8/3/2019 Hospital Evacuation
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Hospital EvacuationHospital Evacuation
WelcomeWelcome
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Agenda
Welcome Commissioner Sutton
Westchester Countys HVA & Inundation Maps
OEM Director Mr. Carl Tramontana
Discussion of Hospital Considerations
RRC Director Mr. Garrett Doering
Break
OEM & EMS abilities
Mr. Jeff Reilly & Mr. Carl Tramontana
Set next meeting date & handouts
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Hospital EvacuationHospital EvacuationHistorical Perspective
There were 275 reportedThere were 275 reported evacuationevacuation incidents from 1971-1999, with anincidents from 1971-1999, with an
annual average of 21 in the 1990s, the period for which databases were moreannual average of 21 in the 1990s, the period for which databases were more
reliable. The most, 33, were recorded in 1994, the year of the Northridgereliable. The most, 33, were recorded in 1994, the year of the Northridge
Earthquake. Of all incidents, 63 (23%) were attributable primarily to internalEarthquake. Of all incidents, 63 (23%) were attributable primarily to internal
fire, followed by internal hazardous materials (fire, followed by internal hazardous materials (HazMatHazMat) events (18%),) events (18%),
hurricane (14%), human threat (13%), earthquake (9%), external fire (6%),hurricane (14%), human threat (13%), earthquake (9%), external fire (6%),
flood (6%), utility failure (5%), and externalflood (6%), utility failure (5%), and external HazMatHazMat (4%).(4%).
CONCLUSION:CONCLUSION:
More than 50% of theMore than 50% of the hospitalhospitalevacuations occurred because of hazardsevacuations occurred because of hazards
originating in theoriginating in the hospitalhospital facility itself or from human intrudersfacility itself or from human intruders
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Critical Issues when considering a hospital evacuation:Critical Issues when considering a hospital evacuation:
Nature of Threat
Risk to patients
Risk to staff
Risk to visitors
Need for continuing acute care
Demands for suppliesDemands for resources
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Complicating Factors:Complicating Factors:
Unable to model the entire event
i.e. Sniper fire halts hospital evacuation
Threats Change over time
Potential competition for limited resourcesInternal & External Resources Change over time
Due to complexity, there is limited transferability
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Nature of Threat:Nature of Threat:
Tornados, earthquakes, HAZ-MAT release, and fires
No time to prepare, will result in an uncontrolled
event
Hurricanes, floods, or critical infrastructure failure
Not immediately life threatening, may result in a
controlled event
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Hospital EvacuationHospital Evacuation
Risk to staff, patients & visitors:Risk to staff, patients & visitors:
Highly variable depending on eventCare givers may become involved in the logistics ofevacuation:
resulting in reduction of patient carestaff performing functions they are not familiar with
Staff accountabilityVisitor accountability
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Discussion Topics:Discussion Topics:
NORMET hospital mutual aid agreement
HEICS
Manpower
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Hospital EvacuationHospital Evacuation
Discussion Topics:Discussion Topics:
Patient Transportation
Ambulance
Critical Care
ALS
BLS
Ambulette/Wheel Chair Van
Passenger Bus
Private Car
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Hospital EvacuationHospital Evacuation
Discussion Topics:Discussion Topics:
Non-patient transportation
Staff
Equipment
Medical Records
Pharmaceuticals (esp. controlled substances)
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Hospital EvacuationHospital Evacuation
Discussion Topics:Discussion Topics:
Internal triage teams
Internal staging areas
Loading point(s)
Bed availability at other facilities
Notification of patient relatives
Handling patient relatives when they arrive
Securing the hospital
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Hospital EvacuationHospital Evacuation
Discussion Topics:Discussion Topics:
Special Patient Care Areas
OR & Recovery
Radiology/MRI/
Secure Psychiatric Units
L & D, peds
ICU/CCU/
Vent dependent patients
Isolation
Prison
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Hospital EvacuationHospital Evacuation
Literature Review:Literature Review:
Benchmarking for hospital evacuation: a critical data collection tool Schultz CH; Koenig KL; Auf der
Heide E; Olson. [Prehospital Disaster Med] 2005 Sep-Oct; Vol. 20 (5), pp. 331-42. ABSTRACT Events
such as earthquakes or terrorist attacks, hospitals may be victims of disasters. They may need to transferpatients to outside facilities rather than continue to provide on-site care. Following the Northridge
earthquake, eight hospitals in the damaged area were the foci of a United States National Science
Foundation study that examined the status of the hospitals' pre-event planning, post-event evacuation
decision-making, and internal and external evacuation processes. Building on this experience, this paper
offers a standardized data collection tool, which will enable researchers to record hospital evacuationinformation in a systematic manner so that comparable data can be accumulated, evacuation research
methods can be improved, and consensus on methods can be reached. The study's principal subjects
include: (1) hospital demographics; (2) description of existing disaster response plans; (3) an event's
impacts on hospital operations; (4) decision-making and incident command; (5) movement of patients within
the facility; (6) movement of patients to off-site institutions; and (7) hospital
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