Hospital Evacuation

8/3/2019 Hospital Evacuation

1/19

Hospital EvacuationHospital Evacuation

WelcomeWelcome


2/19


Agenda

Welcome Commissioner Sutton

Westchester Countys HVA & Inundation Maps

OEM Director Mr. Carl Tramontana

Discussion of Hospital Considerations

RRC Director Mr. Garrett Doering

Break

OEM & EMS abilities

Mr. Jeff Reilly & Mr. Carl Tramontana

Set next meeting date & handouts


3/19

Hospital EvacuationHospital EvacuationHistorical Perspective

There were 275 reportedThere were 275 reported evacuationevacuation incidents from 1971-1999, with anincidents from 1971-1999, with an

annual average of 21 in the 1990s, the period for which databases were moreannual average of 21 in the 1990s, the period for which databases were more

reliable. The most, 33, were recorded in 1994, the year of the Northridgereliable. The most, 33, were recorded in 1994, the year of the Northridge

Earthquake. Of all incidents, 63 (23%) were attributable primarily to internalEarthquake. Of all incidents, 63 (23%) were attributable primarily to internal

fire, followed by internal hazardous materials (fire, followed by internal hazardous materials (HazMatHazMat) events (18%),) events (18%),

hurricane (14%), human threat (13%), earthquake (9%), external fire (6%),hurricane (14%), human threat (13%), earthquake (9%), external fire (6%),

flood (6%), utility failure (5%), and externalflood (6%), utility failure (5%), and external HazMatHazMat (4%).(4%).

CONCLUSION:CONCLUSION:

More than 50% of theMore than 50% of the hospitalhospitalevacuations occurred because of hazardsevacuations occurred because of hazards

originating in theoriginating in the hospitalhospital facility itself or from human intrudersfacility itself or from human intruders


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Critical Issues when considering a hospital evacuation:Critical Issues when considering a hospital evacuation:

Nature of Threat

Risk to patients

Risk to staff

Risk to visitors

Need for continuing acute care

Demands for suppliesDemands for resources


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Complicating Factors:Complicating Factors:

Unable to model the entire event

i.e. Sniper fire halts hospital evacuation

Threats Change over time

Potential competition for limited resourcesInternal & External Resources Change over time

Due to complexity, there is limited transferability


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Nature of Threat:Nature of Threat:

Tornados, earthquakes, HAZ-MAT release, and fires

No time to prepare, will result in an uncontrolled

event

Hurricanes, floods, or critical infrastructure failure

Not immediately life threatening, may result in a

controlled event


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Risk to staff, patients & visitors:Risk to staff, patients & visitors:

Highly variable depending on eventCare givers may become involved in the logistics ofevacuation:

resulting in reduction of patient carestaff performing functions they are not familiar with

Staff accountabilityVisitor accountability


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Discussion Topics:Discussion Topics:

NORMET hospital mutual aid agreement

HEICS

Manpower


9/19



Patient Transportation

Ambulance

Critical Care

ALS

BLS

Ambulette/Wheel Chair Van

Passenger Bus

Private Car


10/19



Non-patient transportation

Staff

Equipment

Medical Records

Pharmaceuticals (esp. controlled substances)


11/19



Internal triage teams

Internal staging areas

Loading point(s)

Bed availability at other facilities

Notification of patient relatives

Handling patient relatives when they arrive

Securing the hospital


12/19



Special Patient Care Areas

OR & Recovery

Radiology/MRI/

Secure Psychiatric Units

L & D, peds

ICU/CCU/

Vent dependent patients

Isolation

Prison


13/19


Literature Review:Literature Review:

Benchmarking for hospital evacuation: a critical data collection tool Schultz CH; Koenig KL; Auf der

Heide E; Olson. [Prehospital Disaster Med] 2005 Sep-Oct; Vol. 20 (5), pp. 331-42. ABSTRACT Events

such as earthquakes or terrorist attacks, hospitals may be victims of disasters. They may need to transferpatients to outside facilities rather than continue to provide on-site care. Following the Northridge

earthquake, eight hospitals in the damaged area were the foci of a United States National Science

Foundation study that examined the status of the hospitals' pre-event planning, post-event evacuation

decision-making, and internal and external evacuation processes. Building on this experience, this paper

offers a standardized data collection tool, which will enable researchers to record hospital evacuationinformation in a systematic manner so that comparable data can be accumulated, evacuation research

methods can be improved, and consensus on methods can be reached. The study's principal subjects

include: (1) hospital demographics; (2) description of existing disaster response plans; (3) an event's

impacts on hospital operations; (4) decision-making and incident command; (5) movement of patients within

the facility; (6) movement of patients to off-site institutions; and (7) hospital


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Documents

Hospital Evacuation