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Disaster Management Mock Drill

 

Hospital Medical CBRNe Disaster Training and Mock Drill at Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad (Andhra Pradesh) India

 
 
 
 

 

Entrance of Basavatarakam Indo-American Cancer Hospital and Research Institute

Introduction

Americares India Foundation had organized and conducted a training course and a mock drill for a possible CBRNe (Chemical, Biological, Radiation and Nuclear) disaster at the Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad on Aug 31 – Sept 1, 2012. The main aim of this drill was to help the participants deal logically through the mitigation, preparedness, response and analysis of disasters which they can face. The target participants of this drill were administrators specifically designated for handling disasters, hospital administrators, healthcare facility managers, emergency department physicians and nurses, security officers, fire safety officers, radiation & safety officers and other hospital staff assigned to areas vulnerable to or at high risk disasters. The two day training course included training of the specific hospital staff, table-top exercise, mock drill and the debriefing session of the mock drill. The evaluation of the mock drill was carried out at four zones namely

  • Triage zone
  • Treatment zone
  • Decontamination zone
  • Incident Commander zone

As part of the PULSE assignment with AmeriCares India Foundation, Jeroze and Bhagesh were trained as evaluators of the Mock Drill. Jeroze also attended training in CBRNe training a day prior by experts of CISF Hyderabad.

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This was followed by training at the hospital on 31st August by the Disaster Management Experts from the country and also an international faculty.

Both Jeroze & Bhagesh were briefed on the role of controllers and evaluators of the Mock Drill. This was followed by training as table top exercise for the relevant hospital staff.Jeroze & Bhagesh trying Protective Gear for Chemical Disaster Relief

 

On Day 2, Sept 1, started with Preparations for the Mock Drill.  It was ensured that each participant was clearly identified by jackets of different colors and tags. Short training on Disaster Management equipments was carried out by DRDE Officials.

Post lunch the Drill started at 1400 hours. The evaluators (Jeroze in the Triage Area & Bhagesh in the Incident Command Zone) observed the activities carried out based upon the following criteria:

  • Time Points
  • Zone description
  • Personnel
  • Zone Operations
  • Communications
  • Information flow
  • Security
  • Rotation of staff
  • Zone disruption
  • Proactive Measures

 

Triage Cards

  • General Observations: Triage area

There was active participation of volunteers and tremendous teamwork. The Zone location was determined before the drill. Triage was performed independently, promptly and only by authorized people and all victim volunteers were labeled with a triage level. The crowd comprising of anxious patient and staff relatives and media were well controlled. There were regular announcements and updates of what is happening in the hospital.


First round of victims being rushed to Triage Zone

  • In terms of what could have been done better, one of the observations was that leadership was missing – no one seemed to be in charge. The ways victims were handled was inappropriate. They were simply carried (at times in hand) & rushed to Emergency Care. (1 victim fell off the wheelchair). There were not enough stretchers/ wheel chairs to move patients who were triaged. Shortage of staff was visible from the fact that some pts were  lying unattended resulting in delayed treatment, in between the two rounds of victims who came in within a gap if 12 minutes. There was no communication for additional staff in Triage zone to ICZ (Incident Command Zone).

Victim handled or manhandled?

Victims lying unattended after Triage are done.
Victim has a yellow tag, but was immediately carried by hand
Whereas there were patients with red tag who were lying unattended
Training & Coordination among healthcare workers lacking

 

 

 

 

  • General Observations: Incident Command Zone

The team was in place, there was no chaos. They promptly took action as soon as they were informed of the bomb blast in hospital car park. The in-charge was active, communication was clear and understandable by all.

Although the action and reaction to requests and requirements during the period were attended to on time, proactive measures to be taken during such incidences were missing. The in-charge should ensure that security arrangements at the ICZ is placed so that the functioning is not disrupted.  Plans for shift change of staff should also be in place.

“Passion To Help, Ability To Deliver”

TeamAmeriCares, External Faculty & Volunteers