HEALTH RESERVE WORKFORCE AND EMERGENCY MEDICAL TEAMS (EMTs)
ATTACHMENT 23 Standard Operating Procedure for Physical and Mental Health Monitoring of
C. Medical (Emergency Box)
2. Flow of Receipt of Health Logistics Assistance
5.1 HEALTH SERVICES SUB-CLUSTER
5.1.1 Pre-Health Care Handling
165 SECTION V
MINIMUM SERVICE STANDARDS FOR HEALTH CLUSTERS DURING A HEALTH CRISIS EMERGENCY
Health Cluster Minimum Service Standards are the type and quality of basic services that every citizen is entitled to receive at a minimum level in a health emergency. The health cluster is divided into several health sub-clusters, as follows.
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and stakeholders from both government and non-government stakeholders. If the Health Emergency Operation Center (HEOC) has been activated, health workers involved in the pre-hospital health response must report and register the team. The success of pre-disaster emergency response is determined by the readiness and continuous coordination of multiple parties during the pre-disaster period.
Health workers assisting in emergency treatment health facilities must prioritize the 3A principle, which includes safety of the helper, safety of the environment, and safety of the patient. Organizing the workflow of victim handling is important to avoid secondary disasters that can happen to the helper, or move the disaster from the accident site to the health facility.
Pre-health facility emergency personnel need to understand and have knowledge of incident site management. Generally, emergency response is carried out at a location that has been designated by the rapid assessment officer or security officer. The security aspects need to be considered are:
a. Identify risks that may occur at the incident site, consider hazards, weather conditions, wind direction.
b. Use personal protective equipment.
c. Conduct regular security risk evaluations
Pre-health facility emergency service organization at least have a triage coordinator and an ambulance coordinator. The duties of the triage coordinator are to coordinate with the field coordinator, ensuring that victims receive first aid based on priority, and coordinate with the ambulance coordinator for the evacuation process to the health facility. Furthermore, the duties of the ambulance coordinator are to manage medical evacuation transportation facilities, ensuring the entry and exit of medical evacuation transportation to be easily accessible and safe.
Figure 5.1 Example of pre-facility emergency handling layout
Management of pre-healthcare facility emergencies includes triage, resuscitation, initial stabilization, and evacuation. Handling emergency management in health care facilities is carried out by health workers and may involve specialized
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health workers and may involve members of the public. In addition to health services health services by health workers, ambulance services and communication systems are needed before being transported to a communication system before being transported to a Health Care Facility.
Communication during pre-facility emergency care is essential, to facilitate coordination and to anticipate delays in service or excessive service that causing chaos at the site. Communication and coordination are established before a disaster occurs.
Communication and coordination aim to ensure that the service chain can be sustained to the next health facility. Officers can be equipped with communication tools, including communication radios, cellular phones, and other communication tools.
Emergency care at the location of the incident. Actions that can be taken in handling pre-facility emergencies health services include:
A. The common people
1. Remove objects that may pose a risk of to the patient.
2. Call for help from neighbors, authorities and security personnel.
3. Contact the Public Safety Center (PSC) 119 call center or other emergency numbers if PSC 119 is not available.
4. Carry out help that can be done with the guidance of PSC 5. 119 or officer guidance.
B. Health workers from Emergency Medical Team (EMT), PSC 119 or from Health Care Facilities:
1. Triage
Sorting out the patient's condition in order to get the appropriate service according to the level of emergency. This action is based on ABCDE (Airway, Breathing, Circulation, Disability, Environment). The triage protocol uses the concept of Mass Casualty Management Triage Model which is not static and must be revised from time to time.
a) First triage, or better known as field triage is usually performed by trained first responders and/or laypeople at the location where the victim is and/or laypersons specialized in the location where the casualty is located, using the acute and non-acute triage system. Acute victims are victims in emergency conditions so that they are prioritized to immediately receive medical get medical action to save lives. Non-acute casualties are casualties who are not in an emergency condition and are emergency conditions and deceased victims. Acute victims must be taken immediately to the medical station or field health post.
b) The second triage should be conducted by medical personnel or more experienced people and uses a four-color triage coding system of red,
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yellow, green and black. This triage is carried out at the medical station or field health post to prioritize medical action.
c) The third triage is carried out for the evacuation of victims from medical stations or field health posts to referral health care facilities for further health services.
General assessment during triage:
1. Assess the issue of safety and protection of oneself, the response team and victims in each phase of disaster response.
2. Identify possible indicators of mass exposure to disaster.
3. Describe common signs and symptoms resulting from exposure to chemicals such as biological, radiological, nuclear, and explosive agents.
4. Identify vulnerable groups/special groups that are sensitive to substance exposure / mass casualty incident conditions, such as pregnant women, the elderly and children.
Specific assessment at triage:
1. Focus on medical history
2. Perform health & airway assessment, cardiovascular, integument system (open wounds, burns, redness), pain, accidents from head to toe, gastrointestinal, neurology, musculoskeletal, mental status and spiritual emotional.
3. Assess the initial (short-term) psychological response of the individual, family and community.
4. Assess the initial (long term) psychological response of the individuals, families and communities.
5. Identify available resources.
The triage system stage approach mentioned above can be excluded by taking into account the situation and conditions in the field.
2. Stabilization/Resuscitation
Resuscitation is for patients who are in cardiac arrest or who have a vital signs crisis (airway, breathing, circulation, seizure).
3. Medical Evacuation
Medical evacuation is an effort to move patients from the location of the incident to the Health Care Facility needed by the patient by using a transportation ambulance accompanied by efforts to maintain resuscitation and stabilization. If there is no transportation ambulance or emergency ambulance, medical evacuation can be carried out by using other means of transportation around the scene with maintaining resuscitation and stabilization. Ambulance emergency ambulance must meet the requirements in accordance with the standard, which includes vehicle roadworthiness requirements, complete
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medical equipment, complete non-medical equipment, and personnel which includes health workers and non-health workers.
Evacuation of victims during a disaster is carried out based on the level of emergency of the victims and the availability of facilities and human resources, for example in a disaster with many victims then after triage is carried out:
a. Red label: Type A/B hospital b. Yellow label: Hospital type B/C
c. Green label: Health Center/Field Hospital.
d. Black Label: dead victims
1) Need to be identified/not yet identified 2) Identified.
In a disaster situation, daily emergency service activities continue, including basic services in health care facilities. In the event of a disaster, PSC 119 or other emergency services may be activated. 119 or other emergency services can be escalated into emergency services during a disaster.