EMERGENCY DEPARTMENT MOH Nga Manea PROCEDURES AND POLICIES FOR EMERGENCY AND DISASTER PREPAREDNESS IN THE HOSPITAL EMERGENCY DEPARTMENT EMERGENCY DEPARTMENT MOH Nga Manea

FUNCTIONING OF HOSPITAL EMERGENCY DEPARTMENT 2009

EMERGENCY TREATMENT ROOM

WAITING ROOM Adequately large, but the space is not functioning Doctors and nurses must pass by the waiting patients. Patients in the waiting room are also exposed to emergency cases. No Patient privacy

EQUIPMENTS

AMBULANCE SERVICES Emergency Call Out System: 999/22664 Emergency Checklists – Amb Drivers/Nurses AmbulanceDrivers Maintain and drive the ambulance Some with the basic life support skills

EMERGENCY SKILLS Nursing School Self Motivated, reading and researcher Visiting Specialist - PTC Recruitment of Staff with emergency Skills Local staff attachments Practical Scenarios In-service Trainings

PROTOCOLS AND GUIDELINES MOH Disaster and Emergency Plan Nursing Standards Emergency Checklist Incident Reporting System Ambulance Call Out Pre-hospital Management Patient Admission Triaging Protocol

WHAT TO DO ! !

PROCEDURES AND POLICIES IN PLACE In consulting and collaboration by MOH, Government Agencies, Donor Agencies with NZ Emergency Specialists, and Local Staff - 28th March 2014

LAYOUT OF ED

RESUS AREA Designated Resus Area Only use to Resus patient – Intubate Bed Pannels Emergency Requirements – Board etc

PROCEDURE AREA 2nd Resus Area Clinical/Medical Nurisng Procedures Grieving and Bereaved families

STAFF WORK STATION Adequate work space View Patients X-tray and ECG on medtech Both Nurses and Doctors access to computers for Documentations

EQUIPMENTS Emergency Trolley AED Infusion Pump Cardiac Monitor – Capnography Istat Machine

TRIAGE Nurses triaged, back to waiting area For critically ill like chest pain, massive bleeding escorted into the ED immediately Australian Triage Code

WAITING AREA Receptionist take patient details and enter them on the computer Then ask patient to wait at waiting area or Triage.  

AMBULANCE

DEFINITIONS DISASTER -A serious disruption of the functioning of a community or a society causing wide spread human, material economic or environmental losses which exceed the ability of the affected community or society to cope to using its own resources - ( World Health Organisation ,2007,p.7) EMERGENCY - An actual or imminent event that endangers or threatens life, property or the environment and which requires a significant coordinated response

PROTOCOL/POLICIES MOH Emergency and Disaster Plan MOH Hospital Emergency Call Out Plan Pre-hospital Documentations MOH Patient Referral Policy CPD Protocol Incident Reporting System

PRE DISASTER PHASE ACTION Understand the threat the likely disaster presents Identifying team leaders and staff members for the different disaster/emergency situations Consider resources available eg staffs, vehicles, mobile phones, 72hrs pack Work in collaboration with support groups/divisions eg: CIEM, Red Cross, Community leaders etc

DISASTER PHASE ACTION - HOSPITAL EMERGENCY Disaster - Activate MOH disaster and emergency Call Tree Plan Emergency - Activate MOH Hospital Emergency Call Out Plan Sign Off Form Hospital Staff report to designated areas Ambulance Service Dispatched – Ambulance Officer and ED Nurse Activate code I -Trauma Team /Medical/ONET Audit

TRAINING OPPORTUNITIES Health Specialist Visits ALS & PLS PRIME/St John Ambulance Primary Trauma Care

TRAINING OPPORTUNITIES APEDNN Meetings Emergency and Disaster attachments Aerodrome exercise Small drills and tabletop exercises ICN meetings

TRAINING OPPORTUNITIES

INITIATIVES Emergency Specialist EMS Committees Full Scenario for the ED Nurses Standing Orders – PRE-HOSPITAL Emergency Nursing- Nursing School Curriculum Istat Machine

ACHIEVEMENTS PTC LOCAL INSTRUCTORS Certify - Level 5 ALS Emergency and Disaster Attachments abroad Outer Island Locum Cover

CHALLENGES Traumatized : Clients Family members - alcohol/Verbal/Pysical Abused Nature of the Cause Difficult Situation: own family Staff/Colleague Stress: handle the lost of a life – informing the families

COPING STRATEGIES Support each other Team Approach Time Off DEBRIEF Police Securities – Ambulance Officers

WAY FORWARD Keep going Communication and Networking Continuous Professional Development Emergency Drills Multi Sectoral approach

DISASTER and EMERGENCY HAPPEND ANYTIME!!!!

THANK YOU! KIA ORANA E KIA MANUIA