Digby General Hospital Hazards Response Plan (updated 2014)

Transcription

DIGBY GENERAL HOSPITAL
ALL HAZARDS RESPONSE
PLAN
OCTOBER 2014
TABLE OF CONTENTS
All Hazards Response Plan Locations
Definitions & Legislation
Emergency Response Voice Codes
Site Profile
CODE RED - FIRE
CODE BLUE – CARDIAC ARREST
CODE GREEN – EVACUATION
CODE ORANGE – EXTERNAL DISASTER
CODE YELLOW – MISSING PATIENT including INFANTS
CODE WHITE – VIOLENT PERSON including HOSTAGE TAKING
CODE BLACK – BOMB THREAT
CODE BROWN – HAZARDOUS SUBSTANCE SPILL
CODE GREY – EXTERNAL AIR EXCLUSION
CODE PINK – PEDIATRIC EMERGENCY
Duties & Responsibilities
Call Back Lists
MISCELLANEOUS
Pandemic (Outbreak) Management
Staff Shortage
Pharmacy Alarm
Electrical Failure
Switchboard Failure
Boil Water
Weather Related Events
ER Overload
Exhibits
ALL HAZARDS RESPONSE PLAN LOCATIONS
Digby General Hospital Administrative Office (Hard Copy)
South West Health Website
(http://www.swndha.nshealth.ca/pages/DigbyGenHospMain.htm)
Shared Directory (S:\YRH\Administration\SWH Emergency
Response\DGH All Hazards Response Plan)
DEFINITIONS
Disaster – See “Emergency”. This document will use the terms “emergency” and
“disaster” interchangeably.
District Health Care Facilities – The primary care facilities within the Health Care
Districts.
DOH EOC – Department of Health Emergency Operations Centre. The Operations
Centre, located in the Joseph Howe building in Halifax, where the Department of Health
co-ordinates health care response to emergencies/disasters.
Emergency – an abnormal event, or threat of an event, of a severity and magnitude that
may result in deaths, injuries, property damage, environmental damage and/or disruption
of medical/health service operations. An emergency/disaster may also require a coordinated response beyond the routine procedures and resources.
Emergency Health Services (EHS) – The Nova Scotia Department of Health ambulance
system.
Emergency Measures Organization – includes all agencies, facilities and personnel who
may be required to respond to an emergency/disaster.
District Emergency Operations Centre (DEOC) – The District’s Emergency Operations
Centre. The DEOC Group works from this location. It is a physical location designated for
gathering, analysing, and disseminating information.
DEOC Manager – is responsible for co-ordinating the actions at the DEOC. These actions
include establishing emergency/disaster response priorities and objectives, liaising with the
Emergency Site Manager (ESM), making major decisions regarding the
emergency/disaster operation, taking recommendations on policy matters to the DEOC
Group for approval and keeping the DEOC Group informed.
Emergency Site – is the area where action and/or control is required to mitigate the threat
or impact of a hazard.
Emergency Site Manager (ESM) – co-ordinates the response to the emergency/disaster
at the site.
Emergency Site Unit – All of the responders at the emergency/disaster site under the
control of the Emergency Site Manager.
Exercises – scheduled events that provide a realistic setting for practising and evaluating
emergency/disaster response plans, procedures, checklists and resources.
Family Support Centre – is the location where family members of persons affected by the
emergency/disaster gather to obtain information about the emergency/disaster situation
and/or the response.
Hazard – a situation with the potential for human injury or death, damage to property,
damage to the environment, a disruption of normal operations, or some combination of
these.
Hazardous Materials – substances, which if accidentally released, may result in serious
harm to life, property and the environment. These substances are listed in the Transport
of Dangerous Goods Schedule XII.
Health Care Facility – includes Hospitals, Nursing Homes, Medical Centres and Clinics.
Local Standby – is the first level of activation of the emergency measures organizations.
Media Centre – location where all media releases and conferences are conducted.
Non-Government Organization (NGO) – Agencies not connected with governments that
provide humanitarian relief services.
METTAG (Medical Emergency Triage Tag):
Priority RED ~ a casualty with life-threatening injuries, requiring immediate transport to a
health care facility.
Priority YELLOW ~ a casualty with serious injuries but for whom transport may be
delayed until after PRIORITY REDS.
Priority GREEN ~ persons who require first aid treatment only.
Priority BLACK ~ casualties who are dead or untreatable.
Recovery – is one of three activation levels of the emergency measures organization.
During recovery, the District(s) are in transition from emergency/disaster to normal
operations.
Responders – are persons responsible for actions during an emergency/disaster
(including those at the emergency/disaster site, in the emergency/disaster support unit and
in the DEOC Group). Actions are generally intended to reduce risk, minimize losses and
damage, and relieve suffering. Responders include, but are not limited to: fire fighters;
police; paramedics; personnel from various government departments and agencies;
NGO's; the private sector; community organizations; and volunteers.
SITREP – Situation Report. A meeting where people summarize the emergency/disaster
situation at a particular time.
Triage – A process for assessing casualties based on their physical and psychosocial
needs and then assigning a priority level of medical treatment or transport to hospitals.
Triage Site – An area at the emergency/disaster scene designated by responders for
conducting triage.
LEGISLATION
All federal and provincial laws remain in effect before, during and after an emergency/disaster. For
example, the Nova Scotia Health Act and the Canada Health Act would remain in effect regardless
of the emergency/disaster situation. The following legislation, however, is of particular relevance to
the Department of Health's emergency/disaster preparedness program and response actions.
FEDERAL
Canadian Environmental Act
This act states that all reasonable emergency/disaster measures must be taken to prevent or
eliminate any dangerous condition, or reduce or mitigate an y danger to the environment, or to
human life or health, that results in the release of, or likely release of, a regulated substance.
Canadian Environmental Protection Act 28 June 1988
This act makes provisions for reporting and emergency/disaster response measures that must be
undertaken in the event that a release of a harmful substance is likely to, or has occurred.
Canada Labour Code
This act details the responsibilities of employers to provide safety equipment, clothing and training.
It also details the responsibilities for employees to use the safety equipment and clothing.
Emergencies Act 21 July 1988
This act defines nation emergencies and details authorities of the federal government.
Emergency Preparedness Act 27 April 1988
This act states that every Federal Minister is responsible for identifying the civil emergency/disaster
contingencies that are within, or related to, the Minister's area of accountability and developing a
civil emergency/disaster plan
Excise Tax Act R.S., c. E-12, s. 1.
This act states that duty shall be levied on any goods that enter into Canada for consumption.
Supplies that may be brought in from another country to help with an emergency/disaster are
exempt. This is arranged through District Director Emergency Preparedness Canada.
Immigration Act 19.76-77, c. 52, s. 1.
This act details the obligations of transport companies with respect to ensuring that all passengers
are presented to immigration officers, and the security and transportation requirements for illegal
immigrants.
PROVINCIAL
Emergency Measures Act 1990, c. 8, s. 1.
This act and supporting regulations details the statutory emergency/disaster duties and powers of
municipalities. The Director Emergency Measures Organization Nova Scotia is of the opinion that
this act supersedes all other provincial emergency legislation in the event of an
emergency/disaster. The act provides for the possibility of the province and municipalities to enter
into agreements with respect to emergency measures plans with other Organizations. This act
also makes municipalities responsible for the response to an aircraft crash in their jurisdiction.
Environment Act 1994-95, c. 1, s. 1.
This act prescribes provincial duties and powers that parallel federal duties and powers at an
emergency/disaster site involving environmentally damaging substances.
Municipalities Act
Acts that authorize the Municipalities to maintain a fire service and to enter into agreements with
other jurisdictions for giving or receiving emergency/disaster assistance.
Health Act R.S., c 195, s. 1.
This act allows the Minister of Health to make regulations with respect to food handling and mass
feeding, potable water, public health and safety of dwellings. This Department of Health will
handle issues that fall under federal jurisdiction such as notification of communicable disease,
however all patient health services will be handled by Nova Scotia Emergency Health Services.
South West Nova District Health Authority
Emergency Response Voice Codes
Code
R ed
Meaning
Fire
Blue
Cardiac Arrest
G re e n
Evacuation
O ra nge
External Disaster
Yellow
Missing Patient including
Infants
Black
Bomb Threat
Brown
Hazardous Substance Spill
G re y
External Air Exclusion
Pink
Pediatric Emergency
Digby General Hospital is a three-story building (1964) with a two-story addition (1987)
constructed of non combustible steel reinforced concrete clad with brick. The building is
protected by an Edwards system technology (EST3) fire alarm panel installed in 2005.
Smoke detectors are located throughout the facility in all corridors and patient sleeping
rooms. Heat detectors are located in storage areas and in the Boiler Plant and Mechanical
room. The facility has sprinklers throughout.
1964 Building
Level 1: Is at grade on the North (front entrance), East Wing and West Wings. The East
Wing houses Central Registry, Administration, Business Office, Health Records and the
Cafeteria. West Wing houses physician offices. South Wing houses the Kitchen, one level
above grade.
Level 2: East and West Wings house a 20 bed Medical Nursing Unit and Pharmacy.
South Wing houses a 13 bed Restorative Care Unit.
Level 3: East Wing houses physicians and nurse practitioners offices. West Wing houses
the OR/Day Surgery and Continuing Care. South Wing houses Public Health and Mental
Health/Addiction Services.
Basement: South Wing houses locker rooms, staff lounge , IT office and VON. West
Wing houses the morgue, storage and the wellness room. East Wing houses Laundry.
Sub-Basement: Boiler room
Penthouse: Mechanical rooms
1987 Building
Level 1: Is at grade on East entrance and houses Consultants Clinic, Cardiac Respiratory
Services, Diabetic Education Centre, Rehabilitation Services, Maintenance Department,
Palliative & Support Care Services and Speech Therapy.
Level 2: Is at grade on North with Ambulance entrance and houses ER, Diagnostic
Imaging and Laboratory Services.
SPRINKLER SYSTEM
Digby General Hospital has a wet pipe sprinkler system employing automatic sprinklers
attached to a system containing water connected to the Town of Digby water supply.
Sprinkler heads are activated or opened only by the heat from a fire. The temperature
near the sprinkler must be 165o F/74o C. Only the sprinkler near the fire will activate. Any
open sprinkler head automatically activates the fire alarm system.
FIRE PANEL
Digby General Hospital is protected by an Edwards System Technology (EST3) fire panel.
The panel monitors smoke detectors, pull stations and sprinkler systems throughout the
facility. The fire panel located on the 1st floor Main Entrance (1964 building) at Central
Registry has an LCD screen where alarm messages are displayed (time, type of alarm,
location, etc.). There are auxiliary LCD display panels in Central Registry (Switchboard),
ER Nurse Station and Boiler Room. 2nd floor East Wing Nurse Station, West Wing Nurse
Station, South Wing Nurse Station. 3rd floor East Wing Reception, West Wing OR Nurse
Station, South Wing Mental Health Nurse Station that displays duplicate information.
The fire panel has a two-stage alarm; the first stage alarm is triggered by activation of a
smoke detector, pull station or the sprinkler system. If the first stage alarm (slow gong of
alarm bells) is not acknowledged or silenced within 5 minutes the alarm will go into second
stage (rapid gong of alarm bells) which is the evacuation alarm. The second stage alarm
can also be activated by using a special key in any pull station. The Boiler Operator,
Maintenance Staff and Charge Nurse have that key on their key rings.
WATER SUPPLY
The hospital uses town water and has its own supply of well water. For locations of well
water sources refer to the “Boil Water” section of this manual.
FUEL/GENERATOR
Daily use of fuel is light fuel oil – approximately 2 days notice (calls when low) for refill
(45,000 litres).
The generator uses diesel and can operate for 86 hours on a full tank (4,200 litres) which
always gets topped up for the winter. Next day delivery for a refill – local delivery.
CELL PHONES
2 cell phones housed in Site Manager’s office for emergency purposes only. Phone
numbers are 245-8588 and 245-8344. Key individuals at DGH have in-house cell phones
for daily use - Refer to the In-House Cell Phone List in the back of the Call Back Lists
Section.
OXYGEN SUPPLY
Phone call away – 2 day delivery. Supplier checks level on a regular basis for top up.
There are more than a dozen O2 tanks including H tanks (very large) in the building.
Emergency Shut Off Valve Locations
Main Valve – in ceiling in basement past staff lockers/lounge South Wing. Wrench to be
used to turn it off is located on wall just below valve
Individual Units (Wings) shut off valves:
3-South –Mental Health/ Addiction Services across from the elevators (Closed)
3-West – (Recovery Room, Continuing Care) on wall left of main doors leading into Health
Services Centre. (OR) outside each OR room (2) and outside Steris clean up room
3-East – Through doors to Health Services Centre on the wall to the left (Closed)
2-South – (Restorative Care) across from the elevators (Closed)
2-West – (Pharmacy, Rehab Rooms, Restorative Care Unit Coordinator) on wall left of
double doors leading into Medical Unit
2-East – (Medical Unit) on wall left of doors as you go into Medical Unit
HAZARD ANALYSIS
The Methodology used in designing the Site Plan is an “all hazards” approach. This allows
the plan to respond to any emergency/disaster situation that will have an impact on the
health care system such as:
Loss of health care facilities (District or Provincial)
Weather related events including storms, hurricanes and severe temperature
Public health crises (I.e. epidemic, pandemic)
Mass casualty situations
The following list of events has a moderate to high probability of occurrence in our
community within the coming decade:
Blizzard or massive snowstorm
Chemical contamination or spill
Electric power blackout
Forest or brush fire
Freezing ice storm
Hurricane
Major hail storm
Major water main break
Mass Casualty Incident
Oil spill
Plane crash in harbour or near coast
Sudden water disposal problem
Tidal wave
Water pollution
Water shortage
Radiation accidents, fall-out from nuclear power plant accident
Potential for marine incidents based on ferry service and fishing Industry
Roads
The continual increase in the volume of traffic increases the danger of accidents
Some communities such as Briar Island and Lockeport can be isolated if roads are
closed
Heavy Snowfall/Ice Storms/Winds
This adds to the threat of transportation. Heavy snowfall and ice storms, plus high
winds, can render navigation difficult to impossible
The disruption of power and communication services by high winds is well known
and must be a consideration
Hurricanes are unpredictable and likely to cause flooding in coastal communities
Fire
In heavily wooded areas there is always a chance of fire which increases during dry
periods
The majority of dwellings are of wood construction and especially in areas of higher
density, fire is a major hazard
Chemical Spills
With the loss of rail service and diminished air service, the transportation of
dangerous goods on highways has increased. Trucks transporting to and from fish
processing facilities and export to Saint John, New Brunswick via ferry increase the
risk of spills on highways
Shipping
Risks of accidents including collisions, spills and weather related incidents
Pleasure boats – those used for fishing, hunting and sailing
Commercial – fishing industry boats
Passenger/cargo – ferries and cruise ships
Airport
The Digby Airport presents a potential for air crashes on and off the airport and
hazmat spills
Explosions
Storage depots and propane tanks in the three counties present risk of explosion
DIGBY EMO has identified three (3) top hazards:
1. Forest or brush fire
2. Chemical Spill
3. Motor Vehicle Incident (MVI) with Mass Casualty (MCI)
CODE
RED
Fire
IN CASE OF FIRE
UPON DISCOVERY OF SMOKE OR FIRE
R Remove Persons In Immediate Danger
A Activate The Fire Alarm System Using The
Nearest Pull Station
C Contain Smoke And Fire By Closing Doors
E Evacuate The Building Using The Nearest Exit
GENERAL FIRE REGULATIONS
UPON HEARING THE FIRE ALARM SIGNAL
If you smell smoke - investigate
If you find smoke or fire in any area:
R - Rescue any person(s) in immediate danger
A - Alarm must be operated immediately
C - Contain the fire (close doors and windows if time permits). Extinguish the fire if
possible
E - Evacuate from immediate area of smoke/fire (horizontally). Evacuation beyond
smoke doors will be at the discretion of the person-in-charge. Passage ways
should be clear of any obstacles and staff will wait there for further instructions
Evacuation of the building will be decided by person(s)-in-charge and
second stage alarm will be sounded (See Evacuation Section)
Check annunciator panels to identify room number of the fire. If there is nothing on
the annunciator panel or you do not have one in your area; listen for the location on
the P.A.
Announcements on Public Address System (0700 – 2230):
o Code Red to ER means the possibility of fire in ER and everyone should
be preparing for possible evacuation
Designated persons will join the fire party (see Fire Party)
Check your area for smoke or fire
Terminate all nonessential phone calls and procedures
Time and safety permitting all nonessential equipment should be turned off
Do not begin any operative, diagnostic or treatment procedure that cannot be
terminated immediately
If not in your work area, report back to your designated work area immediately
(unless instructed otherwise)
Close all doors and windows in your area but do not lock them
All patients, residents, clients and visitors are to be moved to an area of safety
Be prepared for evacuation and listen for further announcements on the public
address system
Do not go to the fire area unless instructed to do so by the Person-in-Charge or the
Fire Department Officer
Remain calm
The Person-in-Charge and/or the Emergency Coordinator will be designated by
wearing a REFLECTIVE VEST located in emergency kit in Site Manager’s Office
Elevators must not be used in an alarm or fire situation, unless authorized by the
Fire Department
Code Green Stat second stage alarm will be sounded in extreme circumstances
and indicates complete and immediate evacuation of all persons (staff, visitors,
patients, etc.) out of the building. A second stage is indicated by a faster bell than
the first stage
FIRE PARTY
0800 – 1600hrs
Environmental Services staff and all JOHS committee members or
alternate - who will immediately report to the scene of the fire and
remain until relieved by the Town Fire Department
1600 – 2300hrs
Environmental Services staff, 1 ER Nurse and/or 1 Medical Floor
backup, the Boiler Room Operator and available staff
2300 – 0700hrs
1 ER Nurse and/or 1 Medical Floor backup and the Boiler Room
Operator
If a complete evacuation of all persons (staff, patients, visitors, etc.) is immediately
necessary, the second stage of the alarm must be activated. The decision to
activate a second stage alarm must only be made by the fire department/fire
chief or his delegate in consultation with the Emergency Coordinator, if at all
possible. This is a very serious decision and must be made with extreme
caution. The activation key is kept on the Charge Nurse’s medication key ring.
(The maintenance department and boiler operators have copies). Every pull station
in the hospital can be used to activate a second stage alarm with the activation key
Area Specific Duties & Responsibilities
Location
Duties/Responsibilities
Basement - Boiler Room/Maintenance Shop
(New Hospital)
Follow Fire Alarm Procedure – Boiler
Operator included in this section of the
manual
Ground Floor East Wing (Old Hospital)
Switchboard Operator refer to Fire Alarm
Procedure – Health Information Clerk
included in this section of the manual
Kitchen & Cafeteria – Ground Floor (Old
Hospital)
Turn off propane switch (cook)
ER – Ground Floor East Wing (New
Hospital)
Designated “Charge Person” will wear a
Reflective Vest and follow Fire Alarm
Procedure – 22:30 to 7:00 Hours included
in this section of the manual
2nd Floor East/West Wings (Old Hospital)
Designated “Charge Person” will wear a
Reflective Vest and follow Fire Alarm
Procedure – 22:30 to 7:00 Hours included
in this section of the manual
All staff must become familiar with the use and location of pull stations
and fire extinguishers in their areas. Please refer to Locations of Fire
Extinguishers/Fire Alarm Pull Stations included in this section of the
manual
EMERGENCY COORDINATOR DUTIES
FIRE ALARM
The Emergency Coordinator is Site Manager or delegate. The following steps will be
followed:
Upon Arrival at scene Emergency Coordinator:
1. Consults with staff
2. Checks annunciator panel to determine zone and where fire originated
↓
Emergency Coordinator consults with Fire Department upon their arrival
↓
If no evidence of fire in identified area, Emergency Coordinator and Fire Department
continue to search for possible cause of alarm
↓
If alarm is determined a "False Alarm" Fire Department will instruct
Maintenance Personnel to reset panel and Emergency Coordinator to silence alarm
↓
Complete Fire Report (Exhibit 2)
EMERGENCY COORDINATOR - DUTIES
PROCEDURE FOR CONFIRMED FIRE
Immediately after you have identified evidence of Fire proceed as follows:
↓
Ensure "RACE" has been initiated - Direct staff to evacuate clients from immediate
area of fire (using unit-specific evacuation plans)
↓
Activate Code Green Stat Alarm
↓
Delegate 2nd in command
↓
Activate Call List (Administration A & B)
(May delegate task)
↓
Set up Command Post:
Administrative Offices
(alternate – Diagnostic Imaging Department)
↓
Open box with emergency supplies and checklist
Give out Reflective Vest to appropriate person(s)
↓
Coordinate activities of staff
USE OF EXTINGUISHERS
P
A
S
S
–
Pull The Pin
–
Aim At The Base Of The Fire
–
Squeeze The Handle
–
Sweep From Side To Side
EXTINGUISHERS AND THEIR USES
ABC
Red, White or Orange in color. All purpose dry chemical –
may be used on any type of fire.
CO2
Red in color – Big black horn on hose. Mainly used in plant
operation and maintenance areas. Good for Oil, Grease &
Electrical Fires.
Note: Do not squeeze the trigger and handle before pulling the pin
How most fire extinguishers work:
1. Remove locking pin from handle.
2. Direct nozzle at base of fire.
3. Squeeze trigger and handle together.
1. 3.
2.
ANNUNCIATOR PANELS
The Annunciator Panels, by means of a light indicator above the zone, identifies the zone
from which an alarm has been initiatied.
South East
1998
Expansion
South
Wing
East Wing
West Wing
NORTH – FRONT OF HOSPITAL
LOCATION – ANNUNCIATOR PANELS
Main Panel
Front Lobby – Ground Floor (This panel shows the location of all the
Fire Zones in the Hospital)
Ground Floor
Switchboard (Front Office)
Main Floor
Nursing Station - ER
2 East
Nursing Station – Medical Floor
2 South
Nursing Station – Restorative Care Unit
2 West
Across the hallway from former nursing station – Pharmacy/Storage
3 East
Health Services Centre Reception
3 South
Mental Health/Addiction Services Reception
3 West
Nursing Station – OR/Day Surgery
LOCATION OF FIRE EXTINGUISHERS/
FIRE ALARM PULL STATIONS
NEW HOSPITAL
UNIT NO.
TYPE
ER
1
ABC
DI Corridor
2
ABC
Lab
3
ABC
DI Office
4
ABC
Consultants’ Clinic
5
ABC
Palliative & Supportive Care Services Corridor
6
ABC
Physiotherapy
7
ABC
Cardiac Services Hallway
8
ABC
Maintenance Shop
9A
ABC
Maintenance
9B
ABC
Ground Floor (New Hospital)
by South stairwell to back parking
(ER, DI, Laboratory)
lot
by North stairwell by elevator
by Main ambulance entrance
Basement East Wing (New Hospital)
by outside door to Maintenance
(Consultants Clinic, Rehab Services,
Shop
Palliative & Supportive Care Services,
by door from Boiler Room to
Cardiac/Respiratory Services, Diabetic
Maintenance Shop
Education & Maintenance)
by Main Entrance
by exit to back parking lot
BASEMENT (OLD HOSPITAL)
UNIT NO.
TYPE
Boiler Room
1
Dry Chemical
Laundry
4
ABC
Corridor by Environmental Services
5
ABC
Corridor by Environmental Services Office
7
ABC
Corridor by IT office
8
ABC
Corridor by Male Lockers
9
ABC
Woodworking Shop
13
ABC
Corridor West Exit by Staff Wellness Room
14
ABC
Basement (Old Hospital) (Boiler Room,
West end stairwell
Environmental Services, Staff Lounge, IT,
South end stairwell
VON, Materiels Mgmt & Staff Wellness
Along east corridor to new wing,
Room)
beyond doors on right side
GROUND FLOOR (OLD HOSPITAL)
Dietitian Office Entrance
Doctor’s Offices Corridor
Corridor East Wing
Corridor East Wing
Cafeteria – Kitchen Pantry
Entrance to Kitchen
UNIT NO.
18
19
21
21 ½
23
25
TYPE
CO2
ABC
ABC
ABC
ABC
ABC
GROUND FLOOR (OLD HOSPITAL)
UNIT NO.
TYPE
Kitchen by Office
26
ABC
Kitchen by Back Corridor
29
ABC
Kitchen System Over Stoves
30 ½
2-Halon
Ground Floor (Old Hospital) (Main
Main entrance (left side of doors)
Entrance, Central Registry, Kitchen,
Back door (loading dock)
Physician Offices, Health Records,
Exit door (past administration
Business Office, Dietitian, Nurse Manager
offices)
& Administration)
Kitchen back door (kitchen loading
dock)
West wing exit door
2nd FLOOR (OLD HOSPITAL)
UNIT NO.
TYPE
Outside Restorative Care Rehab Room
31
ABC
Outside Restorative Care Rehab Room
33
CO2
West Corridor
34
ABC
Medical Floor Corridor
35
CO2
Nurses Station
35B
ABC
Medical Floor Corridor
36
ABC
Restorative Care Nurses Station (South Wing)
39
ABC
Corridor South Wing
40
ABC
2nd Floor (Restorative Care Rehab Rooms,
South wing stairwell by exit door
RCU Coordinator, Chapel, Pharmacy,
West wing stairwell by exit door
Palliative Care Family Room, Restorative
East wing stairwell by exit door
Care Unit & Medical Unit)
3rd FLOOR (OLD HOSPITAL)
UNIT NO.
TYPE
Corridor South Exit
43
ABC
Mental Health Corridor
44
ABC
Operating Room
45
CO2
Operating Room
46
CO2
rd
Corridor 3 East
49
ABC
Stair Well 3rd East
50
ABC
Penthouse (New)
55
ABC
Penthouse (Old)
56
CO2
Penthouse (Old)
57
ABC
3rd Floor (Mental Health/ Addiction
South wing stairwell by exit door
Services, Public Health, Health Services
East wing stairwell by exit door
Centre. Continuing Care & Day Surgery)
West wing (OR) stairwell by exit
door
LOCATION OF SMOKE DETECTORS
Basement West
Basement East
Basement South
Basement New Wing
1st Floor West
1st Floor East
1st Floor South
1st Floor New Wing
Near Morgue
Near West Stair
Corridor to New Wing
Near Doors to New Wing
Near Environmental Services Office
Near Staff Lounge
Near Men’s Locker Room
Near Corridor to New Wing
Near Main Laundry Doors
Near Consultants’ Clinic
By Elevator
Consultants’ Clinic Waiting Area
Main Electrical Room
Near Men’s Washroom – Physiotherapy
By Maintenance Shop Doors
Near Doors to Old Building
Near Physiotherapy Desk
Physiotherapy Corridor
Elevator Machine Room
Physiotherapy
Near Maintenance Shop
Near Hearing and Speech Office
Maintenance Shop
Electrical Room
Near Elevator
Main Lobby
Doctors’ Offices Corridor
Doctors’ Offices Waiting Area
Near West Stair
Near West Reception
Near Cafeteria
By Site Manager
Near Doors to New Wing
Kitchen Entrance
Main Hall to ER
ER near Elevator
ER near Doctors’ Lounge
DI near Lab Office
DI near Hematology
DI near South Stair
DI near Darkroom
DI near Staff Lounge
DI File Storage Dept. #1
DI File Storage Dept. #2
1st Floor New Wing cont’d…
2nd Floor West
2nd Floor East
2nd Floor South
3rd Floor West
ER near Nurses’ Station x 2
Near Emergency Exit
Near Eye Exam Room
ER near Exam Room 31
Nurses’ Sign In Room
Electrical Room
Near Lab Waiting Area
ER Treatment Room
ER Observation Room
ER Trauma Room
Top of Stair by Elevator
Top of South Stair
Corridor by Room 201
Room 202
Room 201
Room 203
Near Room 204
By Stair
Room 204
By Pharmacy
Near Room 210
Room 211
Room 212
Room 210
Room 209
Room 213
Supply Room
Near Nurses’ Station
Room 214
Room 207
Room 206
Room 205
Near Room 206
Near Room 220
Room 220
Room 219
Room 218
Room 217
Room 221
Room 216
Room 215
Near Room 215
Room 222
Near Room 305
Elevator Lobby
Near Servery
OR Recovery Room
Near Recovery Room
Near OR
3rd Floor West cont’d….
3rd Floor East
3rd Floor South
Penthouse
Top of West Stair
Top of West Dumbwaiter Shaft
Top Freight Elevator Shaft
Near Room 306
Room 307
Room 305
Room 306
Tub Room
Room 308
Room 310
Near Room 310
Room 309
Room 311
Dining Area
Reception
Top of East Stair
Near South Stair
Near Room 315
Near Public Health
Room 317
Room 316
Room 315
Room 314
Conference Room
Mental Health /Addictions Services
Reception
Waiting Room
Mental Health/Addictions Nurses Office
Top of South Stair
Top of South Dumbwaiter Shaft
Penthouse Lower Ceiling
Penthouse Upper Ceiling
New Penthouse Det. #1
New Penthouse Det. #2
FIRE ALARM/DRILL PROCEDURE- HEALTH INFORMATION CLERK (HIC)
(Monday to Friday 0700 – 2200 Hrs)
(weekends & holidays 0730 – 2200 Hrs)
1.
(a) When the ALARM sounds, check fire annunciator panel for location
of emergency. Call Boiler Operator on cell phone (speed dial 5 or 308-1007) to
inform of alarm location, “CODE RED + location on annunciator panel”.
The Boiler Operator will proceed to fire location. If they cannot be reached on
the cell phone use the pager system:
Dial 74
Wait for the beeps to stop
Then dial beeper #98 (Boiler Operator)
NOW you have up to 20 seconds to leave your message
(b) With key from office, open and check Fire Panel. Follow instructions to
acknowledge alarm and prevent the alarm going into 2nd stage.
(c) Overhead Page: ATTENTION PLEASE, ATTENTION PLEASE, “CODE RED +
location on annunciator panel”, repeat.
2.
(a) A call will be received by HIC (on emergency cell phone) of the exact location,
nature and seriousness of the “FIRE”.
(b) Instructions will be received on further actions.
3.
When the alarm is silenced the HIC will be instructed to overhead page,
“ATTENTION PLEASE, CODE RED NO LONGER REQUIRED”
4.
The HIC will be informed when the alarm system is reset and the fire panel is back
to normal status.
FIRE ALARM PROCEDURE - 22:00 to 7:00 Hours
The Charge Nurse and Boiler operator are usually informed in advance of a fire drill.
1. (a) When an alarm sounds CHARGE NURSE will check annunciator panel for
location of emergency
(b) Call Boiler Operator (In-House Cell Phone speed dial #5 Or 308-1007) to
notify of alarm location. If they cannot be reached on the cell phone use the
pager system:
Dial 74
Then dial beeper #98 (Boiler Operator)
NOW you have up to 20 seconds to leave your message
2. (a) With key (on charge nurse key ring), open and check Fire Panel. Follow
instructions to acknowledge alarm and prevent the alarm going into 2nd stage
(b) Charge Nurse/Delegate will remain at front to open doors for the fire department
and give them the fire location
3. (a) A call will be received by Charge Nurse from the Boiler Operator of the exact
location, nature and seriousness of the “FIRE”
(b) If serious - Prepare for evacuation if and when it becomes necessary. Call 911
and request police and EHS. Activate call back list, as appropriate
(c) Only the fire department can authorize silencing of alarm and for the Boiler
Operator to reset fire panel
4. Complete Nursing Fire Alarm/Fire Drill Report (Exhibit 3)
Charge Nurse will receive confirmation from the Boiler Operator that the alarms have been
silenced and fire panel reset
Charge Nurse will advise Valley Alarms (tel. 1 902 678 9616) (account #551) that alarm
system is back to normal status
Note: Charge Nurse and Boiler Operator will make contact with each other at the
beginning of their respective shifts
FIRE ALARM PROCEDURE- BOILER OPERATOR
The Boiler operators are usually informed in advance of a fire drill.
1. (a) When an alarm sounds the Boiler Operator will check annunciator panel for
location of emergency
(b) Proceed to alarm location and investigate: RESCUE
ALARM
CONTAIN
EVACUATE
(c) Call will be received by Boiler Operator on in-house cell phone to confirm alarm
location
2. (a) Call Charge Nurse (22:00 to 7:00 hr.) to advise of nature, exact location and
seriousness of the “FIRE”
(b) If serious - Prepare for evacuation if and when it becomes necessary
(c) Only the fire department can authorize silencing of the alarm and for the Boiler
Operator to reset the fire panel
Switchboard / Charge Nurse will receive confirmation from the Boiler Operator that the
alarms have been silenced and reset
Note: Charge Nurse and Boiler Operator will make contact with each other at the
beginning of their respective shifts
FIRE DRILLS
Fire drills are an essential part of this fire plan. The purpose of drills is to provide
opportunity for staff to practice fire emergency procedures in a non-threatening, learning
environment. Drills must be held once per month and at various times and shifts to ensure
all staff have an opportunity to participate and a variety of circumstances are tested.
Documentation of all fire drills must be maintained.
In general, the following procedures will be followed for all fire drills.
1. Although fire drills are scheduled, in advance, once per month, the date and time is
not publicized. Only key individuals are notified, in advance, and might include site
manager, maintenance supervisor, switchboard operator, department manager in
the proposed fire location, and the local fire department.
Note: Although it is routine to notify 911 in an actual fire situation, this call is not made for
a fire drill as it is considered illegal to dial 911 if an actual emergency does not exist.
2. A fire drill can be initiated in several ways:
Option 1 – The use of a sign, note, light or other indicator recognized by staff as a
simulated fire
Option 2 – Activation of a smoke detector using artificial smoke
Option 3 – Activation of a pull station
3. Staff are expected to react in a fire drill in the same manner they would in a real fire,
with some limitations. For example:
Staff are expected to sound the alarm by activating a pull station (if bells are not
already ringing) upon discovery of a simulated fire.
Staff are expected to rescue anyone that would be in immediate danger
provided there is no possibility that any individual will be harmed or become
upset. If evacuation is not convenient, the staff can verbalize the steps they
would normally take.
Staff are expected to take measures to confine the fire, but are not expected to
discharge a fire extinguisher or use other methods to “put out” the simulated fire.
Staff, not in the immediate fire area, will not be made aware it is a drill; they are
expected to react accordingly and carry out activities such as closing doors.
A fire department official may be present at the drill to observe and offer
recommendations.
The person responsible for running the drill must compile the “Fire Drill Reports”
and submit them to the Joint Occupational Health & Safety Committee Chair.
4. JOHS Chair to complete Fire Drill Evaluation Sheet (Exhibit 1)
ACKNOWLEDGEMENTS
The fire plan was prepared with the co-operation of the Site Emergency Response
Committee, Department Managers and Staff of Digby General Hospital, the Digby Fire
Department and in particular Chief Robert Morgan, the office of the deputy Fire Marshal
The office of the Fire Marshal approved this fire plan on
Date:__________________________________
Signature:_________________________________________________
Title:_____________________________________________________
It is a requirement of the Fire Marshal’s Office that this plan be reviewed annually.
CODE
BLUE
Cardiac Arrest
CODE BLUE
Patient is found unconscious, pulseless or apneic
↓
Remain Calm
↓
Dial 62 & Overhead Page
↓
State “Code Blue” to (Location)
↓
Call Physician On-Call for ER
↓
If no Physician available to respond – call 911
***Protocol found on Emergency Carts in each area***
CODE
GREEN
Evacuation
INTERNAL DISASTER
Code Green Evacuation - Second Stage Alarm
Evacuation decision made by Site Manager, Duty Officer and/or Fire Chief
Switchboard/designate to announce “Code Green” three times
Evacuation Location – Off Site:
o Primary – Tideview Terrace – 245-4718 Debra Boudreau, Administrator - ext.
3100 (Tideview), 247-1406 (Cell) or Darlene Cook, Director of Care – ext. 3110
(Tideview), 245-2830 (Home), 247-2331 (Cell)
o Secondary – Digby High School – 245-7500 Ben Elms, Principal - 245-1998
(Home), 247-1226 (Cell) or Ben McNeil, Vice Principal – 665-2626 (Home), 5328150 (Cell) or Craig Thibodeau, Custodian – 245-1810 (Home) or Tri-County
Regional School Board – 1-800-915-0113 or (902) 749-5696
Activate Call Back List for Administration “A” – (Charge Nurse/designate)
Evacuation site (primary/secondary) is notified by person in charge
All visitors are to be directed to leave the building. Business office staff will monitor main
entrance and prevent people from entering the building. All departments to monitor access
points
Notification of EHS/RCMP/Fire Department (phone dispatch 911) for transportation
assistance
Evacuate patients to nearest appropriate exit (depending on location of fire/disaster)
o Evacuation indicator to be put in “up” position when room is emptied of patients
(check closets and washrooms)
o If a door is locked it cannot be checked and the door indicator is to be left flipped
down
o Rooms with more than one access point (doors) are to be checked (if not locked)
and indicator flipped up on each door as you check. Alcoves outside doors are to
be rechecked once the room is checked and both doors to the area have the
indicator flipped up
The front lawn close to the sidewalk is to be used for the congregating of patients/staff
exiting through the front door (West Wing). Lawn area by helicopter pad/parking area if
exiting through the East and South Wings. Pharmasave parking lot should be accessed
from the main level Physician’s Wing exit
Transport off site under the direction of the person in charge
Person in charge or designate to keep a record of patients who have been transported
where & how on In-Patient Evacuation Tracking Form (Exhibit 4a& 4b)
A final decision on transfer/discharge of patients will be made once they are safely in an off
site relocation area
Switchboard & EOC to be relocated as appropriate depending on fire location
**Transport options to be considered are: Ambulance, private vehicles, buses (school, otherwise),
wheelchair vans/buses, etc. Refer to Transportation Resource List in the back of the Call Back
Lists Section
HINTS FOR EVACUATION BECAUSE OF
FIRE RELATED CIRCUMSTANCES
All persons should be aware of which route or routes are being used. We need to
keep in mind location of fire trucks and hoses for evacuation and the use of more
than one safe exit will prevent congestion in the stairwells
Evacuees should stick close together to prevent somebody being left behind
Close all doors behind you but never lock any door
Never open any door without checking it first. This is done by feeling high on the
door with the back of your hand. Never open a hot door. If the door is warm or has
some smoke oozing around it, then the decision to open it will depend on what
alternatives are available. If the door must be opened, stand to the side away from
the hinge, and crouch down. This way if the door opens with any force when the
latch is released you will be out of the way, plus you will be missed should flames,
smoke or hot gases gush through the opening
Air is always easier to breathe closer to the floor - crawl if you must
Wet cloths placed over your nose and mouth eases breathing
When moving in a smoke filled room where visibility is poor to non-existent, it is very
easy to get disoriented. To avoid this always stay close to the wall. Move along the
right wall
If you can move no further along your escape route or go back, go into a room to
the side, preferably one with a window to the outside of the building. Close the
door, seal the crack with whatever is available - towels, sheets, etc. If there is a
window - open it or break it if necessary (watch out for glass). Remove all jagged
edges. Yell to attract attention. Keep low in the room where the air will be cooler
and easier to breathe
If crawling up or down stairs always crawl with your head up
Try to keep calm at all times. This will help slow breathing and put less strain on
your already heavily taxed respiratory system
Mobility will be an issue for many patients. You may use strong blankets or
flannelette sheets to place patients on to then be pulled on the floor to closest safe
exit (usually requires two people)
NURSE IN CHARGE
Code Green Evacuation
Second Stage Alarm
TAKE:
PATIENT KARDEX
COMPUTERIZED MED ADMIN RECORD
DRUG BOX FROM CRASH CART
RESPIRATORY BOX
COMPLETED “INPATIENT EVACUATION TRACKING FORM”
(EXHIBIT 4a & 4b)
Letter of Agreement
Digby General Hospital (DGH) and Digby High School agree that in the event of a disaster
at DGH, necessitating the evacuation of the building, the patients may be temporarily
relocated to the Digby High School until other arrangements are made.
________________________________
Ben Elms
Principal – Digby Regional High School
________________________________
Hubert d’Entremont
Site Manager – Digby General Hospital
CODE
ORANGE
External Disaster
EXTERNAL DISASTER
Code Orange – Incoming Casualties
Person-in-Charge/Site Manager
Initiates Overhead Page (Dial 62) –
“Attention Please – Code Orange” x 3
Confirms number and type of casualties to be expected
Activates Emergency Plan (in consultation with Site Manager)
Site Manager (or delegate) activates Call List - Administration “A”
Administrative Assistant activates Call List – Administration “B”
which initiates Individual & Department Plans/Responsibilities
Call in Security (delegate a person to take charge of security until
security arrives)
Contact Radiation Safety Officer if radiation exposure of victims is
reported
Contact outside agencies as required
**Refer to Quick Reference Duties/Responsibilities located in this section of the manual**
AREAS TO BE SETUP/EXPANDED TO
ACCOMMODATE INCOMING
1.
Triage – Emergency Department Entrance
• 10 spaces available (6 stretchers & 4 treatment tables)
• May overflow into Telehealth Room – will accommodate 2 stretchers
2.
Minimal Treatment Area –Consultants’ Clinic - 5 treatment rooms & 3 tables
and Physiotherapy Department - 6 tables
3.
Information Centre – Board Room (Coordinator)
4.
Waiting/holding area for families or those treated and discharged - Cafeteria
5.
EOC (Site) – Site Administration Offices – Extension 3219 or 3231.
6.
In-Patient bed capacity may be expanded by 8 and include:
3rd floor (Day Surgery/Recovery Room) - 3 stretchers
2nd floor (Medical) - Add a bed to Rooms 204, 213
2nd floor (RCU)
- Add a stretcher to Room 220
- Add 2 stretchers to Room 215
Total = 8
Decision on expansion and the degree of it will be made by the Site Manager,
the Nurse Manager and the Deputy Chief of Staff
Available
Stretchers
Diagnostic Imaging – 1
Day Surgery/Recovery Room – 3
Medical Unit – 1
Consultants Clinic – 1
Cardiac Services – 1
Morgue - 1
Beds
1 – corridor in basement
1 – Crib
CODE ORANGE EXTERNAL
DISASTER GENERAL INFORMATION
CONTAMINATED PERSONS
Victims contaminated with a hazardous product (e.g. chemical, radiation) must be
segregated. ER admission process for patients who have been contaminated:
1) Patients would be brought through the Consultants’ Clinic entrance (basement level)
2) Decontamination will take place in the large washroom (tub/shower) across from the
Cardiac/Respiratory Services office
3) Transport to ER via wheelchair/stretcher on elevator
In the case of radiation exposure, the Radiation Safety Officer must be contacted
immediately by the Emergency Coordinator at the following contact numbers:
Work
Home
Cell
Mrs. Kelly Maloney 742-3542 ext. 1250
742-3228
307-0589
or alternate Mr. Chris Brown
742-3542 ext. 1412
742-8088
ELEVATORS
During evacuation and admissions, hospital personnel are not to use elevators unless
moving patients or victims or in a situation when equipment must be moved.
BURNS
If burn patients need to be transferred to another facility call:
QEII Emergency: 473-3383
Inform them of our intent to transfer patients.
or
Request to speak to the Plastic Surgeon Resident
on call immediately.
Locating:
473-2220
The Plastics Resident will be aware of where
beds are available and how many. There is a
booklet available in ER with instructions for
transfer.
EMERGENCY PHONE NUMBERS
Air Ambulance
QEII
I.W.K.
Switchboard
Emergency
Locating
Switchboard
Emergency
Valley Regional
Dartmouth General
Nova Scotia Hospital
South Shore Regional
Roseway Hospital
Yarmouth Regional Hospital
Queen’s General Hospital
Fisherman’s Memorial Hospital
1-800-743-1334
l-902-473-2700
1-902-473-3383
1-902-473-2220
1-902-470-8888
1-902-470-8050
1-902-678-7381
1-902-465-8300
1-902-464-3111
1-902-543-4603
1-902-875-3011
1-902-742-3541
1-902-354-3436
1-902-634-8801
TRANSPORTATION RESOURCE LIST
Transportation/accommodation/food, etc. – Refer to Town of Digby EMO binder in
Sections “Transportation” and “Resources”. The EMO binder is located in the DGH
Emergency Department.
St. John Ambulance
1-800-565-5056
Canadian Red Cross
1-800-418-1111
DISCHARGE CENTER
Location: Physicians’ Wing (West Wing)
Patients discharged from hospital in preparation for admission of casualties will be
moved here to await pick-up by family
Also:
Treated and released casualties will be directed here to await pick-up
Utilize – Clergy, Mental Health /Addiction Services in this area to assist volunteers
INFORMATION CENTERS
Location: Cafeteria (For Family)
Families will be directed to this area to await information on their family member(s)
Location: Board Room (Coordinator)
The phone (ext. 3216) in this area will be manned by clerical support staff who will
keep updated lists (Incoming Patient Tracking Form - Exhibit 6) of the casualties
and status (as given to them by nursing staff on an hourly basis)
Utilize the laptop computer from the Site Manager’s office. If access assistance is
required then make a “high priority” call to the NShIS Help Desk (1-866-224-2555),
they are available 24/7
Information to family members will be given by the appropriate person – as directed
by the person-in-charge
QUICK REFERENCE DUTIES/RESPONSIBILITIES
Position
(duties are inclusive for all types of disasters so actions will depend on
nature of given emergency)
EMO Health Services
Representative
•
•
Respond to the EOC call
Liaise with community and facility
District Duty Officer
(DDO)
•
•
Contact Senior Management
Assist site with decisions
Site Manager (S.M.)
•
•
•
Liaise with Senior Management
Assist with site decisions
Set up site EOC (Administration Office)
Nurse Manager (N.M.)
•
•
•
Initiate (delegate) Call Back List
Assist with site decisions
Oversee the intake process (location, contact, etc.)
Incoming Patient Tracking Form – ER (Exhibit 6)
Deputy Chief of Staff
(DCOS) and/or Doctor on
Call (DOC)
•
•
•
Assist with discharge decisions
Initiate physician call back list
Evaluate need to increase the amount of blood bank
products
Administrative Assistant
(Site EOC Coordinator)
•
•
•
Initiate Call Back List – Administration “B”
Assist with organizing site EOC
Administer the Staff Sign-In/Sign-Out Sheet
(Exhibit 5)
Medical Unit RN
•
•
Liaise with DCOS regarding disposition of patients
Initiate Incoming Patient Tracking Form – ER
(Exhibit 6)
Direct in-house staff
•
Ward Clerks (ER, Medical
& RCU)
•
•
Initiate Call Back List, as directed by Nurse Manager or
delegate
Assist with Incoming Patient Tracking Form - ER
(Exhibit 6)
Position
Central Registry/Business
Office
•
•
Make announcements as requested by Management
Direct people coming through front lobby
RN in Charge
•
•
Call DDO/Site Manager/Nurse Manager
Liaise with external group regarding disaster type, #,
etc.
Direct switchboard regarding announcements
Initiate set-up/staffing for Emergency Treatment &
Minimal Treatment areas including utilization of tracking
forms – Incoming Patient Tracking Form - ER
(Exhibit 6) and Minimal Treatment Form (Exhibit 7)
•
•
Triage Nurse
•
•
Track incoming patients on Incoming Patient
Tracking Form - ER (Exhibit 6)
Ensure triage tags are on each patient with triage and
assignment of treatment area
Admitting Clerk – Triage
Team
•
•
•
Ensure there is a triage tag on each patient
Obtain, whenever possible, registration information
Ensure each patient has a clipboard chart
Diagnostic Imaging (DI)
•
•
Call in staff as required
Ask routine patients to leave by appropriate exit
Laboratory (LAB)
•
•
Environmental Services
•
•
Maintain essential services
Maintain stocking of warming cabinets in ER, Medical,
OR and Physiotherapy
Maintenance
•
•
Ensure two wheelchairs are in lobby area
Ensure wheelchairs and stretchers are available at the
ambulance entrance
Security and traffic control – wearing orange vest
Place all gates (5) to parking areas in the up/open
position
•
•
•
Position
Boiler Operator on Duty
•
Food & Nutrition Services
•
•
Initiate Call Back List
Pharmacy
•
•
Maintain existing stock
Stock and maintain drug supplies in ER and Minimal
Treatment areas
Obtain pharmaceutical supplies from outside sources,
as required
•
•
Mental Health/Addiction
Services
•
•
•
Report to the Information Centre
Act as resource for staff to assist patients and families
deal with disaster
Counseling of staff
Clergy
•
•
Report to the Information Centre
Assist with support & counseling of victims, families,
etc.
Rehab Services
•
•
•
Act as a porter/lifter for front lobby and ambulance
entrance
Assist with setting up and running the department as
Minimal Treatment Area
Health Records
•
•
Obtain old charts
Assigned to other areas as needed
Information Systems
•
•
Assist with setting up computers/laptops (Board Room)
Assist with Site EOC
Auxiliary
•
•
Act as porters/messengers
Providing snacks for families of victims at the
Information Centre
Helpers for Food & Nutrition Services
•
CONTENTS OF THE EMERGENCY PREPAREDNESS CART
Drawer 1
12 pens
1 spare notebook
1 stapler
1 box of staples
4 black markers
2 pairs of scissors
1 staff sign in book
1 roll of masking tape
2 Minimal Treatment Signs (to be posted)
Incoming Patient Tracking Form – ER (Exhibit 6) (on clipboard)
Drawer 2
2 clipboards
1 box of patient armbands
25 triage tags
1 bag of safety pins
4 safety vests
1 box of gloves, medium
1 box of masks, disposable
Garbage Bags
Patient Garment Bags
Drawer 3
24 clipboards each containing
-
2 pre-numbered armbands
1 pre-numbered label sheet (10 labels)
1 pre-numbered requisition – Lab/DI
1 doctor order sheet
1 nurses notes
Progress sheets
1 admission (ER) sheet
CODE
YELLOW
YELLOW
Missing Patient
Code Yellow – MISSING PERSON INCIDENT
Upon notification of suspected missing person the Emergency Coordinator* will:
1) Obtain information
2) Coordinate a quick search of area where person is missing using
staff present
If quick search unsuccessful:
1.
Check with family
Infant – question parents & family of infant suspected of missing or abducted
as to other possible locations of the infant within the hospital
2.
Notify attending doctor if missing person is a patient/resident
3.
Complete Missing Person Information Form (Exhibit 8)
4.
Notify RCMP at 911 that a detailed search of building is underway – identify
who is missing – adult/child/infant
5.
Notify District Duty Officer – Call Back List Administration A
6.
Nurse Manager of inpatient unit/Nurse-in-Charge/Coordinator will make
decision regarding Code Yellow announcement by switchboard (I.e.
description, name, etc.)
Infant – Code Yellow Infant
7.
Coordinate a detailed search (see next page)
*Emergency Coordinator is the “person-in-charge” after hours or Site
Manager/delegate during normal work hours
DETAILED SEARCH PROCEDURES (Missing Person)
Please note: We will only be responsible to search the facility and property
associated with our facility
A "Command Post" (Site Manager’s Office) will be established to coordinate activities
The person-in-charge of the search acts as liaison with the RCMP
Assign staff to search area and report results of area searches to the person-in-charge of
the search. After an area is searched, it should be sealed off as much as possible to
prevent the missing person from entering this area
Note: Fire regulations must be considered when sealing areas
Person-in-charge will make decision if and when extra help will be called in
If a picture of the missing person is available, photocopies should be made
RCMP will decide if Digby County Ground Search and Rescue will be called in to
coordinate a ground search
A maintenance person should be called in to act as a consultant for a search of the hospital
grounds. Contact Boiler Operator on duty to assign this person
INFANT
Protect the potential crime scene (area where the potential abduction may have occurred)
in order to preserve the subsequent collection of any forensic evidence by law enforcement
officials. Remove all people (including other patients) from the room
Move the parents of the potentially missing or abducted infant (but NOT their belongings) to
a private room. Assign an individual (Eg. nurse, other staff, clergy, etc.) to remain with
them
Secure all records and charts of the mother and infant
Notify the lab to place “hold” on the infants cord blood for follow-up testing
At least one person from each department should respond by going to the nearest exit
Immediately report any suspicious individuals or activities to the person-in-charge. Do not
attempt to approach a suspicious individual
The search continues until the infant is found and/or “Code Yellow Infant – All Clear”
ACTIVATING CODE WHITE (Emergency Assistance)
Procedure:
In an aggressive situation where the employee has assessed that additional
resources are required in order to intervene effectively, “Code White” may be called
A Code White may be called for any situation where the involved person feels a
threat to his/her or others safety by a potentially aggressive/violent situation and
there is not enough support in the area. If in doubt, call “Code White”. It is better
to have unnecessary support than to have no support if it is needed
To activate a Code White:
o Dial 62 and state: “Code White to area (eg. Medical Unit)”
o Call or ask someone else to call 911 if RCMP assistance is required
RCMP assistance should be specified if:
o the aggressor has a weapon
o the aggressor is not a patient or resident (eg. a visitor) and requires physical
intervention or removal from the premises
o internal staffing resources are inadequate to deal with the aggressive
incident
o the aggressor has left the hospital and staff feel he/she may pose a threat to
the community
o an individual has left the building and is under medical certificates stating
he/she is at risk for violence
o the aggressor is under the influence of alcohol and/or illegal substances
Upon arrival of the Code White respondents to the area, the person in charge of the
area (Team Leader) will give his/her instructions
Verbal interventions will be used whenever possible. Physical interventions will be
used as a last resort and with the least force necessary
When immediate risk no longer exists, the person in charge of the area will
announce (Dial 62) or instruct someone to announce “Code White no longer
required”
A Code White Report Form (Exhibit 9a) must be completed as soon as possible
(within 24 hours) and forwarded to the Risk Management Committee Chair
Upon receipt of the Code White Report Form by the Risk Management Committee,
a Code White Responders Questionnaire (Exhibit 9b) will be forwarded to each
responder. This form allows each responder to comment freely regarding the
incident
RESPONDING TO CODE WHITE ANNOUNCEMENT
Procedure:
When Code White announced over the public address system, at least one person
from each department/unit should respond to the area specified
If indicated by caller, switchboard operator will contact RCMP
Once in area, staff must follow instructions from the person in charge. Responding
individuals may be asked to verify with switchboard that RCMP have been
contacted. Responders may be asked to stay with other patients in the area or
requested to return to their department
Remember: Follow instructions from the person in charge of the Code White
situation
HOSTAGE TAKING/BARRICADED PERSON
In the event that a person barricades themselves or takes another person hostage,
the person discovering the situation should:
Immediately notify:
1.
PERSON IN CHARGE (Emergency Coordinator)
THE EMERGENCY COORDINATOR WILL IMMEDIATELY NOTIFY THE RCMP 911.
The following steps should then be taken:
Clear everyone from the immediate area
All telephone communication to the area should be terminated except for a
protected line from the negotiator
Every attempt to STALL FOR TIME should be made until the RCMP arrive
SWH employees should not initiate dialogue with hostage taker. This is a
police role. If hostage taker initiates dialogue, assign one individual to
respond while awaiting RCMP arrival
Guidelines for the Negotiator:
REMEMBER:
We should rely on the RCMP negotiator to conduct the negotiations if at all
possible. Our main role is to prevent escalation of the situation and injuries.
(Note: If at all possible, a trained RCMP negotiator should be used.)
If it is required that the Facility negotiator be used, the following guidelines should
be followed:
If the hostage taker or barricaded person is a patient or otherwise known to
staff, an attempt should be made to summon the staff member most familiar
with, or trusted by, him. (The fewer people who have contact with this
person, the better. Therefore, it is important that the initial contact person be
maintained, if at all possible, until the RCMP arrive.)
Avoid "face-to-face" confrontation. Insist on communicating by phone
Keep the pace slow and calm
Control your voice and talk slowly
Present yourself as a person of authority but not the final decision maker.
Insist on relaying information to the "Supervisor". Play for time
Relay all information and developments to the person-in-charge.
make decisions on your own
Do not
Do not ask about the hostages or show concern for them. The hostage taker
should not know that the hostage is important to you. Do not use the word
"hostage"
LISTEN. Do not speak over the hostage or hostage taker. Do not interrupt.
Let them talk as much as they want
Do not identify needs or offer anything including information. React to the
hostage taker. Needs must develop within the hostage taker in order to
become a bargaining tool
Don't suggest answers - let him make his own decisions
Everything asked for or demanded should be subject to a trade
Do not use the word "NO". Let this person believe his goals are achievable.
Always say "I'll try" or "I'll see what I can do" instead
Lie only if absolutely necessary
Acknowledge deadlines but don't pay attention to them. Either talk through
the deadline or excuse yourself 10 minutes or so before and cut off contact
until deadline is well past
Repeat back demands and conversations
Never try to convince the criminal that you have the same problems
Maintain your safety at all times, ie., protection and escape routes
Don't assume the hostage taker is telling the truth, ie., assume no one is hurt
unless you see evidence
Plan the surrender carefully
Don't allow a hostage exchange
GUIDELINES IF TAKEN HOSTAGE
Don't be a hero. Accept your situation and be prepared to wait.
The first 15 to 45 minutes are the most dangerous for all concerned. Follow the
instructions of your captor. The longer you are together, the less likely the captor
will hurt you.
Don't speak unless spoken to and only if necessary. Try to be friendly if possible,
but not phoney.
Try to get rest. Sit if you can. If the situation goes for a long period of time, try to
sleep if you can.
Don't make suggestions to the hostage taker. If your suggestion goes wrong, he
may think you planned it that way.
Don't try to escape unless you are absolutely sure you can make it, and even then,
rethink it before you try.
If anyone needs special medication, inform your captors.
Be observant of everything you see and hear. Try to memorize the number of
captors, their description and conversations, weapons carried, etc. Also number
and identities of other hostages; you may be released and your information will help
the police.
If you are permitted to speak on the phone, be prepared to answer yes or no to
questions asked by Police.
Don't be argumentative to captors or other hostages.
attitude.
Don't turn your back on your captors unless directed to do so. But don't stare at
them either. Eye contact can be good. People are less likely to harm someone that
they are looking at.
Be patient, even though the police may appear to be doing nothing, they are
engaged in a complete program designed to rescue you unharmed as soon as
possible.
Put forth a cooperative
CODE
BLACK
Bomb Threat
BOMB THREAT
EMERGENCY COORDINATORS DUTIES
Upon notification that a Bomb Threat has been received,
Person-in-Charge calls "911" asking RCMP to activate EHS and Fire Department
↓
Person-in-Charge is the decision maker
Call Switchboard to announce "CODE BLACK"
↓
Notify Boiler Room Operator on in-house cell phone-speed dial #5 (308-1007)
↓
Activate Call Back List – Administration A and others (as appropriate)
↓
The Administration Office will be the Command Centre
(depending on the area of the bomb)
Extensions 3219 or 3231
↓
If appropriate call “Code Green” (Evacuation)
↓
Advise staff to note if they see anything suspicious and if anything is found do not to touch
it and call Command Centre at extensions 3219 or 3231
BOMB THREAT
EMERGENCY PLAN
IN CHARGE - RCMP
Any staff accepting Bomb Threat - obtain information as per Bomb Threat
Telephone Procedure (Exhibit 10), then page person-in-charge
Person-in-charge calls 911 and asks RCMP to activate EHS and Fire Department
Person-in-charge is the Command Centre Coordinator, (Extensions 3219 or
3231 or as announced on P.A. as well as the decision maker in consultation with
the RCMP
Code Black (Bomb Threat) is called over P.A.:
o Notify Boiler Room Operator (in-house cell phone-speed dial #5)-(3081007)
o Ask visitors to leave or ask them to volunteer to assist with a family member
o Refer to Code Green “Evacuation” procedure
o Staff prepare for evacuation during which a quick look can be made
throughout department to see if anything suspicious is found. Staff are
advised not to touch anything they find suspicious but should notify
Command Centre at Extensions 3219 or 3231
RCMP and Command Centre Personnel determine the appropriate action plan for
bomb threat - what areas are to be evacuated and to where:
o Primary – Tideview Terrace – 245-4718 Debra Boudreau, Administrator ext. 3100 (Tideview), 247-1406 (Cell) or Darlene Cook, Director of Care –
ext. 3110 (Tideview), 245-2830 (Home), 247-2331 (Cell)
o Secondary – Digby High School – 245-7500 Ben Elms, Principal - 245-1998
(Home), 247-1226 (Cell) or Ben McNeil, Vice Principal – 665-2626 (Home),
532-8150 (Cell) or Craig Thibodeau, Custodian – 245-1810 (Home) or TriCounty Regional School Board – 1-800-915-0113 or (902) 749-5696
Decide transportation requirements (Ie. buses, ambulances, air ambulance, etc.).
Contact numbers available in the Call Back List Section
Maintenance to restrict entrance to facility parking for staff who have been called
back and check parking lot for people waiting in vehicles - ask them to leave
Assign management person to be in charge of new site until Command Centre
personnel can be transported there
CODE
BROWN
Hazardous Substance Spill
Hazardous Materials
Hazardous Materials are located throughout Digby General Hospital and are stored in
accordance with the National Fire Code of Canada.
The Work Place Hazardous Materials Information System also regulates Hazardous
Materials. The MSDS Master Binder for WHMIS materials is located in the ER and also on
the Intranet (http://wdhaintranet.swndha.nshealth.ca/Pages/Default.aspx)
Compressed Medical Gas cylinders storage room is located in the basement south wing by
the service elevator
Infectious Waste is stored in the cooler in the basement east wing behind laundry
Flammable Liquid – Gasoline - less than 38 litres is stored in the lawn care storage shed
south of Helicopter pad. Light Fuel Oil – 45,000 litres for daily use – tank is located in back
of the hospital by the cafeteria. Diesel – 4,548 litres for generator is stored in an above
ground tank by the maintenance shop.
Note to Fire Fighters: There are numerous containers of hand sanitizer which contains –
70% Ethyl Alcohol throughout the building. This product is used as an antimicrobial hand
rinse, most containers are mounted on the wall, particularly in patient care areas. The
product should be considered a “flammable liquid”.
Code Brown/Hazardous Substance Spill Policy (#VI-255) can be found in
the Occupational Health & Safety Manual
RADIATION SAFETY
If an incident within the Facility involves a radioactive substance, the Radiation Safety
Officer must be contacted:
Notify the following Radiation Safety Officer:
or alternate
Work
Mrs. Kelly Maloney 742-3542 ext. 1250
Mr. Chris Brown
742-3542 ext. 1412
Home
742-3228
742-8088
Cell
307-0589
COMMUNITY AGREEMENT
In the event that a community emergency involves a radioactive substance, the Yarmouth
Regional Health Centre may be contacted to provide initial services of a Radiation Safety
Officer.
The Emergency Coordinator will notify the Radiation Safety Officer as noted above.
The Radiation Safety Officer will report to the requesting agency representative at the onsite Emergency Command Centre.
Please note the South West Health Radiation Safety Officer has limited resources. Under
normal circumstances the following services may be provided:
Monitoring
Clean-up of minor spills
Advice
CODE
GREY
External Air Exclusion
CODE GREY AIR EXCLUSION FROM EXTERNAL
ENVIRONMENTAL THREAT
↓
Call Boiler Operator (in-house cell phone – speed dial #5 – 308-1007
↓
Ensure Manager of Engineering Services is called by Boiler Operator and
heating/ventilation system is shut down
↓
Dial 62 and announce over P.A. system “Code Grey - staff should ensure all windows and
doors are closed”
↓
Consult with Manager of Engineering Services, on an ongoing basis, to check progress
When notification of the “air contaminate” comes from a member of the RCMP, Fire
Department, EMO or Government, the decision to evacuate, or to button down, will be
made by the senior person in charge of the hospital in consultation with the Site Manager
or designate.
Procedure:
The person in charge or designate will ensure that:
1) All external windows and doors are closed.
2) Window mounted air-conditioning units are turned off.
3) Entry into the building is to be restricted to the main entrance double doors ONLY.
“Button Down” signs (Exhibit 11a & 11b) are to be attached to ALL external doors.
Anyone entering or leaving the building shall ensure the interior and exterior door is
closed before proceeding to open the second door. This creates an air pocket. All
other doors will be locked with the exception of ambulance entrance.
4) The building’s main heating ventilation air conditioning systems, which draw
external air, are shut off by Plant Operations/Maintenance. The switches are located
in the mechanical rooms in the penthouse and various areas of the hospital.
Location of Panels and Switches are as follows:
1)
AC-1 Supply Fan
Main switch labeled AC-1
Located - Mechanical Room Penthouse or from Energy Management System
2)
AC-2 Supply Fan
Main switch labeled AC-1
3)
F-1 Return Fan
Main switch labeled F-1
4)
F-2 Return Fan
Main switch labeled F-2
5)
AHU #3
Main switch labeled West Wing except OR (Operating Room)
6)
AHU #4
Main switch labeled OR (Operating Room)
7)
AHU #3 Exhaust (also does AHU #4)
Main switch labeled OR (Operating Room) Exhaust
8)
E3 Exhaust Fan
Main switch labeled E3 Laundry Exhaust
9)
E6 Exhaust Fan
Main switch labeled E6 Toilet Exhaust
10)
E10 Exhaust Fan
Main switch labeled E10 Kitchen
11)
E7 Exhaust Fan
Main switch labeled E7
Located – Dishroom Ground Floor
12)
E11 Exhaust Fan
Main switch labeled E11 Autopsy Exhaust
Located – Mechanical Room Penthouse or from Energy Management System
13)
AHU #5
Main switch labeled Kitchen Supply Air
Located – Mechanical Room Penthouse or from Energy Management System
14)
AHU #10
Main switch labeled Corridor Air 2nd & 3rd South & East
Located – Old Penthouse or from Energy Management System
15)
E12 Exhaust Fan
Main switch labeled E12 Exhaust for AHU #10
Located – Old Penthouse or from Energy Management System
16)
F6 Exhaust Fan
Main switch labeled E6 Electrical Room Exhaust
Located – Main Electrical Room
17)
F5 Supply Fan
Main switch labeled F5 Electrical Room Supply
Located – Main Electrical Room
18)
F7 Supply and Exhaust Fans
Main switch labeled Diesel Exhaust – Supply
Located – Diesel Room
19)
F11 Exhaust Fan
Main switch labeled E11 Laundry Exhaust
Located – Boiler Room
20)
F12 Exhaust Fan
Main switch labeled Deairator Exhaust
21)
F13 Supply Fan
Main switch labeled F13 Boiler Room Supply
22)
F9 Supply Fan
Main switch labeled F9 Boiler Room Supply
23)
S3 Supply Fan
Main switch labeled S3 Laundry Supply
24)
F4 Exhaust Fan
Main switch labeled F4 Lab Exhaust
Located – Janitor’s Closet New Wing
25)
S6 Supply Fan
Main switch labeled S6 Electrical Room Supply
Located – Electrical Room I
26)
S7 Supply Fan
Main switch labeled S7 Electrical Room Supply
Located – Electrical Room II
CODE
PINK
Pediatric Emergency
CODE PINK
Patient is found unconscious, pulseless or apneic
↓
Remain Calm
↓
Dial 62 & Overhead Page
↓
State “Code Pink” to (Location)
***Protocol found on Emergency Cart in ER***
DUTIES &
RESPONSIBILITIES
Administrative Assistant
Admitting Clerk – Triage Team
Auxiliary
Boiler Operator on Duty
Central Registry/Business Office
Clergy
Deputy Chief of Staff and/or Doctor on Call
Diagnostic Imaging
District Duty Officer
EMO Health Services Representative
Food & Nutrition Services
Health Records
Information Systems
Laboratory
Maintenance
Medical Unit RN
Mental Health
Nurse Manager or Delegate
Pharmacy
Rehab Services
RN in Charge
Safety Coordinator
Site Manager or Delegate
Triage Nurse
Ward Clerk (Medical/ER/Restorative Care)
In case of an emergency, staff in all other departments (not
listed above) should close their offices and report to the EOC
(Emergency Operations Centre) (I.e. Nurse Practitioner,
Hearing & Speech, Consultants’ Clinic, Diabetes Centre, etc.)
ADMINISTRATIVE ASSISTANT
Initiate Call Back List – Administration “B”
Assist with organizing Site EOC (Emergency Operation Centre)
Take incoming calls to EOC (once set up)
Assist with setting up area for family, treated and discharged casualties –
Cafeteria
Liaise with other departments as needed
Set out Staff Sign-In/Sign-Out Sheet (Exhibit 5) inside Administration Office
Keep Staff Sign-In/Sign-Out Sheet (Exhibit 5) updated
ADMITTING CLERK – TRIAGE TEAM
Location – Ambulance Entrance Corridor
Identification
o Ensure there is a triage on each patient
o Staple one corner number from triage tag to upper ® corner of ER form
Obtain, whenever possible, registration information:
o Name, Age, Address, Next of Kin and their Phone Number
o Nova Scotia Health Card Number or equivalent
Ensure each patient has a clipboard chart
Keep clothing and valuables with patient. Insert these articles in a patient garment
bag, label with name, when known
Communicate with EOC (Emergency Operations Centre)
AUXILIARY
The Auxiliary members may be willing to assist in various ways, i.e. porters,
messengers, providing beverages/snacks for families of victims at the Information
Centre, helpers for Food & Nutrition Services staff, etc.
Auxiliary Contacts:
o Debby Miller
o June Dickie
245-4128
245-4423
The above contacts will initiate the call back list for auxiliary members
BOILER OPERATOR ON DUTY
Report to Nurse Manager, and assist nurses as directed in moving beds,
equipment, etc. to prepare Day Surgery for admitted patients
Maintain essential services – environmental control – appropriate heat, humidity, etc
Provide security at various exits, if required. Wear orange vest obtained from
Disaster Kit box
Respond to all alarms
Liaise with site person-in-charge
Coordinate response to fire alarm with Fire Department and site person-in-charge
(in case of fire/fire alarm)
Code Green
Ensure that the following is done:
Penthouse equipment is shut down
Main propane line to Hospital is
closed (as directed)
Main O2 line to Hospital is closed (as
directed)
Main oil supply to boiler is closed (as
directed)
Code Orange
Ensure that the following is done:
Essential services are maintained
Monitor and maintain appropriate
levels of propane, oil & O2
CENTRAL REGISTRY/BUSINESS OFFICE
Code Orange:
When notified of a community emergency – immediately notify person in charge of
hospital
Initiate Call Back of Central Registry staff (as directed by person-in-charge) to
assist in switchboard duties, including admissions, communications, staff callback,
etc
If any casualties come in the Main Door, call the Triage Nurse and arrange for either
the Triage Nurse to come to the Front Desk or have them go to the Triage Area
Business Office personnel will assist as needed
Code Green:
Fire alarm to be acknowledged - ALWAYS
Overhead Page “Attention Please – Code Green” – Repeat 3 times at 10 second
intervals (as directed by person-in-charge)
Await further instructions from person-in-charge
Be prepared to relocate switchboard to appropriate location
Direct anyone coming into the building that they must leave the building and
property
CLERGY
Report to the Information Centre to provide support to victims and their families as
required
May be called to assist with support and counseling of victims or families at the
Emergency Treatment or Inpatient Area of the hospital
DEPUTY CHIEF OF STAFF
and/or
DOCTOR ON CALL
Initiate physician call back list, as required
Assist in the assessment of inpatients to identify those who could be discharged
and cared for safely at home
Assist in the triage and treatment of casualties as indicated
Evaluate the need to increase the amount of blood bank products ordered and
obtained from Yarmouth and Kentville
In consultation with Nurse Manager and Site Manager decide the extent to which
the hospital may need to be expanded
When requesting switchboard to contact outside physicians or agencies, please call
in-house cell phone number 308-1277
DIAGNOSTIC IMAGING
Code Orange:
Explain to routine patients that the hospital is responding to a community
emergency, and request that they reschedule their appointment. Urgent cases, not
associated with the emergency, will be attended to quickly
Call in staff as required and directed by person-in-charge
DISTRICT DUTY OFFICER
The District Duty Officer is the key to timely and effective response to emergencies, and
must be available at all times during the duty period. One alpha/numeric priority pager
supplied by the Department of Health will be monitored by the YRH switchboard who will
contact the Duty Officer on call. To notify the DOH Duty Officer call 1-877-408-4394. The
pager will be tested once a week, initiated by the EHS Communications Centre and a
response is expected by the District Duty Officer.
The Duty Officer responsibilities are:
Maintain a list of contacts for individual health care facilities within their district
Maintain a current list of hospital beds and medical resources within their district
Respond to the emergency/disaster notification
Communicate information regarding the emergency/disaster situation
Determine the initial activation level of the emergency/disaster plan
Notify DEOC Manager and initiate Call Back Procedure on their instruction
Ensure activation of appropriate emergency response which may be facility based
or district wide
o Facility
Communicate with facility staff to ensure Facility Emergency Plan is
activated. Support and assist as requested
o District
Arrange DEOC Activation
Communicate information re disaster situation as appropriate to
DEOC, EMO, Department of Health and Facility
Arrange for Duty Officer pager to be taken to DEOC Manager
Hand over responsibilities to DEOC staff and inform hospital
switchboards, EMO, DOH/EHS of DEOC contact numbers
Stand by to assist as directed
Complete the duty officer log
EMO HEALTH SERVICES REPRESENTATIVE
Purpose:
To liaise with, and between, health agencies and EMCs/EMO Organizations
Responsibilities:
Active Role:
Respond to the EOC call
Identify, in consultation with Emergency Operations Centre (EOC), which health
services/agencies would be required to respond immediately, short term, mid
term and long term
Contact/alert the appropriate health services agencies
Liaise with health services/agencies on a regular basis at EMO and Site or
Agency Emergency Response Meetings
Clarify and update roles and responsibilities
Participate in any testing of call-back systems and EMO, Site, District or
Agency Plans
Evaluate and debrief following incidents/exercises
Collaborate in identification of gaps
Contribute to follow up and revision of plans/call-back lists
Work to provide for designated alternatives
Participate in ongoing education/development in the area of emergency planning
through attendance at table-top exercise, self directed learning, journal reading,
in-services, appropriate courses, etc
Criteria for Choosing Health Services Representatives:
Has a broad knowledge of health agencies and the services they provide
Employees should have the support of the employer
A critical thinker
Preference for those not required at their agency for provision of service or
emergency response
Has Emergency Preparedness training or is willing to obtain
ENVIRONMENTAL SERVICES
Code Orange:
Maintain stocking of warming cabinets in ER, Medical, OR and Physiotherapy.
Stock bottom compartments with extra flannels
Stock ER Linen Room with extra blankets
Maintain essential services, as required, to all areas. Removal of garbage and
clean up of spills is a priority
May be re-assigned to other duties elsewhere in the hospital in order to provide
support service in Emergency Areas
May be requested to assist in other ways, i.e. portering, running message, etc. in
order to provide assistance to nursing staff
The Site Manager will decide the necessity to call in Environmental Services staff
May be requested to remove soiled equipment/linen from the ER and Minimal
Treatment Areas
FOOD & NUTRITION SERVICES
Code Orange:
Initiate Call Back List, as required
Provide food services to casualties and workers, as required
Food & Nutrition Services Staff may need to provide direction to volunteer workers,
or staff assigned to assist in the department
HEALTH RECORDS
Code Orange:
Staffing of Health Records on an emergency basis for obtaining old records, etc. will
be at the discretion of the Site Manager
Health Records Staff may be assigned to other areas, as needed, to call in staff, etc
INFORMATION SYSTEMS
Code Orange:
Assist with setting up computers/laptops (Board Room)
Communicate with and be available to assist in Site EOC (Emergency Operations
Centre)
MEDICAL UNIT RN
Code Orange:
Review inpatient list, noting which patients could possibly be discharged. Patients
may be discharged by the Deputy Chief of Staff, or in consultation with the patient’s
Family Physician. The nurse will ensure the patients have safe and appropriate
transportation home by a family member or friend. Set up appropriate referral
(Home Care) and follow up instructions
Initiate Incoming Patient Tracking Form – ER (Exhibit 6)
Arrange to consolidate inpatients by opening beds for potential admissions in
appropriate areas
Arrange for “priority” care of inpatients
Assign 1-2 persons to set up rooms
Expansion of bed facilities will be undertaken with the assistance of Maintenance
Staff
o Beds can be set up in Day Surgery and/or the Restorative Care Dining Area
(3), Restorative Care Meeting Room (2), Restorative Care 3 Bed Ward (1)
Round up Portable IV Poles, IV pumps, etc. and take them to ER, Day Surgery and
Rehab Services
LABORATORY
Code Orange:
Explain to routine patients that the hospital is responding to an emergency, and, if
required, they may be requested to reschedule their visit. Urgent cases, not
associated with the emergency will be attended to quickly
Call in staff, as required
MAINTENANCE
Respond to all alarms
Provide emergency maintenance, security, traffic control on the grounds, or driving
as directed by the Site Manager or designate. (Orange vests should be worn when
acting as security or traffic control person) – found in Emergency Kit located in the
Site Manager’s office
Place all gates (5) to parking areas in the up/open position
Communicate with Emergency Coordinator & EOC (Emergency Operations Centre)
Initiate Call Back List as determined by nature of emergency and direction of
person-in-charge
Lobby:
o Have 2 wheelchairs available
Triage Prep – Ambulance Entrance Corridor:
o Have 2 – 3 wheelchairs available
o Have 2 stretchers available – from morgue
Code Green
Assist with evacuating patients
Assist with moving patients to initial
and backup locations following
evacuation
Assist Boiler Operator to shut down
services
Code Orange
(electrical, plumbing, etc.)
Assemble beds/equipment as
requested
Assist with the movement of
equipment/patients to facilitate
incoming casualties
MENTAL HEALTH
The Mental Health staff will act as resource persons for staff, assisting them in
helping patients and families to deal with the effects of the disaster. These persons
may also be requested to assist with “defusing” and counseling of staff who may
experience after effects due to the stress of working during the disaster
These persons will normally be asked to report to the Information Centre, when it is
established
NURSE MANAGER OR DELEGATE
Arrange for callback and assignment of necessary Nursing Staff. Those living
within 15 minutes of the hospital will be recalled first. Roles to be filled include:
o Triage Nurse – 1 or 2 RNs with experience in ER
o Emergency RN in Charge – RN with experience in ER and Supervisory
Skills
o 1-2 RNs to be assigned to Minimal Treatment Area
o 4-6 RNs to be assigned to ER Treatment Area to accompany patients to XRay and/or transfers to another facility if needed
o Clerical
o Assess need for extra staff on in-patient ward, which may be receiving
multiple admissions
Together with the Site Manager and the Doctor-on-Call decide the extent to which
the hospital will be expanded. Arrange for discharge of patients who are able to go
home. Request Maintenance Staff be called in to assemble spare beds in storage,
if required
Reassign staff presently working in hospital to fill roles until “called in” nurses report
for duty
Keep a record of patients received, admitted, discharged, transferred or sent to
Minimal Treatment Area on the Incoming Patient Tracking Form – ER (Exhibit 6)
Ensure ER is prepared to receive patients:
o Replace beds in ER with stretchers from various locations
NOTE:
Extra staff may be needed for duties such as:
o obtaining drugs from pharmacy
o getting wheelchairs and stretchers
o giving directions to helpers
o answering phones
o relaying messages and information
o holding doors
o recording information
o directing traffic (internally and externally)
o getting supplies, blankets, etc.
o answering questions
o cleaning up
o organizing
o staying with the injured
o providing nourishment
o making announcements
o dealing with regular patients (in waiting rooms, etc.)
o dealing with the patients and public who are at hospital at the time of the
incident
o coordinating activities other than care of the victims
PHARMACY
Maintain existing stock levels at each treatment area
Obtain pharmaceutical supplies from outside sources, as necessary
Called in staff, as required
Stock and maintain drug supplies in ER and Minimal Treatment Areas
REHAB SERVICES
Act as porter/lifter for Front Lobby and Ambulance Entrance
Assist with setting up and running the department as Minimal Treatment Area
RN IN CHARGE
(wear appropriate vest)
Call District Duty Officer, Site Manager and Nurse Manager
Have overall view of number of patients being treated, transfers, and remaining to
be treated, etc
Keep log of patients in the emergency area and their disposition. Provide
information from this log hourly to the Information Centre (Board Room)
Assign nurse to specific rooms or patients. 1:1 ratio (patient: nurse) is ideal for the
seriously injured
Direct volunteers or auxiliary personnel who may be assisting as runner, porters, etc
Communicate the need for additional personnel to Nurse Manager
When appropriate, provide breaks or periods of rest for the triage nurse, or others
working in your area
Call Switchboard via in-house cell phone (speed dial #8 – 308-1277) and give
directions regarding announcements
Blood bank supplies may be depleted quickly – remind physicians and order as
soon as possible as this comes from Yarmouth Regional Hospital or Valley
Regional Hospital
Liaise with external group regarding disaster type, #, etc
Initiate set-up/staffing for Emergency Treatment & Minimal Treatment areas
including utilization of tracking forms – Incoming Patient Tracking Form – ER
(Exhibit 6) and Minimal Treatment Form (Exhibit 7)
SAFETY COORDINATOR
Ensure fire drills are done frequently
Complete the Fire Drill Evaluation Sheet (Exhibit 1)
Assist in the event of an emergency
SITE MANAGER OR DELEGATE
Activate the Emergency Plan and decide to what extent the Plan will be
implemented
Decide together with the Nurse Manager and/or the first physician available the
extent to which the hospital will be expanded
Notify the EMO Coordinator/Municipal Officials in the area when appropriate
Together with the Nurse Manager assess what additional staff is required (outside
of nursing), (I.e. Environmental Services, Pharmacy, Maintenance, Plant
Operations, Food Services, and Health Records)
Arrange for supplementary communications as need be (i.e. Ham Operators,
RCMP, Radio, etc.)
Arrange for security, as appropriate, at entrances/exits to the building, utilizing
Maintenance/Operations Staff. Appoint runners/messengers, if required, from
Housekeeping staff, called-in
Liaise with other emergency services (i.e. Fire, Police, and Ambulance). Set up
EOC (Emergency Operations Centre) within the hospital – Administration Offices
In the event of a large community emergency, the Site Manager or designate may
be requested to go to a “command post” setup by EMO
Communicate, as necessary, with the media for purposes of public information, staff
callback, or requests for assistance. SWH should be advised of any news releases
(Communications Director)
Request “nourishments” as required from Dietary
Consider the need for Critical Incident Stress Defusing
TRIAGE NURSE
Located – Ambulance Entrance Corridor – 1 or 2 with Emergency Room experience
Take “Disaster Cart” from eye room to emergency entrance area
Track incoming patients on Incoming Patient Tracking Form – ER (Exhibit 6)
Place clipboard chart and pen with patient. Note time of triage assessment and
designation as emergency/priority treatment or minimal treatment (note area
treated)
Assign casualties to appropriate treatment areas according to the assessment of
their immediate needs (i.e. to Emergency Treatment Area or to Minimal Treatment
area). Initiate emergency treatments
10 spaces in department (8 stretchers and 4 treatment tables) may be able to
accommodate 2 stretchers in the Telehealth Room
TRIAGE AND TAGGING
All victims are to be triaged in the ambulance bay. The doors can be opened or shut
depending on specific circumstances such as inclement weather
Emergency charts are available and should accompany the victim. Charts are numbered
and have corresponding armbands which should be attached to the victim. Triage Nurse
should also put allergy armbands on patients, if necessary. A copy of the chart with victim
information including destination must be forwarded to Admitting
TRIAGE PRIORITY SYSTEM
TRIAGE TAGS
PRIORITY 0
(Blue or Black): dead. So pronounced by a physician or with injuries
that meet local criteria for obvious assumption of death (I.e.
decapitation, transection of body trunk, etc.)
PRIORITY I
(Red): immediate attention (life threatened). Critical and probably
deteriorating. Patient will die without rapid medical intervention
PRIORITY II
(Yellow): prompt attention. Patient serious but stable at least for the
short term. Will sustain a wait of about 30 minutes to two hours
without hospital/surgical intervention, providing adequate stabilization
is given in the field
PRIORITY III
(Green): delayed/deferrable; non-life threatening. Includes
ambulatory patients
WARD CLERK
(Medical/ER/Restorative Care)
In addition to regular duties:
Initiate call back lists as directed
If a large number of admissions are anticipated, a second clerk may be required
Assist with In-Patient Evacuation Tracking Form (Exhibit 4a - Medical & 4b –
Restorative Care)
Collect documentation to go with patients
Assist with Incoming Patient Tracking Form – ER (Exhibit 6)
CALL BACK
LISTS
Site specific call back lists can be found on the
Shared Directory (S:\YRH\Administration\SWH
Emergency Response)
OTHER RESOURCES
Medical Officer of Health:
J. Richard Gould
Office:
Fax:
Cell:
542-6310
542-6333
670-3927
424-2722
Provincial Medical Examiner’s Office:
Pharmacies:
Pharmasave
Shopper’s Drug Mart
Sobey’s Pharmacy
Superstore Pharmacy
Walmart Pharmacy
245-4071
245-4722
245-6246
245-4795
245-6023
Dentists:
Dr. Grant Creighton
Office:
Home:
245-5666
245-6174
Dr. Merryl Lawton
Office:
Home:
245-4171
665-4096
Long Term Care Facilities
Can be accessed through Continuing Care
Office:
245-4491
Home:
245-2084 (Donna Vickery)
Grief Counseling - Can be accessed through:
Mental Health
Palliative & Supportive Care Services
245-4709
245-2502 ext. 1304
CISM (Critical Incident Stress Management) – Can be accessed through:
EAP (Employee Assistance Program) 1-800-461-5558
Tri-County Regional School Board
1-800-915-0113
Yarmouth Association for Community Residential Options (YACRO)
(902) 742-9258
INTERPRETER SERVICES
Original can be obtained from the
Administrative Reference Manual – Policy & Procedure 515.0
TRANSPORTATION RESOURCE LIST
Transportation/accommodation/food, etc. – Refer to Town of Digby EMO binder in
Sections “Transportation” and “Resources”. The EMO binder is located in the DGH
Emergency Department.
St. John Ambulance
1-800-565-5056
Canadian Red Cross
1-800-418-1111
PANDEMIC
(OUTBREAK)
MANAGEMENT
STAFF
SHORTAGE
ACUTE STAFF SHORTAGE
(Nurse Manager & Site Manager – Digby)
Assess and document manpower situation in all
departments
Notify Duty Officer on Call
Notify Director(s) of service(s) affected
Cancel elective admissions
Coordinate transfer/discharge of
patients to other facilities or home
(where appropriate
Request affected departments to develop
and put in place a 12 hour on, 12 hour off
schedule for all available staff to
maintain essential services
COMPREHENSIVE SITE PLAN
ACUTE STAFF SHORTAGE - Nursing
EMERGENCY COORDINATOR (SITE MANAGER)
Notify
District Director of Nursing
or Delegate
Cancel all admissions, except
emergency
Assess the manpower
situation in consultation with
appropriate Nurse
Manager(s)
(YRH/DGH/RWH).
Cancel all Ambulatory Care
Services; except essential, i.e.
Chemotherapy treatments
Report the staffing situation
in all units to Emergency
Coordinator
Liaise with Physicians, other
facilities and Home Care Services to
coordinate transfer/ discharge of
patients who could be transferred or
sent home
Transfer/conhort patients
within the facility to provide
most efficient utilization of
available staff resources.
Develop a 12-hour-on,
12-hour-off schedule of all
available staff to maintain
essential services.
PHARMACY
ALARM
ELECTRICAL
FAILURE
ELECTRICAL FAILURE
All essential services are handled by stand-by generator. All non-essential lights
and equipment are to be turned off.
There is emergency lighting in the stairwells.
Fuel/Generator Information
Daily use of fuel is light fuel oil – approximately 2 days notice (calls when low) for
refill (45,000 litres).
The generator uses diesel and can operate for 86 hours on a full tank (4,200 litres)
which always gets topped up for the winter. Next day delivery for a refill – local
delivery.
Note:
Only the RED plugs in the New Wing (ER, Lab, Consultants’ Clinic, Physiotherapy,
etc.) are on generated power.
SWITCHBOARD
FAILURE
SWITCHBOARD FAILURE
In case of a switchboard failure the DGH in-house cell phones should be used. There are
2 cell phones housed in the Site Manager’s office for emergency purposes. Refer to the
In-House Cell Phone List in the back of the Call Back Lists Section.
TMR Radio – ER/Medical
There is a two-way radio communication between ambulances and ER/Medical. The
ambulance radio system communicates directly with other ambulance services, and
most other hospitals on Mainland Nova Scotia. We can communicate with the RCMP, Air
Search and Rescue, Department of Natural Resources, EMO, as well as other hospitals
and ambulances indirectly by contacting Shubenacadie (Operator “0” on radio) however;
we must NOT use this radio without authorization from either EMO or the RCMP.
BOIL
WATER
Infection Control/Occupational Health Manual
TITLE: Response to “Boil Water” Advisories at Digby
General Hospital
NUMBER:
Section: Part VI
Effective Date: June 7, 2007
Authorization: _____________________________
Site Manager
Date:
June 7, 2007
Revised:
October 30, 2008
IC: I-100
Policy:
The Digby General Hospital will implement precautionary measures immediately upon receipt of
notification of a Boil Advisory from the Town of Digby and/or the Department of Environment &
Labour and/or on the judgment of the Site Manager in conjunction with Plant Services.
Infection Control/Occupational Health Manual
TITLE: “Boil Water” Advisories due to Presence of Total
Coliforms and/or Fecal Coliforms in Town water supply at
Digby General Hospital
NUMBER:
Section: Part VI
Effective Date: June 7, 2007
Authorization: __________________________
Site Manager
Date:
June 7, 2007
Revised:
October 30, 2008
IC: I-100-1
Reviewed by: ___________________________
Occupational Health Nurse
Procedure:
1.
Upon receipt of the Boil Advisory the person receiving the call will immediately notify the
following:
Site Manager, Maintenance, and Infection Prevention and Control, who will
immediately implement action plans as per protocol below.
2.
The Site Manager will notify all areas by public address system with a follow-up written
notification of details. Exhibit IC: I-100-2E “Boil Water Precautionary/Interpretation”.
Also see Exhibit IC: 1-100-3E.
3.
Maintenance will post signs on water fountains, ice machines and taps to warn not to use.
(eg. “Do not use ice machines”, “Do not drink water”). Signs for posting available in the
Site Manager’s office.
4.
If fecal coliforms are reported, the Site Manager will instruct each department to
immediately assess service levels. Consideration must be given to canceling
admissions/elective procedures. There may be a need to transfer and/or discharge patients
who can be moved.
5.
The Site Manager or Maintenance, will communicate with the Town Engineer.
Switchboard operators will be instructed to refer inquiries from the public to the
Department of Environment & Labour, Town, and/or Public Health. A contact number
will be given to Switchboard by Site Manager or Maintenance.
6.
Infection Prevention and Control will communicate with Public Health regarding the need
to implement monitoring system in OPD/Emergency for cases of water-borne infections.
The Microbiology Lab at Yarmouth Regional Hospital will be notified to assure they
have ample supply of media on hand.
7.
The Site Manager’s office will provide regular updates (via written notification)
regarding “Boil Order” to staff, physicians, public and patients/residents.
8.
The Town and/or Department of Environment & Labour declare when the Boil Order is
no longer in effect. However, use of water throughout the facility can return to normal
only after the completion of required corrective measures by Environmental Services and
Maintenance (eg. cleaning of ice machines, filter changes, purging/flushing system, etc.)
9.
Upon receipt of notification that the Boil Order has been lifted by the Town and/or
Department of Environment & Labour or is no longer in effect, the person receiving the
call will contact:
Site Manager, Maintenance, and Infection Prevention and Control.
10.
The Site Manager will specify this information in a notice to all areas. See Exhibit
IC: I-100-4E. The site will maintain boil water precautions for 24 hours (flush system)
following notification of lifted Boil Water Order by the Town.
11.
Removal of signs (eg. “Do not use ice machines”, “Do not drink water”) must only be
done by Maintenance staff. Maintenance staff will remove signs as appropriate cleaning
procedures are completed on each fountain/ice machine/water source.
12.
The Site Manager will send a memo notifying people in the building when the site water
supply is again safe for use. See Exhibit IC: I-100-5E.
Water (H2O) must be boiled for one (1) full minute at a “rolling boil” in
order to be considered safe when “Boil Water” advisory in effect.
Well water access locations (labeled):
Ice/water machines in Cafeteria and 2nd Floor Servery
Tap in Cafeteria – behind counter
Tap in Laundry
Other cold water taps which also deliver “well water” CANNOT be used for drinking water – without
first boiling it – because it comes out a single spout from which Town water also comes.
WEATHER
RELATED EVENTS
UNUSUAL WEATHER EVENTS GUIDELINES
ER OVERLOAD
CODE PURPLE POLICY
DIVERT POLICY
EXHIBITS
Exhibit 1
FIRE DRILL EVALUATION SHEET
YRH
Date of Drill: _________________________
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
Observations
Was the fire alarm pulled promptly?
Did all employees hear the alarm?
Did all employees hear the “Code
Red”?
Was the annunciator checked?
(multiple areas could be identified)
Did employees communicate with
others? Internally – (between units)
intra-unit
Were employees prompt and calm?
Were all procedures/phones
terminated?
Did all members of the fire party
arrive at the site of the fire quickly?
Were fire extinguishers brought to
the site? If so, were they used
properly?
Were clients evacuated from
rooms? Taken to other areas? If
so, was proper procedure carried
out? Door indicator; what tools
would they use?
Were all corridors and exits free of
obstruction?
Were all fire doors and room doors
closed?
Were elevators used after the alarm
sounded?
Did employees go to staff pool as
designated in fire plan?
Were incoming visitors asked to wait
in appropriate waiting area until all
clear sounded?
If visitors were in client areas, did
they stay in clients rooms until all
clear sounded?
Did all employees know their
assignment? Staging areas outside
building/aware of “exit only” doors?
Was the all clear sounded over the
intercom? Did all personnel hear
the all clear signal?
DGH
RWH
Time of Drill: ___________________
Yes
No
N/A
Comments
Notes:
______________________________________________________________________________________
______________________________________________________________________________________
Signature: ______________________________________________
Please attach this evaluation sheet to the fire drill report.
Exhibit 2
FIRE REPORT
YRH
DGH
RWH
Complete for each Fire Situation/Fire Alarm:
Time of alarm: __________________
Date: ____/____/____
(dd/mm/yyyy)
Alarm activated: ____ Manual/pull station
____ Smoke detector
____ Sprinkler Head
Agencies contacted:
Sprinkler activated:
Fire Dept.
Aliant
____ Yes
____ No
Location: ___________________
Reason for alarm: ____ Fire (flames)
____ Smoldering material
____ Other _______________
RCMP
NS Power
911
Other _______________________
Alarm reset by whom: __________________________
Equipment:
Equipment used:
Portable Fire Extinguisher
Sprinkler System
Standpipe/Waterhose
Other __________________________
Maintenance notified to replace/refill equipment (if applicable): _______________ _______________
Date
Time
Name of person notified: ________________________________
Comments:
Please indicate cause of fire and any problems or concerns noted with the emergency plan:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Please use reverse if more space is required
Signature of person completing report: _______________________________ Date: ______________
Please forward to the Safety Coordinator and copy to Manager of Plant
Operations/Maintenance
Exhibit 3
NURSING FIRE ALARM/ FIRE DRILL REPORT
Date: _____________________
Time: _________________
Location: __________________________________________
Charge Nurse:
1. Has decided on appropriate exit _______________
2. Knows number of patients on unit ______________
3. Knows method of transport for evacuation _____________
# Ambulatory _______
# Ambulatory with assistance ________
# Wheel chair __________
# Stretcher __________
# Blanket drags __________
# In arms carry __________
4. All patients accounted for ___________
5. Can describe how certain patients should be moved __________
6. Assignment of staff duties ___________
7. Number of nurses on duty ___________
8. Hallways cleared __________
9. Door closed ___________
10.Patients/ visitors checked & reassured __________
11. Additional comments, recommendations
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
Signed: _____________________
Cc: Unit/Program Manager
Site Manager (DGH/RWH)
Exhibit 4a
DIGBY GENERAL HOSPITAL – MEDICAL UNIT
INPATIENT EVACUATION TRACKING FORM
Take: Patient Kardex
Medication Kardex
Room
#
Patient Name
Drug Box from Crash Cart
Respiratory Box
Mobility
S W A
Transferred To
Where & How
201
202
203
204
205
206
207
209A
209B
210
211
212A
212B
212C
213A
213B
213C
214A
214B
214C
Mobility S – Stretcher, W – Wheelchair, A – Ambulatory Care
Unit: _____________
Date: ____________
Discharged To
Where & How
Exhibit 4b
DIGBY GENERAL HOSPITAL – RESTORATIVE CARE
INPATIENT EVACUATION TRACKING FORM
Take: Patient Kardex
Medication Kardex
Room
#
Patient Name
Drug Box from Crash Cart
Respiratory Box
Mobility
S W A
Transferred To
Where & How
216A
216B
217A
217B
218
219
220A
220B
220C
221A
221B
222A
222B
Mobility S – Stretcher, W – Wheelchair, A – Ambulatory Care
Unit: _____________
Date: ____________
Discharged To
Where & How
Exhibit 5
STAFF SIGN-IN/SIGN-OUT SHEET
Date:__________________
Time
PRINT NAME
Initial
Department
(normally work in)
Area assigned/
sent to
Sign Out
Time
Initial
Exhibit 6
EXTERNAL DISASTER – INCOMING PATIENT TRACKING FORM - ER
Date:______________________
Tag
#
Patient Name
Primary Disposition
Room #
Minimal
Treatment
Status/Condition
Admitted
To
Final Disposition
Transferred
Discharged
To
To
Critical Unstable
Stable
Critical Unstable
Stable
Critical Unstable
Stable
Critical Unstable
Stable
Critical Unstable
Stable
Critical Unstable
Stable
Critical Unstable
Stable
Critical Unstable
Stable
Critical Unstable
Stable
Critical Unstable
Stable
Critical Unstable
Stable
Critical Unstable
Stable
Critical Unstable
Stable
Critical Unstable
Stable
Take to Switchboard hourly for photocopying – (1 copy kept by Switchboard and 1 copy to Information Centre)
Expired
Exhibit 7
EXTERNAL DISASTER – MINIMAL TREATMENT FORM
Date:______________________
Location: ______________________
Tag
#
Patient Name
Comment (Treatment)
Discharged
Where, Time &
How
Final Disposition
Admitted
Transferred
Room #
Where & How
Exhibit 8
MISSING PERSON INFO FORM
DATE:_____________________REPORTED BY: ______________________________________
SURNAME: ______________________AREA MISSING FROM: ___________________________
GIVEN NAMES: (1) ___________________________ (2) ________________________________
NICKNAME:_____________________________________________________________________
AGE: _________ MALE: ______ FEMALE: ______ PHONE NUMBER: _____________________
ADDRESS:______________________________________________________________________
PHYSICAL DESCRIPTION: _________________________________________________________
HEIGHT:_________/WEIGHT:________/HAIR COLOR:_________/SKIN COLOR:______________
EYE COLOR:__________________ GLASSES/CONTACT LENSES: ________________________
RIGHT HANDED: _____________________ LEFT HANDED: _____________________________
DISTINGUISHING MARKS: _________________________________________________________
HEALTH (GENERAL CONDITION): __________________________________________________
DO THEY SMOKE? _____________________ WHAT BRAND? ____________________________
CLOTHING: _____________________________________________________________________
FOOTWEAR: (Describe and include size if possible)______________________________________
AREA LAST SEEN: _______________________________________________________________
DESTINATION: __________________________________________________________________
AREAS COMMONLY FREQUENTED: ________________________________________________
TIME LAST SEEN: ______________________ REPORTED BY: ___________________________
DETAILS OF DAY'S ACTIVITIES: ____________________________________________________
_______________________________________________________________________________
MEDICATIONS: ____________________________ LAST TAKEN? _________________________
NEXT OF KIN: ____________________________ PHONE: _______________________________
COMMENTS: (Did it happen before - details) (Capabilities) (Problems)
_______________________________________________________________________________
_______________________________________________________________________________
DETAILS PREPARED BY: __________________________________________________________
SEARCH COORDINATOR: _________________________________________________________
EXTENSION: ________________________ &/OR BEEPER: ______________________________
LANGUAGE PREFERENCE: ________________________________________________________
RCMP OFFICER IN CHARGE OF CASE: ______________________________________________
Exhibit 9a
South West Health
Code White Report: To be completed by Person in Charge of Code
Person in charge of Code White:
Position:
Date and time code called:
Call made by:
Location of incident:
Assailant: Patient
Responding team members:
(1)
(2)
(3)
Visitor
Other
(4)
(5)
(6)
Response time (from time code called #first responder arriving on scene):
Response time (from time code called #adequate # of team members present): ___________________________
Description of event (include names and ID if applicable):
RCMP required: Yes
No
MD required:
No
Yes
Switchboard notified: Yes
If yes, time of arrival:
Name of RCMP Officer:
Time of arrival:
Medical interventions required: Yes
No
No
Name of MD:
If yes, please specify:
Other interventions required
Yes
No
Injuries sustained:
Yes
No
Resolution of incident:
“Code White No Longer Required” call made by:
Do you think Critical Incident Stress Debriefing is required?
If so, please contact the Occupational Health Nurse.
Concerns of Code White Team:
Time:
Yes
No.
Recommendations for managing future incidents:
Signature of person completing form:
Date:
Please forward completed form to Risk Management Committee Chair, South West Health
Exhibit 9b
Code White Responders Questionnaire
(Code White Assessment Form)
As a code white responder, the information that you provide will be used to improve the effectiveness of the Code
White Teams.
Code White Details
Date and time of the Code White incident:
Place/location of Code White incident:
Were the procedures used to announce the Code White clear and easily understood?
Please explain:
Yes
No
Responding to Code White Announcement
Did you leave an important task in order to respond to the Code White?
Please explain:
Yes
Was there any difficulty reaching the Code White area (ie. locked doors, etc.)?
Please explain:
In your opinion, was the Code White justified?
Please explain:
Yes
No
Yes
No
No
Team Response to Code White
Were there enough responders to handle the situation?
Please explain:
Was the situation handled correctly?
Please explain:
Yes
Yes
No
No
How would you improve on how the situation was handled?
In your opinion, were the Code White Responders trained to handle the situation?
Please explain:
Were there any injuries to the responders or patients/visitors?
Please explain:
Name
Signature
Yes
Yes
No
No
Date
Please forward completed form to Risk Management Committee Chair, South West Health
Exhibit 10
SOUTH WEST NOVA DISTRICT HEALTH AUTHORITY
BOMB THREAT TELEPHONE PROCEDURES
WHEN A BOMB THREAT IS RECEIVED:
-
LISTEN.
BE CALM AND COURTEOUS.
DO NOT INTERRUPT THE CALLER.
RECORD EXACT WORDING OF THE THREAT.
OBTAIN AS MUCH INFORMATION AS POSSIBLE (SEE QUESTIONS, ETC.
NEXT PAGE) AND RECORD IT ON THIS FORM WHICH IS GIVEN TO
YOUR SUPERVISOR.
NOTIFY THE EMERGENCY COORDINATOR (BEEPER #8515) AND CHARGE
PERSON IN YOUR AREA IMMEDIATELY UPON TERMINATING THE CALL.
EMERGENCY COORDINATOR WILL CALL 911 AND REQUEST SWITCHBOARD
TO MAKE THE FOLLOWING ANNOUNCEMENT 3 TIMES: "THE HEALTH
CENTRE SEARCH PLAN IS IN EFFECT, PLEASE PROCEED AS PLANNED".
RECORDED DATA:
Date
Time
EXACT WORDING OF THREAT:
AM
PM
Duration of Call
QUESTIONS TO ASK:
WHAT TIME WILL THE BOMB EXPLODE?
WHERE IS IT?
WHAT DOES IT LOOK LIKE?
WHERE ARE YOU CALLING FROM?
WHY DID YOU PLACE THE BOMB?
WHAT IS YOUR NAME?
IDENTIFYING CHARACTERISTICS:
Sex
Male
Female
Accent
English
French
Other
Voice
Loud
Soft
Other
Speech
Fast
Slow
Other
Diction
Good
Nasal
Lisp
Other
Manner
Emotional
Calm
Vulgar
Other
Background noises
Voice was familiar (specify)
Caller was familiar with area
Not sure
Uncertain
Estimated
Age
THREAT RECIPIENT'S PARTICULARS:
Name
Telephone
Dept./Br./Sect.
Person to contact
Telephone
PRECAUTIONS:
IF YOU DISCOVER A DEVICE OR A SUSPECT DEVICE:
-
DO NOT TOUCH OR MOVE IT.
-
NOTIFY YOUR SUPERVISOR IMMEDIATELY.
-
DO NOT ASSUME THAT IT IS THE ONLY ONE.
EVACUATION GUIDELINES:
EVACUATION IS ORDERED BY THE EMERGENCY COORDINATOR IN
CONSULTATION WITH THE RCMP.
-
REMAIN CALM.
-
FOLLOW INSTRUCTIONS OF SUPERVISOR.
-
PATIENTS/RESIDENTS/CLIENTS WITHIN A 300 FOOT RADIUS
OF THE SUSPECTED DEVICE (INCLUDING FLOOR ABOVE AND
BELOW) SHOULD BE EVACUATED.
-
REMEMBER, YOU HAVE A PLAN TO COPE WITH A BOMB THREAT.
SEARCH GUIDELINES:
-
SEARCH YOUR IMMEDIATE AREA.
-
DO NOT TOUCH ANY SUSPICIOUS ITEMS - REPORT ANY
SUSPECT OBJECT IMMEDIATELY.
-
UNLOCK DRAWERS, CABINETS, ETC. AND IDENTIFY ANY
STRANGE OR UNFAMILIAR OBJECTS.
NOTE: A BOMB THREAT IS USUALLY A HOAX - BUT MUST BE TREATED AS A REAL
THREAT.
Exhibit 11a
BUTTON-DOWN
IN EFFECT
PLEASE USE
MAIN ENTRANCE
Exhibit 11b
BUTTON-DOWN
PROCEDURE
IN EFFECT
WHEN YOU ENTER,
PLEASE WAIT FOR THE
FIRST SET OF DOORS TO
CLOSE BEFORE OPENING
SECOND SET OF DOORS
EXHIBIT IC: I-100-1E
LIST OF AREAS REQUIRING NOTIFICATION OF BOIL ADVISORY
Department
Notified by written notice
Require Water? (source)
Addiction Tx
Administration
Admitting/Switchboard
Business Office
Consultants Clinic
Continuing Care
Day Surgery
Diabetes Education
Diagnostic Imaging
Doctors’ Offices
Cardiac/Respiratory Services
Health Centre (3rd Floor)
Health Records
Infection Prevention and
Control/Occupational Health
Information Systems
In-Patient Medical Unit
Laboratory
Yes (bottled)
Yes (bottled)
Yes (bottled)
Yes (bottled)
Yes (well)
Laundry
Mental Health
Nutrition & Food Services
• Kitchen
Emergency Department
Palliative Care
Pharmacy
Rehab
Plant Services/Maintenance
Public Health
Restorative Care Unit
Speech Pathology
Stores/Materiels Management
Yes (well)
Yes (well)
Yes (well)
N.B.: Well water may be accessed through the tap behind the counter in the
cafeteria and the tap in the laundry. These are labeled as well water sources.
EXHIBIT IC: I-100-2E
Digby General Hospital
Boil Order Precautions/Interpretation
Minimum Actions to be Implemented throughout the Health Centre
Total and Fecal Coliforms Present
Below are the restrictions that must be implemented throughout the hospital in the event of a Boil
Advisory due to Total Coliforms. If Fecal Coliforms are reported, note special precautions (see
bold instructions).
If hospital well is unaffected then well water may be used in place of bottled or boiled tap water.
• Brushing Teeth/Dentures- use well water for brushing teeth and soaking
dentures.
• Ice machines- Follow instructions posted on each machine. Maintenance will post
clearly labeled signs on each machine depending on water source.
• Handwashing- if hands are visibly soiled, wash with tap water and then use hand
sanitizer. If not visibly soiled use hand sanitizer. If fecal coliform precautions are
in place, hands can not be washed in tap water. Options for removing visible
soiling include disposable wipes, saline, well water, previously boiled water,
toweling, etc.
• Public and Patient Washrooms- Maintenance will post clearly labeled signs in
each washroom alerting public not to use water to drink and/or brush teeth.
• Newborn Infants (bathing)- Use bottled water.
• Baths- The tap water may be used for bathing and washing (excluding newborns
and immune compromised- see above). However, do not use tap water of any kind
on wound care. If fecal coliform precautions are in place, do not use tap water for
any bathing or showering. This is applicable to adults, children, and babies.
• Eye Care- Use normal saline for eye care.
• Sitz Bath- Water for a sitz bath should have an antiseptic added to it or use water
that has been boiled for 2 minutes.
• Drinking Water- Patients/staff/visitors should be given bottled water or well
water to drink.
• Coffee Percolators- Decontaminate appliance before using after “boil water” is
announced.
• Water Fountains- Do not use water fountains. Maintenance will place clearly
labeled signs on each fountain.
Water (H2O) must be boiled for one (1) full minute at a “rolling boil” in
order to be considered safe when “Boil Water” advisory in effect.
Well water access locations (labeled):
Ice/water machines in Cafeteria and 2nd Floor Servery
Tap in Cafeteria – behind counter
Tap in Laundry
Other cold water taps which also deliver “well water” CANNOT be used for drinking water – without
first boiling it – because it comes out a single spout from which Town water also comes.
Exhibit IC: I-100-3E
MEMO
TO:
ALL
FROM:
Site Manager
RE:
Boil Water Order
DATE:
The Town has issued a “boil water advisory” due to (complete as appropriate).
Staff/departments please initiate ALL precautionary measures as appropriate (Response to
“Boil Water” Advisories located in the All Hazards Plan).
Attached is “Boil Order Precautionary/Interpretation” sheet for your information/action.
Please read all bullets in their entirety. ** Only if coliform or fecal coliform is in the advisory**
Further bulletins will be issued in order to keep everyone updated on the boil water status.
Any questions may be directed to the Site Manager, ext. 3219 or the Infection Control
Practitioner, 1-877-742-1407.
________________________________
Site Manager
Digby General Hospital Site
PO Box 820, Digby, Nova Scotia, Canada B0V 1A0
Phone: 902-245-2502 Fax: 902-245-2803
www.swndha.nshealth.ca
MEMO
TO:
ALL
FROM:
Site Manager
RE:
Boil Water Order – Lifted by Town
DATE:
The boil water order has been lifted by the town however; until the hospital has completed its
own water system purge – ALL previous precautions put in place are to be continued.
An advisory will be issued when the Digby General Hospital’s water supply is once again safe
for use.
ALL PRECAUTIONARY MEASURES REMAIN IN PLACE.
Any questions, please contact either the Site Manager, ext. 3219 or the Infection Control
Practitioner, 1-877-742-1407.
____________________________
Site Manager
Phone: 902-245-2502 Fax: 902-245-2803
MEMO
TO:
ALL
FROM:
Site Manager
RE:
Boil Water Order – Lifted by Digby General Hospital
DATE:
Now that the system has been purged at the site (Digby General Hospital) all precautions
regarding use of town water are lifted.
Thank you for your patience and diligence in keeping yourselves and our patient’s safe during
this “boil water” order.
____________________________
Site Manager
Phone: 902-245-2502 Fax: 902-245-2803

Digby General Hospital Hazards Response Plan (updated 2014)

Transcription

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