Hospital Emergencies and Anesthesia

44 Pages·2013·0.74 MB·English

Hospital  Emergencies  
and  
Anesthesia  
Joe Dietrick, CRNA, M.A.
Have A Nice Day Anesthesia Associates, LLC
Chillicothe, MO
©2002  J  Dietrick  CRNA
Declarations  
(cid:135) No  conflict  or  affiliation  to  report  
(cid:135) No  discussion  of  off-­label  use  of  medications  
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Objectives  
(cid:135) The  participant  will  understand  
(cid:177) the  four  facets  of  emergency  management  
(cid:177) personal,  organizational,  &  anesthetic  response  to  
emergencies  
(cid:177) concepts  of  triage  
(cid:177) mechanisms  of  injury  in  terrorism  
(cid:177) anesthetic  considerations  in  disasters  

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What  is  a  Disaster?  
(cid:135) Facility  emergency    
(cid:177) Operations  altered  
(cid:177) Most  likely  
(cid:135) Facility  disaster    
(cid:177) Operations  overwhelmed  
(cid:177) Most  extreme  
(cid:135) Both  require  adequate  Emergency  Plan  
(cid:135) Mandated  by  JCAHO  
(cid:177) E.C.  1.4,  2.4,  &  2.9.1  
(cid:177) Plan  execution  twice  per  year  
Planning
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Four  Facets  of  Planning  
(cid:135) 1)  Mitigation  
(cid:177) Threat  risk  assessment  
(cid:177) Strategy  to  minimize  vulnerability  
(cid:135) 2)  Preparedness  
(cid:177) Building  organizational  capacity  
(cid:135) 3)  Response  
(cid:177) Implementation  of  some  phase  of  plan  
(cid:177) Tracking  &  modifying  activities  
(cid:135) 4)  Recovery  
(cid:177) Restoration  of  essential  service  
(cid:177) Restoration  of  normal  service  
Planning
©©22000022    JJ    DDiieettrriicckk    CCRRNNAA
Risk  Assessment  
(cid:135) Hazard  Vulnerability  Analysis  tool  
(cid:177) Likelihood  of  event  occurring  
(cid:177) Anticipated  severity  if  event  occurs  
(cid:135) Types  of  emergency  categories  
(cid:177) Internal  
(cid:177) External  
(cid:135) (cid:48)(cid:88)(cid:85)(cid:83)(cid:75)(cid:92)(cid:182)(cid:86)(cid:3)(cid:47)(cid:68)(cid:90)  
     -­  
Many  emergencies  result  in  a  combination  
  -­  All  are  Security  events  as  well  
(cid:120)   Must  develop  plans  to  respond  to  each  threat  
Mitigation
©2002  J  Dietrick  CRNA
Types  of  Emergencies:  Internal  
(cid:135) Safety  
(cid:177) Facility  damage  
(cid:177) Inadvertent  HazMat  release  
(cid:135) Operational  
(cid:177) Utility  or  Communication  Disruption  
(cid:177) Impaired  services  
(cid:135) Security  
(cid:177) Fire/smoke  
(cid:177) Hostile  party  /  disturbance  
(cid:177) Implied  /  explicit  threats  
Mitigation
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Types  of  Emergencies:  External  
(cid:135) Mass  Casualty  Incident  (MCI)  (cid:177)  (cid:167)(cid:21)(cid:19)(cid:8)(cid:3)(cid:68)(cid:71)(cid:80)(cid:76)(cid:87)  
(cid:135) Types  
(cid:177) Natural  or  man-­made  cataclysmic  event  
(cid:135) Weather,  earthquake,  nuclear  or  explosive  event  
(cid:177) Cyber  
(cid:177) Terrorism:  CBRNE  
(cid:135) Chemical  
(cid:135) Biological  
(cid:135) Radiological  
(cid:135) Nuclear  
(cid:135) Explosive  
Mitigation
©2002  J  Dietrick  CRNA
Terrorism  
(cid:135) Definition  of  terrorism  (28  CFR  Section  0.85)  
(cid:177) Terrorism  is  the  unlawful  use  of  force  or  violence  
against  persons  or  property  to  intimidate  or  coerce  
a  government,  the  civilian  population,  or  any  
segment  thereof,  in  furtherance  of  political  or  
social  objectives.  
(cid:135) Goals  of  terrorists  
(cid:177) Mass  casualty  generation    
(cid:177) Lethality  
(cid:177) Disruption  
Mitigation
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Building  Organizational  Capacity  
(cid:135) Ability  to  respond  
(cid:135) Expand  resources  
(cid:135) Anesthesia  normally  1:1  patient  care  
(cid:177) Minimal  primary  responsibilities  outside  OR  
(cid:177) May  be  responsible  for  triage  &  immediate  
stabilization  
(cid:177) May  have  to  care  for  multiple  patients  
(cid:135) Requires  organized  system  
Preparedness - ICS
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