width?

1. Does it comply with NFPA 101 chapter 5?
2. Are the stairs arranged per NFPA 101 5-5?
3. Is the travel distance to the stairway arranged per
NFPA 101 5-6?
4. Are there appropriate signs marking the means of
egress per NFPA 101 5-10?
5. Is the lighting of the means of egress provided per
NFPA 101 5-8?
6. Do the emergency stair treads and risers meet the
requirements of NFPA 101 chapter 5-2.2?
7. Is the stairway pressurized and does the
pressurization system meet the requirements of
NFPA 101 chapter 5-2.3.9?
(Is the pressurization system tested at least twice
per year?)
 Yes No NA
8. Notification Systems

A. Which of the following systems are installed in the

building?
1. Systems
a. Manual-pull stations?
b. Audible alarms?
c. Visible alarms?
d. Public address system?
2. Can the alarm be heard in all parts of the
building?
a. Conference room, etc?
3. Are these systems provided with emergency
power?
4. Are the systems tested / maintained per NFPA
recommendations?
 Yes No NA
10. Elevators

A. What are the safety features of the elevators in regards

to emergency use? (See also NFPA 101 chapter 7-4)

B. Do the elevators have automatic recall functions?

C. What is the arrangement of the alarm / detection in the

elevators?

D. Are the elevators equipped with emergency

communications?

E. Are the elevators provided with emergency / standby

power?

F. Are the elevators equipped with pressurization systems?

 Yes No NA
11. Smoke Control

A. What are the provisions for smoke control?

12. Emergency / standby power

A. Emergency generator
1. Are battery backup uses for any of the
suppression / detection / egress system?
2. Is there an emergency generator set for the
building? If yes, what does it power?
a. Lighting?
b. Public address / alarms?
c. Elevators
d. HVAC
e. Fire pumps?
f. Other?
3. Is the generator set tested / maintained ?
 Yes No NA
13. Communications

A. What communications systems are available for the

building?
1. External systems
a. Modems?
b. Auto-diallers?
c. Telephones?
d. Cellular phones?
e. Radio?
f. Satellite?
2. Internal
a. Closed circuit phones?
b. Public address system?

B. Are these systems tested / maintained?

C. Does the building have a central control station

conforming to the requirements of NFPA 101 30-8.5.
 Yes No NA
14. Signage

A. Exits
1. Are exits clearly marked?
2. Are elevators clearly marked?
3. “If problems call______________” ?
4. “In case of fire, do not use”?

B. Are there signs needed on doors? such as:

1. “This door must remain unlocked during business
hours”?
2. “This door is locked at 6 a.m.
Opening the door will sound an alarm”?

C. Are alarm pull stations clearly marked?

1. This alarm does not notify the fire department?
Contact fire department by calling________?

D. Are location of fire extinguisher clearly marked?

E. Are emergency contact numbers clearly marked?

 Yes No NA
15 Fire Safety Check for

A. Improper use of extension cords?

B. Electrical equipment left unattended and on too long?

C. Electrical and ventilation safety of kitchen areas?

D. Unsafe supply storage?

E. Are there provisions for smokers to dispose of their

cigarette?

F. Frayed electrical cords on equipment?

G. Office furniture flammability?

H. Fire extinguishers?

I. Exit signage?

J. Emergency kits fully stocked and products properly

stored?

K. Are flammable materials and products properly stored?

1. Paint?
2. Reproduction fluids?
3. Cleaning solvents?
 Yes No NA
16. Building security

A. Which of the following systems are provided and how

can they affect emergency egress?
1. Access control? Mechanical key lock system
2. Video surveillance system?
3. “Card key” access system?
4. Locking mechanism?
5. Burglar alarm?
6. Emergency standby power (for security systems)?
 Yes No NA
17 Are there any additional systems that can affect an
emergency?
If yes, describe.
.

18. Overall Building System Discussion

A. Critical systems
1. What are the “Single source” failures that could
affect emergency procedures?
2. Central control / operations areas Fire Control
Room?
3. What system redundancies can be built into the
plan?

Is there too much, or too little, system overlap?

.