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Daniel Kollek, MD, CCFP(EM) Director, Centre for Excellence in Emergency Preparedness Chair – CAEP Disaster Committee Associate Professor, Division of Emergency Medicine, McMaster University. Definitions, Classification and Response Structure. Introduction to Disasters. Disaster.

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Introduction to disasters l.jpg

Daniel Kollek, MD, CCFP(EM)

Director, Centre for Excellence in Emergency Preparedness

Chair – CAEP Disaster Committee

Associate Professor, Division of Emergency Medicine,

McMaster University

Definitions, Classification and Response Structure

Introduction to Disasters


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Disaster

  • The Merriam-Webster dictionary definition of disaster is:"a sudden or great misfortune."

  • The Medical definition if a disaster is: "when the destructive effects of an event overwhelm the ability of a given area or community to meet the demand for health care."


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How have health care systems dealt with disaster in the past?


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September 11, 2001- NYC


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September, 2002 - Jerusalem


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2003-Toronto


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What kind of disasters might we face and how do we assess our risk?


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Natural disaster


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Natural Events

  • Hurricane/Tornado

  • Severe Thunderstorm

  • Snowfall

  • Blizzard

  • Ice Storm

  • Earthquake

  • Tidal wave

  • Drought

  • Flood - external

  • Wild fire

  • Landslide

  • Volcano

  • Epidemic

  • Extreme temperature


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Technological disaster


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Technological events

  • Fire alarm failure

  • Communications failure

  • Medical gas failure

  • Medical vacuum failure

  • Info. systems failure

  • Fire – internal

  • Flood – internal

  • Hazmat exposure – internal

  • Supply failure

  • Electrical failure

  • Generator failure

  • Transportation failure

  • Fuel Shortage

  • Natural gas failure

  • Water failure

  • Sewage failure

  • Steam failure

  • Structural damage


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Man-made disasters

Anthrax envelope - 2001


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Human events

  • MCI – Trauma

  • MCI - Medical

  • MCI – Hazmat

  • Hazmat – external

  • Terrorism – chemical

  • Terrorism – biological

  • Terrorism - radiological

  • VIP situation

  • Infant abduction

  • Hostage situation

  • Civil disturbance

  • Labor action

  • Forensic admission

  • Bomb threat


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For each event you must assess risk

  • What is the probability of occurrence?

  • What impact would it have?

  • What is your preparedness?

A formal risk assessment tool is available at www.ceep.ca


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What are the characteristics of disasters?


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A disaster can have multiple settings


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A disaster often has multiple patients


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The Patients:

Tokyo Sarin attack 1995:

  • >5800 victims

  • 12 deaths

  • 17 critical patients

  • 37 severe patients

  • 984 moderate patients

  • 4793 “worried well”


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A disaster always has multiple players


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The Players:

  • Police

  • Fire

  • EMS

  • Hospitals

  • Volunteers

  • Public health

  • Elected officials

  • Civil servants

  • Utilities

  • Transit

  • Provincial / Federal agencies

  • Media


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A disaster can have variable timelines


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Static timeline


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Dynamic timeline


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and despite the range of possible events,

disaster response has more commonality

than event specific characteristics.

Whatever the case,


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What do you need in a disaster?

  • Information

  • Guidance

  • Money

  • Supplies

  • Equipment

  • Human Resources

and……

A system to deliver this to you in a useful fashion


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IMS is the system


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IMSIncident Management System

Incident Management System is

a method of coordinatingparts of one agency or many agencies in a

unified command structureto

use all available resources

in the effective and efficient response to an emergency.


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The Eight Components

of Incident Command Systems


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IMS - Components

  • A unified command structure

  • Common terminology

  • Modular organization

  • Integrated communication

  • Consolidated action plans

  • Manageable and sensible span of control

  • Designated facilities

  • Comprehensive resource management


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IMS Basic Structure


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Incident Commander

  • Most senior trained responder

  • As incident develops, falls back to established command on-site

  • Eventually may fall to Senior Command off site (Emergency Operations Centre)


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Operations

  • Implements response activities as determined by Incident Manager

  • Maintains communication between Command and site

  • Requests and assigns resources as directed


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Logistics

  • Support Operations

  • Allocate resources and provide all materials, equipment, and personnel required

  • Application of additional resources provided by Mutual Aid


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Planning

  • Control and flow of all information

  • Data collection, analysis and forecasting

  • Development of response and recovery objectives and strategies

  • Mutual Aid Requests


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Finance

  • Tracking of expenses

  • Funding

  • Government Financial Aid requests

  • Financial Aid distribution


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IMS - Components

  • A unified command structure

  • Common terminology

  • Modular organization

  • Integrated communication

  • Consolidated action plans

  • Manageable and sensible span of control

  • Designated facilities

  • Comprehensive resource management


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Job Action Sheets


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IMS Structure


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IMS Expanded Structure (1)


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IMS Expanded Structure (2)


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Proposed Hospital IMS Structure For Ontario Hospitals

Legend:

The Colour Code Triage (Yellow, Red, Green, Black) is universally accepted and consistent with Triage Codes used by EMS in the field when addressing large scale emergencies


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IMS - Components

  • A unified command structure

  • Common terminology

  • Modular organization

  • Integrated communication

  • Consolidated action plans

  • Manageable and sensible span of control

  • Designated facilities

  • Comprehensive resource management


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Designated Facilities

  • Emergency Operations Centre (EOC)

  • On-site Command Post

  • Staging Areas

  • Triage Area

  • Resource Storage

  • Morgue


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Primary Response Command

(Initial Command Centre)

On-site Command

(Secondary)

EOC

Off-site Command

(Final)


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Summary


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We need to formally review our disaster risks in order to prepare a plan


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There are common threads in all disaster responses


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IMS is the system used for command and control of a disaster response


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IM Systems have standard components


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IM Systems have a standard command structure


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IMS will have job action sheetsand a planning cycle


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Do it right and you will become the…


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www.ceep.ca


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