First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
BCRN Management Perspectives
Nasser H. Al-AzriBSc, MD, MRCS(A&E), MACEP
PDO
• Introduction• Disaster Management: an overview• BCRN: Definition and Historical Overview• BCRN: the unique disasters• BCRN Disasters: management perspectives• BCRN Disasters
– Pre-Event– Event
• Pre-Hospital• Hospital
– Post-Event• Discussion
HospitalPre-HospitalPre-Event
PLAN
System Testing
Resources & Capabilities
Calling List Staffing
Communication
Post-Event
Testing
Command & Roles
Supporting AgenciesTriage Treat Transport
Staff Care
Hospital Care
Surge
Patient TrackingFamilies
Hospital Disaster Notification
Planitis Syndrome
• Symptoms: itchy need to have a plan placed over your desktop or on the shelf of the department
• Signs: neat clean document seen only by HoD and heard of by staff
• Investigations: on testing staff knowledge, none, or very few, aware of the involved procedures!
Paralysis Deafness
Multi-OrganisationFailure
AcuteIncidentFailure
Coordination
Capacity Communication
Success
Disaster Management: All Hazards Approach
• 80% Generic (to all disasters)
• 15% Specific (to the hazard)
• 5% Unique (to the event)
BCRN – Brotherhood?
• (relatively) New threats
• Unconventional weapons
• Less predictable targets
• Mass effects beyond the scene
BCRN Threats are Unique
Vertical
•Healthcare (prehospital/ hospital)
•Supporting services
Horizont
al
•Direct
•Indirect
Diagonal
•Risk Assessment & Emergency Planning
•Security (environment, science, agriculture, industry, …)
Paralysis Deafness
Multi-OrganisationFailure
AcuteIncidentFailure
Coordination
Capacity Communication
Success
Pre-Event: Coordination
• RA (variables, data)
• Maintaining surveillance/ monitoring• Dividing roles and responsibilities • Incident Command System• Finance/ administration
Pre-Event: Communication
• Risk communication training• Community education • Communicating with action parties
Pre-Event: Prevention
• Biosafety• Bio-security• Infection Control• Quarantine• Early Warning• Environmental detection and monitoring
Pre-Event: Capacity
• Developing protection/ sheltering programmes
• Reviewing response plans• Emergency treatment/ triage/
decontamination/ facilities/ training• Logistics
Biological Agents
Chemical Agents Radiological/ Nuclear Threats
Characterizing functions for
managing risks
•Health surveillance•Early warning•Quarantine •Sampling and analysis •Vaccination and prophylaxis •Epidemiological investigation•Infection control•Biosafety in health facilities
•First response•Environmental detection•Decontamination•Incident site management
•First response•Environmental detection•Facility design •Decontamination
Paralysis Deafness
Multi-OrganisationFailure
AcuteIncidentFailure
Coordination
Capacity Communication
Success
Pre-Hospital: Communication
• Intra-agency communication• Inter-agency communication• Community communication
Pre-Hospital: Capacity
• EMS and supporting services• PPE for first responders• On-site incident management system• Mass casualty/ fatality management• Preparing hospitals for surge
Paralysis Deafness
Multi-OrganisationFailure
AcuteIncidentFailure
Coordination
Capacity Communication
Success
Hospital: Capacity
• Trained staff• PPE/ Occupational safety • Isolation facilities / control measures• Decontamination/ Treatment/ Vaccination • Protection of facility infrastructure • Waste management
Paralysis Deafness
Multi-OrganisationFailure
AcuteIncidentFailure
Coordination
Capacity Communication
Success
BCRN Management
• Hazards• Vulnerabilities• Risks• Management – Prevention– Preparedness– Response– Recovery