Auckland District Health Board
Emergency Preparedness & Response Manual
INTRODUCTION
Purpose of the
The Emergency Preparedness And Response Manual (EPARM)
EPARM
outlines emergency preparedness and response procedures for
Auckland District Health Board (Auckland DHB).
The EPARM is the operational component of the Health Emergency
Plan (HEP) and aligns with the tactical response component for the
Incident Management Team (IMT) set out in the Major Incident Plan
(MIP). The relationship of the plans is shown at
Figure 1 on page 2.
It is designed to be read in conjunction with the Emergency
Response Flipchart (these should be co-located with the EPARM)
and Unit Specific Emergency Plans (USEPs) – see Section 15.
EPARM Aim
The aim of the EPARM is to provide general guidance for all staff to
assist them in preparing for, and responding to, emergency
situations.
Scope of the
The EPARM is intended to be read in conjunction with the
EPARM
Emergency Response Flipchart and Unit Specific Emergency Plans.
It provides guidance associated with the immediate response
actions to an emergency situation.
Structure of the
The EPARM is divided into sections; each contains the roles and
EPARM
responsibilities of individuals or groups during specific events.
Preparedness strategies are also outlined for key areas, with
particular focus on individual Unit Specific Emergency Plans
(USEPs) – see Section 15.
Brief information on associated Auckland DHB plans are on page 3
of this Introduction Section.
Auckland DHB
The EPARM is posted on the Auckland DHB intranet Emergency
Intranet
Management Service webpage.
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Introduction
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Auckland District Health Board
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INTRODUCTION
STRATEGIC
Health
WHY
(Vision &
Emergency
Culture)
Plan
TACTICAL
Major Incident Plan
WHAT
(Supporting
For use by
Systems)
Incident Management Team
EPARM
OPERATIONAL
(Emergency Preparedness
(Underpinning
And Response Manual)
HOW
This document
Processes)
Includes Unit Specific
Emergency Plans (USEPs)
Figure 1: The relationship between Auckland DHB plans and their management levels
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EPARM Introduction
Auckland District Health Board
Emergency Preparedness & Response Manual
INTRODUCTION
Associated Plans
Health Emergency
The Auckland DHB Health Emergency Plan (HEP) has been
Plan
developed as a requirement of the Ministry of Health Operational
(HEP)
Policy Framework. A strategic document, it covers business
continuity planning and major issues, it establishes the link with
Strategic Level
specific national, regional and local Health Emergency Plans and
procedures.
Purpose
The purpose of the HEP is to create a framework within which to
manage a resilient and sustainable health sector during any
potential or significant health or civil emergency by ensuring that all
health services will continue to be delivered to the fullest possible
extent.
The HEP incorporates generic Auckland DHB-wide detailed
information; it does not contain service specific plans but refers to
them.
The HEP is posted on the Auckland DHB intranet Emergency
Management Service webpage and on the internet.
Major Incident Plan The MIP provides a framework to assist the Auckland DHB Incident
(MIP)
Management Team (IMT) in its management, coordination and
control of major incidents and supplies the tactical link with the
Tactical Level
strategic level Auckland DHB HEP and the operational level
Auckland DHB EPARM to provide a coordinated response across
levels within Auckland DHB.
Unit Specific
Section 15 of the EPARM should hold the Unit Specific Emergency
Emergency Plan
Plan (USEP) for the area in which the EPARM is located.
(USEP)
USEPs contain operational information to assist staff in an
emergency situation which is specific to a business unit for example,
Operational Level
critical processes, services and equipment required in order for the
unit to function.
Each business unit needs to produce a USEP which should be
placed as Section 15 in every EPARM held in the unit. USEP
production should be completed by managers and staff working in
the unit who take ownership of the plan and its regular update and
review for example, maintaining the currency of staff call-back lists
and processes.
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Auckland District Health Board
Emergency Preparedness & Response Manual
INTRODUCTION
Definition of a
Emergencies occur continually to which health and emergency
Major Incident
services respond accordingly. The criteria used for assessing
whether an emergency is classified as a major incident is when
usual resources are overwhelmed or have the potential to be
overwhelmed (use of the term
emergency is based upon Civil
Defence Emergency Management Act (CDEM Act) definition, 2002,
Pt 1, s4).
Using the above criteria a Major Incident for Auckland DHB is
defined as:
“Any actual or impending event that may significantly impact
on hospital or Auckland DHB functions.”
Incident Activation
The thresholds for activation and/or escalation will be determined by
Thresholds
the level of impact (actual or potential) an emergency event has on
Auckland DHB’s ability to meet its obligations to the community, and
the length of time the organisation must sustain that level of impact.
National Threshold
National
Co-ordination
Regional Threshold
T
Regional
C
A
Co-ordination
P
ADHB
IM
Threshold
IMT Co-ordination
Service Threshold
Service level
Co-ordination
TIME
Key
Thresholds are not fixed they move depending
Earthquake
upon the nature of the incident, staffing numbers
and experience
Pandemic
Unplanned Power Outage
Water leak on a ward
Figure 2: Examples of incident activation thresholds
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EPARM Introduction
Auckland District Health Board
Emergency Preparedness & Response Manual
INTRODUCTION
Emerging
Auckland DHB Emerging Infectious Disease (EID) Plan.
Infectious Disease
The purpose of this plan is to document the core Auckland DHB
Planning
preparation and response arrangements in the event of an EID
pandemic. The plan incorporates generic Auckland DHB-wide
detailed information. It does not contain service specific plans but
refers to them.
Participation in the response to pandemic influenza A(H1N1)pdm09
at a national and regional level – the Northern Region Health
Coordination Centre (NRHCC – located at Auckland City Hospital)
provided Auckland DHB with a wealth of knowledge in regard to
pandemic planning. Documentation and procedures relating to this
are located on the Greenlane File Server N:\Groups\NRHCC
Industrial Action
Auckland DHB has a contingency planning template for industrial
Plan
action. The template and level of response is modified to suit the
extent of industrial action as required.
The response structure contained within the template considers both
short and long term strategies.
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INTRODUCTION
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EPARM Introduction
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 1 INITIAL ACTION
Early Notification
An incident is to be reported immediately at the time of the
occurrence.
The early notification of an incident is critical in determining the
overall outcome. Reporting via
an emergency telephone call is
essential, as is notification to your supervisor or manager.
Emergency Call
The Hospital emergency telephone number is
777 From an Auckland DHB landline phone 777
From an Auckland DHB-issued Vodafone mobile 777
From a private mobile 09 307 4949, when prompted by the
automated operator enter 777#
Outside of the Hospital, the emergency telephone number is
111 this
is direct to the emergency services.
NOTE
You may have to dial 1 for an outside line
1-111.
If 111 is called this will not activate the internal Auckland DHB
alerting process, so 777 must also be called.
Disaster Contact List – Dedicated Landline phones
Service Area
Extension
AED
24269
APU
24210
CED
24004
AED - Duty Manager (021 943 748)
24594
SSH - Duty Manager (021 539 525)
23366
Radiology
23589
Labs
22000
Blood Bank – Issues Bay
24017
DCCM - Charge Nurse office
23396
CVICU
24470
Level 4 theatres (pager 934827)
24447
Level 8 theatres
24880
Level 9 theatres
23768
Surgical Trauma Specialist
0800 4 TRAUMA (0800 4 872862)
Mortuary
09 375 7013
IMT Boardroom Level 5
24999 DDI 09 307 4998
Security 24/7
25007
The above landlines are connected to hard wired phones (not hands free) and will be the
dedicated inter-service liaison numbers for use during an emergency event.
ED – Surgical Coordination Process
A surgical coordinator or lead clinician will attend ED. This will usually occur as a trauma
call, to the General Surgical registrar cell phone/pager on call. They will attend until the
surgical consultant arrives. The consultant will then take the general surgical registrar's cell
phone so that will be used for ongoing contact with them throughout the incident. The
surgeon will stay for ongoing triage in ED during the incident.
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Section 1 INITIAL ACTION
Staff – Responsibilities
Individual
An incident may be observed or reported to you for immediate
response
action. The appropriateness of your response will depend on a
number of factors, including your ability to:
1. Respond in a calm manner.
2. Assess the circumstances and seriousness of events.
3. Determine the type of emergency and level of assistance
required.
Make an
An emergency telephone call should be made and the following
Emergency
information provided to the
777 Operator.
Telephone Call
777 Operators use the acronym
H E L P to gain this information:
H = Hospital site ACH, GCC, Point Chevalier
E = Extension (phone number)
L = Location
P = Problem
1. Your name.
2. The phone number (or extension) you are calling from.
3. The location of the incident (be as specific as possible to
avoid confusion)
a. Building name/number
b. Room number/ward
c. Department.
4. Your location (if different from number 3).
5. The type of emergency.
6. Number of people involved.
7. Any casualties.
8. Any other hazards.
The Operator will take charge of the call and ask questions, to
provide as much detailed information as quickly as possible. See
the acronym
SAD CHALET (next page) to help you give a quick
assessment of the incident.
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EPARM Section 1 Initial Action
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Emergency Preparedness & Response Manual
Section 1 INITIAL ACTION
Staff – Responsibilities (cont.)
While waiting for the arrival of a person in authority, ensure that you:
1. Consider your personal safety and the safety of others.
2. Seek assistance from others present.
3. Attend to the injured.
4. Evacuate, if appropriate.
5. Isolate the area by closing doors and restricting access.
SAD CHALET
Use the acronym
SAD CHALET to give a quick assessment of the
Survey
incident.
Assess
Disseminate
S = Survey
What has happened?
Casualties
eg Fire in Rm 431, Building 13, Greenlane Clinical Centre.
Hazards
Access
A = Assess
Location
What is happening now?
Emergency Svcs
eg It is not contained and people are evacuating.
Type of Incident
D = Disseminate
Call
777 to alert the organisation and activate a response.
C = Casualties
Estimate of numbers that you can see.
H = Hazards
What are the hazards that responders need to be aware of?
eg clinical gases, live electrical wires.
A = Access
Is the quickest/ most obvious route to the incident blocked?
Where is the nearest emergency exit?
L = Location
Where is the incident?
Where are you?
E = Emergency services
What services are required initially? Fire, police, ambulance?
T = Type of Incident
What has happened? eg fire, flood, power outage.
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Section 1 INITIAL ACTION
Contact Centre – Responsibilities
The Contact Centre On receipt of 777 call take control of the conversation; prompt the
must:
caller to give relevant information quickly by asking set questions.
1. Refer to standard operating procedures (HELP). Ask for:
a. Name of the caller,
b. Auckland DHB site of the incident
c. The phone number they are calling from (may
not be an extension) and
d. Location of the incident - Building, Level, Room
e. Type of incident
2. Are there any casualties?
3. Are there any hazards?
4. Obtain other details as relevant (the acronym
SAD CHALET –
previous page, is an aid to prompt callers for the information
required).
5. Activate the appropriate group alert (Response, Service
Advisory, Support and Management Advisory).
6. Update relevant contacts (eg Duty Manager) with any new
information as it is received.
Duty Manager – Responsibilities
Investigate
1. Assume the role of Incident Controller; wear appropriate
identification (hi-vis jerkin).
2. Verify the information provided (obtain the facts).
3. Assess the immediate needs to resolve the situation.
4. Determine the impact on patient care.
5. Prioritise tasks from most to least important.
6. Plan a course of action; consider setting up an Incident
Control Point (ICP).1
7. Notify affected areas of the ICP location and contact details.
8. Identify the requirement for further assistance.
9. Identify or obtain descriptions of personnel or property
involved.
10. Liaise with the Incident Controller to assess the requirement
to activate the Incident Management Team. (cont. on next page)
1 The Incident Control Point (ICP) is the focal point for the management of operations at emergency incidents
and will be (in most cases) adjacent to the incident. An ICP allows for the effective command, control and co-
ordination of the operational level response activity relating to the incident.
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EPARM Section 1 Initial Action
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Emergency Preparedness & Response Manual
Section 1 INITIAL ACTION
Duty Manager – Responsibilities (cont).
Isolate
1. Restrict access to and from the affected area, use hazard
tape to isolate areas.2
2. Delegate others to control the perimeter.
3. Preserve any evidence at the scene for examination by
the Emergency Services
Communicate
4. Ensure that you are briefed on the events.
5. Notify the 777 Operator on your arrival at the scene.
6.
Ensure that 777 Operator has activated the
appropriate group alerts (Response, Service Advisory,
Support and Management Advisory including
notification to the Emergency Management Service).
7. Identify yourself and maintain contact with those present.
8. Avoid confrontation.
9. Provide support and reassurance to those affected.
10. Direct others to complete tasks, eg security staff,
orderlies.
11. Brief and confer with response personnel, including the
Emergency Services.
12. Notify key management and clinical personnel to ensure
that essential patient needs are being met.
Evacuate
An evacuation should only be conducted in the event of a fire (fire
See also: Section 13 alarm activation) or when the safety or security of others is at risk.
Evacuation.
The following factors should be considered:
1. Patient requirements.
2. Location of assembly areas and evacuation routes
(evacuate away from the affected area).
3. Operational implications (relocation of essential services).
2 Hazard tape is held by Security.
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Section 1 INITIAL ACTION
Incident Control Point
Incident Control
The severity of the incident may require an Incident Control Point
Point (ICP)
(ICP) to be established.
The ICP is the focal point for the management of operations at
emergency incidents and will be (in most cases) adjacent to the
incident. An ICP allows for the effective command, control and
coordination of the operational level response activity relating to the
incident.
Once an ICP is established, the 777 Operator should be advised of
its location.
Personnel responsible for incident management are to report to the
ICP and await instructions from the Duty Manager or other person in
authority.
Orderlies – Responsibilities
The Orderly
1. Check that Radio Telephones (RTs) are available for
Supervisor (or
distribution.
senior person)
2. Check that RTs are in working order.
must:
3. Report to the Duty Manager/Clinical Operations Manager
and await instructions.
Security Staff – Responsibilities
The Security
Supervisor (or
When alerted of an incident report to the Duty Manager and await
senior person)
instructions.
must:
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EPARM Section 1 Initial Action
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 2 EARTHQUAKE
Staff – Responsibilities
During Shaking
Take cover under, or beside a solid piece of furniture or doorway.
Drop, Cover, Hold
Alternatively, crouch low against an interior wall or corner. Hold on
securely.
Do not run outside or try to leave the area you are in.
Move away from windows and outside walls.
Instruct patients to seek cover under their beds, or pull the covers
over themselves.
If outside, seek shelter and do not attempt to go indoors until the
shaking has stopped and the building is stable.
After the Shaking
1. Move carefully. Beware of broken glass, live wires, structural
Stops
damage and unstable objects that could fall.
2. Account for all staff and visitors. Check lift lobbies adjacent
Staying in a building
to your unit.
3. Check for injuries - staff, patients, and visitors.
immediately after an
4. Administer first aid as required.
earthquake is much
5. Do not use lifts.
safer than
6. Advise visitors to remain until the situation has been
immediately going
assessed for safety, particularly exit routes.
outside.
7. Check for hazards - fire, gas or chemical leaks, live wires.
Where practicable, contain the hazard.
8. Turn off utilities at mains source if damage to supply has
occurred (gas, water, electricity).
9. Turn off and unplug all unnecessary electrical equipment.
10. Move people away from windows and outside walls.
11. Close curtains across broken windows.
12. Implement instructions governing water conservation (refer to
Section 10 – Utility Failure).
Do not evacuate automatically. Follow evacuation procedures as
described in Section 13 – Evacuation.
If evacuation is required:
1. Keep clinical records and essential drugs with patients.
2. Salvage vital records and equipment.
3. Take a blanket for each person.
4. If seeking safety outside a building, keep away from
structures and power lines.
Be aware of the potential for aftershocks.
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EPARM Section 2 Earthquake
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Section 2 EARTHQUAKE
Senior Person – Responsibilities
The Senior Person
1. Gather information – Identify ‘at risk’ areas.
present must:
a. Check the safety of environment for hazards for
example:
i. Fires
ii. Gas leaks
iii. Live wires
iv. Water leaks and flooding.
b. Check safe route to assembly area.
2. Organise those who are uninjured to carry out essential
duties, eg first aid, sanitation.
3. Ensure a roll call is completed and information is supplied to
Duty Manager or equivalent.
4. Refer to Unit Specific Emergency Plans.
5. Delegate roles.
6. Check that the telephones are working (refer Section 11 –
Communications Failure).
7. Provide direction, control and reassurance.
8. Check that life safety systems are operating.
9. Put warning signs in dangerous areas or assign a staff
member to prevent access.1
10. Coordinate personnel, including the rostering and relief of
staff.
11. As soon as personal and patient safety is ensured. Report
any relevant information regarding casualties (staff and
patients), or interruption of services (eg water, electricity,
medical gases) to the Duty Manager.
12. Remain on standby and follow the instructions of the Duty
Manager or response personnel.
If you think damage is severe and life threatening initiate evacuation
for your area. Do not wait for approval.
1. Plan your route carefully, use previously identified evacuation
routes if safe to do so and consider the needs of patients.
2. Leave a note in your area to say where you are going and by
which route.
3. Retain control of staff at the assembly area.
4. When you have reached a safe area, notify the Duty
Manager or equivalent notification process (reporting
structures may be disrupted) of your whereabouts.
1 Hazard tape is held by security.
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EPARM Section 2 Earthquake
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 2 EARTHQUAKE
Duty Manager – Responsibilities
The Duty Manager
1. Wear the appropriate identification (hi-vis jerkin).
must:
2. Assess the extent of damage and impact on patient care.
3. Prioritise actions, for example, rescue and first aid, immediate
treatment of casualties.
4. Assess what vital services can and cannot continue to
function. Consider likelihood of multiple admissions and
requirement for triage teams/area.
5.
Ensure that the 777 Operator has activated the
appropriate group alerts (Response, Service Advisory,
Support and Management Advisory – including
notification to the Emergency Management Service).
6. Liaise with the Incident Controller to activate the Incident
Management Team (IMT) and initiate the call-out of IMT
members.
7. Contact Facilities Management:
During working hours contact the PAE (Facilities
Management) Ops Manager (via the 777 Operator)
After hours contact the Shift Engineer.
8. Nominate an Incident Control Point (ICP) and remain in the
vicinity to control and direct activity.
9. Notify 777 Operator and affected areas of the ICP location
and provide contact telephone and fax number(s).
10. Activate Major Incident Whiteboard.
11. Request unit status reports particularly status of delivery units,
theatres, and intensive care units.
12. If required, delegate personnel to undertake ICP functions.
13. Arrange for staff call-back and the implementation of rapid
discharge or multiple admission procedure.
14. Ensure Unit Specific Emergency Plans have been activated
for affected areas.
Daily Operations Manager – Responsibilities
The Daily
1. Maintain close liaison with the Duty Manager.
Operations
2. Maintain close liaison with Facilities Manager (or their
Manager must:
delegated authority).
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Section 2 EARTHQUAKE
Incident Management Team
The IMT will
1. The Emergency Operations Centre (EOC) should be activated
activate the EOC:
by the IMT.
2. If the designated sites for the EOC are compromised an
alternative should be located.
3. Provide details of the EOC location and contact numbers via
all internal and external communication channels to:
Auckland DHB Contact Centre
All responding and liaison agencies.
Facilities Manager – Responsibilities
The Facilities
1. Report to the Duty Manager.
Manager, or
2. Activate Unit Specific Emergency Plan.
persons delegated
3. Make contact with key contractors.
by them must:
4. Begin structural and services damage assessments. Assess
the extent of damage and identify what structures and
systems are intact and safe to use.
5. Complete a building check to assess if it is safe to remain in
the building or evacuate.
6. Check emergency generators and backup systems.
7. Check all vital systems – medical gases, gas, power, water
and sewerage.
8. Cordon off any buildings unsafe to occupy2.
9. Initiate building stabilisation.
10. Maintain contact with Duty Manager.
Note: All lifts have a seismic trip device, so are unlikely to be
operational.
Orderlies – Responsibilities
The Orderly
1. Check that radio telephones (RTs) are available for
Supervisor (or
distribution.
Senior Person)
2. Check that RTs are in working order.
must:
3. Report to the Duty Manager or Clinical Operations
Coordinator and await instructions
2 Hazard tape is held by Security.
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EPARM Section 2 Earthquake
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Emergency Preparedness & Response Manual
Section 2 EARTHQUAKE
Security Staff – Responsibilities
The Security
Supervisor (or
Report to the Duty Manager and await instructions.
Senior Person)
must:
Individual Services – Responsibilities
Individual services
1. Activate their Unit Specific Emergency Plans.
must:
2. Salvage and protect essential supplies and resources.
3. Assess on-going capability to deliver service and report to
Duty Manager or equivalent.
4. Maintain contact with ICP and EOC.
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Emergency Preparedness & Response Manual
Section 3 TSUNAMI
What is a
A tsunami is created by the displacement of a large volume of water
Tsunami?
within an ocean due to an earthquake, volcanic eruption or landslide.
Unlike a normal wave which breaks and recedes quickly the
wavelength of a tsunami is much longer due to the force and volume
of displaced water which keeps on coming ashore as it hits the
coastline.
A large tsunami may feature multiple waves arriving over a period of
hours, with significant time between the wave crests. The first wave
to reach the shore may not have the highest run up (distance it
travels inland).
Tsunami risks
Due to the immense volumes of water and energy involved,
tsunamis can devastate coastal regions. Casualties can be high
because the fast moving waves will overtake fleeing people.
A tsunami may:
1. Disrupt utilities.
2. Disrupt road and transport infrastructure.
3. Cause structural damage.
4. Delay oncoming staff.
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EPARM Section 3 Tsunami
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Section 3 TSUNAMI
Staff – Responsibilities
Staff must:
When a tsunami warning is received
1. Comply with instructions from Supervisors and the Duty
Manager.
2. Keep clinical records (incl. medication charts) and essential
drugs with patients.
3. Advise visitors to leave to evacuate and secure their
property.
4. Turn off and unplug all unnecessary electrical equipment.
When the tsunami wave(s) have struck
1. Check environment for hazards eg live wires and fires.
2. Account for all patients and staff.
3. Turn off utilities at mains source if damage to supply has
occurred (gas, water, electricity).
4. Advise any visitors to remain until the situation has been
assessed for safety, particularly exit routes.
5. Implement instructions governing water conservation (refer
Section 10 – Utility Failure).
Senior Person – Responsibilities
The Senior Person
When a tsunami warning is received comply with instructions from
present must:
the Duty Manager.
1. Refer to and consider activating Unit Specific Emergency
Plans.
When the tsunami wave (s) have struck
1. Check that telephones are working (refer Section 11 –
Communications Failure).
2. If appropriate, activate Unit Specific Emergency Plans.
3. Organise those who are uninjured to carry out essential
duties, eg first aid and sanitation issues.
4. Gather information on injuries and damage sustained, report
these to Duty Manager.
5. Delegate roles to those in your area.
6. Provide direction, control and reassurance.
7. Check that life safety systems are operating.
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EPARM Section 3 Tsunami
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Emergency Preparedness & Response Manual
Section 3 TSUNAMI
Duty Manager – Responsibilities
The
On receipt of tsunami Warning
Duty Manager
1. Wear appropriate identification (hi-vis jerkin).
must:
2.
Notify the 777 Operator ensuring that they have activated
the appropriate group alerts (Response, Service
Advisory, Support and Management Advisory – including
notification to the Emergency Management Service).
3. Liaise with the Incident Controller for decision to activate IMT
and activate the EOC (note the Tsunami threat may require
that the location of the EOC be remote from Auckland DHB).
4. Contact Facilities Management (via the 777 Operator):
During working hours contact the PAE (Facilities
Management) Ops Manager
After hours contact the Shift Engineer.
5. Consider relocation of patients if Tsunami likely to strike.
6. Ensure that you are kept updated of the events.
7. Brief and confer with response personnel.
8. Notify key management and clinical personnel to ensure that
essential patient needs can be met.
9. If required, nominate an Incident Control Point (ICP) and
remain in the vicinity to control and direct activity.
10. Notify 777 Operator and affected areas of the ICP location
and contact telephone/fax number(s).
11. Ensure regular internal communications are sent out.
12. Assess what vital services can and cannot continue to
function. Consider likelihood of multiple admissions and
requirement for triage teams/area.
When the tsunami wave(s) have struck
1. Activate Major Incident Whiteboard.
2. Request unit status reports, particularly status of delivery
units, theatres, and intensive care units.
3. Assess the extent of damage and impact on patient care.
4. Prioritise actions, for example, rescue and first aid, immediate
treatment of casualties.
5. If required, delegate personnel to undertake ICP functions.
6. Arrange for staff call-back and the implementation of rapid
discharge or multiple admission procedure.
7. Ensure Unit Specific Emergency Plans have been activated
for affected areas.
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 3 Tsunami
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Section 3 TSUNAMI
Daily Operations Manager – Responsibilities
Daily Operations
1. Maintain close liaison with the Duty Manager.
Manager must:
2. Maintain close liaison with Facilities Manager (or their
delegated authority).
Facilities Manager – Responsibilities
The Facilities
Upon receipt of tsunami Warning
Manager, or
1. Report to the Duty Manager.
persons delegated
2. Consider activating Unit Specific Emergency Plan.
by them must:
3. Make contact with key contractors.
4. Request additional assistance, if required.
When the tsunami wave(s) have struck
1. Begin structural and services damage assessments.
2. Assess the extent of damage and identify what structures
and systems are intact and safe to use.
3. Complete a building check to assess if it is safe to remain in
the building or evacuate.
4. Initiate building stabilisation.
5. Check emergency generators and backup systems.
6. Check all vital systems – medical gases, gas, power and
water, and sewerage.
7. Arrange to cordon off any buildings unsafe to occupy1 and
advise Duty Manager and 777 Operator.
8. Maintain contact with ICP.
1 Hazard tape is held by Security.
Issued by: Emergency Management Service
Date Issued: September 2014
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EPARM Section 3 Tsunami
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 3 TSUNAMI
Orderlies – Responsibilities
The Orderly
Upon receipt of tsunami Warning
Supervisor (or
Senior Person)
1. Check that radio telephones (RTs) are available for
must:
distribution.
2. Check that RTs are in working order.
3. Report to the Duty Manager/Clinical Operations Coordinator
and await instructions.
Security Staff – Responsibilities
The Security
Supervisor (or
Upon receipt of tsunami Warning
Senior Person)
must:
Report to the Duty Manager and await instructions.
Individual Services – Responsibilities
Individual services
Upon receipt of tsunami Warning
must:
1. Alert all staff and advise of actions to take.
2. Consider activating Unit Specific Emergency Plans.
3. Ensure staff are kept updated.
When the tsunami wave(s) have struck
1. Salvage and protect essential supplies and resources.
2. Assess on-going capability to deliver service and report
status to Duty Manager.
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 3 Tsunami
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Section 3 TSUNAMI
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Date Issued: September 2014
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EPARM Section 3 Tsunami
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 4 SEVERE WEATHER EVENT
Risk Evaluation
A severe weather
Disrupt power and communications.
event may:
Delay oncoming staff.
Cause localised flooding.
Cause structural damage.
Staff – Responsibilities
Staff must:
1. Allay anxiety of patients and visitors.
2. Close windows, doors and curtains.
3. Consider taping / securing windows.
4. If wind gusts are extreme, move people away from exposed
parts of the building.
5. Stay indoors.
Duty Manager – Responsibilities
The Duty Manager
1. Ensure that the 777 Operator has activated the
must:
appropriate group alerts (Response, Service Advisory,
Support and Management Advisory – including
notification to the Emergency Management Service).
2. Nominate an Incident Control Point (ICP) for channelling
messages and remain in the vicinity to direct and control
activity.
3. Notify 777 Operator of the ICP location and contact details.
4. Liaise with Incident Controller to consider full or partial
activation of the Incident Management Team.
5. Relay crucial information, eg road conditions, to on-duty staff
and visitor – global emails.
6. Assess the likelihood of visitors and staff being forced to
remain on site and the logistical implications, eg meals and
accommodation.
7. Consult with Communications Manager to discuss the
requirement to broadcast important information via radio, eg
the cancellation of outpatient clinics.
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 4 Severe Weather Event
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Section 4 SEVERE WEATHER EVENT
Orderlies – Responsibilities
The Orderly
1. Check that radio telephones (RTs) are available for
Supervisor (or
distribution.
Senior Person)
2. Check that RTs are in working order.
must:
3. Report to the Duty Manager/Clinical Operations Coordinator
and await further instructions.
Security Staff – Responsibilities
The Security
Supervisor (or
Report to the Duty Manager and await further instructions.
Senior Person)
must:
Facilities Management – Responsibilities
The Facilities
1. Check emergency generators and assess fuel requirements
Manager, or
and prioritised procurement as a precaution against
persons delegated
sustained electricity outages.
by them must:
2. Check hospital grounds and remove or secure potential
obstacles.
3. Ensure all drains are cleared.
4. Advise the Duty Manager.
Issued by: Emergency Management Service
Date Issued: September 2014
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EPARM Section 4 Severe Weather Event
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 5 VOLCANIC ERUPTION
Risk Evaluation
A volcanic eruption
Create potential problems from ash fallout.
may:
Increase demand for respiratory medicine, equipment and
staffing.
Block or reduce air intake to filters on air-conditioning units and
outside machinery.
Create power surges that are likely to affect communication
systems eg telephone lines and sensitive machinery.
Block sewage systems.
Staff – Responsibilities
Staff must:
1. Seek protection from breathing in dust or gas – these can be
highly toxic (use masks, or if no other alternative improvise with
whatever is available).
2. Monitor people with respiratory conditions.
3. Close all windows and outside doors.
4. Where appropriate, turn off any local air conditioning units that
feed directly from outside.
5. Protect vital machinery from dust (cover where possible).
6. Salvage and conserve vital equipment and supplies.
7. Do not unnecessarily use any machinery that is directly exposed
to dust, including motor vehicles (reduces dust being sucked into
the engine).
8. Stand-by for further instructions.
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 5 Volcanic Eruption
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Section 5 VOLCANIC ERUPTION
Duty Manager – Responsibilities
The Duty Manager
1. Wear appropriate identification (hi-vis jerkin).
must:
2. Assess patient safety, what vital services can and cannot
continue to function. Consider likelihood of multiple
admissions and requirement for triage teams and triage
areas.
3.
Ensure that the 777 Operator has activated the
appropriate group alerts (Response, Service Advisory,
Support and Management Advisory– including
notification to the Emergency Management Service).
4. Liaise with the Incident Controller to activate the Incident
Management Team.
5. Contact Facilities Management:
During working hours contact the PAE (Facilities
Management) Ops Manager (via the 777 Operator)
After hours contact the Shift Engineer.
6. Consider diverting ambulances.
7. Nominate an Incident Control Point (ICP) for channelling
messages and remain in the vicinity to direct and control
activity.
8. Notify 777 Operator of the ICP location and contact details.
9. Relay crucial information to on-duty staff and visitors.
10. Assess the likelihood of visitors and staff being forced to
remain on site and the logistical implications, eg meals and
accommodation.
11. Consult with Auckland DHB Communications Manager to
discuss requirement to broadcast important information
(internal and external) eg the cancellation of outpatient
clinics.
12. Liaise with IMT once activated.
Daily Operations Manager – Responsibilities
Daily Operations
1. Maintain close liaison with the Duty Manager.
Manager
2. Maintain close liaison with Facilities Manager (or their
delegated authority).
Issued by: Emergency Management Service
Date Issued: September 2014
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EPARM Section 5 Volcanic Eruption
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 5 VOLCANIC ERUPTION
Orderlies – Responsibilities
The Orderly
1. Report to the Duty Manager/Clinical Operations Coordinator
Supervisor (or
and await instructions.
Senior Person)
2. Check that radiotelephones (RTs) are available for
must:
distribution.
3. Check that RTs are in working order.
Security Staff – Responsibilities
The Security
Supervisor (or
Senior Person)
Report to the Duty Manager and await further instructions.
must:
Facilities Manager – Responsibilities
The Facilities
1. Report to the Duty Manager.
Manager, or
2. Activate Unit Specific Emergency Plan.
persons delegated
3. Check emergency generators and ensure filters are clean.
by them must:
4. Request additional assistance, if required.
5. Immediately check all external filters and daily thereafter
(clean and maintain as necessary).
6. Increase checking routine should heavy ash conditions
occur.
7. Pay particular attention to air filters into Operating Rooms.
8. Check storm-water drains to prevent blockage by ash run-off.
9. Check flat/glass roof buildings for ash build up.
10. Maintain contact with ICP.
11. Begin structural and services damage assessments.
12. Initiate building stabilisation.
13. Liaise with IMT once activated.
Individual Services – Responsibilities
Individual services
1. Activate their Unit Specific Emergency Plans.
must:
2. Salvage and protect essential supplies and resources.
3. Assess on-going capability to deliver service and report to
Duty Manager or equivalent.
4. Maintain contact with ICP and EOC.
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 5 Volcanic Eruption
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Section 5 VOLCANIC ERUPTION
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Date Issued: September 2014
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EPARM Section 5 Volcanic Eruption
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 6 BOMB THREAT
After a bomb threat has been received:
1.
Do not use cell phones – turn off
2.
Do not set off the fire alarm
3.
Do not use radio-telephones (RTs) – turn off
Staff – Responsibilities
If you receive a
1. Treat the call as genuine.
bomb threat by
2. Attract the attention of another staff member to get the ‘Bomb
telephone:
Threat Checklist’ at the end of this section – Annex A. (This has
questions which aim to gain further information from the caller).
3. Try to keep the caller talking for as long as possible. Let them
finish their message before asking questions.
4. Complete the ‘Bomb Threat Checklist’ at Annex A.
5. Contact your supervisor/senior person in charge.
6. Do not discuss the incident in the hearing of others or with those
who do not have a need to know.
7.
Call 777 on a landline
(refer to Section 1 - Initial Action).
Senior Person – Responsibilities
The Senior
1. Assess the circumstances and determine what actions have been
Person present
taken.
must:
2. Ascertain the reasons and/or circumstances for believing that the
threat is genuine.
3. Initiate additional enquiries and/or actions to safeguard personnel
from further risk.
4. Confirm that the Duty Manager has been advised.
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 6 Bomb Threat
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Section 6 BOMB THREAT
Duty Manager – Responsibilities
The Duty
1. Wear the appropriate identification (hi-vis jerkin).
Manager must:
2. Call the 777 Operator and confirm the location and details of the
incident.
3.
Ensure that the 777 Operator has activated the appropriate
group alerts (Response, Service Advisory, Support and
Management Advisory, including notification to the
Emergency Management Service).
4. Proceed directly to the area where the call was received.
5. Obtain all details from the person who took the call. Ensure that
the person is available for police interview.
6. Determine the level of risk and appropriateness of actions carried
out.
7. Ensure bomb threat information is documented.
8. Ascertain the reasons and/or circumstances for believing that the
threat is genuine.
9. Liaise with the Incident Controller to consider activation of the IMT.
10. Liaise with senior police officer on arrival at Auckland DHB site.
Search
1. If a threat has been made and a specific location identified,
undertake an initial search to verify that a suspicious object has
been left.
2.
Turn off/do not use cell phones or radiotelephones (RTs) (radio
signals are capable of detonating a bomb if used within 20 metres
of an IED – Improvised Explosive Device).
3. Should the entire building require searching (if not already
activated) contact Incident Controller to consider activation of the
IMT. Then make contact directly with the senior person of each
area affected.
4. Assemble search team(s), selecting personnel who are familiar with
the area.
5. Instruct search team(s) to carry out a visual search only
do not
touch any suspicious object found. Instruct search team(s) to
maintain confidentiality.
6. Question personnel whether they have seen anything suspicious.
7. Assess the requirement for further action or declaration of a false
alarm.
Issued by: Emergency Management Service
Date Issued: September 2014
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EPARM Section 6 Bomb Threat
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 6 BOMB THREAT
Duty Manager – Further action if incident is confirmed or highly likely
The Duty Manager
Incident Control Point (ICP)
must:
1. Establish an Incident Control Point (ICP) and remain in the
(continued on next
vicinity.
page)
2. Notify 777 Operator and affected areas of the ICP location
and contact details.
3. If not already done - Liaise with the Incident Controller to
consider full or partial activation of the IMT.
Police Assistance
1. Notify the 777 Operator and request police assistance.
Ensure that the Emergency Services are advised of the
whereabouts of the ICP.
2. Obtain floor plans of the building (print from intranet) of
affected areas.
3. Instruct the Orderly Supervisor to have the police met and
escorted to the ICP.
Evacuate Immediate Area (Section 13 Evacuation)
1. Evacuate the immediate area, instruct staff to:
a. leave doors and windows open
b. Take bags/personal items to avoid being mistaken as
a suspicious object.
2. Assess the implications to essential hospital services and
patient care.
3. Consider the implications of further evacuation and warn
other areas likely to be affected.
4. Decide on evacuation routes and assembly points, in
consultation with police.
5. Ensure evacuation routes and assembly points are advised
to all units.
Notification
1. Notify of evacuation – Group Advisory Alert via 777 Operator.
2. Ensure that supervisors of the affected areas are notified.
3. Ensure that areas providing essential services activate their
Unit Specific Emergency Plans.
Access Control
1. Direct security staff or others present to control access to the
area, including all points of entry and exit1.
Communication
1. Liaise with Communications Manager to deal with media
coverage.
2. Ensure that decisions made are clearly communicated.
3. Maintain contact with supervisory staff and confirm that
patient needs are being met.
4. Notify medical specialists if patient care is likely to be
compromised.
1 Hazard tape is held by Security
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 6 Bomb Threat
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Emergency Preparedness & Response Manual
Section 6 BOMB THREAT
Duty Manager – Responsibilities Continued
The Duty Manager
Liaison
must:
1. Maintain ongoing liaison with the emergency services, Shift
Engineer, Security and Orderly Supervisors.
2. Assemble key personnel to be briefed by the police.
3. Ensure Emergency Services personnel do not act in isolation
and that they provide an outline of their proposed actions.
4. Brief the Incident Controller/IMT.
Daily Operations Manager – Responsibilities
Daily Operations
1. Maintain close liaison with the Duty Manager.
Manager
2. Maintain close liaison with Facilities Manager (or their
delegated authority).
Orderlies – Responsibilities
The Orderly
Supervisor (or
1. Report to the Duty Manager/Clinical Operations Coordinator
Senior Person)
and await instructions.
must:
Security Staff – Responsibilities
The Security
Supervisor (or
1. Report to the Duty Manager.
Senior Person)
must:
Facilities Manager – Responsibilities
Facilities Manager,
1. Report to the Duty Manager.
or persons
2. Consider activating Unit Specific Emergency Plan.
delegated by them
3. Provide plans of buildings from intranet.
must:
4. Provide access to locked areas.
5. Provide building plans for review by the Emergency Services.
6. After notifying affected areas shut down gas and oxygen to
areas on the advice of the Emergency Services.
Issued by: Emergency Management Service
Date Issued: September 2014
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EPARM Section 6 Bomb Threat
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 6 BOMB THREAT
Annex A – Bomb Threat Check List
Ask the caller the following questions
1. When is the bomb going to explode?
Callers Voice: (Accent / impediment; voice -
loud/soft, speech - slow/fast, clear muffled)
Manner (calm/ emotional)
2. Where is the bomb?
Did you recognise the voice?
If so, who do you think it was?
3. What does the bomb look like?
Exact wording of threat
4. What will make the bomb explode?
5. What is the explosive type and quantity?
6. Why did you place the bomb?
Threat Language: (Well-spoken, incoherent,
irrational, taped, message read by caller)
7. What is your name?
8. Where are you?
Background noises: (street, house, aircraft,
vehicle, music, voices)
9. What is your address?
OTHER INFO: Male/Female:
Estimated age:
CALL TAKEN: Date:
Duration of call:
Time:
Number called:
RECIPIENT: Name:
Telephone:
Signature:
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 6 Bomb Threat
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Section 6 BOMB THREAT
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EPARM Section 6 Bomb Threat
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 7 SUSPICIOUS OBJECT (includes mail)
A suspicious object may be any item:
That looks out of the ordinary.
Where there is no reasonable explanation as to why it is there.
Where ownership cannot be determined.
Where an attempt has been made to purposefully conceal it from view.
Staff – Responsibilities
Suspicious Object
What to do if you locate a suspicious object:
Procedure
1.
DO NOT TOUCH IT
2. Assess the reasons for suspicion.
3. Remain calm and control your emotions.
4.
Call 777 (refer to Section 1 – Initial Action).
5. Contact your supervisor.
6. Remove others from the immediate vicinity.
7. Isolate the area and prevent access.
8.
Do not activate a fire alarm call point.
9.
Do not allow the operation of a cell phone or radio telephone in
the vicinity.
What to do if you LOCATE a suspicious unopened letter or
package
1.
DO NOT TOUCH IT
2.
Follow steps 2 – 9 for locating a suspicious object (above)
3. If skin has come in contact with the envelope or package then
wash with soap and water.
What to do if a suspicious letter or package has been OPENED
Undertake the same procedures as for unopened letters and
packages in addition to the following:
If contents have spilled:
1.
Do not clean up or wipe spilt contents.
2. If contaminated, isolate yourself and others.
3. Isolate area (close doors and windows).
4. If possible – switch off air conditioning.
5. Wash all contaminated skin areas with soap and water.
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section7 Suspicious Object
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Section 7 SUSPICIOUS OBJECT (includes mail)
Senior Person – Responsibilities
The Senior Person
1. Assess the circumstances and determine what actions have
present must:
been taken.
2. Ascertain the reasons and/or circumstances for believing that the
object is suspicious.
3. Determine the level of risk and appropriateness of actions
carried out.
4. Initiate additional enquiries and/or actions to safeguard
personnel from further risk.
5. Confirm that the Duty Manager has been advised.
Duty Manager – Responsibilities
The Duty Manager
1. Wear their appropriate identification (hi-vis jerkin).
must:
2. Call the 777 Operator to confirm the location and details of
the incident.
3.
Ensure that the 777 Operator has activated the
appropriate group alerts (Response, Service Advisory,
Support and Management Advisory, including
notification to the Emergency Management Service).
4. Proceed directly to the area where the object is located.
5. Obtain all details from the person who found the object. If
required, ensure that the person is available for police
interview.
6. Ascertain the reasons and/or circumstances for believing that
the object is suspicious.
7. Ensure that inquiries have been made in the area to
establish ownership of the suspicious object.
8. Check the area for similar objects.
9. Ensure that information is documented.
10. Could the suspicious object be a bomb – Improvised
Explosive Device (IED)? Has a bomb threat been received?
(Refer to Section 6 – Bomb Threat).
11. Liaise with the Incident Controller to consider full or partial
activation of the Incident Management Team.
12. Assess the requirement for further action or declaration of a
false alarm.
Issued by: Emergency Management Service
Date Issued: September 2014
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EPARM Section 7 Suspicious Object
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 7 SUSPICIOUS OBJECT (includes mail)
Duty Manager – Further Action
Further action by
Incident Control Point (ICP)
Duty Manager if
1. Establish an Incident Control Point (ICP) and remain in the
incident confirmed
vicinity.
2. Notify 777 Operator and affected areas of the ICP location
and contact details.
Police Assistance
1. Notify the 777 Operator and request police assistance.
Ensure that the Emergency Services are advised of the
whereabouts of the ICP.
2. Instruct the Orderly Supervisor to have police met and
escorted to the ICP.
Evacuate Immediate Area
1. Evacuate the immediate area and assess the implications to
essential hospital services and patient care.
2. Consider the implications of further evacuation and warn
other areas likely to be affected.
3. Decide on evacuation routes and assembly points, in
consultation with police.
4. Ensure evacuation routes and assembly points are advised
to all units.
Notification
1. Ensure all response groups/managers are notified.
2. Ensure that supervisors of the affected areas are notified.
3. Ensure that areas providing essential services activate their
Unit Specific Emergency Plans.
Access Control
1. Direct security staff or others present to control access to the
area, including all points of entry and exit1.
Liaison
1. Maintain ongoing liaison with the emergency services, Shift
Engineer, security and orderlies.
2. Assemble key personnel to be briefed by the police.
3. Ensure Emergency Services personnel do not act in isolation
and that they provide an outline of their proposed actions.
Communication
1. Ensure that decisions made are clearly communicated
2. Maintain contact with supervisory staff and confirm that
patient needs are being met.
3. Notify medical specialists if patient care is likely to be
compromised.
Liaise with Communications Manager to deal with media
coverage.
1 Hazard tape is held by Security.
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section7 Suspicious Object
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Auckland District Health Board
Emergency Preparedness & Response Manual
Section 7 SUSPICIOUS OBJECT (includes mail)
Daily Operations Manager – Responsibilities continued
Daily Operations
1. Maintain close liaison with the Duty Manager.
Manager
2. Maintain close liaison with Facilities Manager (or their
delegated authority).
Orderlies – Responsibilities
The Orderly
Supervisor (or
1. Report to the Duty Manager/Clinical Operations Coordinator
Senior Person)
and await instructions.
must:
Security Staff – Responsibilities
The Security
1. Report to the Duty Manager.
Supervisor (or
2. Implement standard operating procedures.
Senior Person)
3. Control access to and from the area.
must:
Facilities Manager – Responsibilities
The Facilities
1. Report to the Duty Manager.
Manager, or
2. Consider activating Unit Specific Emergency Plan.
persons delegated
3. Provide plans of buildings from intranet.
by them must:
4. Provide access to locked areas.
5. Provide building plans for review by the Emergency Services.
6. After notifying affected areas shut down gas and oxygen to
areas on the advice of the Emergency Services.
Issued by: Emergency Management Service
Date Issued: September 2014
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EPARM Section 7 Suspicious Object
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 8 THREAT TO PERSONAL SAFETY
(CODE ORANGE)
Staff – Responsibilities
All staff must:
If threatening or aggressive behaviour takes place you must:
1. Seek assistance.
2.
Call 777 or direct others to do so advise 777 Operator of a
‘Code Orange’ (refer to Section 1 - Initial Action).
3. Provide a description of the aggressor(s).
4. If your area has a duress alarm activate this to summon help.
It is better to activate the alarm and then find you have the
situation under control than to wait and see how the situation
develops.
5. Remove yourself and others from immediate danger if it is
safe to do so.
6.
Do as you are told but be aware of further danger.
7. Identify the nearest safe exit.
8. De-escalate – acknowledge the problem and feelings of the
aggressor(s).
9. Show empathy and understanding.
10. Use the aggressor(s) name(s) if known – a personal touch
can be calming.
11. Avoid provocation by careful use of words and body
language.
12. Do not argue or make light of the situation. This will only
increase the levels of anxiety and anger.
13. Speak quietly, calmly, and slowly so whatever you say can
be heard and easily understood.
14. Avoid staring and any sudden movements.
15. Move carefully and explain your moves as you go.
16. Record a mental description of the aggressor(s).
17. Complete the Incident Checklist at the end of this Section –
Annex A.
Senior Person – Responsibilities
The Senior Person
1. Obtain details of the incident.
present must:
2. Attend to the injured.
3. Ask all witnesses to wait for the arrival of the police (if
appropriate) and not to talk to each other prior to being
interviewed.
4. Ensure that a staff member is at the appropriate entrance to
direct the police to the scene by the quickest route.
5. Brief the Duty Manager and response team on arrival.
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 8 Threat to Personal Safety
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Section 8 THREAT TO PERSONAL SAFETY
(CODE ORANGE)
Contact Centre – Responsibilities
The 777 Operator
1. On receipt of a ‘Code Orange’ activate the appropriate
must:
pagers and notify responding staff as to what is known of the
situation.
2. Notify the police of the initial situation, location, and any other
relevant details.
Duty Manager – Responsibilities
The Duty Manager
1. Call the 777 Operator and confirm the location, details of
must
the incident, and notification to the police (if appropriate).
2.
Ensure that the 777 Operator has activated the
appropriate group alerts (Response, Service Advisory,
Support and Management Advisory, including
notification to the Emergency Management Service).
3. If the situation warrants an ICP (eg weapons involved) –
Notify 777 Operator and affected areas of the ICP location
and contact details.
4. Obtain the facts and names of persons involved.
5. De-escalate the situation.
6. Ensure that others are not at risk.
7. Assess injuries and treatment.
8. Call the 777 Operator and request further assistance if
required.
9. Await the arrival of the police, if called.
10. Arrange a ‘Hot’ Debrief and on-going support for all staff
involved.
Security Staff – Responsibilities
The Security
Supervisor (or
Report to the Duty Manager and await instructions.
Senior Person)
must:
Issued by: Emergency Management Service
Date Issued: September 2014
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EPARM Section 8 Threat to Personal Safety
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 8 THREAT TO PERSONAL SAFETY
(CODE ORANGE)
Section 8 Annex A – Code Orange Checklist
Complete one form for each aggressor. Always consider your own safety.
Name of person completing (Print)
Date/Time
What did the person/people want?
Are they known to you?
Did they use a name?
Where did they come from?
Where were they going?
Were they alone?
Were they armed?
What was their mental state? (Confused, agitated etc.)
Aggressor
Thin
Medium
Large
Tall
Short
Stocky
appearance/size
Close
Short
Long
Curly
Straight
cropped
Hair
Multi-
Dark
Fair
Grey
Untidy
coloured
Shorts
Jersey
T-shirt
Hat
Coat
Clothing & Colour Longs
Jacket
Open shirt
Hospital
Other
clothing
Ethnicity
Caucasian Maori
Polynesian
Asian
African
Other
Gender
Male
Female
Age group (Approx)
Distinguishing
marks (identify body
Scars
Tattoos
Marks
Glasses
part)
Facial Hair
Moustache
Beard
Other
Direction of travel (eg went out of main doors)
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Date Issued: September 2014
EPARM Section 8 Threat to Personal Safety
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Auckland District Health Board
Emergency Preparedness & Response Manual
Section 8 THREAT TO PERSONAL SAFETY
(CODE ORANGE)
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Date Issued: September 2014
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EPARM Section 8 Threat to Personal Safety
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 9 ROBBERY
Staff – Responsibilities
DURING a robbery
1. Co-operate with instructions.
the protection of
2. Remain calm, control emotions, avoid eye contact and make no
life is most
sudden movements.
important.
3. Avoid challenging the offender (s) or touch anything they may
Staff must:
have handled.
4. Under no circumstances attempt to apprehend the offender(s)
when there is a threat to life or safety.
5. Note the offender’s clothing and other distinguishing features.
Complete the checklist at Annex A of this Section.
AFTER a robbery,
1. Call
777 or direct others to do so.
Staff must:
2. Notify their supervisor.
Contact Centre – Responsibilities
Standard Operating
Procedures
The 777 Operator is to implement standard operating procedures.
The 777 Operator
1. His/her name.
must ask the
2. Location of the robbery.
caller:
3. If the robbery is in progress.
4. If there are any injuries.
5. The number of offenders, description, direction and means of
escape.
6. What, if any weapons were used.
7. The Police are to be contacted (with the caller – if safe for
them to remain on the line) and the following information
provided:
a. The exact location of the robbery and number of
offenders.
b. A description of the offenders.
c. Whether the crime is still in progress.
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EPARM Section 9 Robbery
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 9 ROBBERY
Duty Manager – Responsibilities
The Duty Manager
1. Wear appropriate identification (hi-vis jerkin).
must:
2. Call the 777 Operator and confirm the location, details of the
incident, and notification to the police.
3. Confirm whether the offender(s) has/have left.
4. Arrange to evacuate the surrounding area if the robbery is
still in progress.
5. On arrival, establish an Incident Control Point (ICP) and
remain in the vicinity to direct and control activity. Ensure the
area is at a discrete distance from the incident.
6. Assess injuries and arrange medical treatment.
7. Contact the 777 Operator and request further assistance if
required.
8. Cordon off the area where the robbery took place and advise
people not to touch anything at the scene.
9. Ask all witnesses to wait for the police to arrive, or ask for
their name, address and telephone number if any insist on
leaving.
10. Ensure that witnesses do not discuss the robbery until
interviewed by the police.
11. Brief Senior Management and the Communications
Manager.
12. Liaise with police on their arrival.
13. Facilitate return to normal function.
14. Provide ‘Hot’ Debrief and support for all staff involved.
Security Staff – Responsibilities
The Security
1. Report to the Duty Manager
Supervisor (or
2. Observe from a safe distance, remain unobtrusive and where
Senior Person)
necessary evacuate the surrounding area.
must:
3. Under no circumstances attempt to apprehend the offenders
when there is a threat to life or safety.
4. Keep onlookers away from the scene, including the media.
5. Request persons involved to remain until interviewed by the
police.
6. Preserve the crime scene.
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Date Issued: September 2014
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EPARM Section 9 Robbery
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 9 ROBBERY
Annex A – Robbery Checklist
Complete one form for each offender. Always consider your own safety.
Name of person completing (Print)
Date/Time
What did the person/people want?
Are they known to you?
Did they use a name?
Where did they come from?
Where were they going?
Were they alone?
Were they armed?
What was their mental state? (confused, agitated etc.)
Aggressor
Thin
Medium
Large
Tall
Short
Stocky
appearance/size
Close
Short
Long
Curly
Straight
cropped
Hair
Multi-
Dark
Fair
Grey
Unkempt
coloured
Shorts
Jersey
T-shirt
Hat
Coat
Clothing & Colour
Hospital
Longs
Jacket
Open shirt
Other
clothing
Ethnicity
Caucasian Maori
Polynesian
Asian
African
Other
Gender
Male
Female
Age group (Approx)
Distinguishing
marks (identify body
Scars
Marks
Tattoos
Glasses
part)
Facial Hair
Moustache
Beard
Other
Direction of travel (eg went out of main doors)
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Date Issued: September 2014
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EPARM Section 9 Robbery
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 9 ROBBERY
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Date Issued: September 2014
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EPARM Section 9 Robbery
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 10 UTILITY FAILURE
This section contains generic information. Clinical procedure information in the
event of utility outages must be detailed in Unit Specific Emergency Plans
Staff – Responsibilities
Staff must:
1. Report the incident to their Supervisor or Service Manager.
2. Maintain life and safety.
3. Remove people from immediate danger.
4. Remain calm and provide reassurance to patients and visitors.
5. Prevent further damage by turning off any unnecessary
equipment.
Senior Person – Responsibilities
The Senior Person
1. Take control and coordinate actions in the unit.
must:
2. Activate the Unit Specific Emergency Plan.
3. Consider patient safety and treatment in consultation with clinical
staff.
4. Liaise and cooperate with nearby units.
5. Place someone by the telephone for messages.
6. Notify the Duty Manager and await further instruction.
7. Notify the Shift Engineer if a localised event.
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EPARM Section 10 Utility Failure
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Auckland District Health Board
Emergency Preparedness & Response Manual
Section 10 UTILITY FAILURE
Duty Manager – Responsibilities
The Duty Manager
1. Wear appropriate identification (hi-vis jerkin).
must:
2. Assess the extent and type of failure and impact on patient care.
3. Prioritise actions and access resource requirements, including
personnel.
4.
Ensure that the Contact Centre has activated the
appropriate group alerts (Response, Service Advisory,
Support and Management Advisory, including notification to
the Emergency Management Service)
5. Notify Managers as appropriate.
6. Contact Facilities Management:
During working hours contact the PAE (Facilities
Management) Ops Manager via the 777 Operator.
After hours contact the Shift Engineer.
7. Consider the requirements to maintain essential services, life
support etc. in the affected area, eg allocation of staff.
8. If required, nominate an Incident Control Point (ICP) and remain
in the vicinity to control and direct activity. Notify Contact Centre
and affected areas of the ICP location and contact telephone/fax
number(s).
9. Consult with key clinical personnel to ensure clinical priorities are
established.
10. If a major fault, advise neighbouring hospitals and St John
Ambulance for the transfer and/or diversion of patients.
11. Contact the Incident Controller – to consider full or partial
activation of the Incident Management Team.
Facilities Manager – Responsibilities
The Facilities
1. Report to the Duty Manager to establish priorities for repair or
Manager, or
restoration of services.
persons delegated
2. Consider activating Unit Specific Emergency Plan.
by them must:
3. Assess the extent and type of failure.
4. Notify the PAE Ops Manager and request additional assistance,
if required.
5. Check emergency generators and backup systems.
6. Provide periodic updates to the Duty Manager, including
estimated repair times.
7. Plan for the following:
a. Uninterrupted secondary power supply, eg generators
b. Uninterrupted water supply
c. Sewage disposal
d. Availability of plant equipment and supplies
e. Utilisation of external contractors.
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Date Issued: September 2014
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EPARM Section 10 Utility Failure
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 10 UTILITY FAILURE
Orderlies – Responsibilities
The Orderly
Orderly Supervisor report to the Duty Manager/Clinical Operations
Supervisor (or
Coordinator and await instructions.
Senior Person)
must:
Orderlies must:
Report to the Orderly Supervisor (or Senior Person) and await
instructions to assist with:
a. Movement of patients
b. Accessing and delivering resources
c. Relaying messages.
Security Staff – Responsibilities
The Security
Supervisor (or
Report to the Duty Manager and await instructions.
Senior Person)
must:
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Auckland District Health Board
Emergency Preparedness & Response Manual
Section 10 UTILITY FAILURE
ELECTRICITY FAILURE
In the event of a total power failure, including failure of essential power via generator, all
electrical services not supplied by battery will shut down.
Staff Responsibilities – Electricity Failure
Staff must:
1. All essential equipment should (if not already) be plugged into
standby power electricity sockets (these are identified by a
black plate or
black switch)
2. Know where these plugs and switches are before the event.
3. Obtain briefing from senior person in charge.
4. Ensure patient safety and check frequently.
5. Check that patient call systems are functional.
6. Discontinue patient bathing and showering.
7. Only use telephones when absolutely necessary.
8. Turn on essential lighting switches, only if required.
9. Use essential power wisely and switch off unnecessary
equipment, lights and electric heaters.
10. Use battery operated equipment sparingly.
11. Retain a torch in your area.
12. If computers are being used, save data, shut down and switch
off, consideration should be given to clinical systems which
need to remain operational for as long as possible.
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Date Issued: September 2014
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EPARM Section 10 Utility Failure
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 10 UTILITY FAILURE
Important Considerations – Electricity Failure
Loss of electricity may result in the supply of the following services being compromised.
Wall Suction
1. Use manual pumps or battery operated suction units if wall
suction units do not operate in a power cut.
Medical Gases
1. If medical gas supply is affected by loss of electricity, use
portable cylinders for essential cases.
2. Bottle banks (oxygen and other medical gases) are located on
the ACH and GCC sites.
3. The orderly service manages a limited supply of small oxygen
bottles for patient transport.
Water Supply,
1. Water will be available for the first few hours following an
Heating and Steam
electrical failure. However, it is vital that water rationing begins
immediately if the electricity supply fails.
2. Power loss will disrupt the normal supply of hot water, steam and
heating. This will affect the ability of some departments to
maintain their services.
3. Use linen and other supplies sparingly.
4. Expect delays and changes to the provision of meals.
5. Temperatures in your unit may fluctuate. Request extra blankets
for patients if necessary.
Refrigeration
1. All essential equipment (including refrigerators) should be
plugged into an essential power socket.
2. Open fridge doors as little as possible to keep cold air from
escaping.
Lifts
1. Loss of electricity will mean that some lifts do not function and
others will only operate at half speed.
2. If lifts are functioning, only use them for essential services.
3. Do not use lifts if fire alarms are ringing.
4. Check lifts for people trapped inside and notify the Contact
Centre operator via 777.
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EPARM Section 10 Utility Failure
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Auckland District Health Board
Emergency Preparedness & Response Manual
Section 10 UTILITY FAILURE
GENERATOR TESTING
All Areas
All areas must ensure that they have appropriate plans in place to
cope with the loss of
Essential Power during any Generator Testing.
Items with batteries or where a brief interruption is not of concern can
be left in
Essential Power sockets, otherwise items should be
transferred to non-essential Power sockets. Checks should be made
to ensure that batteries are available and working for those devices
that must continue to run.
If
Essential Power does not come back on areas should check their
Residual Current Devices (RCDs).
RCD: Residual Current Device
All general purpose power outlets in patient-occupied rooms are
protected by a device called a RCD. If you have plugged in a piece of
equipment and find that you have no power, check the following on
the RCD panel (usually on the wall of that room, near the door):
1. Is the “
Line Power Available” light on?
2. Is the “
Supply Power Available “light on?
If the
Line light is off, power supply to unit has failed, log problem onto
BEIMS.
If the
Supply light is off, simply press
Reset (black button).
Transferring items to UPS should only be done in
conjunction with the Shift Engineer as this could result in
an overload creating even greater problems.
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Date Issued: September 2014
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EPARM Section 10 Utility Failure
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 10 UTILITY FAILURE
Generator
Testing (cont.)
Switches and Plugs
Throughout the hospital colour coding is used to denote the different
power sources available. The colours denote:
Red – Uninterrupted Power Supply (UPS) – will continue
uninterrupted through an unplanned grid outage.
Black – Essential Power – during an unplanned outage will
switch off and be replaced by generator power after a short
interruption.
White – Non-essential Power – will not be supplied during an
unplanned grid outage.
During the 90 second planned outages UPS (Red) and non-
essential Power (White) sockets and switches will not be
affected.
Only items with
black switches will be affected.
Lighting
Essential lighting will be interrupted during the outages; however,
areas will have a mixture of lighting on
essential and non-essential
power. By turning off all lighting with
black switches you should be
able to determine the affect on your area.
Air Conditioning
Air conditioning will halt for the period of the interruption. It will then
automatically restart indicating that essential power has been
restored.
Call Bells
Ward annunciator panels will stop working during the outages. Call
bells and call lights above patient room doors will continue to
operate.
Computers
Computers that need to keep running during the planned power
outages should be plugged into
non-essential power. Those not
required should be turned off during this time.
Lamson Tubes
The blowers of the Lamson tube will be interrupted but will resume
normal operation with the resumption of essential power.
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Date Issued: September 2014
EPARM Section 10 Utility Failure
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Auckland District Health Board
Emergency Preparedness & Response Manual
Section 10 UTILITY FAILURE
Generator
Testing (cont.)
Medical Gases
Medical Gas Alarm screens will not display during interruption.
Fire Panels
During a generator test fire panels will switch over to battery
power.
Examples of Visual Display Panels
Lifts
During generator testing, lift operation will be affected. Each lift will
stop functioning for around 20 seconds; when power is restored the
lift will initially return to its home floor prior to resuming normal
operation.
All lifts will have appropriate notices placed both inside and out to
warn users of the possible impacts and notify them of the alternative
routes that they can take. Any lifts where patients or visitors could
be stuck or trapped will be staffed to avoid incident.
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Date Issued: September 2014
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EPARM Section 10 Utility Failure
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 10 UTILITY FAILURE
FAILURE OF WATER SUPPLY
Staff must:
Apply water conservation guidelines as follows:
1. Assess ward/department water needs for the next 72 hours
2. Drinkable (potable) water. Allow for 3 litres per person per day.
Count staff and patients.
3. Non-drinkable (non-potable) water. Estimate your needs for
washing, cleaning, sterilisation etc. Drinking water must not be
used for these purposes.
4. Packaged water – take an inventory of any bottled water, or
bottled drink available in your unit.
5. Ration your supply and notify the Duty Manager of your situation.
Use of toilets,
Do not flush toilets
showers and sluice
Do not use the sluice or shower or sanitisers
facilities
Do not use washing machines
Do not bath patients
Lock the majority of toilets, keeping one or two in use.
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 10 Utility Failure
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Auckland District Health Board
Emergency Preparedness & Response Manual
Section 10 UTILITY FAILURE
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EPARM Section 10 Utility Failure
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 11 COMMUNICATIONS FAILURE
PROCEDURE FOR LOCATOR/PAGER FAILURE
Staff – Responsibilities
Staff must:
1. Notify the 777 Operator that locator and or pagers are not
functioning.
2. Notify staff in the area (do not assume that they already know).
3. Notify their Supervisor/Service Manager during business hours
and Duty Manager out of hours.
PROCEDURE FOR TELEPHONE FAILURE
Staff – Responsibilities
Staff must:
1. Notify their supervisor.
2. Check every phone in the unit (including public pay phones and
fax phones).
3. Follow instructions from the Service Manager/Duty Manager.
If an emergency has occurred:
1. Seek help from adjacent units.
2. Follow instructions from the Service Manager/Duty Manager.
Senior Person – Responsibilities
The Supervisor or
1. Notify the 777 Operator from the nearest working phone.
senior person
2. Utilise cell phones, to telephone 777.
present must:
a. If operating an Auckland DHB-issued Vodafone
mobile dial 777.
b. If using a private cell phone dial (09) 307 4949 and
when prompted by the automated operator enter
777#.
3. Check adjacent areas to ascertain if the failure is local or
widespread.
4. Notify staff in the area.
5. Seek assistance from other Units.
6. If practical, use the nearest working phone as the primary
contact. Notify Contact Centre and key personnel of the
number(s).
If the telephone failure is widespread:
1. Set up a runner system in consultation with the Duty
Manager.
2. Appoint a ‘Runner’ to take messages off the floor.
3. Messages
must be written, not verbal.
4. Runners must be familiar with the building and be physically
fit.
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EPARM Section 11 Communications Failure
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Auckland District Health Board
Emergency Preparedness & Response Manual
Section 11 COMMUNICATIONS FAILURE
Duty Manager – Responsibilities
The Duty Manager
1. Attempt to call the 777 Operator via landline and cellular
must:
networks to confirm the extent of the failure. Ensure repair
services have been notified.
2. Verify that the 777 Operator has initiated standard operating
procedures, and alerted Information Systems (IS) staff.
3. Ensure that the 777 Operator has activated the
appropriate group alerts (Response, Service Advisory,
Support and Management Advisory – including
notification to the Emergency Management Service).
4. If contact cannot be made with the 777 Operator, attempt to
identify the affected areas by setting up a runner system.
Suggested minimum of two runners on stand-by at all times
to ensure coverage.
5. Prioritise the distribution of radiotelephones (if available) to
key areas and response personnel, including clinicians, shift
engineer and security staff. Confirm what radio channel is to
be used with all users and ensure spare batteries are on
charge.
6. Nominate an Incident Control Point (ICP) for channelling
messages and remain in the vicinity to direct and control
activity. All messages should be written (to prevent
misunderstanding), prioritised (for action), and logged
(messages sent and received).
7. Notify affected areas of the ICP location and contact details.
8. Appoint an individual to monitor radio transmissions and
record all messages, note the distribution of radios and
undertake periodic radio checks.
9. Ensure that each ward or department is aware of the nearest
radio to their area.
10. Notify senior management and confer with the Incident
Controller to consider activation of the Incident Management
Team (IMT) if appropriate.
11. Notify St John Ambulance Communications Centre via
regional health disaster network base station radio held by 24
Hour Centre. The ambulance control room can also be
accessed via base station radios located in the Adult and
Children’s Emergency Departments.
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Date Issued: September 2014
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EPARM Section 11 Communications Failure
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 11 COMMUNICATIONS FAILURE
Daily Operations Manager – Responsibilities
The Daily
1. Maintain close liaison with the Duty Manager.
Operations
2. Maintain close liaison with Facilities Manager (or their
Manager must:
delegated authority).
Use of Radio Telephones (RTs)
1. The person delivering the radio telephone will brief staff on
how to operate the equipment.
2. A radio check is to be made to the ICP confirming delivery.
The following steps should be used when transmitting
messages:
Step 1: Initiate transmission:
i. Example: “ICP this is Ward 12, over”.
Step 2: Wait for acknowledgement from ICP:
ii. Example: “Ward 12 this is ICP, over”.
Step 3: Relay message:
iii. Example: “ Ward 12 radio received” (end
transmission with “out”)
3. Staff allocated a radiotelephone are required to keep it on
their person at all times and are to brief relieving staff before
handing over the equipment.
Emergency Transmissions
All emergency transmissions are to be prefixed by the words:
“
EMERGENCY MESSAGE”
Upon hearing this transmission, all other radio telephone users are to remain silent until the
transmission of the emergency message is complete.
Orderlies – Responsibilities
The Orderly
1. Report to the Duty Manager/Clinical Operations Coordinator
Supervisor (or
and await instructions.
Senior Person)
2. Identify available and non-essential radio telephones for
must:
distribution.
3. Distribute radio telephones as directed.
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Date Issued: September 2014
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Auckland District Health Board
Emergency Preparedness & Response Manual
Section 11 COMMUNICATIONS FAILURE
Security Staff – Responsibilities
The Security
Supervisor (or
Report to the Duty Manager and await instructions.
Senior Person)
must:
Contact Centre – Responsibilities
The Contact Centre
1. Activate standard operating procedures.
must:
2. Report fault and request urgent technical support (use cell
phone if working).
3. Notify IS staff (Technical Manager and Contact Centre
Manager).
4. Notify the Duty Manager and PAE (Facilities Management)
Ops Manager – work hours; Shift Engineer – after hours
(message to be relayed via radio transmission to Orderlies).
5. Determine the extent of the failure.
6. Notify neighbouring hospitals and the Emergency Services if
a major failure (use cell phones if functioning).
7. Identify working phones.
8. Monitor the base set radio.
9. Log all messages.
10. To provide situation reports when available to the Duty
Manager (via radio).
11. Advise the Duty Manager when the system is fully
operational.
Facilities Manager – Responsibilities
The Facilities
Manager, or
Liaise with the Duty Manager and await instructions.
persons delegated
by them must:
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EPARM Section 11 Communications Failure
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 12 FIRE
In a fire the priority is to safely remove anyone in immediate danger.
The acronym
RACE highlights the main points to be considered during a fire. Remember –
RACE should be used in the order that best suits the circumstances – it is often possible to
carry out more than one action at a time.
R
Remove anyone in immediate danger – if safe to do so.
A
Announce - get help, shout “Fire” to alert others in the area – activate a
Manual Call
Point and call
777.
C
Close doors and windows to contain the heat and smoke (turn off hazardous
processes, gas, oxygen, etc. only if safe to do so).
E
Extinguish the fire – only if safe to do so.
Staff Responsibilities
All staff must:
1. Alert anyone close to the fire – get help – activate the
Manual
Call Point.
2. Notify the Contact Centre operator
777 and give your name, unit
name, floor level, building number, hospital name, and site (Refer
Section 1 – Initial Action, for further details).
3. Confine fire and smoke by closing all doors and windows.
4. Determine the exact location of the fire or smoke.
5. If possible, identify what is burning.
6. Ensure exits and exit routes are clear.
7. Liaise with your supervisor/unit warden – arrange evacuation of
all people from the immediate area as per Fire Action Notices.
8. Ensure those patients who are dependent upon electrically
operated equipment, oxygen or intravenous therapy equipment
receive special attention.
9. Check toilets, changing rooms, and all other rooms/storage
areas/confined places to ensure no-one has been left behind.
10. Turn off oxygen; consider the welfare of patients being
administered oxygen.
Do not place your safety at risk.
11. Leave lights on.
12. Take a roll-call immediately to ensure all patients and staff are
accounted for. Print and use CHiPs whiteboards, if appropriate.
13. Ensure that one staff member is at the appropriate building
entrance to direct the Fire Service to the fire by the quickest route.
14. Attempt to put the fire out only if safe to do so eg fire smaller than
a waste paper bin – obtain suitable fire extinguishers and at least
one person to back you up to begin fire fighting.
Issued by: Emergency Management Service
Date Issued: September 2014
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Auckland District Health Board
Emergency Preparedness & Response Manual
Section 12 FIRE
Unit Warden – Responsibilities
The Unit Warden
Role undertaken by the shift coordinator or senior person
must :
present in the absence of the designated warden
1. Ensure that
777 is called.
2. Put on the ‘UW’ armband.
3. Take command and coordinate the actions of everyone in the
area.
4. If in a staged evacuation building:
a. Initiate Stage 1 evacuation – consider Stage 2.
5. Allocate duties to staff members.
6. Account for all persons in the Unit Warden area of responsibility.
7. Only if safe to do so, ensure that equipment, clinical records and
medications, are moved with patients.
8. Liaise with the Duty Manager and Fire Service.
Generic Staged Evacuation – Clinical and Non-clinical Buildings
Explanation of
There are
three stages of evacuation in place at Auckland DHB.
staged process
Most of the clinical buildings have a Stage 1 and 2 (internal
evacuations process) based upon the type of building construction
(fire cells) and fire protection systems in the building.
Most of the non-clinical buildings go directly to Stage 3 (complete
building evacuation).
Staged evacuation
Stage
Description
process:
Move everyone away from immediate danger, behind
1
fire doors.
2
Move everyone to the next fire cell.
3
Total Building Evacuation.
Contact Centre – Responsibilities
The Contact Centre The 777 Operator is to implement standard operating procedures.
must
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Date Issued: September 2014
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EPARM Section 12 Fire
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 12 FIRE
Duty Manager – Responsibilities
The Duty Manager
1. Wear appropriate identification (hi-vis jerkin).
must:
2. Liaise with Unit Warden and obtain a situation report.
3. Coordinate resources as required to manage the emergency.
4.
Ensure that the Contact Centre has activated the
appropriate group alerts (Response, Service Advisory,
Support and Management Advisory including notification to
the Emergency Management Service).
5. Set up an ICP at a suitable location.
6. Liaise with group call response members and allocate duties.
7. Liaise with external agencies.
8. On arrival of the Fire Service, make immediate contact with the
Officer in Charge.
a. Provide situation report
b. Issue a hospital radio to the Fire Service Officer in
Charge
c. Confirm if lifts can be used for urgent patient transport
d. Ensure the Officer in Charge is fully informed of any
clinical implications of evacuation orders.
9. If critical care units are compromised eg theatres, arrange for
alternative treatment areas and notify key Fire Service and
hospital staff. This may also involve a request for assistance
from other hospitals.
10. Advise affected areas if gas and oxygen will be shut down.
Ensure that sufficient warning is provided.
11. If applicable, request St John to redirect urgent cases.
12. Action the ‘Al Clear’ from the Fire Service:
13. Relay the ‘Al Clear’ to the Contact Centre, orderlies and security
staff.
14. Any staff, visitors or patients physically affected by the event, eg
smoke inhalation, must be sent to ED for treatment.
15. Document the incident.
Daily Operations Manager – Responsibilities
Daily Operations
1. Maintain close liaison with the Duty Manager.
Manager
2. Maintain close liaison with Facilities Manager (or their
delegated authority).
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 12 Fire
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Section 12 FIRE
Orderlies – Responsibilities
The Orderly
1. Report to the Unit Warden/Duty Manager or Clinical
Supervisor and
Operations Coordinator for allocation of duties.
Orderlies (in the
At ACH take the Resource Pack with you – this contains the
area) must:
Site Manager hi-vis vest and two additional RTs, 1 for Duty
Manager and 1 for the Shift engineer.
2. Communicate with the hospital Orderly Base (by RT) as soon
as practical to confirm contact made with Duty Manager.
3. Assist with evacuation as directed.
Security – Responsibilities
The Security
1. Liaise with the Duty Manager.
Supervisor (or
2. Go to the alarm panel with keys and access codes.
Senior Security
3. Meet the Fire Service, and direct them to the affected area.
person must):
4. In consultation with the Fire Service secure the immediate
fire area.
5. Assist with evacuation as directed.
6. Undertake traffic control.
Facilities Manager – Responsibilities
The Facilities
1. Verify the location with the Contact Centre.
Manager, or
2. Isolate, protect and control services as appropriate.
persons delegated
3. Where necessary, turn off air conditioning, ventilating units
by them must:
and fans where manually controlled, (or as directed by the
Fire Service Officer In Charge).
4. Where necessary, control electric circuitry at distribution
boards (or as directed by the Fire Service Officer In-Charge
and in consultation with the Duty Manager).
5. Shut down gas and oxygen to affected areas (upon direct
instructions from the Duty Manager).
6. Advise local electricity and gas authorities where necessary.
Issued by: Emergency Management Service
Date Issued: September 2014
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EPARM Section 12 Fire
Auckland District Health Board
Emergency Preparedness & Response Manual
Section 13 EVACUATION
The Auckland DHB definition of the term evacuation is:
The organised, phased and supervised withdrawal, dispersal, or removal of persons
from dangerous or potentially dangerous areas, to safe receiving areas1.
Important
In emergencies people are usually better off sheltering where they are
considerations
(shelter in place), but evacuation must be considered when risks are
too high and cannot be reduced.
Evacuation should take place only when the risk of staying in place is
greater than the risk of moving. Patients should be evacuated only
when absolutely necessary. If evacuation is required, the objective is
to evacuate people in a timely, safe, and effective way.
The stage (see below) of evacuation is determined by the nature of
the emergency and the circumstances of the staff and patients
affected.
Staged Evacuation Process
At Auckland DHB there are three stages of evacuation
Staged
Stage
Description
evacuation
process:
1
Remove everyone from immediate danger
2
Remove everyone to a safe area
3
Total Building Evacuation
Shelter in Place
(Stages 1 and 2)
Stages 1 and 2 are internal evacuations.
Closing doors and windows in wards/rooms should provide initial
protection from hazards. In most incidents, the safest place for
patients and staff is to remain inside the building.
Total Building
In the case of a complete building evacuation, everyone should
Evacuation
leave the building.
(Stage 3)
Total evacuation of buildings with a staged evacuation process
should be initiated only as a last resort. This decision requires
coordination with the Duty manager, Service and managers, Incident
Management Team (if operational) and emergency services (if
applicable).
1 This definition is used in the Auckland DHB Evacuation Plan.
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 13 Evacuation
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Section 13 EVACUATION
Staff – Responsibilities
All staff must:
1. Be responsible for their own safety.
2. Check for and remove anyone from immediate danger.
3. ALL staff should take directions from the Unit Warden (or shift
coordinator/senior person present).
Unit Warden – Responsibilities
The Unit Warden
1. Role undertaken by the shift coordinator/senior person
must:
present in the absence of the designated warden.
2. Put on the ‘UW’ armband.
3. Ensure that a
777call is made.
4. Take command and coordinate the actions of everyone in the
area.
5. Initiate Stage 1 evacuation – consider Stage 2.
6. Allocate duties to staff members.
7. Liaise with the Duty Manager.
8. Account for all persons in their area of responsibility.
9. Only if safe to do so, ensure that equipment, clinical records and
medication, are moved with patients.
Evacuation Order
1
ALL patients/persons in immediate danger
Evacuation Order
2
Ambulant patients and visitors
General Guideline
3
Patients requiring guidance or some assistance
4
Fully dependent patients
GENERIC STAGED EVACUATION ASSESSMENT GUIDELINES
Stage 2 Evacuation Assessment
Assessment
1. Is there anyone at risk from the hazard?
2. Is the hazard spreading despite containment efforts (closing
doors, windows etc.)?
If yes to any of the above remove everyone to a safe place on
the same floor if possible.
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 13 Evacuation
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Section 13 EVACUATION
Duty Manager – Responsibilities
The Duty
1. Wear appropriate identification (hi-vis jerkin).
Manager must:
2. Liaise with unit wardens and obtain a situation report.
3. Coordinate resources as required to manage the evacuation.
4.
Ensure that the Contact Centre has activated the
appropriate group alerts (Response, Service Advisory,
Support and Management Advisory including notification to
the Emergency Management Service)
5. Set up an ICP at a suitable location.
6. Liaise with the Incident Controller to consider activating the
Incident Management Team.
7. Liaise with group call response members and allocate duties.
8. Liaise with external agencies.
9. On arrival of the Police/Fire Service, make immediate contact
with the Officer(s) in Charge.
a. Provide briefing
b. Issue a hospital radio to the Police/Fire Service
Officer in Charge
c. Confirm if lifts can be used for urgent patient transport
d. Ensure the Officer(s) in Charge are fully informed of
any clinical implications of evacuation orders.
10. If critical care units are compromised, eg theatres arrange for
alternative treatment areas and notify key Police/Fire Service
and hospital staff. This may also involve a request for
assistance from other hospitals.
11. Advise affected areas if gas and oxygen is to be shut down.
Ensure that sufficient warning is provided.
12. Request St John Ambulance to redirect urgent cases.
13. Document the incident.
Daily Operations Manager – Responsibilities
The Daily
1. Maintain close liaison with the Duty Manager.
Operations
2. Maintain close liaison with Facilities Manager (or their
Manager must:
delegated authority).
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 13 Evacuation
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Section 13 EVACUATION
Orderlies – Responsibilities
The Orderly
1. Report to the unit warden and/or Duty Manager/Clinical
Supervisor (or
Operations Coordinator for allocation of duties.
Senior Person)
2. Communicate with the hospital Orderly Base by RT as soon as
must:
practical to provide update.
3. Assist with evacuation as detailed.
Security – Responsibilities
The Security
1. Liaise with the Duty Manager.
Supervisor (or
2. Secure the immediate area.
Senior Person)
3. Assist with evacuation as directed.
must:
4. Undertake traffic control.
Facilities Manager – Responsibilities
The Facilities
1. Confirm the location of evacuation with the Duty Manager/IMT.
Manager, or
2. Isolate, protect and control services as appropriate.
persons
3. Where necessary and in consultation with the Duty Manager,
delegated by
turn off air conditioning, ventilation units and fans where
them must:
manually controlled.
4. In consultation with the Duty Manager and emergency services:
a. Control electric circuitry at distribution boards
b. Shut down gas and oxygen to affected areas.
5. Advise local electricity and gas authorities where necessary.
General Evacuation Principles
1. Start evacuation with the room or area of hazard origin.
2. Close doors where possible.
3. Do not run.
4. Do not stop to collect belongings.
5. Do not re-enter the evacuated area until the all clear is given.
6. At night, lights in corridors are to be turned on.
7. Do not use lifts, unless advised by the emergency services.
8. After an area is completely evacuated ensure all fire doors are
closed.
9. Limit the use of telephones.
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 13 Evacuation
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Auckland District Health Board
Emergency Preparedness & Response Manual
Section 14 HAZARDOUS MATERIALS INCIDENT
HAZARDOUS SUBSTANCES
A hazardous substances1 is any substance that has one or more of the following intrinsic
hazardous properties:
Explosiveness
Flammability
Oxidising capacity
Corrosiveness
Toxicity
Ecotoxicity
Capacity, on contact with air or water, to develop one or more of the above
properties.
Hazardous material
A HAZMAT incident involves the spillage or escape of a hazardous
(HAZMAT) incident
substance.
A serious HAZMAT situation exists when staff are unable to
contain the situation resulting in a risk to people, buildings and
services. This will require Fire Service assistance and the possible
evacuation of building(s).
If staff are able to contain the spillage or escape, Fire Service
assistance may be required to dispose of the material.
Levels of
There are two classification levels of HAZMAT incident in use at
HAZMAT incident Auckland DHB.
The type of hazardous material and/or the quantity spilt will
determine the level of response. Refer to relevant Safety Data
Sheet (SDS) for more information. Standard SDS should have 16
sections1 and not be more than five years old.
Level 1 1.
Safety Data Sheet (SDS) available to confirm process and
appropriate spill kit is available.
2.
Small spill, usually as a result of accidental spill by handler
during decanting.
3.
Approved Handler available who is familiar with product,
associated hazards and spillage clean up requirements.
4.
Able to easily contain spill.
Level 2
1.
Large or continuous spill, usually resulting from equipment
failure and leakage or storage drum leakage.
OR
2.
No approved handler available, staff unfamiliar with
substance and associated hazards.
1Hazardous Substances and New Organisms (HSNO) Act 1996, Section 2.
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 14 Hazardous Materials Incident
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Section 14 HAZARDOUS MATERIALS INCIDENT
Staff – Responsibilities
Staff must:
Level 1
1.
Isolate area.
2.
Locate spill kit and Safety Data Sheet (SDS).
3.
Put on Personal Protective Equipment (PPE).
4.
Clean up spillage according to SDS and spill kit instructions.
5.
Dispose of spill kit as per chemical waste.
6.
Check PPE used, if damage dispose as per disposal
regulations
7.
Complete an OH&S Occurrence Report.
If in
any doubt follow process for
Level 2.
Level 2
1.
Remove anyone affected from immediate area.
2.
DO NOT risk further contact with the material.
3.
Dial
777 and give details to operator, including location, type
of substance, level of response and any requirement for
medical assistance.
4.
If practical and safe to do so follow SDS guidelines on
minimizing spread.
5.
If you do not know the correct procedures, summon help and
evacuate area
.
6.
If no safe route is available and evacuation is not essential to
immediate survival, move to an uncontaminated room and
Shelter-In-Place refer to Shelter-in-Place Procedure below.
7.
Ensure the SDS is available for emergency service
personnel refer to Section 11 of the SDS.
Shelter-in-Place Procedure
1.
Move to an uncontaminated room.
2.
Seal off from the contaminated source, i.e. close doors,
windows and seal draughts under doors.
3.
Follow personal protection guidelines as identified on the
SDS.
4.
Attract the attention of others.
5.
Remain in the area until notified that it is safe to leave.
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 14 Hazardous Materials Incident
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Section 14 HAZARDOUS MATERIALS INCIDENT
Contact Centre – Responsibilities
The Contact
Initiate notification procedures.
Centre must:
Duty Manager – Responsibilities
The Duty
1.
Wear appropriate identification (hi-vis jerkin).
Manager must:
2.
Ensure correct level of response in progress, including
notification to the Fire Service.
3.
Ensure that the Contact Centre has activated the
appropriate group alerts (Response, Service Advisory,
Support and Management Advisory, including
notification to the Emergency Management Service).
4.
Ascertain the following information:
a. Action taken
b. Material and area involved
c. Anyone inside contaminated area
d. Anyone injured or contaminated
e. Location of nearest protective equipment/clothing
f. Hazardous material information (type, amount etc.)
g. Area and number of people evacuated
h. Whether area cordoned off/isolated.
5.
Nominate an Incident Control Point (ICP) and remain in the
vicinity to control and direct activity.
6.
Co-ordinate and liaise with all key personnel.
7.
Ensure health needs for those involved are attended to.
8.
Gain telephone advice from AED or CED on the transport
and management of any persons exposed to the material.
The SDS must accompany personnel.
9.
Do not allow contaminated persons to move through the
hospital (especially patient areas). Have a safe route cleared
to exit the hospital.
10.
Stay out of contaminated area and await the arrival of the
Fire Service. On arrival provide the substance SDS to the
Fire Office in Charge.
11.
Consult with the Fire Service and St John Ambulance as to
how severely the hospital may be affected by exposure.
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 14 Hazardous Materials Incident
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Section 14 HAZARDOUS MATERIALS INCIDENT
Daily Operations Manager – Responsibilities
Daily Operations
1. Maintain close liaison with the Duty Manager.
Manager
2. Maintain close liaison with Facilities Manager (or their
delegated authority).
Hospital Shelter-in-Place Procedure
Hospital Shelter-
Should the Hospital be exposed to a HAZMAT threat requiring
in-place
shelter in place, the
Duty Manager is to:
procedure
1.
Follow instructions of the Fire Service/St John Ambulance.
2.
Request Fire Service/St John Ambulance to maintain close
contact and to issue half-hourly progress reports.
3.
Ensure that the ICP is operational and that key personnel
have been advised.
4.
Instruct all staff to:
a. Close doors and windows as required to isolate the
threat.
b. Turn-off independent air-conditioning systems
c. Remain inside until further notice and advise patients
and visitors to do the same
d. Notify medical staff if anyone becomes unwell from
fumes (persons with respiratory problems may need
special assistance).
If evacuation is advised, the
Duty Manager, in consultation with
senior management, is to:
1.
Evaluate the consequences of evacuation against shelter-in-
place.
2.
Seek advice from the Emergency Services to identify
buildings most at risk.
3.
Prioritise the evacuation of specific areas.
4.
Identify factors that are likely to influence the decision to
evacuate eg wind drift, availability of transportation, location
and suitability of assembly area(s), on-going clinical care and
staffing resources.
Security Staff – Responsibilities
The Security
Supervisor (or
Report to the Duty Manager and await instructions.
Senior Person)
must:
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 14 Hazardous Materials Incident
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Section 14 HAZARDOUS MATERIALS INCIDENT
Facilities Manager – Responsibilities
The Facilities
1.
Report to the Duty Manager.
Manager, or
2.
Consider activating Unit Specific emergency Plan.
persons delegated
3.
Assess the extent of the incident and identify action required.
by them must:
4.
Shutdown external air-conditioning and other ventilation
systems.
5.
Notify the Duty Manager and request additional assistance, if
required.
Emergency Department – Responsibilities
The Emergency
1.
Prepare for the receipt of casualties and initiate internal
Department must:
response procedures.
2.
Activate decontamination procedures.
3.
Prior to the movement of patients, give advice about
contaminated or exposed patients to the Duty Manager
including:
a. Local decontamination processes
b. Movement of patients
c. Decontamination in the ED (and route to ED)
d. Medical treatment required.
HAZMAT – Follow-up
Level 1 Classification
1.
Complete relevant reporting forms.
2.
Undertake necessary investigation to prevent re-occurrence.
Level 2 Classification
1.
Completion of designated incident forms, as soon as
practicable after the event.
2.
An investigation of the incident is to be initiated by the
respective Service Manager to include the OH&S area
advisor and relevant Approved Handler.
3.
Follow up report to be submitted to General Manger,
Emergency Management Services and OH&S.
4.
Any protective clothing or equipment, which has been
contaminated, must be checked and decontaminated/or
replaced.
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 14 Hazardous Materials Incident
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Section 14 HAZARDOUS MATERIALS INCIDENT
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Date Issued: September 2014
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Section 15 UNIT SPECIFIC EMERGENCY PLAN
UNIT SPECIFIC EMERGENCY PLANS
Intended to be read in conjunction with the Auckland DHB Emergency Preparedness and
Response Manual (EPARM) and Emergency Response Flipcharts, Unit Specific Emergency
Plans (USEPs) provide detailed guidance for all staff working in a service unit such as a
ward or department to assist them in preparing for and responding to emergency situations.
USEPs contain the detailed information that is relevant to a particular service unit. The
USEP shows the processes and resources available in the unit and which of these are
critical to its continued function during any emergency event. This complements the generic
Auckland DHB-wide information contained in the EPARM and Emergency Response Flip
Charts.
USEP Template
A USEP template is available from the Emergency Management Service. The template
provides information to assist with the development of a customised Unit Specific
Emergency Plan (USEP).
USEP Production and Awareness
USEP production should involve all sections of staff in the unit. USEPs can be used to for
staff training and orientation as well as being an operational document to assist response
activities as they can contain task cards and staff call-back processes.
All staff members within the service unit should be aware of their USEP and its contents; it is
a resource tool to assist them with their immediate response actions.
Issued by: Emergency Management Service
Date Issued: September 2014
EPARM Section 15 Unit Specific Emergency Plan
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Section 15 UNIT SPECIFIC EMERGENCY PLAN
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Date Issued: September 2014
EPARM Section 15 Unit Specific Emergency Plan
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