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PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA
DOKUMEN:
NOMBOR
DOKUMEN:
GUIDELINES ON DISASTER PLAN
DS-0799
TARIKH KELULUSAN :
24-05-2010
TARIKH BERKUATKUASA :
24-05-2010
MUKA
KULIT
TARIKH KAJISEMULA :
PENULIS DOKUMEN :
DISEMAK OLEH :
DILULUSKAN OLEH :
Mohd Idzwan Zakaria
Ketua, Jabatan Trauma & Kecemasan
Wakil Pengurusan-QMS
DISAHKAN OLEH WAKIL
PENGURUSAN :
DOKUMEN INI ADALAH HAK MILIK SEPENUHNYA PUSAT PERUBATAN UNIVERSITI MALAYA (PPUM).
SEBARANG SALINAN SEBAHAGIAN ATAU SELURUHNYA DOKUMEN INI TIDAK DIBENARKAN SAMA
SEKALI KECUALI MENDAPAT KEBENARAN SECARA BERTULIS DARI BAHAGIAN PENGURUSAN
KUALITI, PUSAT PERUBATAN UNIVERSITI MALAYA.
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
NOMBOR DOKUMEN:
GUIDELINES ON DISASTER PLAN
DS-0799
MUKA:
2/64
INTRODUCTION
The University Hospital was officially opened in August 1968 and as early as April
1967 it was involved in the preparation of the contingency plans to handle disasters
involving aircraft using the Subang International Airport. A University Hospital
Disaster Plan was then formulated in 1969 on how to respond to request for medical
support in cases of disasters involving aircraft at and around the vicinity of the
Subang International Airport.
In 1976, the Medical Advisory Committee of University Hospital formally set up the
University Hospital Disaster Plan Committee which was given the responsibility to
oversee the implementation of the University Hospital Disaster Plan. But by this time
the University Hospital Disaster Plan was expanded to include besides aircraft
disaster; civil disaster like flood, fire, landslides, high-way accidents, riots and
industrial accidents. Also included in this new University Hospital Disaster Plan are
internal disasters arising from bomb hoax, power failure, fire and explosion.
The University Hospital Disaster Plan has served well for the past 30 years, but due
to certain factors (discussed briefly below), there arise a need to review to suit the
present busy Emergency Unit. There had been occasional inconsistencies mainly
due to an inadequate definition which is addressed now. Attempts have been made
to rectify unnecessary teams responding to inappropriate calls. The duties with
Action Cards for every member of the team have been identified. The new
Corporatised Administration of UMMC, necessitates changes in personnel and their
duties, all of which have been accommodated in this new University Malaya Medical
Center Disaster Plan.
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
3/64
THE UMMC DISASTER COMMITTEE
The UMMC Disaster Plan Committee was formed on 17.12.76 with the following
objectives:a) To implement and update the Hospital Disaster Plan
b) To initiate and coordinate trial practices regularly.
c) Familiarize hospital staff in regard to University Hospital responsibilities and the
procedure to follow, in respect of Airport Disaster and Civil Disaster like flood, fire,
landslide, road traffic accidents, riot etc.
d) To take any other necessary action
The Committee members are :
1. Director (Chairman)
2. Deputy Director (Professional)
3. Deputy Director (Management)
4. Head of Trauma and Emergency
5. Clinical Coordinator, Trauma and Emergency
6. Administrator of Emergency
7. Head of Department of Orthopaedic Surgery
8. Head of Department of Anesthesiology
9. Head of Department of Surgery
10. Head of Plastic Surgery Unit
11. Head of Department of Pathology
12. Head of Department of Radiology
13. Head of Department of Psychological Medicine
14. Head of Department of Medicine
15. Head of Neurosurgical Unit
16. Head of Department of Paediatric
17. Head of Maxillofacial Unit
18. Head of Department of Pharmacy
19. Head of Catering Unit
20. Head of Medical Record Unit
21. Head of Medical Social Welfare Unit
22. Chief Matron
23. Matron In Charge of Inpatient
24. Matron In Charge of Ambulatory
25. Matron In Charge of Policy
26. Head, Transfusion Medicine
27. Chief Public Relation Officer
28. Head of Security
29. Head of Transportation Unit
30. Head of Cleaning Service
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
4/64
OPERATION OF THE DISASTER PLAN
Definitions:Stand by - STAGE I
Stand by is an alert response, that warns the First Management Team of an
impending incident. The incident can be any event that is suspected or imminent,
which might result in multiple casualties (for example hijack, aircraft in difficulty,
village or building on fire, police alert on major Road Traffic Accidents etc.). The first
management Team must standby for further instructions.
Full Emergency - STAGE II
Full Emergency is a transient adaptational response in the Trauma and Emergency
Unit with prompt and vigorous help form all the major active personnel on-call. It is
an extension of good everyday emergency management with sound decision making
at Lecturers/Assoc. Prof. Level. Supportive personnel to be called without hesitation
as required, to team up with the overall management.
Full emergency is applied when there are multiple “casualties” of more than FIVE (5)
at a similar time, in a mass casualty incident. Examples are many casualties in a
road traffic accident, bus overturned, poisoning, burns and gang war. An aircraft in
difficulty with imminent crash with the possibility of multiple casualties with injury is
also an example for Stage II (Full Emergency).
Disaster - STAGE III
The term Disaster is used to denote usually overwhelming events and
circumstances that test the adaptational responses of the Emergency Unit
beyond their capacity and lead temporarily to significant disruption of
functions of the Emergency Unit including other Units of the Hospital. It also
involves team management and communications with other emergency
organizations outside the Hospital. Good disaster management is not merely an
extension of good everyday emergency procedures. It is more than just the
mobilization of additional personnel, facilities and supplies. Disasters often pose
unique problems rarely faced in daily emergencies. These problems are varied
depending on the immensity of the incident with many casualties (plane crash,
building cash, LRT crash etc.) which needs timely decision making, management
and organization skills with roles being played by All the respective units of the
Hospital. It is applied when there are multiple casualties of more than Ten (10) at a
similar time.
Stand Down – Stage IV
Stand Down stage occurs when the impending incident has been averted or when
disaster relief efforts have ceased. This stage is to end all other disaster stages and
indicates that the hospital and staff would revert back to normal functioning.
Following Stand Down, the staff involved will be debriefed, all casualties and
equipments accounted for, and a Post-Mortem of the disaster management activities
will be conducted later.
Activation of Plan
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
5/64
1. Director UMMC
2. Clinical Coordinator/Head/Lecturers/Administrators/Sisters, Trauma and
Emergency
Communication Codes
As the Hospital Disaster Plan caters for all emergency situations, including airport
disaster, highway and civil accidents, it is necessary to standardize code used during
communication.
The terms “stand by”, “full emergency” and “disaster” used by control tower,
Department of Civil Aviation are universally used by International Airlines Association
and will continue to be used. The Hospital Disaster Plan uses Stage I, Stage II and
Stage III as communication codes to denote different situations and responses
needed in general emergency situations.
The comparison is as follows:Department of Civil Aviation
UMMC Disaster Plan
a) “Standby” (aircraft in difficulty)
b) “Full Emergency” (crash is imminent)
c) “Disaster” (aircraft crash)
- Stage I
- Stage I progress to Stage II
- Stage II progress to Stage III
Emergency Operation Room (Bilik Operasi Bencana)
This room is located in the Trauma and Emergency just beside the administrative
office, used for briefing of medical and paramedical staff during the operations of the
Full emergency (Stage II) or Disaster (Stage III). It is opened when “Disaster” is
activated by the Director. The staffs in the Operations Control Rooms are:
Staff
Record officer (In charge)
Matron
Trauma
and
Emergency or Sister on
duty (emergency)
2 nurses
1 staff nurse
1 administrative officer
Duties
Assist in documentation and data for report
• Ensure equipments in the room are adequate and
functional
To receive and make phone calls
To document the incident activity and disaster
responses
Assist in documentation and record
Ensure food is adequate in the room
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
6/64
Information Centre
If necessary, a room or an area will be established by the Administrative Officer in
consultation with the Director of UMMC. It shall be in one of these three areas
depending on the magnitude of the Disaster:-
1. Radiology A Group Waiting Area
2. Polyclinic Reception Area
3. Dewan Rawatan Utama
The functions of this area are:-
1. To provide information and answer all queries regarding casualties to relatives
2. For the Hospital Director to meet the Press and brief them regarding the situation.
LAYOUT OF THE EMERGENCY UNIT IN RELATIONS
HOSPITAL DISASTER PLAN
Area 1
-
Reception Area
⇒ for registration of patients
⇒ for triage of patients
⇒ communication with ambulances and Airport
Terminal 1, Health Centre, Air Disaster Unit,
Kuala Lumpur Hospital. (it will be stationed in the new call
centre once it is ready)
Area 2
-
Resuscitation Area (Resus Hall)
⇒ for patients needing resuscitation and other immediate
attention
Area 3
-
Treatment Area (AMC)
⇒ for non-ambulant trolley patients
⇒ can accommodate for T1 patients if resus hall is
overwhelmed
Area 4
-
Consultation Hall
⇒ for ambulant patients with minor injuries
Area 5
-
Observation Ward
⇒ for patient requiring temporary observation
⇒ can accommodate for T2 patients if AMC is overwhelmed
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
7/64
Triaging of Casualties:Triaging (in French : ‘to sort’) of multiple casualties is done according to the urgency
of the Medical Emergency. Internationally, this type of prioritization is done by color
tagging/coding :RED
- UMMC Triage 1 - Casualty having an ABCD problem
- Needs immediate management
YELLOW
- UMMC Triage 2 - Needs urgent management
GREEN
- UMMC Triage 3 - Needs delayed management
Walking wounded
WHITE
- Dead casualties
Ambulance Services
⇒ Four ambulances are available at the Trauma and Emergency Unit
⇒ All are equipped with radio communication to the Trauma and Emergency Unit
⇒ Resuscitative equipments in the ambulance includes, airway equipments, oxygen,
suction, defibrillators (when required), emergency kit and various splints (air splint,
plastic splints etc.), scoop stretcher etc. Other surgical equipments are readily
available as and when required
⇒ Ambulance from other organizations are also mobilized when necessary
ACTION PLAN IN CASE OF DISASTER - TEAMS
For this purpose, the following teams are organised:1. 1st Ambulance Team
1. Emergency Medical Officer (at least a Phase II
emergency medical resident of emergency
physician)
2. Emergency Medical Assistant/Staff Nurse
3. Emergency Attendant
4. Ambulance driver
2. 2nd Ambulance Team
Lecturer
1. Emergency physician/orthopeadic/surgery
2.
3.
4.
5.
Emergency Medical Assistant
Emergency Staff Nurse
Emergency Attendant
Ambulance driver
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
NOMBOR DOKUMEN:
GUIDELINES ON DISASTER PLAN
DS-0799
MUKA:
8/64
TEAMS
NO
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
TEAM 1
Director
Deputy Director (Clinical)
Deputy Director (Administration)
Head of Trauma & Emergency and/or
Clinical Coordinator, Trauma & Emergency
Emergency Physician On-Call
Trauma & Emergency Administrator
Trauma & Emergency Matron
Orthopaedic Lecturer On-Call
Orthopaedic Medical Officer On-Call
Surgical Lecturer On-Call
Surgical Medical Officer On-Call
Anaesthesiology Lecturer On-Call
Anaesthesiology Medical On-Call
Matron On-Call
Administrator On-Call
Chief Security Officer
NO
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
TEAM 2
Director
Deputy Director (Clinical)
Deputy Director (Administration)
Head of Trauma & Emergency and/or
Clinical Coordinator, Trauma & Emergency
Emergency Physician Lecturer
Trauma & Emergency Registrar
Trauma & Emergency Administrator
Trauma & Emergency Matron
Orthopaedic Lecturer On-Call
Orthopaedic Medical Officer On-Call
Surgical Lecturer On-Call
Surgical Medical Officer On-Call
Anaesthesiology Lecturer On-Call
Anaesthesiology Medical On-Call
Medical Lecturer On-Call
Paediatrics Lecturer On-Call
Biomedical Imaging Lecturer On-Call
Radiographer On-Call
Primary Care Medicine Lecturer On-Call
Medical Transfusion Lecturer On-Call
Matron On-Call
Administrator On-Call
Chief Security Officer
Patients Information Centre Officer On-Call
Forensic Patologi Lecturer On-Call
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
NOMBOR DOKUMEN:
GUIDELINES ON DISASTER PLAN
DS-0799
MUKA:
27.
28.
Forensic Patologi Medical Officer On-Call
Information Techonology Officer On-Call
NO
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
TEAM 3
Orthopaedic Consultant On-Call
Anaesthesiology Consultant On-Call
Surgical Consultant On-Call
Medical Consultant On-Call
Pathology Consultant On-Call
Neuro Surgical Consultant On-Call
Biomedical Imaging Consultant On-Call
Primary Care Medicine Consultant On-Call
Cardiothoracic Lecturer On-Call
Psychiatric Lecturer On-Call
Medical Transfusion Officer On-Call
Ambulatory Matron
Inpatient Matron
Critical Care & Operation Theatre Matron
Pharmacist On-Call
General & Facilities Management Senior
Manager
Patients Information Centre Senior Manager
Medical Social Work Senior Manager
Security Officer
NO
1.
2.
3.
4.
5.
6.
7.
8.
TEAM 4
Obstetrics & Gynecology Consultant On-Call
Pediatrics Consultant On-Call
Otorinolaringologi Consultant On-Call
Ophthalmology Consultant On-Call
UPAS Manager
Clinical Diagnostics Lab Manager
Pharmacy Senior Manager
All Clinical Head Units
Tarikh Berkuatkuasa:
No. Kajisemula:
9/64
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
NOMBOR DOKUMEN:
GUIDELINES ON DISASTER PLAN
DS-0799
MUKA:
10/64
Brief Description of Plan (Details described in the flow chart)
When Stage I Emergency or Stand by (Aircraft in difficulty) is declared, the
Emergency Unit is alerted by the ringing of the emergency bell once in a long stretch
or “Tahap I” mentioned on the loud speaker, which shall then take all the necessary
actions in anticipation of receiving multiple casualties. The hospital telephone
operator will use the SMS system “C1-Standby” to alert the Team I to be on standby
for further instruction.
When the message is received that the plane had landed safely or the emergency
averted the hospital telephone operator will then alert everyone through the SMS
system that the “C 1 Standby” is over.
When Stage II or Full Emergency is declared, the emergency bell at the Emergency
Unit is pressed twice in long stretch or “Tahap II” mentioned on the loud speaker
and the 1st Ambulance Team is dispatched to the Airport or to the site of the disaster,
(the ambulance maintaining communication with the Emergency Unit regularly). All
existing patients in Trauma & Emergency are quickly assessed and if needed
admission, are quickly admitted to the ward. The telephone operator will then alert
the “C2-Full Emergency”. The members of Team 2 will proceed to the Emergency
Unit Conference Room and be briefed about the situation by the Emergency
Head/Lecturer/Administrator. They will remain at the respective Areas and follow
their respective duties until the all clear signal is given. Members of Team 3 are
called as and when necessary to help in the management.
When Stage III Emergency or Disaster is declared, the emergency bell at the
Emergency Unit will be rung thrice in long stretch or “Tahap III” mentioned on the
loud speaker, the 1st Ambulance and 2nd Ambulance Team will be dispatched
immediately and the Team 2 and Team 3 members will proceed immediately to the
Emergency Unit. Members of Team 4 will be called as and when necessary to help
in the management. The whole Emergency Unit will be organized to handle the
incoming injured patients. Stations will be marked accordingly as Reception and
Triage area (Area I), Resuscitation area (Area 2), AMC (Area 3), Consultation (Area
4), Observation wards (Area 5) for easy identification. Non-urgent cases will be
cleared and all equipment, medication etc. will be mobilized and stocked. The
wards, operating theatre and Blood Bank will be alerted. The Emergency Head
Lecturer/Administration will be coordinating all activities at the Emergency Unit,
together with all members of Team 2 and Team 3. Close contact is maintained with
the Ambulance Teams and The Commander at the site of the disaster to keep
abreast as to the latest regarding the disaster.
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
11/64
FLOW CHART OF DISASTER ACTIVATION PLAN
START
RECEIVE INFORMATION STAGE 1/
STAGE 2/ STAGE 3
SEND AMBULANCE TEAM TO
DISASTER SITE
REPORT INFORMATION RECEIVE TO
HEAD KLINIKAL COORDINATOR/
ADMINISTRATOR
ACTIVATION OF DISASTER PLAN
(STAGE1/ STAGE 2/ STAGE 3
ACCORDING TO INSTRUCTION)
ALL CLEAR
END
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
NOMBOR DOKUMEN:
GUIDELINES ON DISASTER PLAN
DS-0799
MUKA:
12/64
ACTIVATION OF ‘STANDBY’ – STAGE 1
START
RECEIVE INFORMATION FROM
CONTROL TOWER/ OTHER SOURCE
REPORT SITUATION TO CLINICAL
COORDINATOR/ HEAD
INFORM OPERATOR TO ACTIVATE
'STANDBY' - STAGE 1 IF
INSTRUCTED
TEAM 1 TO STANDBY (NEED NOT
PROCEED TO T& K) (C1
TRIGGERED) FOR INFORMATION
CALL 03-79492500/ 03-79492151
ALL CLEAR WHEN RECEIVE
INSTRUCTION (C0 TRIGGERED)
END
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
13/64
ACTIVATION OF ‘FULL EMERGENCY’ – STAGE 2
START
RECEIVE INFORMATION FROM
CONTROL TOWER/ OTHER
SOURCE
REPORT SITUATION TO CLINICAL
COORDINATOR/ HEAD
SEND 1ST AMBULANCE
TO ADU/ SITE TO ASSES
SITUATION
DIRECTOR ACTIVATES FULL
EMERGENCY
INFORM OPERATOR TO ACTIVATE
'FULL EMERGENCY' - STAGE 2 IF
INSTRUCTED
TEAM 2 TO T& K TO TAKE OVER
ASSIGNED RESPONSIBILITIES (C2
TRIGGERED) TEAM 3 WILL BE
CALLED WHEN NECESSARY
SEND 2ND AMBULANCE
TO ADU/ SITE TO ASSES
SITUATION
ALL CLEAR WHEN RECEIVE
INSTRUCTION (C0 TRIGGERED)
END
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
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ACTIVATION OF ‘DISASTER – STAGE 3
START
RECEIVE INFORMATION FROM
CONTROL TOWER/ OTHER
SOURCE
REPORT SITUATION TO CLINICAL
COORDINATOR/ HEAD
SEND 1ST AMBULANCE
TO ADU/ SITE TO ASSES
SITUATION
DIRECTOR ACTIVATES FULL
EMERGENCY
INFORM OPERATOR TO ACTIVATE
'DISASTER' - STAGE 3 IF
INSTRUCTED
TEAM 2 & 3 TOPROCEED T& K TO
TAKE OVER ASSIGNED
RESPONSIBILITIES (C3
TRIGGERED) TEAM 4 WILL BE
CALLED WHEN NECESSARY
SEND 2ND AMBULANCE
TO ADU/ SITE TO ASSES
SITUATION
ALL CLEAR WHEN RECEIVE
INSTRUCTION (C0 TRIGGERED)
END
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
15/64
Team functions:
Stage I: Standby
Action of Team 1
To be carried by
Team 1
Location
At respective areas
Action
1. Stand by
2. Wait
for
further
instructions. Do not
proceed to Trauma &
Emergency yet
Stage II: “Full Emergency”
Action of Team 2 and 3
To be carried by
Location
Team 2 (including Team Trauma & Emergency
1)
Team 3
At respective areas
Action
1. Proceed to Emergency
Operation Room
2. Document arrival on
response chart
3. Collect action cards
4. Manage
respective
areas as assigned
Will be called and advised
accordingly by Clinical
Coordinator
Stage III: “Disaster”
Action of Team 2, 3 and 4
To be carried out
Team 2
Team 3
Team 4
Location
Action
Trauma & 1. Proceed to Emergency Operation
Emergency
Room
2. Document arrival on response chart
3. Collect action cards
4. Manage respective areas as assigned
Trauma & 1. Proceed to Emergency Operation
Emergency
Room
2. Document arrival on response chart
3. Collect action cards
4. Manage respective areas as assigned
All
respective
areas
Action will be called and advised
accordingly by Clinical Coordinator
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
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Lay out of Trauma & Emergency during disaster and teams responsible
RESUSCITATION
AREA
DISASTER
OPERATIONAL
ROOM
AREA 2
ACUTE
MEDICAL CARE
(SEMI CRITICAL)
AREA 3
EMERGENCY WARD
CONSULTATION
(NON-CRITICAL)
AREA 5
AREA 4
TRIAGE
AREA 1
Area
1
2
Vest colour
Blue
Red
Team responsible
Emergency
Anaesthesiology
3
4
Orange
Green
Orthopaedic
Medical
Assisting team
Emergency, surgical and
orthopaedic
Emergency and medical
Paediatric, psychiatric and
other specialties
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
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Functions of medical personnel
Stage II: Full Emergency
Functions of Ambulance Team
To be carried out Location
by
Senior Emergency 1st ambulance
MO or emergency
physician on call
1. Emergency/
2nd ambulance
Actions
1. Proceed to disaster site
2. Identify
yourself
to
On-scene
Commander
3. Assess situation in disaster area and
get information regarding the disaster
4. Report to UMMC Call Center:
• Type of disaster
• Number of casualty expected
• Current status
• Any other information
• Request for second ambulance if
required
5. Proceed to on-site medical base and
report to Medical Commander if there is
an earlier medical team has arrived. If
the
medical
commander
is
inexperience, UMMC emergency MO
can take over as Medical Commander.
A brief discussion regarding the current
situation is carried out.
6. If the Medical Base Station has not
been set up, it has to be up by then.
7. Proceed to triage area under guidance
by the security officer
8. On arrival at the site, start triaging the
patients
according
to
START
guidelines, following the categories as
follows; red (critical), yellow (semicritical), green (non-critical), white
(dead). All the walking wounded are
considered green triage.
9. Provide first aid to patients at the
Medical Base Station
10. Coordinate the transfer of casualties to
the hospital starting from red tag
patients followed by yellow. All green
cases are transferred using other
vehicles.
11. Constantly report back to UMMC call
center.
12. All white tag victims are handled by
the police and forensic team.
1. Assist in the work process of the 1st
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
NOMBOR DOKUMEN:
Orthopaedic/
Surgical lecturer
2. AMO
3. Emergency staff
nurse
4. Emergency
Attendant
5. Ambulance driver
GUIDELINES ON DISASTER PLAN
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MUKA:
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ambulance team
2. Call for more medical staff if needed
3. Keep continuous contact with UMMC
Call Center
Plan of action of ambulance team at a major incident site
• The 1st ambulance team that has arrived to the incident site has to report to the
On Scene Commander (OSC). According to Arahan 20, the OSC is the police.
• Obtain current situation from OSC as below:
o Type of disaster
o Expected number of casualties
o Probable hazards
o Proposed medical base station site
o Ingress and egress for ambulance
o Other hospitals or agencies involved in providing emergency services
• If there is an established medical commander, report to him/her
• Perform a short meeting with other hospitals or agencies involved
• Set up a medical base station if not done yet
• The medical base station has to be in the yellow zone as stated below in the
diagram
•
Initiate triage of casualties according to START protocol (Simple Triage and
Rapid Transport) as shown below
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
19/64
S.T.A.R.T
Simple Triage And Rapid Treatment
RESPIRATION
All walking wounded
MINOR
YES
NO
Patent Airway
Or
Insert OPA
> 30 min
< 30/min
IMMEDIATE
YES
NO
IMMEDIATE
DEAD / DYING
PULSE
Radial pulse Present
Radial pulse Absent
MENTAL STATUS
Cover Bleeding
&
Elevate legs
IMMEDIATE
Not able to follow
Simple commands
IMMEDIATE
Able to follow
Simple commands
DELAYED
Stage II: “Full Emergency”
Functions of Medical Personnel in Team 2
To be carried out
Location
Clinical Coordinator / Emergency
Head of Trauma & Operation Room
Emergency
• Anaesthesia lecturer Resuscitation
Action
1. Take charge of the clinical operation
(Clinical Coordinator)
2. Proceed to Emergency Operation
Room to brief all doctors:
• Lay out of T+K during a
disaster incident
• Inform nature and extent of
disaster
3. Wear a blue vest
4. Assign disaster triaging at area 1
5. Assign Emergency Medical Officer
to respective areas
6. Monitor information from disaster
site and keep the Emergency
Operation Room staff informed
7. Coordinate activities of all areas
8. To keep on-site Commander
updated on clinical operation
1. Proceed to Emergency Operation
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
NOMBOR DOKUMEN:
•
•
•
•
•
GUIDELINES ON DISASTER PLAN
DS-0799
MUKA:
20/64
hall (Area 2)
on call
Anaesthesia MO on
call
Orthopaedic lecturer
on call
Surgical lecturer on
call
Surgical MO on call
Emergency medical
officer
• Orthopaedic MO on
call
• Emergency medical
officer
• Medical MO on call
• Emergency medical
officer
Trauma and Emergency
lecturer / Trauma and
emergency registrar /
triage officer
Room for briefing
2. Document arrival in response chart
3. Collect action card
4. Wear red vest
5. Lecturer will supervise activities in
area 2
6. Check all equipments and
requirements
7. Attend to all resuscitation cases
8. Decide movement of patients in
consultation with surgical,
neurosurgical and orthopaedic
consultants to:
• ICU
• OT
• Wards
• Emergency ward
• Mortuary
9. Deploy other staff if necessary
10. Keep Clinical Coordinator informed
of movements of patients
AMC (Area 3)
1. Proceed to Emergency Operation
Room for briefing
2. Document arrival in response chart
3. Collect action card
4. Wear orange vest
5. Lecturer will supervise activities in
area 3
6. Clear existing cases
7. Check equipments to receive
patients who are on trolleys
8. Decide movement of patients in
consultation with surgical,
neurosurgical and orthopaedic
consultants to:
• ICU
• OT
• Wards
• Emergency ward
• Mortuary
9. Deploy other staff if necessary
10. Keep Clinical Coordinator informed
of movements of patients
Area 1 (triage 1. Proceed to Emergency Operation
area)
Room for briefing
2. Collect action card
3. Wear orange vest
4. First Look assessment is done to
prioritize the patient according to
their severity
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
21/64
•
4 1. Proceed to Emergency Operation
Medical lecturer Area
(consultation)
Room for briefing
on call
2. Collect action card
• Medical
officer
3. Wear green vest
from
other
4. Supervise and assist in
specialties
management of non-trauma and
• Psychiatric team
minor injury cases
• Paediatric
lecturer on call
NB: Paediatric lecturer and MO on-call
• Paediatric
MO
will proceed to paediatric emergency if
on call
there is a paediatric T1 cases
• Emergency
medical officer
Radiology
1. Proceed to Emergency Operation
• Radiology
Room for briefing
lecturer on call
2. Document arrival in response chart
• Radiology
MO
3. Collect action card
on call
4. In charge of movement of patients
• Radiographer on
to and fro Radiology Unit
call
5. Ensure X-ray, CT scans and other
radiological investigations are done
swiftly
6. Deploy other radiology staff to assist
in areas of shortage
Blood bank lecturer and Blood bank
1. Proceed to Emergency Operation
MO on call
Room for briefing
2. Document arrival in response chart
3. Collect action card
4. Ensure blood availability and control
usage
Pathology lecturer and Mortuary
1. Proceed to Emergency Operation
pathology officer on call
Room for briefing
2. Document arrival in response chart
3. Collect action card
4. Overall in charge of mortuary affair
Stage II – “Full Emergency”
Functions of Medical Personnel in Team 3 (will be called down if needed)
To be carried Location
by
Area 2 (resus hall)
Consultant
anaesthetist on
call
Consultant in
emergency
medicine
/
emergency
physician
Consultant
surgeon on call
Action
1. Proceed to Emergency Operation
Room for briefing
2. Document arrival in response chart
3. Collect action card
4. Wear red vest
5. Take overall charge in area 2,
assisted by lecturer and team
6. Coordinate and organize
management of all resuscitation
cases to:
• ICU
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
Consultant
Area 3 (AMC)
orthopaedic on
call
Consultant
neurosurgeon
on-call
Area 2 and 3
DS-0799
MUKA:
22/64
• OT
• Wards
• Emergency ward
• Mortuary
7. Liaise with other unit consultants
with regards to prioritize of cases
for further management
8. Keep Clinical Coordinator informed
of movements of patients
1. Proceed to Emergency Operation
Room for briefing
2. Document arrival in response chart
3. Collect action card
4. Wear orange vest
5. Take overall charge in area 3,
assisted by lecturer and team
6. Coordinate with Consultant in
Anaesthesia in managing all
resuscitation cases.
7. Decide with other surgical based
consultants
and
Head
of
Anaesthesia
on
cases
for
emergency operations in the
Trauma OT.
8. Manage all surgical cases as
required
9. Keep Clinical Coordinator informed
of movements of patients
1. Proceed to Emergency Operation
Room for briefing
2. Document arrival in response chart
3. Collect action card
4. Wear orange vest
5. Communicate with consultants
/lecturer in area2 and 3
6. Assist in resuscitation of head
injury cases
7. Be available for consultation with
regards to head injury cases from
all areas
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
23/64
Stage II – “Full Emergency”
Functions of Medical Personnel in Team 3 (will be called down if needed)
To be carried Location
out by
Area 4
Consultant
medicine
on
call Consultant
family
medicine
on
call
Consultant
Radiology unit
radiology
on
call
Head
of Blood bank
Transfusion
Medicine
Consultant
forensic
pathologist
Mortuary
Action
1. Proceed to Emergency Operation Room
for briefing
2. Document arrival in response chart
3. Collect action card
4. Wear green vest
5. Coordinate with Clinical Coordinator
6. Supervise and assist in management of
non-trauma or minor injury cases
1. Proceed to Emergency Operation Room
for briefing
2. Document arrival in response chart
3. Collect action card
4. In charge of movement of patients to
and fro Radiology Unit
5. Ensure X-ray, CT scans and other
radiological investigations are done
swiftly
6. Deploy other radiology staff to assist in
areas of shortage
1. Proceed to Emergency Operation Room
for briefing
2. Document arrival in response chart
3. Collect action card
4. Ensure blood availability and control
usage
1. Proceed to Emergency Operation Room
for briefing
2. Document arrival in response chart
3. Collect action card
4. Overall in charge of mortuary affair
Stage II – “Full Emergency”
Functions of Medical Personnel in Team 3 (will be called down if needed)
To be carried Location
out by
Consultant in Area 2 and 3
Cardiothoracic
Action
1. Proceed to Emergency Operation Room
for briefing
2. Document arrival in response chart
3. Collect action card
4. Wear orange vest
5. Communicate with consultants / lecturer
in area 2 & 3
6. Assist in resuscitation of chest injury
cases
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
Psychiatric
lecturer on call
Area 4
Other lecturers Area 4
in Team 3
DS-0799
MUKA:
24/64
7. Be available for consultation with
regards to chest injury cases from all
areas
1. Proceed to Emergency Operation Room
for briefing
2. Document arrival in response chart
3. Collect action card
4. Clear existing psychiatric cases
5. Manage all psychiatric problems that
may arise
1. Proceed to Emergency Operation Room
for briefing
2. Document arrival in response chart
3. Collect action card
4. Coordinate with Clinical Coordinator
5. Supervise and assist in management of
non-trauma cases
Stage III – “Disaster”
Functions of ambulance team
To
be Location
carried out
by
1st ambulance
Emergency
MO
or
emergency
physician
Action
1. Proceed to disaster site
2. Identify
yourself
to
On-scene
Commander
3. Assess situation in disaster area and
get information regarding the disaster
4. Report to UMMC Call Center:
• Type of disaster
• Number of casualty expected
• Current status
• Any other information
• Request for second ambulance if
required
5. Proceed to on-site medical base and
report to Medical Commander if there
is an earlier medical team has arrived.
If the medical commander is
inexperience, UMMC emergency MO
can take over as Medical Commander.
A brief discussion regarding the
current situation is carried out.
6. If the Medical Base Station has not
been set up, it has to be up by then.
7. Proceed to triage area under guidance
by the security officer
8. On arrival at the site, start triaging the
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
9.
10.
11.
12.
2nd ambulance
Emergency
physician
/
orthopaedic /
surgical
lecturer
MUKA:
25/64
patients
according
to
START
guidelines, following the categories as
follows; red (critical), yellow (semicritical), green (non-critical), white
(dead). All the walking wounded are
considered green triage.
Provide first aid to patients at the
Medical Base Station
Coordinate the transfer of casualties to
the hospital starting from red tag
patients followed by yellow. All green
cases are transferred using other
vehicles.
Constantly report back to UMMC call
center.
All white tag victims are handled by
the police and forensic team.
1. Assist in the work process of the 1st
ambulance team
2. Call for more medical staff if needed
3. Keep continuous contact with UMMC
Call Center
Stage III – “Disaster”
Functions of Medical Personnel in Team 2
To be carried by
Location
Clinical
Coordinator/ Bilik bencana
Head of Trauma &
Emergency/ Emergency
Physician
Action
1. Take charge of the clinical
operation (Clinical Coordinator)
2. Proceed to Emergency
Operation Room to brief all
doctors:
• Lay out of Trauma &
Emergency
during
a
disaster incident
• Inform nature and extent of
disaster
3. Wear a blue vest
4. Assign disaster triaging at area 1
5. Assign Emergency Medical
Officer to respective areas
6. Monitor information from disaster
site and keep the Emergency
Operation Room staff informed
7. Overall coordination of Trauma &
Emergency
• Coordinate with all heads
• Coordinate with doctors in
all areas
• Coordinate with nursing
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
NOMBOR DOKUMEN:
•
•
•
•
•
•
•
•
•
•
GUIDELINES ON DISASTER PLAN
DS-0799
Resuscitation
Anaesthesia
(Area 2)
lecturer on call
Anaesthesia MO
on call
Orthopaedic
lecturer on call
Surgical lecturer
on call
Surgical MO on
call
Emergency
medical officer
Orthopaedic MO AMC (Area 3)
on call
Emergency
medical officer
Medical MO on
call
Emergency
medical officer
MUKA:
26/64
officers
8. To keep the Ketua Operasi
updated on clinical situation
hall 1. Proceed to Emergency
Operation Room for briefing
2. Document arrival in response
chart
3. Collect action card
4. Wear red vest
5. Lecturer will supervise activities
in area 2
6. Check all equipments and
requirements
7. Attend to all resuscitation cases
8. Decide movement of patients in
consultation
with
surgical,
neurosurgical and orthopaedic
consultants to:
• ICU
• OT
• Wards
• Emergency ward
• Mortuary
9. Deploy other staff if necessary
10. Keep Clinical Coordinator
informed of movements of
patients
1. Proceed to Emergency
Operation Room for briefing
2. Document arrival in response
chart
3. Collect action card
4. Wear orange vest
5. Lecturer will supervise activities
in area 3
6. Clear existing cases
7. Check equipments to receive
patients who are on trolleys
8. Decide movement of patients in
consultation with surgical,
neurosurgical and orthopaedic
consultants to:
• ICU
• OT
• Wards
• Emergency ward
• Mortuary
9. Deploy other staff if necessary
10. Keep Clinical Coordinator
informed of movements of
patients
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
27/64
Trauma and Emergency Area 1 (triage area)
lecturer / Trauma and
emergency registrar /
triage officer
•
•
•
•
•
•
•
•
•
•
Medical lecturer Area
(consultation)
on call
Medical
officer
from
other
specialties
Psychiatric team
Paediatric
lecturer on call
Paediatric MO on
call
Emergency
medical officer
1. Proceed to Emergency
Operation Room for briefing
2. Collect action card
3. Wear orange vest
4. First Look assessment is done to
prioritize the patient according to
their severity
5. Direct cases to appropriate areas
6. Deploy other staff if necessary
7.Keep
Clinical
Coordinator
informed of movements of
patients
4 1. Proceed to Emergency
Operation Room for briefing
2. Collect action card
3. Wear green vest
4. Supervise and assist in
management of non-trauma and
minor injury cases
NB.
Paediatric
lecturer
and
paediatric MO on call will manage
cases in paeds emergency if there
is a paeds T1 case
Area 5 (emergency 1. Area 5 will be used as T2 cases
Emergency
ward)
if there is an overwhelmed cases
medical officer
coming to AMC
Medical officers
2. Manage cases accordingly
from
other
3. Clear existing cases
specialties
4. Check equipments to receive
patients who are on trolleys
5. Decide movement of patients in
consultation
with
surgical,
neurosurgical and orthopaedic
lecturers to:
• ICU
• OT
• Wards
• Emergency ward
• Mortuary
6. Deploy other staff if necessary
7. Keep Clinical Coordinator
informed of movements of
patients
Radiology
Radiology
lecturer on call
Radiology MO on
call
1. Proceed to Emergency
Operation Room for briefing
2. Document arrival in response
chart
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
•
DS-0799
Radiographer on
call
Blood bank lecturer and Blood bank
MO on call
Pathology lecturer and Mortuary
pathology officer on call
MUKA:
28/64
3. Collect action card
4. In charge of movement of
patients to and fro Radiology Unit
5. Ensure X-ray, CT scans and
other radiological investigations
are done swiftly
6. Deploy other radiology staff to
assist in areas of shortage
1. Proceed to Emergency
Operation Room for briefing
2. Document arrival in response
chart
3. Collect action card
4. Ensure blood availability and
control usage
1. Proceed to Emergency
Operation Room for briefing
2. Document arrival in response
chart
3. Collect action card
4. Overall in charge of mortuary
affair
Stage III– “Disaster”
Functions of Medical Personnel in Team 3
To be carried Location
by
Area 2 (resus hall)
Consultant
anaesthetist on
call
Consultant in
emergency
medicine
/
emergency
physician
Consultant
surgeon on call
Consultant
Area 3 (AMC)
orthopaedic on
call
Action
1. Proceed to Emergency Operation
Room for briefing
2. Document arrival in response chart
3. Collect action card
4. Wear red vest
5. Take overall charge in area 2,
assisted by lecturer and team
6. Coordinate and organize
management of all resuscitation
cases to:
• ICU
• OT
• Wards
• Emergency ward
• Mortuary
7. Liaise with other unit consultants
with regards to prioritize of cases
for further management
8. Keep Clinical Coordinator informed
of movements of patients
1. Proceed to Emergency Operation
Room for briefing
2. Document arrival in response chart
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
Consultant
neurosurgeon
on-call
DS-0799
Area 2 and 3
MUKA:
29/64
3. Collect action card
4. Wear orange vest
5. Take overall charge in area 3,
assisted by lecturer and team
6. Coordinate with Consultant in
Anaesthesia in managing all
resuscitation cases.
7. Decide with other surgical based
consultants and Head of
Anaesthesia on cases for
emergency operations in the
Trauma OT.
8. Manage all surgical cases as
required
9. Keep Clinical Coordinator informed
of movements of patients
1. Proceed to Emergency Operation
Room for briefing
2. Document arrival in response chart
3. Collect action card
4. Wear orange vest
5. Communicate with consultants
/lecturer in area2 and 3
6. Assist in resuscitation of head
injury cases
7. Be available for consultation with
regards to head injury cases from
all areas
Stage III – “Disaster”
Functions of Medical Personnel in Team 3
To be carried Location
out by
Area 4
Consultant
medicine
on
call Consultant
family
medicine
on
call
Consultant
Radiology unit
radiology
on
call
Action
1. Proceed to Emergency Operation Room
for briefing
2. Document arrival in response chart
3. Collect action card
4. Wear green vest
5. Coordinate with Clinical Coordinator
6. Supervise and assist in management of
non-trauma or minor injury cases
1. Proceed to Emergency Operation Room
for briefing
2. Document arrival in response chart
3. Collect action card
4. In charge of movement of patients to
and fro Radiology Unit
5. Ensure X-ray, CT scans and other
radiological investigations are done
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
Head
of Blood bank
Transfusion
Medicine
Consultant
forensic
pathologist
Mortuary
MUKA:
30/64
swiftly
6. Deploy other radiology staff to assist in
areas of shortage
1. Proceed to Emergency Operation Room
for briefing
2. Document arrival in response chart
3. Collect action card
4. Ensure blood availability and control
usage
1. Proceed to Emergency Operation Room
for briefing
2. Document arrival in response chart
3. Collect action card
4. Overall in charge of mortuary affair
Stage III – “Disaster”
Functions of Medical Personnel in Team 3 (will be called down if needed)
To be carried Location
out by
Consultant in Area 2 and 3
Cardiothoracic
Psychiatric
lecturer on call
Area 4
Other lecturers Area 4
in Team 3
Action
1. Proceed to Emergency Operation Room
for briefing
2. Document arrival in response chart
3. Collect action card
4. Wear orange vest
5. Communicate with consultants / lecturer
in area 2 & 3
6. Assist in resuscitation of chest injury
cases
7. Be available for consultation with
regards to chest injury cases from all
areas
1. Proceed to Emergency Operation Room
for briefing
2. Document arrival in response chart
3. Collect action card
4. Clear existing psychiatric cases
5. Manage all psychiatric problems that
may arise
1. Proceed to Emergency Operation Room
for briefing
2. Document arrival in response chart
3. Collect action card
4. Coordinate with Clinical Coordinator
5. Supervise and assist in management of
non-trauma cases
Stage III – “Disaster”
Functions of Medical Personnel in Team 4
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
NOMBOR DOKUMEN:
GUIDELINES ON DISASTER PLAN
DS-0799
MUKA:
31/64
To be carried Location
Action
by
Consultant
Area 5 (emergency 1. Proceed to Emergency Operation
O+G on-call
ward)
Room for briefing
2. Document arrival in response chart
3. Collect action card
4. Take overall charge of area 5
5. Make decision regarding further
management and movements of
patients. Consult and coordinate with
staff of other units, if necessary
6. Deploy other staff including
Gynaecology Lecturer and medical
officers
7. Clear existing cases
Consultant
Paeds emergency
1. Proceed to Emergency Operation
paediatric onRoom for briefing
call
2. Document arrival in response chart
3. Collect action card
4. In charge of paeds emergency for
paediatric disaster cases
5. Manage all paediatric patients as
required in all areas
Ophthalmology
/
ENT
consultant on
call
Adult receiving ward
(a ward has to be
cleared or allocated
for disaster patients)
observation ward
1. Proceed to Emergency Operation
Room for briefing when called
2. Document arrival in response chart
3. Collect action card
4. In charge of receiving wards for adult
patients\
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
32/64
Functions of personnel in the trauma and emergency unit and nursing
personnel
Stage I – “Standby”
Functions of personnel in trauma and emergency
To be carried out by
Triage officer
Location
Area 1
Telephone operator
Telephone exchange
Emergency
medical Areas 2,3,4 & 5
officers and nurses
Clinical Coordinator / Trauma and Emergency
Head of Trauma and
Emergency
Drivers
Trauma and Emergency
Trauma and Emergency Trauma and Emergency
Administrative Officer
Emergency
Nurse Area 2, 3, 4 and 5
Manager (Matron Trauma
and Emergency)
Action
1. Receive message
regarding disaster
2. Verify disaster
3. Inform Clinical
Coordinator
4. Receive message from
Clinical Coordinator /
Head of Trauma &
Emergency to “Stand by”
2. Inform telephone
operator to activate
“Stage I – Standby”
3. Press alarm bell one
long stretch or
mentioned “Tahap 1” on
the loud speaker
4. Send out one
ambulance if requested
Notify team 1 via:
SMS system “Stage 1 –
Stand by
Clear patients swiftly
1. Inform Director (Chief
Opration) / Deputy
Director (Clinical) of
the
situation
and
advice
Prepare ambulances for
use
1.Organize administrative
activities in Trauma and
Emergency
2.Remain on standby
1. Ensure that all staff in
Trauma
and
Emergency,
drivers,
attendants and security
guards are aware of the
“stand by” situation
2. Wait for further
information and
instruction
Stage II – “full emergency”
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
33/64
Functions of personnel in trauma and emergency
To be carried out by
Telephone operator
Location
Telephone exchange
Registration counter staff
Area 1
Trauma and Emergency Emergency
administrative officer
Room
Senior Emergency MO or 1st ambulance
emergency physician oncall / Area 2 staff nurse
/assistant medical officer
Action
Notify Team 2 by SMS
Notify to individuals or
team as directed by “Chief
Operation”
1. Prepare disaster files,
tags, clip boards, casualty
movement record etc
2. Remain on standby
registration counter
3. Organize staff to carry
on
normal
emergency
duties
Operation 1. Proceed to Emergency
Operation Room
2. Document arrival in
response chart
3. Collect action card
4. Wear blue vest
5. Ensure that a minimum
of 2 clerks are available for
registration of casualties
• To tag patients
• Registration
6. Assess situation and call
up additional clerical staff
to tag and register patients
if necessary
7. Ensure clerical staff
complete
Disaster
Movement Record
8. Monitor information from
disaster site and keep all
staff informed
9. Coordinate the needs
(welfare) of all personnel in
Trauma and Emergency
until administrative officer
on call arrives
10. Coordinates with Chief
Operation and Clinical
Coordinator in all matters
of the disaster
1. Assemble at area 1
2. Ensure initial disaster
equipments are complete
and
loaded
into
the
ambulance
• MCI kit
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
Area 2 staff nurse and 2nd ambulance
assistant medical officer
Triage officer
Area 1
MUKA:
34/64
• Disaster trunk
• Splints
• Spinal board
• Linens
3. Proceed to disaster site
4. Team leader (senior MO
or
the
emergency
physician) needs to report
to
the
On
Scene
Commander (OSC)
5. Establish a medical base
station and act as medical
commander
6. Communicate with OSC
and
forward
field
commander
to
initiate
triage according to START
triage protocol (Appendix
1)
7. The victims are send to
the
nearest
most
appropriate hospital based
on START triage protocol
1. Assist the 1st team in the
management of victims at
the medical base station
1. Receive information
from disaster site
2. Verify disaster from
police / fire and rescue or
send a 1st ambulance
3.
Inform
clinical
coordinator
4. Receive message from
clinical
coordinator
regarding “Full emergency”
5. Ring emergency bell x 2
in long stretches and state
in “Tahap 2” over the loud
speaker
6. Inform operator to
activate “Full emergency”
7. Dispatch 1st ambulance,
with the 1st set of disaster
equipments
and
the
following staff:
• Senior emergency
MO or emergency
physician on call
• Staff
nurse
or
assistant
medical
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
NOMBOR DOKUMEN:
Team leader
GUIDELINES ON DISASTER PLAN
DS-0799
Areas 1,2,3,4 & 5
MUKA:
35/64
officer
• Attendant
Inform ambulance driver to
standby 2nd ambulance at
the emergency entrance.
Ensure 2nd disaster chest is
ready to load
8. Inform any messages
from the disaster site to the
Klinikal koordinator
9. Dispatch 2nd ambulance
equipped with disaster
chest
and
needed
equipments
with
the
following staff:
• Emergency
physician
/
orthopaedic
/
surgical lecturer
• Assistant medical
officer
• Staff nurse
• Attendant
10.
Pass
over
all
information to emergency
nurse manager
11. One triage nurse will
proceed to area 2
12. Prepare emergency
and procedure trolleys, top
up CSSU sets, IV sets, IV
fluids and drugs
13.
Assemble
all
resuscitation equipments
14. Assist doctors in
procedures
and
resuscitations
15. Record all disaster
patients’ movements chart
16. Ensure all patients’
properties are taken care
of
and
handed
to
emergency nurse manager
1. Ensure all doors to the
following
areas
are
opened:
• Disaster store room
• Store rooms
• Bilik bencana
• Visitor’s room
2. Ensure preparations are
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
Triage 2 (AMC) staff nurse Area 2
/ AMO
DS-0799
MUKA:
36/64
carried out in all areas by
the other team members
and are ready to receive
casualties
3. Ensure existing patients
are cleared swiftly
4. Coordinate with team
members from areas 1-5
5. Collect all the lists of
items and equipments
required by areas 3, 4 and
5
6. Assist in area 1-5
whenever required
7. Report all disaster
patients admitted / died to
the policeman on duty at
the police beat
8.
Maintain
accurate
document of all disaster
patients in medico-legal log
book
9. Collect and check all
disaster
patients’
movement
chart
from
areas 3,4 and 5 and hand
over to matron in charge
ambulatory
10. Assess bed situation in
orthopaedic / surgical / ICU
until arrival of Matron On
Call
1. Proceed to Area 2 as
soon as possible
2. Prepare resuscitation
and procedure trolleys, top
up CSSU sets, IV sets, IV
fluids and drugs
3.
Assemble
all
resuscitation equipment in
readiness
4. Open all cupboards
(except DDA)
5. Prepare and submit list
of items and equipments
required and submit to
emergency nurse manager
5.
Assist
doctors
in
procedures
and
resuscitations
6. record all disaster
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
Observation
nurse
ward
DS-0799
staff Area 5
POP room nurse / AMO Area 3
and assistant nurse in
minor OT
MUKA:
37/64
patients
in
patients’
movement chart
7. Ensure all patients’
properties are taken care
of
and
handed
to
emergency nurse manager
1. Clear existing patients
swiftly ie for admission and
discharge
2. Prepare beds ready to
receive casualties
3. Prepare and submit list
of items and equipments to
mentor
4. Proceed to resuscitation
room when relieved by
staff nurse from which
ward
5. Prepare emergency and
procedure trolleys, top up
CSSU sets, IV sets, IV
fluids and drugs
6.
Assemble
all
resuscitation equipment in
readiness
7.
Assist
doctors
in
procedures
and
resuscitations
8. Record all disaster
patients’ movements chart
9. Ensure all patients’
properties are taken care
of
and
handed
to
emergency nurse manager
1. Prepare emergency and
procedure trolleys, top up
CSSU sets, IV sets, IV
fluids and sutures
2.
Assemble
all
resuscitation equipment in
readiness
3. Prepare and submit list
of items and equipments to
mentor
4. Clear existing patients
swiftly ie for admission and
discharge
5.
Assist
doctors
in
procedures and treatment
of patients
6. Ensure swift movement
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
38/64
of patients for admissions /
x ray / OT
7. record all disaster
patients
in
disaster
movement chart
Stage II – “Full emergency”
Functions of relief staff nurses
To be carried out by
Location
Relief 2 staff nurse, Area 2
allocated by Matron In
Patient on duty.
Relief staff nurse x1 (post Area 5
natal ward)
Action
1. Assist doctors in
procedures
and
resuscitations
2. Prepare patients for
admissions to wards/ OT
3. accompany ill patients
to OT, ICU or wards
4. Ensure all patients’
properties are taken care
of
and
handed
to
emergency nurse manager
5. Record movement of all
disaster patients in the
‘disaster movement chart
6. Go back to ward when
stand down
1. Proceed to function in
observation ward
2. Observe patients and
carry out treatment as
ordered
3.
Ensure
safety
of
patients’ property
4. Lease with emergency
mentor / team leader for
DDA, extra equipment and
supplies needed
5. Ensure movement of all
disaster
patients’
are
recorded in the disaster
movement chart
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
39/64
Stage II – “Full emergency”
Functions of emergency attendants
To be carried out by
Area 2 attendant
Location
1st ambulance
Area 4 attendant
2nd ambulance
Area 4 attendant (2)
Area 1 & 2
Area 5 attendant
Area 5
Action
1. To get the following
disaster equipments and
assemble them at area 1
• MCI kit
• Disaster chest
• Spinal board
• Splints
• Linens
2. Load them into the
ambulance after checked
by staff nurse / AMO
3. Assist the 1st ambulance
team at the disaster site
1. Follow the same as the
1st ambulance’s attendant
duties
1. Proceed to function in
area 1 & 2
2. Ensure adequate supply
of trolleys and wheelchairs
in the reception area
3. Ensure there are
enough splints and linens
4. Assist staff nurse / AMO
in the preparation of
resuscitation
room
in
readiness
to
receive
patients
5.
Transfer
existing
patients to wards swiftly
when instructed
6. Assist in lifting of
patients, application of
splints and transportation
of patients
7. Ensure cleaniness in the
resuscitation room
1.
Transfer
existing
patients to wards swiftly
when instructed
2. Assist in the preparation
of observation ward in
readiness
to
receive
patients
3. Assist in the care of
patients in the observation
ward:
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
•
•
40/64
Lifting of patients
Patient
transportation
Stage II – Full emergency
Functions of relief attendants
To be carried out by
Relief attendant (1)
Location
Area 1
Relief attendant (2)
Area 2
Relief attendant (3)
Area 3 & 4
Actions
1. Lift patients from
ambulance and transport
to areas 2, 3 or 4 as
instructed
1.
Transfer
existing
patients to wards swiftly
when instructed
2. Assist in lifting of
patients, application of
splints and transportation
of patients
1.
Transfer
existing
patients to wards swiftly
when instructed
2. Ensure enough supply
of linen and splints
3. Assist nurse in giving
patient care
4. Transport patient
5. Ensure cleanliness of
treatment and examination
rooms
Stage II – “Full emergency”
Functions of nursing personnel in team 2 and 3
To be carried by
Emergency
manager
Location
nurse Areas 1,2,3 & 4
Action
1.
To
ensure
documentation is done in
“borang
panggilan
bencana”
2. To ensure 1st ambulance
is sent without delay
3. Activate stage I if it is still
not done by the triage
officer
4. Inform message from
disaster site to Chief
Operation or Trauma &
Emergency Administrator
5. Activate stage II if it is
still not done by the triage
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
NOMBOR DOKUMEN:
GUIDELINES ON DISASTER PLAN
DS-0799
MUKA:
41/64
officer
6. To ensure 2nd ambulance
is sent without delay
7. Receive and document
all information received
from disaster site
8. Stop accepting nonurgent cases. Check from
team leader the bed
situation in ICU, surgical
and orthopaedic ward.
9. Pass over all information
received and all action
already taken to matron oncall (in patient)
10. Proceed to prepare
Emergency
Operation
Room once relieved by
matron on-call (in patient)
11. Ensure all emergency
staff are mobilized to all
areas and ready to receive
casualties
12. Call relief staff nurse
from ward allocated by
Matron on duty to area 5
13. Proceed to area 2 when
casualties arrive
14.
Coordinate
with
admitting wards, till arrival
of matron on call or matron
ambulatory.
Brief
the
situation
and
receive
instructions
15. Make arrangements for
staff required to accompany
patient for inter-hospital
transfer
16. Assist relatives
17.
Ensure
patients’
property
are
collected,
placed in envelope, sealed,
labeled and submit to
matron on-call for safe
keeping
18. Ensure movements of
disaster patients in area 2
are recorded in disaster
movement charts
19. Supervise and assist
whenever required
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
Matron on-call
Matron ambulatory
DS-0799
Area 1
Areas 3,4 and 5
MUKA:
42/64
1. Proceed to Emergency
Operation Room for briefing
2. Document arrival in
response chart
3. Collect action card
4. Receive information from
emergency nurse manager
and take over functions at
area 1
• Monitor
and
document
all
information received
• Work closely with
emergency
medicine registrar /
emergency
physician
in
overseeing activities
in area 1
• Receive and record
patients’ properties
that are submitted
from other areas
5. Call and mobilize backup staff for the emergency
areas 2,3 and 4 from the
following wards as and
when necessary:
• EYE / ENT ward
• Orthopaedic wards
(non-admitting)
• Maternity wards
• CICU
• Anaesthesiology
6. Assess and identify bed
situation as reported by
team leader
7. Resume duty of other
matrons
who
is
not
available
8. Coordinate in fetching
patients at the helipad
1. Proceed to Emergency
Operation Room for briefing
when called
2. Document arrival in
response chart
3. Collect action card
4. Monitor response chart
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
NOMBOR DOKUMEN:
Matron in patient
Matron OT on call
GUIDELINES ON DISASTER PLAN
DS-0799
MUKA:
43/64
at conference room
5. Work closely with
lecturer / consultants at
area 3,4&5 in overseeing
the activities in the areas
• Coordinate the extra
item required
• Coordinate
with
admitting wards
• Make arrangement
for staff required to
accompany patients
for
inter-hospital
transfer
• Assist
relatives
whenever
necessary
• Ensure
patients’
properties
are
collected, put in
envelope,
sealed,
labeled and submit
to matron on call
5. Ensure movements
of disaster patients
in areas 3,4 and 5
are recorded in the
disaster movement
charts
6. Supervise
and
assist
whenever
required
Adult
and
paediatric 1. Proceed to Emergency
admitting wards
Operation Room for briefing
when called
2. Document arrival
in
response chart
3. Collect action card
4. Review bed utilization
and
make
necessary
recommendation of patient
transfer
5. Ensure availability of
equipment and supplies
6. Mobilize nursing staff to
wards and arrange for
backup staff if required
7. Assist in evacuation of
patients when required
Main OT
1. Proceed to Emergency
Operation Room for briefing
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
NOMBOR DOKUMEN:
GUIDELINES ON DISASTER PLAN
DS-0799
MUKA:
44/64
when called
2. Document arrival in
response chart
3. Collect action card
4. Receive report and
return to main OT
5. Organize main OT
activities
6.
Coordinate
with
anaesthesiology
for
allocation and assignment
of nurses and attendants in
OT
7. Ensure availability of
items and supplies
8. Ensure movement of
disaster
patients
are
recorded in the disaster
movement chart.
Stage III – “Disaster
Functions of emergency staff nurses / AMO
]
To be carried by
Location
Senior Emergency MO or 1st ambulance
emergency physician oncall / Area 2 staff nurse
/assistant medical officer
Action
1. Assemble at area 1
2. Ensure initial disaster
equipments are complete
and
loaded
into
the
ambulance
• MCI kit
• Disaster trunk
• Splints
• Spinal board
• Linens
3. Proceed to disaster site
4. Team leader (senior MO
or
the
emergency
physician) needs to report
to
the
On
Scene
Commander (OSC)
5. Establish a medical base
station and act as medical
commander
6. Communicate with OSC
and
forward
field
commander
to
initiate
triage according to START
triage protocol (Appendix
1)
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
Area 2 staff nurse and 2nd ambulance
assistant medical officer
Triage officer
Area 1
MUKA:
45/64
7. The victims are send to
the
nearest
most
appropriate hospital based
on START triage protocol
1. Assist the 1st team in the
management of victims at
the medical base station
1. Receive information
from disaster site
2. Verify disaster from
police / fire and rescue or
send a 1st ambulance
3.
Inform
clinical
coordinator
4. Receive message from
clinical
coordinator
regarding “Full emergency”
5. Ring emergency bell x 2
in long stretches and state
in “Tahap 2” over the loud
speaker
6. Inform operator to
activate “Full emergency”
7. Dispatch 1st ambulance,
with the 1st set of disaster
equipments
and
the
following staff:
• Senior emergency
MO or emergency
physician on call
• Staff
nurse
or
assistant
medical
officer
• Attendant
Inform ambulance driver to
standby 2nd ambulance at
the emergency entrance.
Ensure 2nd disaster chest is
ready to load
8. Inform any messages
from the disaster site to the
Clinical Coordinator
9. Dispatch 2nd ambulance
equipped with disaster
chest
and
needed
equipments
with
the
following staff:
• Emergency
physician
/
orthopaedic
/
surgical lecturer
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
NOMBOR DOKUMEN:
GUIDELINES ON DISASTER PLAN
DS-0799
MUKA:
46/64
•
Team leader
Areas 1,2,3,4 & 5
Assistant medical
officer
• Staff nurse
• Attendant
10.
Pass
over
all
information to emergency
nurse manager
11. One triage nurse will
proceed to area 2
12. Prepare emergency
and procedure trolleys, top
up CSSU sets, IV sets, IV
fluids and drugs
13.
Assemble
all
resuscitation equipments
14. Assist doctors in
procedures
and
resuscitations
15. Record all disaster
patients’ movements chart
16. Ensure all patients’
properties are taken care
of
and
handed
to
emergency nurse manager
1. Ensure all doors to the
following
areas
are
opened:
• Disaster store room
• Store rooms
• Emergency
Operation Room
• Visitor’s room
2. Ensure preparations are
carried out in all areas by
the other team members
and are ready to receive
casualties
3. Ensure existing patients
are cleared swiftly
4. Coordinate with team
members from areas 1-5
5. Collect all the lists of
items and equipments
required by areas 3, 4 and
5
6. Assist in area 1-5
whenever required
7. Report all disaster
patients admitted / died to
the policeman on duty at
the police beat
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
Triage 2 (AMC) staff nurse Area 2
/ AMO
Observation
nurse
ward
staff Area 5
MUKA:
47/64
8.
Maintain
accurate
document of all disaster
patients in medico-legal log
book
9. Collect and check all
disaster
patients’
movement
chart
from
areas 3,4 and 5 and hand
over to matron in charge
ambulatory
10. Assess bed situation in
orthopaedic / surgical / ICU
until arrival of Matron On
Call
1. Proceed to Area 2 as
soon as possible
2. Prepare resuscitation
and procedure trolleys, top
up CSSU sets, IV sets, IV
fluids and drugs
3.
Assemble
all
resuscitation equipment in
readiness
4. Open all cupboards
(except DDA)
5. Prepare and submit list
of items and equipments
required and submit to
emergency nurse manager
5.
Assist
doctors
in
procedures
and
resuscitations
6. record all disaster
patients
in
patients’
movement chart
7. Ensure all patients’
properties are taken care
of
and
handed
to
emergency nurse manager
1. Clear existing patients
swiftly ie for admission and
discharge
2. Prepare beds ready to
receive casualties
3. Prepare and submit list
of items and equipments to
mentor
4. Proceed to resuscitation
room when relieved by
staff nurse from ward nurse
allocated by Matron In
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
POP room nurse / AMO Area 3
and assistant nurse in
minor OT
MUKA:
48/64
Patient on duty
5. Prepare emergency and
procedure trolleys, top up
CSSU sets, IV sets, IV
fluids and drugs
6.
Assemble
all
resuscitation equipment in
readiness
7.
Assist
doctors
in
procedures
and
resuscitations
8. Record all disaster
patients’ movements chart
9. Ensure all patients’
properties are taken care
of
and
handed
to
emergency nurse manager
1. Prepare emergency and
procedure trolleys, top up
CSSU sets, IV sets, IV
fluids and sutures
2.
Assemble
all
resuscitation equipment in
readiness
3. Prepare and submit list
of items and equipments to
mentor
4. Clear existing patients
swiftly ie for admission and
discharge
5.
Assist
doctors
in
procedures and treatment
of patients
6. Ensure swift movement
of patients for admissions /
x ray / OT
7. record all disaster
patients
in
disaster
movement chart
Stage III – “Disaster”
Functions of relief staff nurses
To be carried out by
Relief staff nurse (x2)
Location
Area 1
Action
1. Proceed to triage area
2. Assist matron on call in
triage to see that all
patients are identified and
safely
transported
to
appropriate
areas
as
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
Relief staff nurse (x4)
Area 2
Relief staff nurse (x5)
Area 3
Relief staff nurse x1
Area 5
MUKA:
49/64
instructed
and
return
immediately
3. Fetch patients from the
helipad as instructed by
matron on call
1. Proceed to resuscitation
room
2.
assist
doctors
in
procedures
and
resuscitations
3. Prepare patients for
admissions to wards / OT
4. Accompany ill patients
to OT, ICU or wards
5. Ensure all patients
properties are taken care
of
and
handed
to
emergency nurse manager
6. Record movement of all
disaster patients in the
disaster movement chart
1. Proceed to treatment
room
2.
Assist
doctor
in
procedures
3. Do dressings and give
injections
4. Prepare patients for
admissions to ward / OT
5. Ensure all patients’
properties are taken care
of and handed to matron
ambulatory
6. Record movement of all
disaster patients in the
disaster movement chart
1. Proceed to observation
ward
2. Observe patients and
carry out treatment as
ordered
3.
Ensure
safety
of
patients’ properties
4. Liaise with emergency
team leader for DDA, extra
equipment and supplies
needed
5. Ensure movement of all
disaster
patients
are
recorded in the disaster
movement chart
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
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Stage III – “Disaster”
Functions of emergency attendants
To be carried out by
Area 2 attendant
Location
1st ambulance
Area 4 attendant
2nd ambulance
Area 4 attendant (2)
Area 1 & 2
Area 5 attendant
Area 5
Action
1. To get the following
disaster equipments and
assemble them at area 1
• MCI kit
• Disaster chest
• Spinal board
• Splints
• Linens
2. Load them into the
ambulance after checked
by staff nurse / AMO
3. Assist the 1st ambulance
team at the disaster site
1. Follow the same as the
1st ambulance’s attendant
duties
1. Proceed to function in
area 1 & 2
2. Ensure adequate supply
of trolleys and wheelchairs
in the reception area
3. Ensure there are
enough splints and linens
4. Assist staff nurse / AMO
in the preparation of
resuscitation
room
in
readiness
to
receive
patients
5.
Transfer
existing
patients to wards swiftly
when instructed
6. Assist in lifting of
patients, application of
splints and transportation
of patients
7. Ensure cleanliness in
the resuscitation room
1.
Transfer
existing
patients to wards swiftly
when instructed
2. Assist in the preparation
of observation ward in
readiness
to
receive
patients
3. Assist in the care of
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
51/64
patients in the observation
ward:
• Lifting of patients
• Patient
transportation
Stage III – “Disaster”
Functions of relief attendants
To be carried out by
Relief attendant (2)
Location
Area 1
Relief attendant (2)
Area 2
Relief attendant (2 in each Area 3 & 4
areas)
Actions
1. Lift patients from
ambulance and transport
to areas 2, 3 or 4 as
instructed
2. Ensure trolleys and
wheelchairs are place
back in area 1 in readiness
for use
1.
Transfer
existing
patients to wards swiftly
when instructed
2. Assist in lifting of
patients, application of
splints and transportation
of patients
1.
Transfer
existing
patients to wards swiftly
when instructed
2. Ensure enough supply
of linen and splints
3. Assist nurse in giving
patient care
4. Transport patient
5. Ensure cleanliness of
treatment and examination
rooms
Stage III – “Disaster”
Functions of Nursing Personnel in Team 2 and 3
To be carried by
Emergency
manager
Location
nurse Areas 1,2,3 & 4
Action
1.
To
ensure
documentation is done in
borang panggilan bencana
2. To ensure 1st ambulance
is sent without delay
3. Activate stage I if it is still
not done by the triage
officer
4. Inform message from
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
NOMBOR DOKUMEN:
GUIDELINES ON DISASTER PLAN
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MUKA:
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disaster site to ketua
operasi or administrative
officer
5. Activate stage II if it is
still not done by the triage
officer
6. To ensure 2nd ambulance
is sent without delay
7. Receive and document
all information received
from disaster site
8. Stop accepting nonurgent cases. Check from
team leader the bed
situation in ICU, surgical
and orthopaedic ward.
9. Pass over all information
received and all action
already taken to matron oncall (in patient)
10. Proceed to prepare bilik
bencana once relieved by
matron on-call (in patient)
11. Ensure all emergency
staff are mobilized to all
areas and ready to receive
casualties
12. Call relief staff nurse
from ward allocated by
Matron In Patient on duty to
area 5
13. Proceed to area 2 when
casualties arrive
14.
Coordinate
with
admitting wards, till arrival
of matron on call or matron
ambulatory.
Brief
the
situation
and
receive
instructions
15. Make arrangements for
staff required to accompany
patient for inter-hospital
transfer
16. Assist relatives
17.
Ensure
patients’
property
are
collected,
placed in envelope, sealed,
labeled and submit to
matron on-call for safe
keeping
18. Ensure movements of
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
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disaster patients in area 2
are recorded in disaster
movement charts
19. Supervise and assist
whenever required
Matron on-call
Matron ambulatory
Area 1
Areas 3,4 and 5
1. Proceed to Emergency
Operation Room for briefing
2. Document arrival in
response chart
3. Collect action card
4. Receive information from
emergency nurse manager
and take over functions at
area 1
• Monitor
and
document
all
information received
• Work closely with
emergency
medicine registrar /
emergency
physician
in
overseeing activities
in area 1
• Receive and record
patients’ properties
that are submitted
from other areas
5. Call and mobilize backup staff for the emergency
areas 2,3 and 4 from the
following wards as and
when necessary:
• EYE / ENT ward
• Orthopaedic wards
(non-admitting)
• Maternity wards
• CICU
• Anaesthesiology
6. Assess and identify bed
situation as reported by
team leader
7. Resume duty of other
matrons
who
is
not
available
8. Coordinate in fetching
patients at the helipad
1. Proceed to Emergency
Operation Room for briefing
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
NOMBOR DOKUMEN:
Matron in patient
GUIDELINES ON DISASTER PLAN
DS-0799
MUKA:
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when called
2. Document arrival in
response chart
3. Collect action card
4. Monitor response chart
at conference room
5. Work closely with
lecturer / consultants at
area 3,4&5 in overseeing
the activities in the areas
• Coordinate the extra
item required
• Coordinate
with
admitting wards
• Make arrangement
for staff required to
accompany patients
for
inter-hospital
transfer
• Assist
relatives
whenever
necessary
• Ensure
patients’
properties
are
collected, put in
envelope,
sealed,
labeled and submit
to matron on call
7. Ensure movements
of disaster patients
in areas 3,4 and 5
are recorded in the
disaster movement
charts
8. Supervise
and
assist
whenever
required
Adult
and
paediatric 1. Proceed to Emergency
admitting wards
Operation Room for briefing
when called
2. Document arrival
in
response chart
3. Collect action card
4. Review bed utilization
and
make
necessary
recommendation of patient
transfer
5. Ensure availability of
equipment and supplies
6. Mobilize nursing staff to
wards and arrange for
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
backup staff if required
7. Assist in evacuation of
patients when required
1. Proceed to Emergency
Operation Room for briefing
when called
2. Document arrival in
response chart
3. Collect action card
4. Receive report and
return to main OT
5. Organize main OT
activities
6.
Coordinate
with
anaesthesiology
for
allocation and assignment
of nurses and attendants in
OT
7. Ensure availability of
items and supplies
8. Ensure movement of
disaster
patients
are
recorded in the disaster
movement chart.
Matron OT on call
Main OT
Matron critical care
ICU / CICU / Neuro ICU
Matron
matron)
policy
(chief Emergency
Room
55/64
1. Proceed to Emergency
Operation Room for briefing
when called
2. Document arrival in
response chart
3. Collect action card
4. Receive report from
matron on call
5. Review requirement with
matron on call
6. Review bed situation in
critical care areas
7.
Notify
Emergency
Operation Room regarding
bed availability
8.
Coordinate with
anaesthesiology
for
allocation and assignment
of nurses
Operation 1. Proceed to Emergency
Operation Room for briefing
when called
2. Document arrival in
response chart
3. Collect action chart
4.
Take
position
in
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
Matron CSSU
DS-0799
CSSU
MUKA:
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Emergency
Operation
Room
5. Get information from
matron on call and matron
in patient of additional
staffing requirement
6. Coordinate for additional
nursing back up staff from
nurses hostel
6. Coordinate for additional
supportive back-up staff
7. Submit report and record
of back up staff to
Emergency
Operation
Room
1. Proceed to Emergency
Operation Room for briefing
when called
2. Document arrival in
response chart
3. Collect action card
4. Assess disaster items
5. Return to CSSU
6. Send items as required
to Trauma and Emergency,
OT or wards
7. plan for coverage of
CSSU for 24 hours
8. Coordinate with laundry
for
further
supply
if
necessary
Stage II and III
Functions of personnel in Team 2
To be carried out by
Director
Location
Emergency
Room
Action
Operation 1. Act as Chief Operation
2. Proceed to Emergency
Operation Room
3. Collect action card
4. Wear blue vest stated
“Ketua Operasi”
5. Get briefing from
Clinical
Coordinator,
consultants,
deputy
director
administration,
chief matron
6.
Take
charge
of
Emergency
Operation
Room
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
Deputy director (clinical) ie Emergency
TPI
Room
Deputy
(Administration)
Director Emergency
Room
MUKA:
57/64
7. Direct personnel to
carry
out
additional
functions as necessary
8. Issue press statements
9. Lease with other
hospital,
agencies
(government or private as
necessary)
Operation 1. Act as Chief Operation
in the absence of the
director
2. Proceed to Emergency
Operation Room
3. Collect action card
4. Wear blue vest stated
“Ketua Operasi”
5. Get briefing from
Clinical
Coordinator
,
consultants,
deputy
director
administration,
chief matron
6.
Take
charge
of
Emergency
Operation
Room
7. Direct personnel to
carry
out
additional
functions as necessary
8. Issue press statements
9. Leaise with other
hospital,
agencies
(government or private as
necessary)
10. In the presence of the
director, the TPI will assist
the Chief Operation in
executing the required
tasks
Operation 1.
Coordinate
the
administrative aspects of
running the hospital during
the disaster
2. Ensure the adequacy of
the staff and equipments
in Emergency Operation
Room
3. Ensure the adequacy of
staff and equipments for
registration of casualties
4. To provide additional
funds for smooth running
of the process
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
Chief medical record unit
DS-0799
Area 1
Medical record unit officer Area 1
on call
MUKA:
58/64
1. Proceed to Emergency
Operation
Room
for
briefing when called
2. Document arrival in
response chart
3. Collect action card
4.
Organize
and
coordinates
supply
of
folders and notes
5. Ensure the smooth
running
of
patient
registration
1. Proceed to Emergency
Operation Room
2. Document arrival in
response chart
3. Collect action card
4. Assess need for supply
of extra folders
5. Assist in tracing folders
as necessary
6. Updates of current
situation to chief MRU
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
59/64
Stage II and III
Functions of non medical personnel
To be carried out by
Location
Administrative officer on Area 1 (reception)
duty
Facility manager
Emergency
Room
PRO
Emergency
Room
Action
1. Proceed to Emergency
Operation Room
2. Document arrival in
response chart
3. Collect action chart
4. Wear blue vest
5.
Brief
the
Chief
Operation
regarding
current
administrative
situation
6. Take overall charge of
coordinating
needs
(welfare, refreshments) of
all personnel
7. Assist relatives as
required
8. Contact for assistance
example medical students
(warden Ibnu Sina hostel
ext 2740)
9. Handle and hand over
cash of casualties to
accountant
Operation 1. Proceed to Emergency
Operation
Room
for
briefing
2. Document arrival in
response chart
3. Collect action card
4. Assist in providing
facilities for VIPs, relatives
of casualties etc
Operation 1. Proceed to Emergency
Operation Room
2. Document arrival in
response chart
3. Collect action card
4. Wear blue vest
5. Arrangement for press
conference and handle
press as required
6. Assist in contacting next
of kin of victims
7. Liaise with other
agencies (MPPJ, embassy
etc)
Stage II and III
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
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Functions of personnel in team 3
To be carried out by
Head of Social work
Chief pharmacist
Pharmacist on call
Location
Trauma and Emergency
Action
1.
Organize
main
counseling area / rooms
2. Plan and coordinate for
counseling
and
crisis
intervention
3. Assess the need of
patients’ and relatives for
counseling
or crisis
intervention
4. Compile / record, the
progress of counseling in
the counseling area /
rooms
5. Referred cases to
psychiatric
teams
if
symptoms of PTSD or
other
mental
illness
surfaced
6. Prepare emergency
rosters
7. Coordinate with the
clinical coordinator for
further management of
patient / relatives if
necessary
Trauma and emergency / 1. Proceed to Emergency
pharmacy
Operation
Room
for
briefing when called
2. Document arrival in
response chart
3. Collect action chart
4. Update on nature and
extent of disaster
5. Ensure availability of
medications
6. Coordinate pharmacy
team members
Trauma and emergency / 1. Proceed to Emergency
pharmacy
Operation
Room
for
briefing when called
2. Document arrival in
response chart
3. Collect action chart
4. Assess supply of
medications (oral, IV etc)
5. Top up and when
necessary
to
ensure
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
DS-0799
MUKA:
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availability of supply
6. Activate the pharmacy
team
Stage I – “Standby”
Function of security personnel
To be carried out by
Location
Security
personnel
in Trauma and emergency
Trauma and Emergency
Senior security personnel Trauma and emergency
on duty
Action
Inform senior security
personnel on duty at ext
2403 once standby is
declared
1. Arrange and position
personnel at important
security areas
2. Inform all personnel to
be prepared for further
instructions
3. Inform Chief of Security
regarding situation
4.
Inform
all
senior
personnel to be on stand
by
5. Equipments are made
ready
Stage II – “Full emergency”
Function of security personnel
To be carried out by
Senior security personnel
Location
Trauma and emergency
Security personnel officer
Trauma and emergency
Action
1. Once “Full emergency”
is declared, all security
personnel is called to
security office
2. Give action cards to
personnel
3. Direct personnel to
designated areas
4. Inform Chief of Security
to report at Emergency
Operation Room
5. Proceed to Emergency
Operation
Room
for
briefing
6. Inform senior personnel
not on duty to stand by
1. Report to Emergency
Operation Room
for briefing
2. Ensure senior security
personnel and security
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
NOMBOR DOKUMEN:
GUIDELINES ON DISASTER PLAN
DS-0799
MUKA:
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personnel are ready to
perform instructed duties
3. Inform Chief of Police of
Brickfields to ask for help
in crowd control and traffic
control at Jalan Universiti
4. To assess the necessity
for extra personnel
5. To help in allocating
parking
place
for
ambulances
6. To allocate personnel at
Emergency
Operation
Room, press room and
relatives area
7. To secure helicopter
landing area
8. Ready to receive
directions
from
Chief
Operation,
clinical
coordinator
or
administrative coordinator.
Stage III – “Disaster”
Specific functions of security guards at trauma and emergency
To be carried out by
Security guard x 2
Location
Trauma &
front road
Security guard x2
Trauma & Emergency 1. Clear entrance of
front entrance
existing crowd
2. Guide patients inside
T+K
3. Prevent unauthorized
entries into the hospital
3. Maintain close liaison
with police
Trauma & Emergency 1. Maintain ‘no entry’ at
back entrance
this point for exit only
Security guard x 1
Action
Emergency 1. Clear and control traffic
and crowd
2. Control and direct
visitors
3. Maintain ‘no entry’ for
non hospital staff
4. Parking reserved for
authorized vehicles only
Security guard x1
Entrance to area 3
Security guard x 1
Exit from observation ward
Control
unnecessary
crowd
1. Maintain ‘no entry’ to
unauthorized personnel
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
GUIDELINES ON DISASTER PLAN
NOMBOR DOKUMEN:
Security guard x 1
Security guard x 2
Security guard x 2
DS-0799
MUKA:
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2. Guide and direct
patients and visitors
Exit to radiology suite and Maintain no entry to
trauma OT
unauthorized personnel
Disaster ward
1. Maintain ‘no entry’ to
unauthorized personnel
2. help to maintain order
and assist visitors
Disaster ward
1. Maintain ‘no entry’ to
unauthorized personnel
2. Help to maintain order
and assist visitors
Function of personnel when received message “all clear” ie “stand down”
Stage I – “stand down”
To be carried out by
Triage officer
Location
Area 1
Telephone operator
Telephone exchange
Action
1. Receive message “all
clear or stand down” from
clinical coordinator
2.
Inform
telephone
operator to notify
3. Inform T+K to stand
down via loud speaker
1. Notify Team 1 via SMS
system
Stage II – “Full emergency”
To be carried out by
Triage officer
Location
Area 1
Telephone operator
Telephone exchange
Action
1. Receive message “all
clear or stand down” from
clinical coordinator
2.
Inform
telephone
operator to notify
3. Inform T+K to stand
down via loud speaker
1. Notify Team 1 &2 via
SMS system
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00
PUSAT PERUBATAN UNIVERSITI MALAYA
NAMA DOKUMEN:
NOMBOR DOKUMEN:
GUIDELINES ON DISASTER PLAN
DS-0799
MUKA:
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Stage III – “Disaster”
To be carried out by
Clinical coordinator
Ketua operasi
Triage officer
Telephone operator
Location
Area 1
Action
1.
Assess
whether
disaster is under control
2. Advice Chief Operation
regarding current situation
3. Receive direction from
Chief Operation
Emergency
Operation 1.
Assess
whether
Room
disaster is under control
2. To direct for “stand
down”
Area 1
1. Receive message “all
clear or stand down” from
clinical coordinator
2.
Inform
telephone
operator to notify
3. Inform T+K to stand
down via loud speaker
Telephone exchange
Notify teams via SMS
Management At Emergency Unit Post-Disaster Stand Down
Debriefing of Rescuers
To some of the mentally unprepared staffs involved at the Disaster Site, the
experience could be emotionally horrifying, especially after seeing mutilated bodies.
Debriefing sessions are arranged by the Head of Emergency Unit and conducted by
the Psychiatric Medicine Team.
Equipment
All non-disposable equipments are accounted for. Damages are corrected at the
earliest. Procurement of new equipment recommended. All disposable equipments
are replaced.
Post-Mortem
Post-Mortem of the Disaster Management or the Disaster Drill are conducted as
soon as possible and any shortcomings addressed and corrected.
Tarikh Berkuatkuasa:
No. Kajisemula:
24-05-10
R00