Learning for a better emergency preparedness
2012
Follow up of proposals for improvement of the medical response, 22.juli 2011 Inggard Lereim , | Læring for bedre beredskap - Helseinnsatsen etter terrorhendelsene 22.juli 2011
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The remit issued by the Ministry of Health and Care Services.
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To document and assess how the health sector discharged its duties,including any learning areas that might provide a basis for charging how similiar situations are handled in the future. • To provide a reliable basis for information about the health services actions,experiences and asessments. • On request from the 22-July comission,to assist the Commission in aspects of inquiery
2012
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External sequering of quality •
Internatianal Advisory Council.:Members from the Nordic countries,UK and Spain. • Specialists on disaster medicine,disaster psychiatry,traumatology,administration of medical care on the highest national level. •
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National top qulified specialists from other Norwegian university hospitals than those directly involved in diagnostics and treatment. | Læring for bedre beredskap - Helseinnsatsen etter terrorhendelsene 22.juli 2011
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Results of treatment
2012
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Report from the working goup handed over to the Minister March 9.2012 •
66 proposals on improvement. • Priority 1:Can and should be started immediately • Priority 2:Can be started quite soon • Priority 3:May be postponed until major changes are carried out in cooperation with ofther sectors of society
09.10.20 122012
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Some important proposals,priority 1. •
Systems and routines for the follow up of survivors and their relatives • Emergency medical alarming and communication • National guidelines and common plans for the rescue services(medical,police,fire brigade).A key issue is the cooperetion in hot zoones(shooting etc.)See belove . • National guidelines for triage.See belove. 09.10.20 122012
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Recommendations,continued •
Revised regulations,plans and prosedures,among others evaluations of the present law on medical and social preparedness and the excisting regulations • on emergency medicine. • Secure resources for further education leading to a high competence in disaster medicine and preparednes. • This includes resources for manouvres 09.10.20 122012
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Hot zoones •
Increase the competence of all member bodies having responsibility in hot zoones • Train police and fire brigade members in advanced emergency medical care in the field(prehospital) • Train emergency medical personel how to behave in hot and warm zoones,reducing the risk and train them by working with heavy safety cothing and other protecting devices 09.10.20 122012
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Hot zoones,continued •
Every hospital with responsibility for major traumata must take part in this theoretical and above all practical training. • Personel(nurces and doctors)should be evaluated properly in the aim of finding the best qualified participants of such teams . • A system of examination and certification must be created.
09.10.20 122012
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Hot zoones,continued. •
Instuctors/leaders by the education must be well qualified,if possible by their own experience from hot zoones and other situaytions of high risk. • Professionals from the police(DELTA)and army medical personel and other army officers are expected to give valuable contributions by this education(frequently exposed to risky situations in Afganistan etc.)
09.10.20 122012
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National guidelines for triage • • •
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Present situation: Different guidelines pre-and in-hospital Different guidelines in the respective regions Different guidelines in trauma hospitals Different knowledge,skill, and experience among doctors even in the same hospitals Doctors working in administrative positions have in particular situations duties as head of prehospital medical care by major accidents
09.10.20 122012
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Triage,continued. •
A common norm for triage guidelines is afforded • Level of experiece and other qualifications by doctors given such obligations by disasters and major accidents must be cleared. • A trauma manual on national level,anually updated to top international standard should be compulsory.
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Conclusion •
A trauma manual of the quality mentioned above was used by the successful treatment av Oslo University Hospital(see result and the evaluation-top international score) • Regulations,rules,guidelines,improvements, • training and reliable technical systems must be a part of the presense and the future. • Learning for better emergency preparedness gives Norway the chance to follow this. 09.10.20 122012
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