Module II: Concept of Disaster
Part II
CAPACITY
D. WHAT IS CAPACITY:
“all strengths, attributes, and resources available within a community, organization, or
society that be used to achieved an agreed goal.”
• Cope with, overcome the adverse effect, reduce the risks of disaster
Plan: preparation mitigation
and recovery
At the area of Disaster:
Assessment on medical response capacity for disaster in local area:
• Rescue Capacity, Should be assessed in peace/normal Referral to the DESIGNATED
DISASTER HOSPITAL: SEVERE
• Transport Capacity and time to determine how to SHORTEN the
time for medical emergency response.
INJURIES
• Treatment Capacity
And in peace/normal time the Designated Disaster Hospital should be Assessed:
o Maximum Receivable Numbers of Patients in Hospital
# of Emergency Department
# Emergency Doctors
# of Surgeon
# anesthetist
# of Bed/s in Emergency Room
# of ICU Bed
# of OR
# of Angiography Room
# of Respirators
# of Anesthetic Medicine
# Monitor
# of Blood transfusion
# patient and Average Time of
Treatment
Simple Algorithm in determining the Hospital Capacity in time of Disaster
1 Patient with Severe Injury
Needs 2 Emergency
Doctors and 2 Nurses
Operation or Angiography is required
YES NO
Operation: 2 EMDs, 1 Surgeon, 1
2 EMDs, 2 Nurses
Anesthetist, 3 Nurses
Angiography: 2 EMDs, 1 Radiologist,
2 Nurses
To further Improve the Disaster Management there is Need to Improve 3 Key
Areas:
Proactive Efforts to Improve the Emergency Management/Capacity:
o Information System for Emergency Medicine
o Designating more Key Disaster Hospitals
o Implementing Disaster Medicine Education and Trainings
Information System for Emergency Medicine
A. INFORMATION AND COMMUNICATION MANAGEMENT
Emergency Needs:
o Moment-to-moment situational analysis
o A real time information to assess the needs and available resources
THUS, there should be an accurate
information from the field: incident
casualties, medical needs, triage, and
treatment
This information have the critical impact on the
utilization and preparedness of the community
resources. (ambulances, available or accessible
hospitals, emergency department..etc…
Information and Communication Tools
Telecommunication Technologies
• Landline
• Airwaves (Radio)
• Satellite media
• Smart Devices (Internet)
LAN or the Wireless Local Area Network
Ambulances have been linked via wireless
communication devices to the internet to transmit
Data to ED while in transit.
• Patient Tracking, Monitoring, and Medical Care
Paper tags around the neck and wrist. To
Recent Development: Triage tagging using BAR Coding and
identify the patient and serve as primary
Mobile Wireless Data to individually identify and tract
means of documentation and information
victim of disaster.
transfer to the hospital
• Ambulance Tracking Radio Communication via GPS
• Incident Command Radio Communication
• Emergency Department/Hospital Linkage Landline, Radio Communication, Samart
Divices..etc…
B. DESIGNATING MORE KEY DISASTER HOSPITALS
• Base on Number of Casualties: This will determine the ability of the hospital to cope
with these casualties
# of Doctors, # of Nurses, availability of supplies and support serivices,
Hospital Treatment Capacity, Hospital Surgical capacity
• Base on the Type of Casualties
o Patient in Critical Condition
o Head Injuries, Thoracic Injuries, Abdominal Injuries ..etc…
o Patient is Serious but not life threatening condition
Fracture, Crush injury of limbs without major blood loss, facial
injuries… etc…
o Walking Wounded Require wound dressing, Limb fracture that require close
reduction and immobilization…etc..
C. Implementing Disaster Medicine Education and Trainings
• “The science for analysis and development of the methodology requested to handle
situations where available re-sources are insufficient in relation to the immediate
need of medical care”
• Objective: Reduce or eliminate avoidable loss of life and health and physical and
psychological suffering
LEVELS OF TRAINING
• Undergraduate Level:
Any doctor, nurse and ambulance crew can be involved in a major accident
or disaster at any time. Therefore, it is self-evident that basic knowledge in disaster
medicine should be included in their under- graduate curriculum. (for nursing:
Emergency Nursing; Disaster Nursing Theory and RLE)
Similar but shorter courses are organized for nurses, and in some
universities the training for medical, nursing and ambulance crew students is
integrated with very positive results.
POSTGRADUATE LEVEL
• It is important that all staff that potentially can be involved in disasters in their
professional position also receive basic education in disaster medicine within
their field of specialization.
Such training programs: individual hospitals, regional trauma centers in disaster medicine, since such
centers are staffed by specially trained teachers and instructors, and have facility for high-quality
training.f
Example:
Physicians and nurses working in anesthesiology and emergency medicine should be trained to perform
actions and interventions at the scene and during transport (such as field triage, communication,
collaboration with other agencies)
for high-quality training.
o Emergency Department should have regular practical exercises in mass-casualty management;
o Those designated to lead the hospital in these situations, hospital management or command
groups,
should undergo a special training program based on well prepared simulation exercises;
o It is also important that all surgeons and nurses, irrespective of sub-speciality, receive a basic
postgraduate education in trauma.
