INTRODUCTION
This plan is designed for health care facilities in normally resource-sufficient regions. It may need to be adapted for facilities in resource-poor areas.
“Triggers” indicate the situations that should initiate the “Actions” and associated “Treatment Priorities.”
The Triggers change with each “Level.” Within each Level, all Actions or Treatment Priorities are in addition to or modify those listed for the preceding Levels.
In resource-poor institutions:
“ICU” beds and treatment mean any beds and treatment used for the sickest patients
“ED beds” are beds in the facility’s intake or reception area
“ED physician or equivalent” is the clinician with the most experience in quickly evaluating patients to make difficult triage decisions
The institutional disaster plan should be used when the facility does not use the “Hospital Incident Command System”
| Level 0 | |
| Triggers | “Normal” demand-to-available-resource ratio. |
| Actions | Normal activity. |
| Treatment Priority | Five-level nurse-run triage in emergency department (ED). Immediately lifesaving surgeries before urgent surgeries before elective surgeries. ICU bed allocation based on greatest need. Patients’ attending physicians and intensivist make decisions. |
| Level 1 | |
| Triggers | 50% of ED (A&Ea) beds are filled with admitted patients.b – or – Staffed inpatient beds are 98% filled.b – or – External incident(s) is likely to generate or has already generated a combination of critical and/or noncritical patients exceeding 30% of normal ED or reception-area bed capacity in a short period of time. – or – Only 75% of any critical resourcec will be available for a significant period during the next 24 hours. |
| Actions | Notify the Hospital Incident Command System (HICS) leadership.d Stop all elective admissions and do not begin any elective surgeries.e Refuse to accept transfers from other facilities if patients can be treated elsewhere.e Related posts:
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