Emergency Management

Welcome Emergency management is a key focus for all organisations. Would you know what to do if an alarm sounded? Would you know who to approach about various hazards and risks? This course covers requirements for safety procedures in respect to emergency management, and is based on best practice standards that are designed to be applied nationally. All Australian jurisdictions have their own legislation on emergency management and there are differences between them. Where possible, we have highlighted where the differences may lie.

This course is designed for all employees in a workplace who need to understand and manage various workplace emergency situations. This understanding and management of workplace emergencies will ensure your safety in the workplace.

Learning Objectives On completion of this course, you should be able to: • Define workplace emergency management; • Describe the importance of workplace emergency management legislation; • State what your legal duties are; • Determine your role in various types of workplace emergencies. • Recognise the various types of emergencies that could impact the Friendly Society Private Hospital

What is an Emergency? An event, actual or imminent, which endangers or threatens to

endanger life, property or the environment, and which requires a significant and coordinated response. Reference: Planning for emergencies- Healthcare facilities- AS 4083-2010

An event that arises internally, or from sources, which may adversely affect the occupants or visitors in a facility, and requires an immediate response. Reference: Planning for emergencies in facilities- AS 3745-2010

So, what kind of situation is considered an emergency, threat or disaster? • Bomb threat

• External Emergency • Internal Emergency • Fire/ Smoke • Personal Threat • Medical Emergency, Cardiac Arrest

The coordinated response to any of the above situation is referred to as Emergency Management

Emergency management consists of four phases: The Friendly Society Private Hospital Emergency Management Plan is designed to ensure that, in the event of an emergency situation occurring, the Organisation/ staff are able to respond quickly and decisively in ensuring we meet the following key priorities: • Protect and save lives. • Protect our property and the local environment..

The plan establishes a framework for

the effective handling of emergencies and managing the return to normality. The FSPH's approach brings together four key elements:

Emergency Prevention

Prevention management consist of a range of measures implemented to eliminate or reduce the incidence or severity of the emergency • Risk management has four main stages: 1.

Identify hazards- find out what the cause harm

2.

Assess risks- understand the nature of the harm that could be caused by the hazard, how serious the harm could be and the likelihood of it happening

3.

Control risk implement the most effective control measure that is reasonably practicable in the circumstances.

4.

Review- Regular review control measure to ensure they are working as planned.

Poor Housekeeping

Unsafe storage and handling of chemical

Electricity

Deteriorating patient

Emergency Preparedness

Preparedness Management describes measures that are designed to ensure that, should an emergency occur resources and services are capable of coping with the effects. Policies / Procedures

Emergency plans

Maintaining contact details up to date for all StaffStaff Responsibility

Annual Training/ Emergency Drills/ Competencies

Chain of Command

Communication equipment

Response Equipment

Emergency Evacuation Points

Chain of Command at FSPH The established hierarchy, already applying to normal work related activity, will generally apply during an emergency; some areas will have nominated emergency officers (Area/ Fire Wardens). Unit

Managers, level 2, team leaders and Wardens in their specific areas will provide the initial control.

Chief Warden Hospital Coordinator, After Hours Coordinator Chief Executive Officer

Area Warden Nurse Unit Manager, Office Managers, Level 2‟s, Team Leaders

Executive Committee Chief Executive Officer , Chief Finance Officer, Director Clinical Services, Operations Manager, Human Resource Team, ADON - Clinical , ADON – Compliance

Warden

Communication Officers

Any Employee as directed by Area Warden

Administration Staff

Traffic Wardens

Code Blue Team

Purchasing staff/ Security Officers

Designated Medical officer/ Nurses

• On the arrival of the external Fire and Emergency Services (QFRS), the senior officer in attendance will assume the role of Incident Commander or Chief Warden. However, there will continue to be considerable reliance on effective interaction between on-site staff and the emergency services.

Chief Warden: On becoming aware of a possible emergency, the Chief Warden will take the following actions:  Proceed to the fire alarm panel in main foyer  Ascertain the nature of the emergency and determine the appropriate actions.  Ensure the appropriate emergency services are notified, Chief Executive Officer or delegee if necessary.  Advise Area Wardens on findings.  Control entry procedure Staff, Visitors and Public.  Initiate evacuation if necessary.  Brief the emergency services personnel upon arrival of the scope and location of the emergency and the status of the evacuation and then act on the senior officer‟s instructions. (The fire brigade / Police will assume full control of the emergency).  Advise the all clear if no emergency is found.  Conduct a debriefing as soon as practicable after every emergency.  The Chief Executive Officer will be responsible for the release of information to the media in relation to all emergencies. Note: If 2 or more Chief Wardens are present the HC is to take control, CEO or delegee will control entry of public and media and assist the HC where required at front panel.

Area Warden: On becoming aware of a possible emergency, the area wardens will take the following actions:  Attend the Warden Intercom Phone (WIP) red phone in the various service areas.  Advise/ring Chief Warden or delegee on the alarm being activated.  Co-ordinate a search of the service areas.  Advise the Chief Warden of the results of the search (e.g. nature and extent of emergency) or “all clear”.

 Implement emergency procedure for service area if required.  Organise for emergency equipment and medications to be delivered to safe area if evacuation is implemented.  Organise for the medical gas to be switched off. Note: The Area Warden will assume the responsibilities normally carried out by the Chief Warden if the Chief Warden is unavailable

Warden: Employees delegated as Wardens may be required to carry out a number of duties:  Conduct a search for possible emergency as instructed from Area Warden.  If fire/smoke is located, remove all non-essential personnel from the immediate area.  Alert Area Warden and employees, contact the appropriate emergency services by operating the manual alarm point or telephone if required.  Check to ensure fire doors are properly closed.  Operate first attack fire fighting equipment, e.g. portable fire extinguishers, hose reels and fire blankets provided this can be conducted without danger.  Conduct an evacuation if required.  Ensure orderly flow of persons into protected areas.  Assist mobility-impaired patients.  Move patients to assembly areas.  Collect computer print out for patient and staff allocation sheets. Note: The Warden may assume the responsibilities normally carried out by the Area

Warden if the Area Warden is unavailable.

Other Emergency Response Personnel Executive Committee

Executive members’ role in an emergency:  CEO assists / control evacuation from building at main fire panel and attends to any media concerns.  CFO controls the evacuation of ancillary staff from Unit 4 ground floor.  HR assist in assembly area Woondooma Street to communicate missing patients, contractors or staff  ADON - Clinical to assist the area wardens to take control in affected area.  ADON - Compliance to assist in assembly area Crofton Street to communicate missing patients, Contractors or staff.

Traffic Warden

Purchasing staff/ Security Officers Traffic wardens have been appointed to assist with:  Directing personnel across the roads to assembly area.  Public traffic in adjoining streets.  Limiting access.

Communication Officers

Administration Staff  Assist the chief/ Area wardens as needed to communicate to all other service areas within the affected emergency zone.  Contact the appropriate emergency service by operating the manual alarm point / or telephone 0-000 and ask for the fire police or ambulance as required.  Notify the appropriate internal personnel.

Code Blue Team

The Code Blue Response Team comprises of the following :  ICU Medical Officer  ICU nurse  Allocated Nurse from each Clinical Unit.

Communication during an emergency Alerting External Emergency Services

Internal Emergency Communication

e.g. Police / Fire Brigade must be alerted by calling

e.g. Fire / Evacuation Emergencies

e.g. Personal threat or Medical Emergencies

0-000

WIP Phone PA system

8888

Fire Detection Systems When fire breaks out, every second counts. The earlier the fire can be detected and the faster actions can be taken to ensure the safety of staff, patient and visitors. The hospital has 2 categories of fire detection systems.

• •

Automatic Detection Systems

Manually Activated Systems

Smoke/ Heat detectors

Manual Call Points (MCP)

Heat or smoke detectors Early Smoke Detection Alarms

• MCP are located strategically in or near main hallways and emergency exits.

Fire Suppression Systems The organisation has a number of fire suppression devices assist in containingHose andreels extinguishing fires including the following Fire Extinguishers Fire blankets Automatic Sprinkler system placed throughout buildings including near emergency exists in main

CO2 Extinguisher • Electrical Fires • Oils

Dry Powder Extinguisher • All fires

placed throughout buildings including near emergency exists in main corridors

suitable for containing small fires. When placed over the fire, the blanket has a smothering effect.

will operate automatically when heat causes the glass bulb to break, releasing water

Designated evacuation areas Depending on your workplace location will depend on the designated evacuation area. • Building A + B- Woondooma Street Car park • Building C + D- Crofton Street Car park

On arrival at your assembly area report to the delegated hospital member, who will check you off the roster on list.

No one is to re-enter the building unless directed by an authorised person

Emergency Evacuation assembly area In the event that a code orange is implemented, staff are to ensure they muster at the designated assembly area.

Buildings A + B are to proceed to Woondooma Street Car park

Building C + D are to proceed to Crofton Street Car park

Workplace areas within Buildings A + B Ground Floor Consulting Rooms S&N Pathology/ BMI- Radiology Friendlies Chemist/ Atrium Café Pacific Plastic Surgery Consulting Rooms B WideBay Anesthetics Specialists Friendlies Afterhours Day Oncology 1st Floor Bundaberg Cardiology Education Centre Unit 1/ Unit 2 ICU/CCU 2nd Floor Friendlies Physiotherapy Health Information Main Generators Unit 4

Workplace areas within Buildings C + D Ground Floor Day Surgery Unit Jack Scott Unit (JSU) Exec Services Coral Coast Anesthesia Purchasing Offices Environmental Offices Corporate Services Information Services Department Maintenance office 1st Floor Unit 3 Unit 5 Hospital Coordinators Office Kitchen Board Room Staff Development Department •Including training room

Emergency Response

Code Purple- Bomb Threat If you are involved in receiving a bomb threat, remember these key points: • Keep calm. Do not do or say anything that may encourage irrational behaviour; • Keep the caller on the line as long as possible. -DON'T HANG UP; • Obtain information if possible about the bomb and it's location; • Listen carefully for any background noises or details that might indicate the age, sex, identity or location of the caller; • Read and record the number from the phone display if possible; • DO NOT discuss the call with other staff members; • Immediately after the bomb threat, contact your Supervisor who will contact security to notify the police.

Code Black - Personal Threat Code Black personal threat encompasses a number of areas, all of which display numerous variables and characteristics. Due to the inherent nature of Code Black type emergencies, i.e. dealing with people, it is always difficult to expect or plan for certain outcomes. It is the volatility of human nature and emotion that ultimately dictates the way in which this type of emergency will play out. Armed offender

Unarmed offender

Under no circumstances should staff, patients or visitors place themselves in further jeopardy

Stay calm. Do not act in such a manner that may exacerbate the or cause it to become a catalyst for life threatening outcomes.

Calling a Code Black from any phone within the organisation 1 Pick up Handset Dial 8-8-8-8 A ring tone will be heard via the hand set, once the ring tone stops, 3 a click will be heard and the system is activated. 4 With Handset to your mouth, clearly announce Telephone call for Dr Black to ………. Unit/ Area (e.g. CCU please; Reception please) 5 Telephone call for Dr Black to ………. Unit/ Area (e.g. CCU please; Reception please) 6 Dial 8 2

7 Replace Handset

Code Brown- External Threat The police will determine the extent of the disaster and notify the emergency organisations as needed. Should the Base Hospital require back-up assistance, they will notify Friendly Society Private Hospital. If you receive a telephone call requesting assistance record the following: • • • • • •

Who is calling, contact number, type of disaster, location of disaster, time of incoming call, requirements for assistance.

Advise manager of disaster & requirements Prepare to check for availability of beds Arrange for the preparation and receival of low risk patients from the base hospital Be prepared to support disaster measures with both personnel and consumables, e.g • • •

Medical equipment / supplies Food Linen

On request, arrange for medical equipment & supplies, food to be delivered to disaster site Document all equipment/supplies and consumables forwarded onto disaster site

Code Yellow - Internal Threat Internal emergencies are any incidents that threaten the safety of the physical structure of the hospital, staff, patients and visitors. It may also reduce the capacity of the hospital to function normally. Such incidents include but are not limited to: • Explosion. • Natural Disaster (Earthquakes). • Engineering failures (burst water mains, loss of electrical power, gas leaks, air-conditioning failures). • Impacts on buildings or grounds. • Incidents in the immediate surrounds of the hospital (chemical spills, with noxious vapours affecting people). • Illegal occupancy. • Information and communication failures. • The internal emergencies that are most likely to occur in the hospital will be of short duration and

low intensity. • Staff in the affected area will manage such emergencies, with provision for co-ordination by the most senior staff member on site at the time of the incident. Some emergencies will escalate to a serious nature, and others will have a long time frame. These incidents will require the systematic evacuation of patients and others from all or part of the hospital.

Code Red- Fire/ Smoke The procedures and equipment discussed below relate to the initial

response to a fire emergency, and not for any long term action. The Queensland Fire and Rescue Service can be expected on site within five to seven minutes. The hospital is equipped with a comprehensive range of thermal and smoke sensors, incorporated into alarm systems directly connected to the Queensland Fire and Rescue Service. In addition, fire hoses and portable fire extinguishers are available to provide the initial response to an emergency, as well as automatic fire doors.

When a fire alarm is activated •

Notify Area Warden of emergency.

•

Area Warden proceeds to WIP (red phone) to report to Chief Warden and await instructions.

• Area warden will ask you to check your area for emergency. • Report outcome of inspection to Area Warden. • Check escape/exit routes are clear.

WAIT FOR THE ALL CLEAR OR FURTHER INSTRUCTIONS

Action on Discovery of a Fire DO NOT PANIC as panic may cause injuries more serious than those caused by the fire. Follow the General Code Red Procedures depending on the situation.

When the fire alarm sounds Immediate action on discovery of a threatening emergency

Action on Discovery of a Fire Immediate action on discovery of a threatening emergency: If you see fire or smoke, no matter how small: • Remove personnel from the immediate area. • Do not obstruct exits and exit routes. • Alert all staff in the affected area and inform adjacent units. • Sound the alarm by breaking the glass of a manual call point and ringing Fire Services on 0-000. Notify senior personnel. • Confine fire and smoke – close all doors and windows. • Extinguish or contain the fire. DO NOT take unnecessary risks. Use suitable fire extinguishers available to you.

Medical Gases In event of fire medical gases need to be isolate due to them fueling a fire. The following Gases need to be isolated:

Oxygen Medical Air Nitrous Natural gas Suction

Isolating Medical Gases Medical Gases can be isolated within each unit:  Unit 1- On main entry

 Unit 2- Opposite entry to CCU/ICU  Unit 3- Staff Station 1 Opposite Rm 7  Unit 4- Entry Passage to Unit  Unit 5- Dirty Utility Staff station 3  CCU/ICU- Adjacent to CIU doors  CIU- Opposite the admissions bay  Theatre- Opposite reception

Natural Gas has an automatic shut off valve

Code Red Procedure to follow if there is an outbreak of fire

R A C E

Remove people from immediate danger, e.g. outside a room, to a corridor. Alert staff. Activate manual fire alarms and Dial 0-000 to notify emergency personal

Contain fire or smoke

Extinguish if safe to do so, if not prepare to Evacuate.

Code Orange – Evacuation In an emergency, the appropriate personnel shall make an assessment of the emergency and advise which stage of evacuation is to be carried out. Stage 1 • Affected Room or Area Stage 2

• Affected Floor Section Stage 3 • Total Evacuation

When reference is made to an evacuation, most people feel this involves the total evacuation of a building. This is not entirely correct, as an evacuation can be brought about in the following three stages:

Evacuation Stages Stage 1- Affected Room or Area •Remove from immediate area –evacuation all personnel through the nearest fire door. Stage 2- Affected Floor Section • Move vertically or laterally through a fire/smoke door to a safe zone. (Persons should be moved downstairs and never upstairs.) Stage 3- Total Evacuation

• Total hospital evacuation via designated exits to nominated assembly areas.

Lifts Lifts should not be used in a fire emergency unless authorized by the Queensland Fire and Rescue Service.

• Electric power may fail or be switched off causing people to be trapped. • The lift shaft could act as a chimney and thus contribute to the spread of fire, heat, toxic fumes and smoke to other parts of the building. • Fire isolated stairs, fire escapes and other safe routes should be used.

Grouping of patients Evacuation involves the movement of patients, staff and other personnel from or within the health care facility in a rapid and safe manner as possible. For the purpose of evacuation it is desirable to place patients into three groups taking into account the type of patients present. Group 1

Group 2

Ambulatory patient, Semi-ambulant patients, requiring only a member requiring some of staff to guide or direct assistance. them to place of safety. This group is to be moved first.

Group 3 Non-ambulant patients who have to be physically moved or carried.

Area warden is to co-ordinate the evacuation process.

Group 3 - Non Ambulant Patients: Non-Ambulatory patients may be carried on stretchers, blankets or specifically designed equipment,

• e.g. Evacuation sheets. Evacuation sheets- these are located on each patient bed under the mattresses, with exception in Unit 1 where they are located in the linen cupboard between Rm 15-16

Patients may also be moved by emergency removal techniques such as: -Blanket drag -Fore and Aft carry/ 2 person lift Fore and Aft carry and 2 persons lift

must only be carried out in an emergency situation.

Persons refusing to comply with Directions: In the event of persons/s refusing to comply with the directions given by a member of the Emergency Control Organisation / Wardens. The wardens are to ascertain the following:  Ensure that the person has been clearly advised they are required to evacuate the area or premises because of an emergency situation.  Should the person refuse to evacuate the premises, ask them twice to leave/ evacuate then request the person‟s name.  The Warden should then notify the Chief/ Area Warden. The Chief Warden will advise the Officer in Charge of the Emergency (Fire Brigade) who at their discretion may take appropriate action under law to remove the person.

Code Blue – Medical Emergency Code Blue 8888

Code blue: An emergency situation announced in a hospital or institution in which a patient is in cardiopulmonary arrest, requiring a team of providers (sometimes called a 'code team') to rush to the specific location and begin immediate resuscitative efforts. The Friendly Society Private Hospital has implemented the Code Blue Team' to respond to both Medical Emergencies and Arrests. • The Code Blue Response Team comprises of the following : • • •

ICU Medical Officer ICU nurse Allocated Nurse from each Clinical Unit.

Calling a Code Black from any phone within the organisation 1

Pick up Handset

2

6

Dial 8-8-8-8 A ring tone will be heard via the hand set, once the ring tone stops, a click will be heard and the system is activated. With Handset to your mouth, clearly announce Code Blue. Code Blue, Unit ……., Room #:……, All available doctors, please attend. Code Blue. Code Blue, Unit ……., Room #:……, All available doctors, please attend. Dial 8

7

Replace Handset

3 4

5

Emergency Recovery

Receiving the ‘All Clear’ • After the emergency is over, the emergency officer ( Chief Warden or Fire Brigade Chief) will inform hospital personnel over the PA system of the ‘All Clear’ • If a false alarm is discovered, the emergency officer will broadcast the ‘False Alarm’ over the PA system to recall all personnel to a normal working program

Recovery is a coordinated process of supporting; • Affected individuals, • Reconstruction of physical infrastructure and • Restoration of emotional and physical well-being

The organisation will put into place a process for recovery for structural damage and physical infrastructure as required following the emergency. After any Emergency: • The incident must be reported via „Riskman‟ • A debriefing should also be conducted with appropriate personal

Further Reading Knowing your role and responsibility in an emergency is vital to the safety of all personnel within the facility. Keeping up to date with the changes in policies and procedures is essential. These documents are located in

I:\Public\1. FSPH Quality Management System\12. Health & Safety\ Policy & Procedure

the Quality Management System accessible via the Friendlies Internet.

Quick emergency procedure flipchart are available in all areas, located at unit nursing stations, main

reception desk or within an office area.

It is mandatory to complete annual training and competency in Emergency Procedures including Fire Extinguisher Competency. It is mandatory to participate in any ‘mock’ emergencies as they occur in your area.

Thank you very much for your time and patience  Remember to tick the box  I have read and understood this document before submitting If you have any questions in relation to your the policies, procedures and practices of the Friendlies, please feel free to speak with your Manager or the Fire Safety Officer- 4331 1377

Thank you