1. E EMERGENCY R RESPONSE T TEAM TRAINING
Presented by:
Mr. Nasser Al Luhaidan , DCOO
Safety Committee Chairman

2. Objectives :
To attend promptly and effectively to all possible emergencies in SMC.
To train and educate on emergency evacuation procedures.
To explain the individual roles and responsibilities in an emergency.
To protect property, facilities, and equipment.
To identify responsibilities of individuals and departments in the event of a disaster situation.
To prepare the staff and Hospital resources for optimal performance in an emergency.
To manage effectively utilities , equipments during emergencies.

3. Why are We Concerned ?
Healthcare facilities could be faced with an emergency at any time.
Every employee in the organization needs to know how to respond promptly and act up on during an emergency.

4. What is an Emergency ?
Any unplanned event that can cause deaths, or significant
injuries to:
Employees, Patients, customers, or the public
Or, that can:
shut down the business
disrupt the operations
cause physical or environmental damage
threaten the facility’s financial standing
threaten the facility’s public image / reputation

5. EMERGENCY MANAGEMENT
The act of developing procedures and plans to create effective preparedness, mitigation, response, and recovery during a disaster affecting a health care facility.

6. EMERGENCY LEVELS
A ranking that classifies the SMC emergencies according to their severity and potential impact:
Level 1 Minor, localized emergency. The Emergency Plan and ICC is not activated.
Level 2 Major incidents that disrupts operation (may need outside experts). The Emergency Plan and ICC might be partially activated.
Level 3 Disaster involving the Hospital and community. The Emergency Plan and ICC is automatically activated.

7. Common Emergencies that May happen in Healthcare .
Medical Emergencies.
Fire or Explosions
Chemicals / Hazardous Materials Release
Violence / Aggressive Behavior
Infant / Child Abduction etc..

8. EMERGENCY RESPONSE TEAM
An  Emergency Response Team (ERT) is a group of people who prepare for and respond to any emergency incident, such as internal or external emergencies / disaster or an interruption of business operations.
This team is generally composed of specific members designated before an incident occurs, although under certain circumstances the team may be an ad hoc group of willing volunteers.

9. MEMBERS IN ERT Deputy COO – Team Leader Assistant COO
Security Director & Manager, Supervisors
Case Management / Executive on Duty
Patient Services Director
Engineering & Facility Management Director
EFMD HVAC Engineer
Environmental Services Director & Manager
Nursing Coordinator
ICU Coordinator
Clinical Engineering Supervisor
Environmental Health and Safety Manager / Officer
Executive on Duty
Electrician on Duty
Plumber on Duty / Supervisor

10. ERT PRIMARY RESPONSIBILITIES
Determine the scope and impact of the incident
Make appropriate emergency notifications
Prioritize emergency actions
Deploy resources and equipment
Communicate information and instructions
Monitors and re-evaluate emergency situation
Coordinate with External Agencies in coordination with Incident Command Leader 

11. Emergency Response Team in SMC
To respond promptly for any internal emergencies via Bravo group # 3 communication SMC Safety Committee and EHS Office initiated to have an in-house multidisciplinary responds team as part of SMC Emergency and Disaster Preparedness plan.
The mission of the ERT is to provide information to the Incident Commander (CEO) on the direction on how the emergency impacts the hospital and the likelihood that the emergency will escalate.
The ERT coordinates essential services necessary to address the situation, and provides emergency information.

12. EMERGENCY RESPONSE TEAM

13. HOW TO ACTIVATE ERT ?
The activation of the ERT during an internal emergency is initiated by the staff through a phone call to SMC Hotline numbers 2090/1234/1529.
At the back of employee badge has all MEGA CODES emergency contact numbers for every specific emergency including the utility failures.

14. ERT MEMBERS DO NOT DO THE FOLLOWING:
Do not try to fight / suppress any large fires.
Perform hazardous materials clean up, respond to incidents involving radiology , chemical , biological incidents.
Evacuation of critically ill / ventilated patients without assistance of Medical Team.

15. ROLES & RESPONSIBILITIES:
ERT LEADER / DESIGNEE
Responsible for overall control & coordination with concerned Department heads, Emergency Response Team and Incident Command Center.
Coordinates with the Incident Commander of SMC, the CEO.
Directs overall activities of the operation in major incidents as designated by CEO.
May contacts outside agencies/authorities as designated by CEO.
Announces the Code Clear once the emergency is resolved as designated by CEO.

16. ROLES & RESPONSIBILITIES: Continue…. SECURITY DIRECTOR / OFFICERS
Secure the Area
Maintain good traffic flow during building evacuation
Provide parking area for ambulances & Fire Trucks etc.
Maintain crowd control
Maintain order and traffic control for the arrival of local emergency responders.
Assist in fire fighting ( if it is safe to do so) and assist healthcare providers for patient evacuation.
Be trained on how to use evacuation tools and fire fighting gears.

17. ROLES & RESPONSIBILITIES: Continue…. NURSING TEAM
Provide medical and nursing needs of the patients/victims.
Coordinate with ERT / local emergency responders in evacuation of patients.
Take care of medical records of the patients and coordinate with admission for inter-facility transfer.
Coordinate with Pharmacy and Materials management, Dietary Services and Line for supplies.
Coordinate with the Incident/ERT Commander or HRD for additional staff to help in the evacuation of patients.
Attend injured patients in the Triage area.

18. ROLES & RESPONSIBILITIES: Continue…. MEDICAL TEAM
Coordinate with  Incident Command Center or Emergency Response Team for patient transportation.
Prepare & assist the patients for the internal transportation of patients within the Critical Care Areas.
Organize, prioritize and assign , physicians to areas where medical care is being delivered.
Advice the Incident Commander (CEO / CMO) on issues related to the Medical staff.

19. ROLES & RESPONSIBILITIES Continue…. MEDICAL TEAM
Meet with CMO for update of the situation regarding medical staff and projected needs.
Updates  the CMO regarding all field medical emergency response, including field triage, medical transportation, first aids, deaths and casualty counts.
Manages and provides patient care services, including protection, feeding, rescue and relocation as needed in all hospital facilities.
Reports the status of patients to the Chief Medical Officer or his designee.
Coordinates the allocation of medical resources

20. ROLES & RESPONSIBILITIES: Continue…. ENGINEERNG & FACILITY MANAGEMENT
Shutdown or provision of needed utilities and facilities.
Coordinate with ERT Leader for preparation of evacuation and relocation areas.
Sets up the Incident Command Center together with IT & ESD.
Operate fire fighting systems & Assist Local Officials ( Civil Defense )
Supervise the use of elevators
Follow instruction from ERT & ICS

21. ROLES & RESPONSIBILITIES: Continue…. CLINICAL ENGINEERNG
Coordinate with medical & nursing staff.
Provide portable medical gas cylinders and life support equipments as needed.
Shut off medical gas valve as needed in coordination with Nursing Unit & ERT.
Follow instruction from ERT & ICS

22. ROLES & RESPONSIBILITIES: Continue…. PATIENT SERVICES
Coordinate with families of patients.
Coordinate with Medical & Nursing Officers for patient’s needs.
Preparation for patient relocations
Follow instruction from ERT & ICS

23. ROLES & RESPONSIBILITIES: Continue…. ENVIRONMENTAL SERVICES
Assist in relocation or evacuation of patients.
Provide house keeping services/equipment as needed.
Maintain unobstructed hallway & exits
Mark the hazardous areas to prevent harm for others (keeping sources of the combustible materials and chemicals away from the site of fire).
Assist in setting up ICC and decontamination area.
Assist in recovery stage of the emergencies.

24. Incident Command Center
CEO
COMMANDER IN CHIEF
Operations Section
Public Safety , Facilities , Patient Care
Planning & Recovery Section
Damage Assessment , Repair & Construction
Finance Section
Accounting , Insurance , Claims , Purchasing
Logistics
Engineering & Facility Management , IT, Human Resources
LIASON OFFICER
COO / DCOO
SAFETY COMMITTEE CHAIRMAN / ERT LEADER
PUBLIC INFORMATION OFFICER

25. EMERGENCY
MEGA CODES IN SMC

26. (Fire alarm, smoke, smell of burning material)
CODE RED
(EXT. 2090)
FIRE
(Fire alarm, smoke, smell of burning material)
In the event of fire or suspected fire,
Remember to R.A.C.E.:
RESCUE
ALARM
CONTAIN
EXTINGUISH – P.A.S.S.
(EVACUATE)
CODE BLACK
(EXT. 1234)
BOMB THREAT
Notify Security/management.
Gather information from the caller using the bomb threat telephone checklist.
Search your unit but don’t touch anything suspicious.
Isolate the area/suspicious thing and report to supervisor or Security/ERT Leader.

27. CODE ORANGE (DIAL 1529/1234) CODE PINK (DIAL 1234) CODE SILVER
HAZARDOUS MATERIAL RELEASES
Minor-Unit Head’s and ERT’s responsibility
Major – Civil Defense
Remember S.I.N.
Safety of the people
Isolate the chemical or the area
Notify the supervisor/ERT
(Don’t handle the spill if you are not trained for it. Refer to the Material Safety Data Sheet of the chemical.)
CODE PINK
(DIAL 1234)
INFANT-CHILD ABDUCTION
In case of Code Pink call 1234.
Secure the exits in your area until the Code Clear or Code White is announced.
Wear your ID and identify all suspicious persons and report to security or your supervisor.
CODE SILVER
VIOLENCE AGGRESSIVE BEHAVIOR
The purpose is to alert appropriate authorities of the dangerous situation while keeping a safe distance and preventing others from entering the area.
Do not negotiate if you are not trained to do so.

28. MASS CASUALTY INCIDENT
CODE TRIAGE
(Dial ER Extension)
MASS CASUALTY INCIDENT
Triaging/sorting of casualties will be done in ER.
Expansion of facilities will be done in the OPD clinics to accommodate casualties.
Discharge of some in-patients will be done to accommodate the casualties.
Altered standard of care will be authorized by the CEO or his designee.
Inter-facility or intra-facility evacuation and relocation will be done as needed in coordination with MOH and civil Defense
CODE WHITE
ALL CLEAR
This code will be announced by the Hospital Incident Commander or his designee if the situation has been cleared and all personnel can go back to work.

33. ERT BRAVO GROUP 3 COMMUNICATION FLOW CHART

34. HAZMAT TEAM ( CERT)
As part of the SMC Emergency & Disaster plan , there is a Chemical Emergency Response Team under ERT to deal /manage the chemical / hazardous substance spills lead by ESD Director.
Member of the team are:
Director , ESD
Manager , ESD
Supervisors & Trained staff , ESD
EHS Officers

35. Utility Back Up Plans
To manage essential utilities 24/ 7 in normal operation SMC have utility failure back up & recovery plans as well as to mitigate timely any possible emergencies may occur.
Essential Utilities are in the facility are :
Medical gas system
Electrical Systems / Emergency Generators
Heating , Ventilating & Air Conditioning system
Elevators
IT , Pharmacy supplies , Medical Records etc.

36. Back Up / Emergency Recovery Plans
Information Technology Department Disaster Response & Recovery / Continuity Plan
Engineering & Facility management Department Back Up plan for Utility failures
Infection Prevention Control Pandemic Plan
Medical Records Contingency & Recovery Plan
Medical Gas / Equipment Back Up / Recovery Plan
Inpatient Pharmacy Dept pharmaceutical supply / Recovery plan
Surge Capacity Plan

37. Surge Capacity Plan
Surge capacity is a measurable representation of ability to manage a sudden influx of patients.
It is dependent on a well-functioning Incident / Emergency management system and the variables of space, supplies, staff and any special considerations (contaminated or contagious patients, for example).