Petroleum Development Oman L.L.C.

PR-1243B

Medical Emergency Response Plan

Qarn Alam Area

User Note:

The requirements of this document are mandatory. Non-compliance shall only be authorised by the Document Owner or his Delegate through STEP-OUT approval.

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I  Document Authorization

Document AutherisationDocument Authority (CFDH)Document CustodianDocument updaterDr. Sulaiman Al Rawahi

Ref. Ind: MCCDate: 01/08/2018

Dr. Salim Al Sawai

Ref. Ind: MCOHDate: 01/08/2018

Haitham Al Adwani

Ref. Ind: MCOH601/08/2018

Reviewed by:Jose Petrizzo

Ref. Ind: MCOH101/08/2018

II Revision History

Chapter No.

Section No.

Description Date Initials Reference Indicator

All All First Version of the Procedure March 2007 NA MCO11NAll All Specific Information for Lekhwair

areaMay 2015 S.S.H MCOH6

All All Update existing medical facility and contact points

August 2017 H.S.A MCOH6

Appendix 9 Food protocol for camps added August 2018 J.P. MCOH1

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III Scheduled Local Review & Update of Site Specific MER Manual for Qarn Alam

Date of Review & Update

Medic Signature

Site Manager Signature

Notes

IV Distribution List

CUSTODIAN  COPYCECC - MAF 01MCC 02MCOH 03MCO/1 04MCO/1N 05Lekhwair PAC Clinic 06Galfar clinic, Lekhwair 07STS clinic 08MCN 09MCN:Fahud 10Lekhwair 11LECC 12ONO/1Q 13GGO1Q 14

 

V Glossary of Terms, Definitions, and Abbreviations

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ACLS Advanced Cardiac Life SupportAED Automatic External DefibrillatorsALARP As Low As Reasonably PracticableATLS Advanced Trauma Life SupportBLS Basic Life SupportBU Base UnitCCR Central Control RoomDD Deputy DirectorDFA Designated First AiderECG ElectrocardiogramER Emergency ResponseETO Emergency Telephone OperatorFA First AidHSSE Health Safety Security and EnvironmentKPI Key Performance IndicatorLEBC Local Emergency Base ControllerLECC Local Emergency Control CentreMAF Mina Al-FahalMCC Chief Medical OfficerMCI Multiple Casualty IncidentMER Medical Emergency ResponsePDO Petroleum Development OmanPR Procedure

CONTENTS

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I Document Authorization …………………….……………………………………..…….……3 II Revision History ………………………………………………..……………….……..….……3III Scheduled Local Review & Update of Site Specific MER Information…………..…….3IV Distribution List …………………………………………………………………………….…...4V Glossary of Terms, Definitions, and Abbreviations ………………………………………5

1 INTRODUCTION.................................................................................................................................71.1 Overview.............................................................................................................................................71.2 Objective.............................................................................................................................................71.3 Scope..................................................................................................................................................81.4 Site Characteristics…………………………..…………………………………………………....91.5 Related Business Control Documents ………………………………………………………….9

2 PDO MER PROCEDURE.................................................................................................................102.1 Overview ………………………………………………………………...…………………………102.2 First Response and Call-Out Procedure ……………………………………………………………112.3 Tier 2-3 Medevac Procedure ……………………………………………………………………….112.4 Tier 4 Medevac Procedure …………………………………………………………………………122.5 Site Specific Medical Infrastructure ……………………………………………………………….132.6 Site Specific General Infrastructure ……………………………………………………………….14

3 SITE SPECIFIC MER ORGANIZATION AND RESOURCES..........................................................153.1 Site Specific MER Organization........................................................................................................153.2 Site Specific MER Manual Responsibilities.......................................................................................163.3 Site Specific MER Equipment...........................................................................................................17

4 MER PROCEDURES........................................................................................................................184.1 Information Prompt List.....................................................................................................................184.2 MER Contact Information..................................................................................................................184.3 First Response and Call Out Procedure...........................................................................................194.4 Tier 2 –3 Medevac Procedure...........................................................................................................204.5 Tier 4 Medevac (Tier 3 to Tier 4 Hospital) Procedure.......................................................................224.6 Multiple Casualty Incidents (MCI) Procedure....................................................................................23

5 IMPLEMENTATION AND PERFORMANCE MONITORING...........................................................245.1 Inspection and Maintenance Program..............................................................................................245.2 MER Exercises..................................................................................................................................245.3 MER Skills Maintenance...................................................................................................................245.4 KPIs................................................................................................................................................... 245.5 Audits................................................................................................................................................ 245.6 Management Review........................................................................................................................24

ATTACHMENTS................................................................................................................................................25 Attachment 1 Site MER Response Attachment 2 Medical Personnel Attachment 3 MER Responsibilities Attachment 4 Medical Equipment Attachment 5 Medevac Resources and Contact Information Attachment 6 Initial Call - Information Prompt List Attachment 7 Multiple Casualty Incidents (MCI) - Responsibilities Attachment 8 Multiple Casualty Incidents (MCI) - Triage Protocol Attachment 9 Food Poisoning protocol for Camps Attachment 10 Hazards and Effects Management

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1 Introduction

1.1 OverviewThis Site Specific Medical Emergency Response (MER) Manual outlines the facilities and equipment available at Qarn Alam and defines the organization and procedures for responding to a medical emergency. It must be read along with PDO Medical emergency Response Manual PR-1243.

This MER Manual provides a framework for the management of medical emergencies and describes the appropriate response. The Site Specific MER Manual is part of the overall Emergency Response Plan, but provides specific information for medical emergencies. Where appropriate, reference is made to the Emergency Response Plan.

An updated copy of this Site Specific MER Manual should be always readily available at:1. Medical Clinic & Site Ambulance2. LEBC/ LECC Room/ Site Manager3. Site CCR/ ETO/ Radio Room4. Copy to Regional PDO Clinic (MAF/ North/ South)

o Nothing in this document is intended to prevent the Incident Commander from using their judgment or expertise to initiate necessary action to secure the safety of the facility and its

occupants during a medical emergency situation.

1.2 ObjectiveThe objective of the MER Manual is to help ensure an effective response to medical emergencies by:

Documenting the organization roles and responsibilities of personnel managing the medical emergency.

Defining interfaces between the different response teams.

Providing clear concise instructions and guidance on what action to take in response to a medical emergency.

Detailing communication requirements.

Providing templates to facilitate the medical emergency response.

Specifying equipment / facilities / resources that are available during the medical emergency.

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1.3 ScopeThis MER Manual covers Qarn Alam and associated operations that comprise:

Oil production

Gas production

An overview of the site and associated facilities is presented in Figure 1 Figure 1 Overview of Facilities

An overview of the MER response for the site is provided in Attachment 1.

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1.4 Site Characteristics

The details of the site are presented in Table 1.Table 1 Site Characteristics

Site Category Category 2 SiteNature of Site The Qarn Alam is part of the Central Oman operating area.Is located 130

km south-east of Fahud.The Qarn Alam Field, situated in the Ghaba Salt Basin, contains heavy viscous oil in the fractured, low permeability limestone's of the Shuaiba, Kharaib and Lekhwair Formations. The field has the largest STOIIP in the Qarn Alam Area, but also the lowest recovery factor (<2%). It therefore constitutes an important strategic resource with a SFR of 40 million m3 (>10% of the total PDO scope). The field was discovered in 1972 by QA-1 and came on production in 1975. Oil from the Qarn Alam gathering station, Saih Nihayda and Ghaba north is dehydrated in the Qarn Alam MPS. This dehydrated oil along with the dehydrated oil from Saih Rawl, Al Ghubar, Burhaan and from South Oman (Sahma Booster Station) are pumped to the Qarn Alam NOCS. After the oil isstabilised in Qarn Alam NOCS plant it is exported by shipping pumps alongwith the stabilised Condensate from QA CCP into the MOL. The NahadaBooster Station is positioned along the route to assist the oil on its journey to the MAF terminal, in Muscat, on the coast. Within Central Oman, the shipping pumps are sited at Qarn Alam and their function is to transfer oil at a total rate of approximately 85,000- 100,000 m3/d along the MOL to the booster station at Nahada-2.

Activities Performed at Site Production (oil, gas, steam), maintenance Engineering, Training Center and Airport

Population at Site

Hours of Operations Administrative and some operational tasks from 7am to 6pm(10 hours)

The main production station is manned 24 hours a day, 12 hours shift. Approximately 80% of the interior-based staff works a 15/13 shift cycle, whilst the balance works a 28/28 cycle.

Specific High Risks

1.5 Related Business Control Documents

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Code of Practice

Ambulance Code of Practice

Procedures Medical Emergency Response Manual Part I PR-1243E R Document: Part III Contingency Plan : Vol. 2 : Well Engineering

PR-1287

E R. Document(s) part III, Contingency Plan Vol. 3 : Production Operations

PR-1066

E R Document: Part III Contingency Plan Vol. 14 : Government Gas System

PR-1246

E R Document: Part III Contingency Plan : Mina Al-Fahal Offices

PR-1329

E R Document: Part III Contingency Plan : Vol. 9 : Air Operations

PR-1269

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2 PDO MER PROCEDURE:

2.1 Overview

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Inform MCC

Medical assistance not required

Yes

No

No

Yes

Coastal support needed.Inform DD and MCC immediately.

Follow Emergency Procedures PR – 1065 and Emergency Response Contingency Plans as required

Control situation

using local medical and emergency

services

Inform LEBC, Duty Doctor

ETO or CCR operator Contacts Local Medical Staff, Ambulance, emergency Services, etc. as required

Medical Assistance Required

Emergency call received

2.2 First Response and Call Out Procedure

The ‘First Response personnel at the emergency location shall: Take immediate action in case of a medical emergency; call 5555 Contact the nearest Designated First Aider (DFA); Advise the Site Manager and the Site Medical Professional of the emergency (often through a site

control center (CCR) or radio room). Provide information about:

o Location of the emergency;o Number of casualties and condition of these casualties (vital life support)o Situation on Site;o Identity of caller.

On the receiving side (Site Manager, site control centre, radio room) shall: Ensuring all essential information is captured, perform confirmation of emergency location; Inform and alert relevant MER personnel e.g (Site Manager, Site Medical Professional, where

applicable nearest DFA) through telephones and or paging system, radio etc Maintaining communication with the emergency site; Imposing radio silence and discipline; Accurate note taking throughout the emergency.

2.3 Tier 2-3 Medevac Procedure

The Site Medical Professional shall communicate with the personnel at the emergency location, advise the Site Manager and go to the emergency location immediately if warranted;

If significant transport is needed to mobilize more Medical Professionals to the casualty (e.g. helicopter flight, long overland trip in ambulance), this shall require approval of the Site doctor, site manager or MCC.

The Site Medical Professional shall advise the Site Manager of the need and conditions (urgency, ambulance or common vehicle) for transport of the casualty to the Site Clinic, Extended Site Clinic or Tier 3 Hospital (Medevac);

If warranted, the Site Medical Professional shall consult with Remote Medical Support (MCC) and continue to do so during the emergency;

The Site Medical officer or deputy shall take the final decision on the need for Medevac and the way it shall be executed;

If an aircraft is needed for the Medevac, the Pilot or the Vessel Master shall advise the Site Manager on their ability to transport the casualty and they shall have the right to refuse or delay the transport if in their opinion the prevailing conditions entail unacceptable risk;

If it is decided to proceed with the Medevac:1) The Site Medical Professional in liaison with site manager shall:

o Be in command and issue the corresponding instructions and nominateo communicators, observers and record keepers for the duration of the emergency;o Send a Tier 2 MER Professional to the casualty who shall accompany the casualtyo during the Medevac;o Impose radio silence and discipline as appropriate;o Mobilise the MER assistants (stretcher bearers etc. as appropriate) to theo emergency location;o Call Out the aircraft or ambulance.o Advise the Tier 3 Hospital of the imminent arrival of a casualty.o Inform PDO Emergency Duty Coordinator;o Inform the relevant authorities directly involved in the MER;o May delegate tasks to subordinates.

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2) The Site Medical Professional shall:o Coordinate the medical actions of his team (DFAs, MER assistants, other Tier 2 MER

Professionals);o Provide relevant medical information about the casualty to the service providers, such as

ambulance service and Tier 3 Hospital;o Advise the MCC or Company Health Adviser

3) The Emergency Duty Coordinator, DD shall:o Advise the PDO Company management;o Inform relevant authorities;o Maintain contact with the PDO press if warranted;o Contact Next of Kin of the casualty(s)

4) The Company Medical Officer on site shall:o Contact the Tier 3 Hospital;o Advise Emergency Duty Coordinator.

The Tier 2-3 Medevac Procedure shall contain up to date and complete list of emergency communication information (telephone numbers, radio frequencies, and contact persons).

2.4 Tier 4 Medevac Procedure

If appropriate specialist medical care (Tier 4) is required and available in country of operation, the decision to transfer the client to Tier 4 hospital is at the discretion of the treating doctor at Tier 3 hospital. Transport out of Oman will require the approval of PDO MCC/health adviser and PDO management. Requirements for local government authorisation prior to transport out of country shall also be considered.

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2.5 Site MER Infrastructure

The infrastructure that is available to provide support in the event of a medical emergency is presented in Table 2.1Table 2.1 Infrastructure of Surrounding Area & their Contacts

Facility Type Facility Name Distance Contacts

Tier 3 Hospital Nizwa Regional ReferralHospital

208 km 25449155

Adam Hospital 144 km 25434055Tier 4 Hospital Royal Hospital 335 km 24599457

Khoula Hospital 361 km 24563625

Nearby Clinics

Level 1 call QA PAC Clinic 500 meters 94471219

STS Clinic 800 meters 24388312/97201498Galfar Steam Clinic 1½ km 24380926Galfar ODC Clinic 1 km 93302805/ 85912

Level 2 call Alhassan Clinic- SN 25 km 24380794

Galfar – Wadi Musallam 45 km 99861075

Level 3 callPAC Masarat – S.Rawl 66 km 98923118

93962783

Airstrips Qarn Alam Airport 11 km 24385631/85841

Areas to avoid during MER NoneAdjacent Facilities (including 3rd party) that can provide support

Ghaba Health Center 21 km

N.B. Medical Facilities Levels of Call in case of MCI on instructions from Site Medic/ Site Manager:Level 1 call : Number or Nature of casualties requires summing help from some of the nearby clinicsLevel 2 call : Number or Nature of casualties requires summing help from all clinics within the areaLevel 3 call : Number or Nature of casualties requires summing help from clinics outside the area

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On-Scene Commander

First Responder

Remote MedicalSupportDedicated Site

First Aiders

Company HealthAdvisor/ PDO Doctor

Site MedicClinic

3 Site Specific MER Organization and Resources

3.1 MER Organization

An overview of the MER organization at the site is presented in Figure 3.1Figure 3.1 MER Organization

A list of the designated first aiders, medical professionals and remote medical support provider(s) together with contact information is provided in Attachment 2.

3.2 Site Specific MER Manual Responsibilities

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The responsibilities for management and maintenance of MER Site Specific manual are:

Site Manager, The most senior responsible position on the Site (e.g. Senior Site Supervisor)

Ensuring this MER Manual is distributed and understood by the workforce.

Ensuring process is in place to maintain MER Manual.

Ensuring MER exercises are performed in line with company requirements

Liaising with Site Medical Professional

Maintaining MER Manual and contact information.

Verifying medical equipment is maintained.

Roles and responsibilities for key personnel during MER, in the form of checklists, are provided in Attachment .

3.3 MER Equipment

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An overview of the site MER equipment is presented in Table 3.3 below Table 3.1 MER Equipment

Medical Facilities on Site7 clinics

Location of Site Control Center PDO Qarn Alam (North Oman)

Communication Facilities Pager – Radio Tetra – Line Phone – Mobile Phone -

MER Equipment Defibrillator – Emergency Bags – Crush Cart - Suction Machine – Oxygen Cylinders – Ambulance – ECG Machine – Intubation Set – H.F Injury Box -

First Aid Boxes (see Attachment 4)

Automatic External Defibrillators (see Attachment 4)

Medevac Transport

For details and contact information see Attachment 5

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4 MER Procedures ChecklistsER procedures have been developed to provide guidance on tasks to be performed during a medical emergency. These are provided in the form of flow charts providing an overview of the process and required action to respond to the following MER events:Tier 0 - 1 First Response and Call Out ProcedureTier 2 – 3 Medevac ProcedureTier 4 Medevac Procedure - Transfer to Specialist HospitalMultiple Casualty Incidents (MCI)

o Nothing in this document is intended to prevent the Incident Commander from using their judgment or expertise to initiate necessary action to secure the safety of the

facility and its occupants during a medical emergency situation.

4.1 Information Prompt List

It is important when providing initial details of the medical emergency to provide as much information as possible. To assist with this an emergency response prompt list has been developed and is provided in Attachment 6.

4.2 MER Contact Information

The contact details for personnel that would provide support in the event of a medical emergency is provided in Attachment 2 – Medical Personnel.

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4.3 First Response and Call Out Procedure

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4.4 Tier 2 –3 Medevac Procedure

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4.5 Tier 4 Medevac (Tier 3 to Tier 4 Hospital) Procedure

Note: this procedure is not site controlled, but managed by the Medical Professionals.

Medical Professional in consultation with Tier 3 hospital identify appropriate Tier 4 Hospital

Medevac required?

Yes

No

Notify medical transport provider of Medevac requirements

Notify hospital of patient detailsMedevac

CHECK?Tier 4 Medevac

MEDICAL EMERGENCY RESPONSE

Requirement for Tier 4 (specialist) hospital to treat patient identified

Confirm patient transport to hospital organized

Confirm patient in hospital care and notify

responsible parties

Patient remains in Tier 3 facility

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4.6 Multiple Casualty Incidents (MCI) Procedure

* Responsibilities associated with Multiple Casualty Incidents (MCIs) are outlined in Attachment 7.* Triage Protocol for MCI is outlined in Attachment 8.

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5 Implementation and Performance Monitoring

5.1 Inspection and Maintenance Program

To ensure medical equipment is adequately maintained and will function as required during a medical emergency an inspection and maintenance program is in place. The MER equipment forms part of the routine inspection program and scheduled according to the table provided in ATTACHMENT 4.

5.2 MER Exercises

A series of MER exercises shall be performed to test the effectiveness of the MER. The requirements for holding drills and exercises are identified in PDO MER Manual PR-1243 (Appendix 2). MER exercises are managed through the emergency response plan, which details the schedule and type of exercises to be performed.

5.3 MER Skills Maintenance

To ensure the competency of MER personnel is maintained, there is a requirement for personnel to meet the initial competency requirements and to undergo refresher training. The qualification criteria and training requirements are defined in the PDO MER Manual section 3.2.3. Skills maintenance is managed through the competency assurance program.

5.4 KPIs

Key Performance Indicators (KPIs) shall be developed, maintained and regularly reviewed to monitor the implementation and effectiveness of Medical Emergency Response. KPIs developed shall be specific and measurable and be monitored and reviewed as part of the HSSE monitoring and reporting process.

5.5 Audits

Medical Emergency Response shall be subjected to periodic audits to assess compliance against the requirement of the MER Standard. MER should be included in the Terms of Reference of local and independent HSE Management System audits.

5.6 Management Review

The effectiveness of Medical Emergency Response shall be periodically assessed by management. This Site Specific Manual should be reviewed and updated locally by medic in charge and sit manager on an annual basis or if any changes to the Site specific contents is required. Regional PDO doctor (MAF, North, and South) should be informed upon completion of the review and updated if any changes have taken place.

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ATTACHMENTS

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Attachment 1Site Initial MER Response*

* Site Initial MER Response should be kept in a prominent, accessible place at the site. All Site employees should be aware of its’ location.

Medical Emergency Response

Site: Qarn Alam Site Manager : ONO1Q/GGO1Q

Emergency Action Contact Raise Alarm

Make Area Safe (if possible)

Stabilize injured party

Remain with injured party until medical assistance arrives

Call Call 55555555Provide details:

# injured

Injury

Location

Cause of injury (if known)

Non Emergencies Contact

For all other injuries and illnesses Site medic : MCN11Q

Use first aid kit, if necessary

On Site Medical Emergency Response Equipment & their Location First Aid Kits

Automatic External Defibrillator (AED)* Please indicate down the DFA responsible for regular inspection and maintenance of Site FA Kits and AED

On Site Medical Emergency Responders (DFA) Shift Name Certification Location Contacts

A MCN11Q QarnAlam Clinic

B MCN11Q QarnAlam Clinic

Attachment 2Medical Personnel

Designated First Aiders Shift A (Please indicate personnel responsible for scheduled inspection of FA Kit & AED)

# Name Location Latest Certification Contacts1 Julio Cesar Ismael Braga PDO Qarn Alam camp 19/01/2017 96126105

2 Eric Amanor PDO Qarn Alam camp 15/12/2016 95693772

3 Saud Al-Hadhrami PDO Qarn Alam camp 01/09/2017 99767069

4 Badar Zadjali PDO Qarn Alam camp 11/02/2018 99254445

5 Prasanna P Mayekar PDO Qarn Alam camp 01/06/2018 98262948

6 D.Thulaseedharan PDO Qarn Alam camp 01/08/2018 95626088

7 Shabib AL-Maqbali PDO Qarn Alam camp 11/02/2019 24385525

8 Salim Hamed AL-Mamari PDO Qarn Alam camp 11/02/2019 24385525

9 Khalifah Hamed AL-Sidairi PDO Qarn Alam camp 11/02/2019 24385525

10 Naif Salim Al-Kalbani PDO Qarn Alam camp 11/02/2019 24385525

11 Muntasir Nasser Al-Mahrouqi PDO Qarn Alam camp 11/02/2019 24385525

12 Ahmed Al-Mahrouqi PDO Qarn Alam camp 11/02/2018 99844225

Designated First Aiders Shift B (Please indicate personnel responsible for scheduled inspection of FA Kit & AED)

# Name Location Latest Certification Contacts1 Maxwell Obeng PDO Qarn Alam camp 19/01/2015 95700622

2 Mohammed Al-Balushi PDO Qarn Alam camp 01/10/2018 96166886

3 Sathishkumar Perumal PDO Qarn Alam camp 11/02/2018 96534381

4 Said Hussain Said Al-Ghaithi PDO Qarn Alam camp 01/10/2018 99812332

5 Lalam naga venkata durga rao PDO Qarn Alam camp 01/02/2018 96251569

6 Bahjat Khamis Al-Saadi PDO Qarn Alam camp 19/03/2019 95744718

7 Younis AL-Wahibi PDO Qarn Alam camp 19/03/2019 93691100

8 Harib Said Al-Hinai PDO Qarn Alam camp 19/03/2019 24385707

9 Salim Suleiman Al-Harrasi PDO Qarn Alam camp 19/03/2019 99605142

10 Tariq Abdullah Al-Amari PDO Qarn Alam camp 19/03/2019 94447234

11 Mohammed Salim Al-Amri PDO Qarn Alam camp 19/03/2019 24385525

On Site Medical Professionals# Name Emergency Certification Location Contacts

BLS ACLS ATLS RigMedic

Other

1 Dawood Suliman Al Kindi Yes Yes Yes Yes QarnAlam PDO Clinic 24385544 Mobile: 91776507

2 Mishal Ali Al Raisi Yes Yes Yes Yes QarnAlam PDO Clinic 24385544 Mobile: 71110536

3 Rashid Said Al Farqani Yes Yes Yes Yes QarnAlam PDO Clinic 24385544 Mobile: 71110536

4 Shiboun Hamed Al Jassasi

Yes Yes Yes Yes QarnAlam PDO Clinic 24385544 Mobile: 91776507

5 Dr. JaronMr.Riju

Yes Yes No No PAC Masarat Clinic (QA) 9665124293847900, 94471219

6 Dr.ShanikrMr. Adverson

Yes Yes No No Al Hasan – Saih Nahiada 92482530, 2438079491717049

7 Mr. Maheesh Yes Yes No No STS Clinic (QA) 97201498

8 Mr. Manoj Yes Yes No No Galfar- steam Clinic(QA) 92883424, Pager: 44338

9 Mr. Charles Yes Yes No No Galfar ODC Clinic (QA) 93302805

10 Dr.MarufMr. Mathew

Yes Yes No No Tawoos PAC (SR) 9892311893962783

11 Mr. Lyaqat Yes Yes No No STS Clinic- Saih Rawl 96019961

12 Mr. LijuDr. Ali

Yes Yes No No Galfar- Saih Rawl (ODC)Galfar- Saih Rawal(CRM)

9274004291263607

13 Mr. Lexon Yes Yes No No Galfar- Wadi Musalem 99861075

Remote Medical Support Providers# Name Location Contacts1 Dr. Salim Shoukari PDO Fahud Clinic 24384245/ GSM 91409386, 71110215

2 Dr. Hamed Al Mazroui PDO Fahud Clinic 24384245/ GSM 91409386, 71110215

Attachment 3MER Responsibilities

First Responder

Assess Scene and communicate with site ETO/CCR/Telephone Operator

Make Area Safe for patient and responders

If unable to make area safe – move casualty to safe location (if safe to do so)

Provide Care – remember Do’s and Don’ts

Handover to DFA – communicate information on injuries, action taken and cause of injury (if known)

Designated First Aider

Assess Scene and condition of casualty

Provide Care - provide initial first aid care and stabilize patient

Call Out - alert Tier 2 MER professional of medical emergency

Provide Care -remain with patient and await arrival of Tier 2 MER professional

Tier 2 Professional (on site)

Assess Scene and condition of casualty

Provide Care - provide care to stabilize / treat patient

Consult Medical Support Provider – obtain advice (as required) on diagnosis / treatment

Communicate Medevac requirement – notify Incident Commander of required Medevac response

Accompany Patient to Tier 3 hospital (if medevac required)

Remote Medical Support

Provide Advice - readily available to provide advice to the site Tier 2 Professional

Facilitate Response - provide assistance with response (as required)

Incident Commander

Coordinate Response

Verify Tier 2 Professional notified

Verify Medevac organized

Verify Hospital notified

Ensure Shell Health Provider notified

Attachment 4Medical Equipment

Medical Equipment on Site – First Aid Boxes# Location Size Medical

Inspection Date

123

Medical Equipment on Site – Automatic External Defibrillators# Location Make & Model Medical

Inspection Date

1 PDO Qarn Alam Clinic PowerHeart AED GB Pro 06/08/20172 PDO Qarn Alam Clinic - Ambulance (S-6009) PowerHeart AED GB Pro Weekly3 PDO Qarn Alam Clinic - Ambulance (S-6004) PowerHeart AED GB Pro Weekly4 Mess PowerHeart AED GB Pro 06/08/20175 Central Processing Plant – Control Room PowerHeart AED GB Pro 06/08/20176 Central Processing Plant PowerHeart AED GB Pro 06/08/2017

Frequency for Scheduled Clinic MER Equipment Inspection*# Medical Equipment Frequency Notes

1 Defibrillators Twice/ week or After Use2 Oxygen Cylinders Once/week or After Use3 Emergency Bags Once/2 weeks or After Use4 Emergency Drugs Once/week or After Use5 Crash Box/ Trolley Once/week or After Use6 ECG Once/week or After Use7 Communication Modes Once/week8 Ambulance Daily by Ambulance Driver

Once/week by Medic9 Other MER Equipment as per MER

Manual PR-1243 Appendix 4Once/2 weeks or After Use

* A signed Check-list should be kept attached to these items

Attachment 5Medevac Resources and Contact Information

Medevac Personnel (Ambulance Drivers) Details and Contact InformationName Location Contacts Mobilization Time /

RestrictionsEquipment

Issa Shibani - Shift B Qarn Alam Clinic

92256345 / 2438594471110582

Any time

Amour Habsi – Shift A Qarn Alam Clinic

92097657 / 2438594471110582

Any time

Attachment 6Initial Caller/Telephone Operator – Action Check List

Initial Caller/Telephone Operator – Assessment Prompt ListDescription Location of incident

Number of casualties

Nature of Injuries / Illness

Time of Incident

Cause of Incident

Name of Casualty

Age of Casualty

Sex of CasualtyStatus Area secure

Personnel dealing with incident

Number of personnel involved

Contained or escalating

Current response activityResponse Requirements Immediate response needs

Longer term response needsContact Information Name of Informant

Position / Responsibility

Contact Numbers

Attachment 7Multiple Casualty Incidents (MCI) - Responsibilities

On-Scene Commander Assess Scene

Assign MER Team - to coordinate:

Rescue

Medical supplies

Triage

Communications

Treatment

Transportation

Verify Primary Search complete

Coordinate and Monitor MER

Site Medical Professional Coordinate medical supplies and manpower

Verify number and type of casualties

Coordinate Triage and treatment of casualties

Coordinate patient evacuation

Communicate with remote site medical support, public health authorities, incident commander (as appropriate)

Rescue Team Leader Coordinate and conduct primary search

Notify casualty numbers – notify Site Medical Professional and Incident Commander once primary search completed, transfer of casualties to triage area

Logistics Identify Transportation area – select area which allows easy access from ambulance staging and treatment

area

Coordinate patient transportation - in priority order as determined by Triage and Treatment Officers

Request additional ambulances and air operations resources

Coordinate helicopter / ambulance operations

Acquire and distribute medical equipment and supplies

Maintain records on where casualties were dispatched

Communications

Establish and maintain communication with appropriate company and local authorities as per the emergency response plan

Remote Site Medical Support Provide advice and support to the onsite medical professional

Arranging mobilization of additional medical resources to site (as required by the incident)

Coordinating medical response with local and company health authorities

Attachment 8Multiple Casualty Incidents (MCI) – Triage Protocol

Triage – Mass Casualties and Multiple InjuriesTriage is the sorting or prioritising of MER action based on need for treatment and the available resources to provide it. In simple terms it aims to ‘do the most for the most gain’. In cases of multiple causality incidents it also refers to sorting of those who should be treated first because their problems require priority attention or which patients need to be transferred to a higher care centre first.

Triage can be performed quickly using START Protocol (Simple Triage And Rapid Treatment):

Guidance of Stages of Triage

Stage 1 – RED - Immediate aggressive resuscitation. Conditions that are a threat to life or limb with imminent risk of deterioration (e.g. tension pneumothorax or conditions of deep coma, respiratory rate of <10, or >29).

Stage 2 - YELLOW – Urgent emergency attention required. These are conditions that could potentially progress to a serious problem requiring emergency intervention, e.g. previously stable vital signs but clinical suspicion of ectopic pregnancy, proximal long fractures.

Stage 3 - GREEN – Emergency action is delayed or non urgent till concurrent stages 1-2 above are stable or transferred. Conditions where level of seriousness could benefit from reassurance and intervention can be delayed for 1-2 hours. Usually relate to mere distress, e.g. sprained ankle.

Stage 4 - BLACK – The casualty is dead or in a terminal state and beyond resuscitation.

It should always be kept in mind that this staging may not be static, the three main natural steps of resuscitation should be followed – assess & triage, treat and re-evaluate.

Attachment 9Hazards and Effects Management

Hazards And Effects Management

This section outlines the risk assessments that have been performed to demonstrate that the risks associated with medical emergency response have been reduced to As Low As Reasonably Practicable (ALARP).

Classification of Site Category

Classification of Site Category.

Waivers / Deviations

Waiver for not having a Site Clinic.

Non Routine Activities

List of Non-routine Activities and associated risk assessments or references to these studies.

Tier Response Times Cannot Reasonably Be Achieved

List of ‘Sites and workgroups where Tier response times cannot reasonably achieved’ and associated risk assessments or references to these studies.

Site Medical Review

Reference to Site Medical Review.

Site Specific Risk Assessments

Reference to Site-specific risk assessments (e.g. Health Risk Assessment, Impact Assessment).

ALARP Demonstration

Risk assessment (or references to the study) to demonstrate that chosen alternative solution for smaller Sites not having a Site Clinic ensures risks are ALARP.

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