DISASTER MANAGEMENT

OBJECTIVE

 Know how to assess a disaster scene.

 Explain the tasks to be performed before medical
treatment of casualties can commence.
 Identify the zones of field management of disasters.
 Know the disaster management on hospital & on site
phase.
Definition (MKN)
 Incident
 Sudden onset
 Complex
– Loss of life
– Loss of property
– Environmental damage
– Disrupts normal activities of society
 Requires extensive resources to handle
– equipment
– manpower
– logistics
– time
Types of Disaster

 Natural
 Man made
Natural disasters
 Earthquakes
 Floods
 Typhoons/hurricane/cyclone
 Tsunamis
 Volcanic eruptions
 Diseases Outbreak
ACHEH – TSUNAMI 2004
Man made disasters
 Industrial incidents
 Transport incidents
 Sporting incidents
 Terrorist incidents
World Trade Center attack, NY – Nov, 2001
Estimated death ~ 30 000
Main objectives of Emergency
Services during disaster
 Save life
 Prevent escalation of the incident
 Relieve suffering
 Protect the environment
 Protect property
 Rapidly restore normality
 Assist any criminal investigation @
enquiry
TRAGEDI KEBAKARAN SYARIKAT BRIGHT
SPARKLERS, SUNGAI BULOH SELANGOR
PADA TARIKH: 7.MEI 1991
 KEBAKARAN DILAPANGAN TERBANG
SULTAN ABD.AZIZ, SUBANG, SELANGOR
PADA TARIKH: 5 APRIL 1992
 KEBAKARAN KAPAL CHONG HONG III,
(SYARIKAT SHELL TIRAM),PELABUHAN
KLANG,SELANGOR
PADA TARIKH:20 JUN 1992
TRAGEDI BANGUNAN RUNTUH HIGHLAND
TOWER DI HULU KELANG
PADA TARIKH: 11 DISEMBER 1993
TRAGEDI DI KM:34,JALAN SUSUR KE GENTING
HIGHLAND,PAHANG
PADA TARIKH: 29.OGOS 1995
TRAGEDI KEMALANGAN DI KM 15,JALAN
GENTING HIGHLAND,PAHANG
PADA TARIKH: 5 APRIL 1996
 TRAGEDI BANJIR LUMPUR DI
PERKAMPUNGAN ORANG ASLI DI POS
DIPANG ,KG SEKOM,KAMPAR,PERAK
PADA TARIKH: 29.NOVEMBER 1996
TRAGEDI RIBUT GREG DI PANTAI BARAT
SABAH
PADA TARIKH:26 DISEMBER 1996
TSUNAMI 26. DISEMBER 2004
TRAGEDI BATANG KALI 16.12.2022
 A “Chain of Survival” for Disasters

Early Rescue
Early Definitive
Care

Early Initial
Life Support Early Transportation

“ … a strength of the chain as strong as the weakest link”

 Planning & knowledge
 Equipment
 Training
ARAHAN 20
 Di keluarkan pada 11 Mei 1997
 2012 (Semakan Semula)
 GREEN ZONE

Temporary
YELLOW ZONE Mortuary
Media Pertahanan
Centre Emergency
Medical Services Awam
RED ZONE

Access Road JBPM

Guard Post Guard Post Operating zone for Specialised

Search And Rescue Units PDRM
Rest Area

Food Store
SMART ATM
PKTK Family
Counseling Bereavement
Centre Centre
Aid Agencies and NGOs
PROSES AKTIVASI BENCANA
Peringkat Hospital
PLAN AKTIVASI
 Pengenalan :-
 Satu Sistem Amaran Pemberitahu
 Menggerakan “Resourses” Hospital

 Tujuan :-
 Menangani Masalah Kecemasan secara effektif
 Berupaya meggerakkan anggota terpilih ke tempat / unit kejadian dengan segera
 Membantu unit / tempat secara effektif dan teratur
 EMERGENCY
RESPONSE PLAN
 INCIDENT SITE MANAGEMENT

1. Zoning and coding

2. Work matrix
3. Medical Base Station Layout
4. Role & responsibilities
5. Human resource management
6. Triage
- Primary
- Secondary
7. Forensic activities
8. Public Health
9. Psychological Management
Safety First !
Evacuate to safe area !
 ON SITE MANAGEMENT
AREA LAYOUT OF MEDICAL BASE STATION

WHITE ZONE •REST AREA

M.E.L.O
•DEAD •RESCUER CLINIC
•BODY PARTS •PANTRY

FORENSIC REST ZONE

STRATEGIC
PLANNING AREA
YELLOW ZONE GREEN ZONE
O.M.C
Semi Critical Non Critical
COMMITTEE
1 Dr + 2 asst. Drs + Pts + asst.
DATABASE
Qx

Scramble
RED ZONE
Rescue Eqt
Critical Zone
1 Dr + 4 asst. TRIAGE AREA
 ON SITE MANAGEMENT

WORK MATRIX
YELLOW ZONE

OSC
(POLICE )
M.E.L.O.
FORENSIC
P.K.T.K.
QUARTER
O.M.C. MASTER
BOMBA

MEDICAL
BASE SAR
M.E.S.A.R.O.
SAR
CRTICAL
S.CRITICAL
SPECIALISTS COMMAND POST
N.CRITICAL SJAM
DEAD MRCS F.F.C. - BOMBA
RESCUERS JPA 3
BOMBA
S.B.

SAR TEAM

RED ZONE
 PKTK TRAGEDI TANAH
RUNTUH BATANG KALI DEC
 On Site Medical Coordinator
Tanggungjawab OMC

 Menyelaras semua Akiviti Perubatan di Base Medical Station

 Menyelaras sustem triage

 Menyelia pengurusan perubatan mangsa di base

 Melantik Pegawai Perhubungan (Medical Liasion Officer iaitu

MELO)

 Menyelaras ambulans dan pengangkutan / pemindahan mangsa

 Menyelaras system komunikasi antara tempat kejadian zon /

hospital pusat kawalan

 Menyelaras sumber manusia termasuk perkhidmatan sokongan

contohnya, PBSM, SJAM, JPAM.
 MEDICAL
COMMANDER
 MEDICAL
COMMANDER
MEDICAL SEARCH & RESCUE OFFICER ( M.E.S.A.R.O. )

 Menyelaras proses penyelamat dari aspek

perubatan

 Berhubung dengan FFC

 Lakukan Triage

 Berkomunikasi dengan OMC

 Memberikan rawatan perubatan kecemasan

 Menyelaras tenaga semua pekerja di zon merah

 Medical Liaison Officer ( M.E.L.O. )

 Penghubung OMC dan OSC

 Mengumpul dan menyampaikan maklumat

 Bertanggungjawab mengekalkan komunikasi antara

OMC dan OSC

 Berkomunikasi dan menyelaras penyaluran maklumat

antara tempat kejadian dan hospital

 Mengadakan penyelarasan bagi perancangan

strategik dan metodologi
 Quarter Master ( Qx )

 Mengurus sumber logistic

 Menyediakan makanan, minuman dan tempat bagi

penyelamat dan mangsa.

 Mengadakan Kawasan pengurusan perubatan

 Menguruskan inventori dan

penyimpanan/pergerakan sumber
EFFICIENT QUATER MASTER
 Transport Coordinator

 Pengurusan kenderaan

 Menyelaras pergerakan kenderaan

 Manage drivers and escort

 Routing and Traffic

Transport
Coordinator
FIELD TRIAGE
 PRINCIPLES
Salvage of life take precedence over
salvage of limbs

The 2 immediate Rx to life are :-

 Asphyxia (Open airway)
 Hemorrhage (pressure

Bandage @splinting)
Triage tag
 Most effective
 1 tag 1 patient
 Colour codes
 Use of number, picture or label codes.
(interchangeable)
 Transparent
 Highly visible and inconspicuous
 Durable & weather/water proof
 Hang over neck
 Contains recording of casualty, injury,
Rx & Mx details (Medico legal
document, formated document)
 Regional / National/international
standard
 TRIAGE CATEGORY

RED – SEMI CRITICAL

CRITICAL/IMMEDIATE
/DELAYED
YELLOW
GREEN – NON CRITICAL/MINOR
WHITE – UNSALVAGEABLE
FIELD TRIAGE CONCEPT

 SIMPLE TRIAGE AND RAPID TREATMENT

(START)
 SECONDARY ASSESSMENT OF VICTIM ENDPOINT
(SAVE)
FIRST UNIT ON SCENE START – Simple Triage And Rapid Treatment
What to do ?
How to begin ? 1 Call out

REMEMBER 5 S’s Walking wounded

Non Walking
&
1.SAFETY assessment Uninjured
2 RESPIRATIONS
GREEN
2.SIZE UP the scene Yes No
How big ?
How bad ? < 30/min > 30/min
3.SEND information: Position
3 PERFUSION RED Airway

4.SETUP the scene for Management

of the casualties. Capillary Refill
or Radial Pulse Yes No
5.START
Remember “RPM” Under 2 sec Over 2 sec
Or Pulse Present Or Pulse Absent RED WHITE
RESPIRATIONS
PERFUSION 4 MENTAL STATUS RED
MENTAL STATUS
Colour codes: Follows simple command Can’t follow simple command
RED -
IMMEDIATE
YELLOW -DELAYED YELLOW RED
GREEN -MINOR
WHITE -DEAD
ACHEH – TSUNAMI 2004
PATIENT 1
Not walking on her
own
• Breathing on her own
at < 30 bpm
• + radial pulse
• Follows commands –
points to where it
hurts…
YELLO
W
PATIENT 2
 Not walking out on
own
 Initially not breathing on own
 Breathing on own
once airway is opened
RED
PATIENT 3
 Not walking out on
own
• Breathing on own and crying
• Breathing at 50 bpm
RED
PATIENT 4

• Carried to you by
bystanders
• Not breathing on own
• Not breathing after
airway is
opened/repositioned
WHITE
PATIENT 5
 Not walking out on
own
• Breathing on own at
20 bpm
• + radial pulse
• Not following
commands
RED
PATIENT 6

 Not walking out on

own
• Not breathing on own
• Not breathing when
airway is opened
WHITE
PATIENT 7
 Not walking out on
own
• Breathing on own
• Breathing at 8 bpm
• + radial pulse
• Does not follow
commands
RED
Patient 8

• Walking on own
(Red Circle)
• Walks to designated area
GREEN
Patient 9

 Walking on own (Red

Circle)
• Will not follow command
 will not walk to
designated area
• Continuously walking
around talking to injured
and rescuers
RED
Automatically Red Tagged

• Injured Care Providers

• Emotionally uncontrollable patients

References

 Pelan pengurusan bencana (sub-modul mass casualty

incident)
 PK-HM-KS-01 – Pengurusan bencana Hospital Melaka
 MKN – Arahan 20