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HomeMy WebLinkAboutDepartmental disaster maual for nursing personnel DEPARTMENTAL DISASTER MANUAL FOR NURSING PERSONNEL r r / "A calamity, catastrophy; an unforeseen and generally ruinous mischance which happens suddenly!" In a disaster of any degree, people turn to a hospital for help. Therefore, the job of providing immediate medical and hospital care falls directly on the doctors and nurses. A disaster's impact on the medical resources of the hospital and /or the community is immediate and demanding whether or not they are prepared to care for mass casualties. Our job at St. Joseph Hospital is to be BE PREPARED, not only for reoccuring tragedies such as flood, fire, epidemics, explosions, and transportation accidents; but for a role in Civil Defense in case of a Federal declaration of disaster or nuclear attack. This booklet, DISASTER AND YOU, is our effort to familiarize YOU with th- disaster program at St. Joseph Hospital. It is only when each individual understancs his or her duties and responsibilities with a combined and united effort on the part of ALL departments, that any disaster program can function efficiently and adequately to care for civilian casualties in the event of a natural disaster or enemy action against our homes. DISASTER AND YOU I. I shall base my decisions on the information immediately available to me and shall make them in prayerful consciousness to possible unknowns. II. I shall earnestly strive to provide maximum help to the maximum number of people within my immediate area. III. I shall, in my evaluation of injuries, consider the whole patient and his wounds. IV. I shall attempt to recognize the impact of emotional trauma upon my patients and do my best to guard against possible panic. V. I shall give due consideration to those immediate dangers which may threaten the future safety of my patients. VI. I shall make every effort to maintain established professional standards, but shall temper my actions to meet immediate needs. From Eliason's Surgical Nursing EMERGENCY CREED The calling of a Disaster Alert must be determined and coordinated with the Administrator and /or her relief. Determine whether it is a Major or Minor Alert. Minor Alert = Disaster Plan A Consists of 25 -50 injured people There is a need of more personnel and additional medical help, but not the need for the full plan. Major Alert = Disaster Plan B Consists of more than 50 injured, with an unknown number. A need for the full plan to go into action exists. CLASSIFICATION OF DISASTER 1. The Assistant Director assumes command until the Chairman of Disaster arrives. 2. The first doctor on the scene assumes command until the Medical Disaster Director arrives. 3. The doctor at the scene shall prescribe care for the victims until the family physician is known. 4. In absence of the family physician, or a doctor: the Director of Nursing in command may order discontinuation of a resuscitation at any time if vital signs cease, monitor shows no activity, or if the eyes have been dilated over 3 minutes. PROTOCAL FOR CHAIN OF COMMAND AT A DISASTER UPON THE ALERT OF A DISASTER ...the Assistant Director should: 1. Assume responsibility of Triage 2. Assign an A.C.C. clerk to call a. the Administrator b. the Director of Nursing Service c. the Secretary of Nursing Service d. the President of the Auxiliary 3. Assign members of present nursing staff to areas of need, leairtng a skeleton staff on the floors. 4. Check assignment plan for necessary personnel of each area. IMMEDIATE DUTIES OF THE ASSISTANT DIRECTOR 1. Prevent the occurrurence of the Disaster, whenever possible. 2. Minimize the number of casualties if the disaster cannot be prevented. 3. Prevent further casualties from occurring after the initial impact of the disaster. 4. Rescue the victims. 5. Provide immediate first aide. 6. Promote the reconstruction of the lives of the victims. BASIC PRINCIPLES IN DISASTER AS A NURSE AND AS AN EMPLOYEE OF ST. JOSEPH HOSPITAL She should be prepared to: 1. Answer immediately to a call for her services. 2. Adapt Nursing Skills to emergency situations even with the lack of equipment. 3. Understand her responsibility for leadership in a disaster. 4. Know and participate in this hospital disaster plan completely. 5. Have a knowledge of self-protection and care for the protection of others. 6. Know what she can and cannot do. THE ROLE OF A NURSE DURING DISASTER 1. Maintain a Patent Airway. 2. Control hemorrage. 3. Maintain Cardiac status. Lt. Start Intravenous infusions. 5. Adjust rate of flow of existing infusion with vaso pressors and antiarrhythmic agents. 6. Administer prescribed medications. 7. Administer oxygen when necessary. 8. Give anesthesia (if previous preparation). 9. Debride wounds. 10. Apply pressure dressings. 11. Dress burns. 12. Apply splints as necessary. 13.. Observe vital signs. 14. Institute rotating tourniquets in acute pulmonary edema. 15. Start resuscitation measures as necessary. 16. Prepare for and perform defibrillation if a physician does not arrive within (1) minute•.of onset of ventricular fibrillation. 17. Use and /or regulate the external pacemaker if necessary. 18. May steri -stip minor lacerations. FUNCTIONS OF A NURSE IN A DISASTER DISASTER REACTIONS AND HELF'JD MEASURES TYPE SYMPTOMS DO'S DON'TS Normal (common) perspire no immediate reactions (quickly tremble help required regaining control) nauseated momentarily confused Individual panic Unreasoning attempt Try gentle firmness Don't use brutal (blind flight) to flee first. restraint. loss of judgment Give something warm Don't strike. uncontrolled weeping to eat or drink or Don't douse with wild running about smoke. water. Get help, if neces- Don't administer sary to isolate. sedatives. Depressed reactions Stand or sit without Establish contact Don't tell them to (slowed down, numbed) moving or talking. gently. " snap out of it" Vacant expression. Try to get them to Don't overwhelm Seems to be without tell you what with p emotion. happened. Don't feel resent - Find simple routine ment towa d them or jobs for them. show it. Give something warm Don't administer to eat, drink or smoke. sedatives. Overly- active responses Argumentative Give them your attention Don't tell them they Talks rapidly for a few minutes to shouldn't feel the Jokes inappropriately talk about the disaster. way they do. Makes endless sug- Suggest that rightness Don't administer gestions. or wrongness can be sedatives. Jumps from job to job. settled later. Don't argue with them. Find them jobs that require physical activity. Give them something warm to eat, drink or smoke. Bodily reactions Severe nausea Show them you are Do not tell them Vomiting interested. there is nothing Conversion hysteria Find them small jobs wrong with them. Can't use some part to make them forget Do not blame or of body. disability. ridicule them. Make comfortable to await medical help. PSYCHOLOGICAL REACTIONS IN DISASTER ASSIGNMENTS AREAS AREA NO. PERSONNEL ASSIGNED DUTIES Casualty Entrance 1 Triage Area 2 RN: Examine the patients and deter - (inside the MD: Roy Smith mine the injuries; send to proper E.R. door) T.O. Walton area for treatment. Minor Cases and 3 Surgical Nurses: General emergency care. fractures (cysto room Setting of fractures. and fracture Placing of casts. room in surgery) MD: Dr. Coleman Dr. O.C. Cooper Dr. Marsh Dr. Rich Ambulatory Patients 4 RN: Bring Twin Emergency i?.00m and Discharges (shelled -in cart (chargeable cart) area at Med. Records) Also bring third floor Crash LVN: Cart to this area. (1) examine (2) treat MD: Dr. Andres (3) discharge or admit Dr. Caperton Dr. Harris Dr. Kahil Dr. Novosad Dr. T.T. Walton Dr. Searcy Mzjvr Surgery Staff Nurses: Surgery as necessary (Surgery Suite) MD: Dr. Frank Anderson Dr. Fred Anderson Dr. Baird Dr. Coscia Dr. McQuaide NURSING PERSONNEL ASSIGNMENTS Minor Surgery 6 RN: Routine Emergency Room -Duties and First Aide (Emergency Room Suite) LVN: MD: Dr. Buck Dr. Kemp Dr. McGill Burns 8 RN: Routine Nursing duties for (ICU and the patients suffering with burns. Corridor in the clean area) LVN: Set up stock for dressings. Set up sterile linen cart. MD: Dr. Lindsey Dr. McNew Shock and 7 RN: Routine Nursing Duties for Observation (Recovery Rm) patients in shock. LVN: MD: Dr. Grant Dr. Hall Expentant Control 10 RN: Monitoring of patients,con- Center (Surgery sidered by a physician, shelled -in LVN: beyond help. area) MD: Call physicians from RR area. Personnel Resources 11 Secretary: Calls in nursing personnel. (Nursing Service Office) Labor & Delivery 24 RN: Routine duties as necessary. (Routine area) LVN: MD: Dr. Benbow Dr. Roman Dr. Rasberry 12 I-14 v d I EMERGENCY ENTRANCE I I I I OR 111 1 _ 1� ET -_ � t - - 6I 311...', I T 011E jY MY of 111.•1SSS LOVNOE [n NEWS / , Q �_� OIGi _ x - RAY � Si. ° CriOL SP PROCEOISE � SialR T L D IN P . a ' WZ ER E 1 CR p ■ � WARY Ok3 �1 S I OAIIK� FILM OFf � _ _ ■�. • I I �� INO LD R:OM SOR71N0 �l �. -7 �IH- l i W MI T FRd - THIN I '�I OVINE SOILED NOLO A IT FILM OIST RLOOD RED _ LLL + - «. • ACTS ! A ■ FILE! ° WAITING ERA SANK 1I y I S ACT9 . L. / '— T F ST -' 1 CLEAN SUPPLY 'MO Lg.- I i� i I NURSE CYST. FRA C T IINE C� W M - 0,11E7 w '. N 1; b 4N muses T ROOM 01 CNAIM CLEAN CLEAN CN . L OVIET IS LOBBY LOBBY Sf.R VICE m , CLEAN STAFF COR00R • • 1 Ei— CONT BUSINESS Of F CASH RQ MECNAISCAL S • • . m i I _. LA / .._. . CE T[R EQUIPMENT NT 1. •- � Y • tik",0� 0 S CLEAN I ® ' �'T S MOLD s C0011D. a ii . 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TREATMENT AREA LOCATION NO, Casualty Entrance 1 Minor Surgery & Labor/Delivery 24 First Aid 6 Triage Area 2 X-Ray Dept, 26 Shock/Observation 7 Minor Cases & Fx. 3 Burns 8 Ambulatory Pt. & Discharges 4 Expectant Control Center 10 Major Surgery 5 Personnel Resources News Media Office 16 Employee Volunteer Chaplain 18 Nursing 11 TREATMENT AREA FLOOR PLAN . . _ _ _ 0,....^ A EO IP JOICT EQUIP MECHANICAL EQUIPMENT W•SHER \ 1 �,, �` Ilk HONE WIN PHONE 57011 M - < ! EOUIP F� 1 [ STAIR • , ` EQUIPMENT 1 ELE, CTS ` 1$j yik IS N MEN T X111 DECONTAMINMION I'1 PACKAGING AG V i II TRANS - PUEV II CCC G _ W _- FORMER J tUeE it CAROUSEL . ■ - � w I STERILIZING u s VAULT Ot• II ACTS, W 0 �y S ACTS IPM III1 _ • u W .. -6111 - - SULK STORES za H • RES AIL IMINI 9T11R I ry, � RY COUP. LIFT Y ry ■ . C 9 • _ • v S E R V I C E A R C A HSKPO 0 EOUIP _... _ __ _. [ . L P IUR PHARMACY STORA R E IN KA n _ TN[ PRINT 04 I � A .0 H NC __ _ ��� WAIT SHOP CAN �® a Q. +'^ ELECTRICAL �' WAIT - 'T WASH 1�� - - - - LOB 0 • ,.1 . w A. !OILED I.. IIiIR.. TT „„ dlHES au. ,.T..,__:, �t STAIR 5 - isitors' Entrance T DEM/G dNIN• MOCK CLASS il l I..r R- • p ROOM TING, pyeEnrance IL II% hTE. IT I ERVINO OR 1 .. M.•• T RV[■ OFFICE . EMI .• • COOLER M[N•5 FRE[Z[ LOYINC WOMEN • I WOYfN J LOCKER LOUNGE 1 LOCKERS KITCHEN • ag is A cr COOLER / STOREROOM FR[CZER BASEMENT FLOOR PLAN TREATMENT AREA LOCATION NO. TREATMENT AREA LOCATION NO. DOA'S 9 Dietary 19 Pt, Information Center 12 Housekeeping 20 Visitor's Waiting 13 Laundry 22 Radiation Rx Area 14 Maintenance 23 Psychiatric Pts. 15 Purchasing - Supplies 25 Inhalation Therapy 27 Dispatching 17 TREATMENT AREA FLOOR PLAN 1 rfiirr r iEmrrg i' n DISASTER EMERGENCY PREPAREDNESS! 5:00 P.M 16 mm color, sound film 5 :30 P.M Mrs . Hugh Eiland, R.N. Director of Nursing Service Disaster Chairman St. Joseph Hospital Why Community Preparedness is necessary? The Steps to Preparedness! Defining The Problems. Test and Critique the Plan. .... The degree to which we improve our planning to handle disasters, we improve our system to handle the day -to -day emergencies ... .