How to set up a guideline for mass casualty incident management Pre-hospital VS In-hospital - ผศ.นพ.ประสิทธิ์ วุฒิสิทธิเมธาวี

1. How to set up guideline for MCI
Pre-hospital & In-hospital
Asst Prof Prasit Wuthisuthimethawee
Attending physician, Department of Emergency Medicine, Faculty of
Medicine, Prince of Songkla University, Hatyai, Songkhla
Adjunct faculty of BIDMC Disaster Medicine Fellowship Program, Beth
Israel Deaconess Medical Center, Harvard Medical School,
Boston, MA, USA

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รายงานการวิเคราะห์อุบัติเหตุบนท้องถนน ประจา ปี 2555 กระทรวงคมนาคม

14. Leader
Data
Coordination
Committee/unit/organization
Budget HVA
Strategy

15. Plan
Do
Check
Act

18. 4 C’s
• Collaborate
• Communicate
• Coordinate
• Capitalize

20. Hazard Vulnerability Analysis
• Knowing your risks and preparing of them
• Disaster guideline or plan is based in result of
HVA
• All data gathering: past and present

21. Hazard Vulnerability Analysis
• Events
• Probability
• Effect and impact
• Current capabilities
• Ranking

22. Campus Safety
Landscape

23. Risk = VCP
• Vulnerability
• Consequence
• Probability

24. Hazard Vulnerability Analysis
Disaster Management
DETERMINATION OF POTENTIAL RISK OF THE HAZARD OCCURING
HAZARD LOW MODERATE HIGH
Natural Disasters
Ice/Snow/Blizzards
Flooding
Earthquakes
Fire
Outbreak/Epidemic
Resource/Utility Disasters
Loss of Power/Electric/Generator
Communication/Telephone
Failure
IT Failure
Loss of Water
Fuel Shortage
Fire- Internal
Medical Gas Shutdown
Staff Unavailability
Mass Casualty Accidents
Bus Accidents
Train Accidents
Airplane Accidents
Hostage Situation
Industrial Accidents
Fires
Chemical
Hazmat
Weapons of Mass Destruction
Chemical Weapons
Biological Weapons
Nuclear Weapons
Radiological Weapons
High Explosive Devices
Bomb Threat

25. earthquake in the lower mainland because it is more likely and will have
considerable damage even though the extent of damage will be considerably
less than the strongest earthquake possible.
Hazard Groups Hazard
Accidents • Air crashes
• Marine accidents
• Motor vehicle crashes
Atmosphere • Snow storms
• Blizzards
• Ice storms and fog
• Hailstorms
• Lightning
• Hurricanes
• Tornadoes
• Heat waves
Dam failure • Dam failure (includes foundations and abutments)
Disease and epidemics • Human diseases
• Animal diseases
• Plant diseases
• Pest infestations
Explosions and emissions • Gas and gas leaks (pipeline)
• Gas and gas leaks (gas wells)
• Mine
• Other explosions
Fire - urban and rural • Fire (urban and rural - excludes interface fire)
Fire - wildfire and interface • Wildfire (includes interface fire)
Geological • Avalanches:
- highways
- other
• Debris avalanches and debris flows
• Landslides:
HRVA Tool Kit 4-5

26. Hazard and Vulnerability Identification
- highways
- other
• Submarine slides
• Land subsidence
Hazardous materials • Hazardous spills
- general (on site or transport routes)
- radiation
- infectious materials
Hydrologic • Drought
• Erosion and accretion
• Flooding
• Ice jams
• Storm surges
Power outage • Electrical power outage
Riots • Riots/public disorder
Seismic • Ground motion effects
• Tsunamis
Space object • Space object crash
Structural • Structural collapse
Terrorism • Terrorism (hostile act against state)
Volcanic • Ash falls
• Pyroclastic flows
• Lava flows
• Mudflows
There may be other hazards. Do not limit yourself to this list, however, you may
with to constrain the scope of risk analysis work to the highest risks. If so, include
those hazards with a potential to have at least an occasional possibility of
occurring and a high level of impact.

28. RISK ANALYSIS Date: APRIL 21, 2003
No HAZARD SCIENTIFIC DETAILS INCLUDING IMPACTS &
VULNERABILITY
LIKLIEHOOD CONSEQUENCE
SEVERITY
1 FLOODING FRESHET FLOODING IMPACTS
VILLAGES AND FAMRS CAUSING
LOCALIZED AND SEVERE
PROPERTY DAMAGE.
VULNERABILITIES:
SCHOOL, STORM CREEK BRIDGE,
AND NO EVAC PLAN
4 3
2 INTERFACE
FIRE
WILDFIRE THREATENS VILLAGE
AND FORCES EVACUATION.
VULNERABILITIES: SMOKE
IRRITANT, ACCESS CUT OFF TO
NORTH, EVAC TO SOUTH OK BUT
NO ARRANGEMENTS IN PLACE FOR
EVAC AND SHELTER TO NEAREST
TOWN.
3 3
Impacts:
Fatal 1
Injury 1
Crit. Inf. 2
Lifeline 2
Property 3
Envir. 2
Econ./Soc. 2
LIKLIEHOOD
6: Frequent or Very Likely
5: Moderate or Likely
4: Occasional, Slight Chance
3: Unlikely, Improbable
2: Highly Unlikely (Rare Event)
1: Very Rare Event
CONSEQUENCE:
IMPACT AND VULNERABILITY
4: Very High
3: High
2: Low
1: Very Low

29. FREQUENCY OR
PROBABILITY
INCREASING RISK
CONSEQUENCE:
IMPACT & VULNERABILITY
6
5
4
3
2
1
1 2 3 4
VERY HIGH
CONSEQUENCES
FREQUENT OR
VERY LIKELY
6: Frequent or Very Likely
5: Moderate or Likely
4: Occasional, Slight Chance
3: Unlikely, Improbable
2: Highly Unlikely (Rare Event)
1: Vary Rare Event
4: Very High
3: High
2: Low
1: Very Low

30. HAZARD AND VULNERABILITY ASSESSMENT TOOL
NATURALLY OCCURRING EVENTS
SEVERITY = (MAGNITUDE - MITIGATION)
EVENT
PROBABILITY HUMAN
IMPACT
PROPERTY
IMPACT
BUSINESS
IMPACT
PREPARED-NESS
INTERNAL
RESPONSE
EXTERNAL
RESPONSE
RISK
Likelihood this will
occur
Possibility of
death or injury
Physical losses
and damages
Interruption of
services
Preplanning
Time,
effectiveness,
resources
Community/
Mutual Aid staff
and supplies
Relative threat*
SCORE
0 = N/A
1 = Low
2 = Moderate
3 = High
0 = N/A
1 = Low
2 = Moderate
3 = High
0 = N/A
1 = Low
2 = Moderate
3 = High
0 = N/A
1 = Low
2 = Moderate
3 = High
0 = N/A
1 = High
2 = Moderate
3 = Low or none
0 = N/A
1 = High
2 = Moderate
3 = Low or none
0 = N/A
1 = High
2 = Moderate
3 = Low or none
0 - 100%
Blizzard 0 2 2 3 2 2 3 0%
Drought 1 2 2 2 2 2 2 22%
Dust/Sand Storm 1 1 2 1 3 3 3 24%
Earthquake, >6
Local
3 3 3 3 3 3 2 94%
Epidemic/Natural 2 3 2 3 3 3 2 59%
Flood, Local 2 3 3 3 3 3 2 63%
Hurricane 0 0 0 0 0 0 0 0%
Ice Storm 1 3 2 3 3 3 3 31%
Infectious Disease
(SARS, etc.)
1 3 3 3 3 3 2 31%
Landslide 1 1 2 2 3 3 2 24%
Severe
Thunderstorm
1 1 1 1 2 2 2 17%
Snow/Ice/Hail Storm 2 2 2 2 3 3 3 56%
Temperature
Extremes
1 1 1 1 2 2 2 17%
Tsunami -
Tidal Wave
0 0 0 0 0 0 0 0%
Tornado 0 0 0 0 0 0 0 0%
Volcano 0 0 0 0 0 0 0 0%
Wild Fire 2 3 2 3 3 3 2 59%
AVERAGE SCORE 1.06 1.65 1.59 1.76 2.06 2.06 1.76 21%
*Threat increases with percentage.
* Events in Bold have occurred previously
18 RISK = PROBABILITY * SEVERITY
185 0.21 0.35 0.60
Notes
Natural Hazards : HVAlDetailedHM.xls

63. Guidelines for community disaster
preparedness plan
• Aims of the plan
• Assessment of community
– Strength VS Weakness
– Risk, Vulnerability, Resources
• Relationship with government
• Warning system
• Evacuation procedures
• Emergency shelters
International Federation of Red Cross and Red Crescent Societies

64. Guidelines for community disaster
preparedness plan
• Search and rescue
• Damage/Needs assessment
• Road cleaning/Debris clearing
• Communication
• Law and Order/Security
• Transport
• Repair of community services
International Federation of Red Cross and Red Crescent Societies

65. Guidelines for community disaster
preparedness plan
• Health
• Personal support
• Welfare
• Relief supplies
• Outside assistant
• Testing plan
• Revision and update plan
• Aware of plan
• Risk reduction activities
International Federation of Red Cross and Red Crescent Societies

71. International Federation of Red Cross and Red Crescent Societies

74. 74

92. Phonetic Alphabet
Alpha Juliet Sierra
Bravo Kilo Tango
Charlie Lima Uniform
Delta Mike victor
Echo November Whiskey
Foxtrot Oscar X-ray
Golf Papa Yankee
Hotel Quebec Zulu
India Romeo

93. ?

94. Summary

95. Leader
Data
Coordination
Committee/unit/organization
Budget HVA
Strategy

96. Plan
Do
Check
Act

97. Preparedness cycle
Plan
Organize & Equip
Train
Evaluate/Improve
Exercise
Preparedness cycle

100. ขอบคุณครับ

104. Email: prasit0552002@yahoo.com

105. Disaster and Emergency Medicine
Research workshop
• Professor Marvin Birnbuam
• Former president of WADEM
• 7-9 December, 2014
• Royal Phuket City Hotel