General Information
Antelope Valley Center
Services
Special Dates
Fee Schedule
Hepatitis B
Requirement
Measles/Rubella Requirement
Mumps
recommendation
HIV Testing
Nursing Clearances
TB Testing
Wart Clinic
Women's Clinic
Campus Building Marshals
DISASTER MEDICAL SERVICES
PURPOSE
The purpose of this disaster plan is to provide guidance to the Student Health Center (SHS) in the event of a multi-casualty incident. The SHS is the primary campus unit responsible for medical operations in the event of disaster. The SHS will coordinate emergency campus triage and emergency medical care. The SHS will coordinate with the Kern County Health Officer and campus emergency responders. The Department of Nursing (DON) will also have a major role in disaster as a key support system to the campus and the SHS. Therefore, this plan will also provide supplemental guidance for utilization of the DON faculty, students and facilities.
The Health Center is the primary Casualty Collection Point
(CCP) for medical operations. Other
campus organizations such as the DON and the Athletic Department will be
involved in the actual rescue and first aid operations.
Romberg Nursing Education Building (RNEB) will serve as a holding area
and alternate CCP.
GENERAL RESPONSE – ALL
HAZARDS
1. Campus Police will request an EMS response through County EMS.
2. Campus Police will escort ambulances to the site and will assist ambulance personnel in establishing an ambulance staging area.
3. The SHS will be notified and placed on standby. SHS personnel, initially physician and nurse, will respond to the first call from Public Safety.
4. In the event of a disaster of major proportions the Emergency Operations Center (EOC) will be activated and any further communication will be through EOC.
5. Request field teams to report persons needing medical assistance.
6. Determine number and location of persons needing medical attention,
7. Report information to EOC.
8. Request additional medical personnel through EOC as needed.
9. Assign medical personnel to assist injured until transportation possible.
MEDICAL
CARE
Priorities:
Medical resources at CCPs should be oriented towards stabilization for transport
and relief of suffering. Supplies,
personnel, and conditions will not usually allow definitive care of even minor
or moderate injuries. Care should ordinarily be limited to:
1. Arrest of significant bleeding
2. Splinting of fractures
3. Maintenance of improvement of hemodynamic conditions by intravenous solution
4. Treatment of severe respiratory conditions
5. Pain relief
Tracking:
Patient tracking will begin at CCPs, using a Mettag (Patient Tracking
Tag) attached to the patient during triage operations.
The Mettag will remain with the patient until the final medical treatment
facility is reached.
Treatment Areas:
Red
or Immediate (Priority I) casualties will be routed to the East
Hallway (Corridor 25) and the Urgent Care Hallway (Corridor 33).
Treatment will be primarily in the Urgent Care (Room 37) and Minor
Surgery (Room 34). Ambulance access
will be through the Urgent Care Entrance. Helicopter
access is also through this entrance.
Yellow or Delayed (Priority II) casualties will be routed to the SHS Conference Room (Room 8) and North Hallway (Corridor 18)
The RNEB will be utilized as a holding area for casualties with minor injuries needing first aid only and those who are psychologically disturbed.
ALTERNATE CCP
In the event the primary SHS-CCP is nonfunctional the RNEB will serve as the alternate CCP.
1. Red: Immediate (Priority I) casualties will be routed to the RNEB Rooms 115 and 116. Evacuation will be via hall doors to the exterior.
2. Yellow: Delayed (Priority II) casualties will be routed to RNEB Rooms 102 and 105. Evacuation will be via exterior doors in those rooms.
Responsibilities
of the Campus Disaster Medical Coordinator
1.
Assessing the extent of casualties on campuses and reporting the
situation to local medical authorities through established channels.
2.
Requesting disaster medical assistance as needed through established
channels.
3.
Directing the activities of campus medical and health personnel to assist
local responders on campus.
4.
Coordinating with the Kern County Health Officer concerning disaster
medical operations on campus and the transportation of casualties to medical
facilities.
If available resources
are not sufficient to respond to campus needs because of the severity of the
disaster situation, the Campus Health Officer, will be responsible for:
1.
Directing campus personnel and volunteers to provide casualty care as
feasible.
2.
Establishing temporary casualty care facilities and CCPs by expedient
means.
A more detailed list of responsibilities for the medical operations, as well as, the regional responsibilities and supporting organizations can be found in the campus disaster handbook.
extreme
emergency situations
If county
medical units cannot respond sufficiently under extreme emergency situations,
consider the following actions as appropriate.
1. Establish contact through EOC and determine condition of local hospitals.
2. Establish contact through EOC with local medical clinic to determine status of personnel, facility and services.
3. Determine which on campus facilities will be used for emergency care and support facilities.
4. Mobilize and brief volunteer medical support personnel. Allocate to the following locations or activities as required:
¨ CCP
¨ SHS
¨ Transport of injured
¨ Obtaining and transporting supplies
¨ Maintain records of workers, volunteers and students
5. Assign volunteer medical staff to medical care facilities.
6. Ensure that briefings of medical staff include:
¨ Triage
¨ Arrest of severe bleeding
¨ Use of IV solutions
¨ Pain relief
¨ Tagging injured
¨ Patient tracking
¨ Identification and handling of fatalities
7. Request volunteers from other campuses in CSU system. See Mutual Aid plan.
8. Request volunteers through county EMS radio broadcast to report to medical facilities for assignment
9. Ensure that injured requiring supplemental treatment are taken to CCP
10. Arrange with City/County for pick-up of seriously injured at the CCP.
11. Develop 12 hour shifts for medical support volunteers and ensure that initial work group is relieved.
12. Determine the following support needs for CCP and request from EOC:
¨ Medical supplies
¨ Portable generators
¨ Emergency radio set/Cell phone
¨ Transport for medical personnel unable to reach CCP
¨ Food for patients and staff.
13. Nursing Assignment Officer to monitor needs for volunteer support medical function.
14. Public Relations staff will make public announcements through EOC for any significant changes in emergency medical services.
15. Keep EOC Director advised for any major medical actions and operations.
16. Be prepared to provide a report to the City/County authorities about the injured and estimated long-range medical needs. Periodically poll hospital and medical care facilities to determine patient load and support.
17. Be prepared for requests from nearby areas for medical support. See Mutual Aid Plan for response to other CSU campuses.
In situations involving numerous casualties, available
personnel and resources may not be sufficient to treat or transport all
casualties immediately. In such
situations, it will be necessary to triage casualties.
Under such conditions, the rule the “the greatest good for the greatest
number’ will be the guiding principle. Triage
procedures used on campus will be in accordance with procedures adopted by
neighboring jurisdictions. In
multicasualty incidents, the following casualty-sorting (TRIAGE) procedures
should be used.
Triage
Principles:
·
Mettag: RED
– Priority I – Immediate
attention. Identifier is a
Mettag torn to the red stripe or Roman numeral I placed on the forehead or back
of left hand. First priority
casualties are those that have life-threatening injuries that are readily
correctable. For purposes of
priority for dispatch to the hospital, however, a second sorting or review may
be necessary so only those “transportable” cases are taken early.
Some will require extensive stabilization at the scene before transport
may be safely undertaken. A red tag
may be used as an additional means of identification.
· Mettag: YELLOW – Priority II –Delayed attention. Identifier is the Mettag torn to the yellow stripe or Roman numeral II placed on the forehead or back of left hand. Delayed category casualties are all those whose therapy may be delayed without significant threat of life or limb and those for whom extensive or highly sophisticated procedures are necessary to sustain life.
·
Mettag: GREEN
– Minor injuries. Casualties
with minor injuries will receive minimum first aid treatment.
They will not be transported to hospitals until all Priority I and II
patients have received care. They will be sent from the triage area to a
designated area away from the disaster scene in order to reduce confusion. If
they are capable, they may also be used as litter bearers or first aid
providers.
· Mettag: BLACK – Dead. Identifier is the Mettag torn up to the black stripe or an X on the forehead and covered with a sheet, blanket or other opaque material as soon as possible. Unless absolutely necessary, they should be left in place until released by the coroner. The temporary morgue should be an area away from the scene of the triage area.
Persons who are psychologically disturbed, who interfere with casualty handling, should be isolated from the incident scene as quickly as possible. Campus Police will be requested to escort individuals to a designated area away from the disaster scene.
TRIAGE CATEGORY GUIDELINES
RED:
IMMEDIATE (Priority I)
1. Asphyxia
2. Respiratory obstruction from mechanical causes
3. Sucking cheat wounds
4. Tension pneumothorax
5. Maxillofacial wounds in which asphyxia exists or is likely to develop
6. Shock caused by major external hemorrhage
7. Major internal hemorrhage
8. Visceral injuries or evisceration
9. Cardio/pericardial injuries
10. Massive muscle damage
11. Severe burns over 25%
12. Dislocations
13. Major fracture
14. Major medical problems readily correctable
15. Closed cerebral injuries with increasing loss of consciousness
Simple Treatment
and Rapid Treatment (START): Quick identifiers for Red
¨ Ventilation > 30/min
¨ Perfusion < every 2 seconds
¨
Mental status: unable to
follow simple directions
YELLOW: DELAYED (Priority II)
1. Vascular injuries requiring repair
2. Wounds of the genitourinary tract
3. Thoracic wounds without asphyxia
4. Severe burns under 25%
5. Spinal cord injuries requiring decompression
6. Suspected spinal cord injuries without neurological signs
7. Lesser fractures
8. Injuries of the eye
9. Maxillofacial injuries without asphyxia
10. Minor medical problems
11.
Victims with little hope of survival under the best of circumstances of
medical care
For multiple casualty incidents with an overwhelming number
of survivors or over 80 victims:
RED:
IMMEDIATE (Priority I)
1. Asphyxia
2. Respiratory obstruction from mechanical causes
3. Sucking cheat wounds
4. Tension pneumothorax
5. Maxillofacial wounds in which asphyxia exists or is likely to develop
6. Shock caused by major external hemorrhage
7. Dislocations
8. Severe burns under 25%*
9. Lesser fractures*
10. Major medical problems that can be handled readily
1. Major fractures (if able to stabilize)*
2. Visceral injuries or evisceration*
3. Cardio/pericardial injuries*
4. Massive muscle damage*
5. Severe burns over 25%*
6. Vascular injuries requiring repair
7. Wounds of genitourinary tract
8. Thoracic wounds without asphyxia
9. Closed cerebral injuries with increasing loss of consciousness*
10. Spinal cord injuries requiring decompression
11. Suspected spinal cord injuries without neurological signs
12. Injuries of the eye
13. Maxillofacial injuries without asphyxia
14. Complicated major medical problems*
15. Minor medical problems
16. Victims with little hope of survival under the best of circumstances of medical care
*Conditions which have changed categories
NURSING
STUDENTS
All nursing students will report to the Nursing Assignment Officer, SHS Medical Records Office, for assignments. All students must sign-in and sign-out with date and time. All licensed certified personnel will bring proof or licensure (RN, LVN, EMT, RT). Possible assignments for students of the Department of Nursing would include:
Medical Assistance Teams
Triage support
Pediatrics
SHS-CCP
RNEB-Holding Area/First Aid
Evacuation Assistance
Psychologically Disturbed
Communication support
No student should be expected to work above his or her skill level or above his or her license. Students should report to the Nursing Assignment Officer if they have any questions.
Other individuals who volunteer their services should report to the Personnel Office with documentation for certification and assignment.
Updated 1/01