The happening of a ‘Disaster’ is a low probability but it is high impact calamity which causes many people to become injured, ill or die. A disaster is considered when an event occurs and creates a major short-term spike in the requirement for emergency care services that need exceptional measures to address sufficiently.
In case of any natural disaster, transfer/evacuation procedures have to be conducted to make the people secure and to draw them out of danger. In these situations of disaster, the partial evacuation of the patients become imperative as till the time the old patients who have become medically appropriate will not be discharged, the new patients will not be able to get their treatment done. The balance has to be maintained and regular inspection, as well as smooth evacuation, has to be strategized.
Sometimes patients need to be transferred through ambulance or some suitable vehicle following all procedures and policies to some other hospital for their further treatment under the guidance of incident command center.
There are different types of evacuations that are ordered by the concerned department at the time of natural calamity such as-
1) Horizontal evacuation
The first stage evacuation order is given by incident command center, NYPD or FPNY. The logistic chief and facility unit leader is directed by the incident commander to notify the need to secure the water, electricity and medical gasses.
The patients will then be moved to the area of imminent danger ensuring their safety. The nurse in charge will be responsible for the patient’s transfer and will make sure all the rooms have been completely evacuated or not. The security officer will notify the incident commander of the completion of the process of evacuation. Sometimes a personnel resource such as Labor pool will be utilized to assist the evacuation.
2) Vertical evacuation
The patients are to be prioritized on the basis of their health condition and are classified as ambulatory and non ambulatory and evacuated accordingly. This happens when the vertical evacuation becomes necessary. There are 3 types of cases in vertical evacuation:
a) Patients are in walking state. Patients are evacuated with care to prevent accidents.
b) Patients are mobility- impaired. When a patient is not able to walk, they are evacuated on a wheelchair or are wrapped in the blanket for carrying them. Evacuation can also be done in the chairs which will be carried by 2 men on either side or by clasping the patient’s arms tightly.
c) Patients are not able to walk. In this case, you have to use stretchers for those patients to evacuate.
3) Staff evacuation
When the evacuation alarm 3-3-3-3 is sounded, all occupants must evacuate the building except the medical staff which attends the patients and get their treatment done. People shall follow the command of university police officers to evacuate when in doctor's clinics or hospitals, laboratories and office areas at the time of disaster. No one will be permitted to enter till the time 1-1-1-1 alarm is sounded which is an 'All clear' signal. It is always advisable to use stairs instead of elevators during an evacuation.
4) Transfer coordinator
The transportation unit leader will be responsible for the current admitting, transfer and discharge procedures. He will be accountable for giving suitable and available transports to the patients. It may include buses, vans or ambulance.
5) Transfer area responsibility
The patient has been transferred, identification tag will be placed on them. The patient's medical record will also be sent along with them.
The transportation unit leader will maintain the confirmation log. They also arrange a holding area for the patients if an immediate transfer is not possible.
Once the disaster is over and patients are being accepted with clear facilities, there will be no more urgency of evacuation.
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Nepal Earthquake Evacuation Plan team