Question

The Scenario

It is a beautiful Indian Summer fall Saturday evening in September. The barbeque pit is lit and the coals are warming and ready for those tasty burgers you are cooking for supper. The phone rings just as you are about to put the burgers on the fire. It’s work! You are requested to report immediately to El Centro Medical Center. There has been a horrific airplane crash at DFW.

Two planes were involved. One plane was taking off and the other landing. The impossible happened. They collided into each other just as each was a few yards off of the runway. There are approximately 500 passengers plus the crews. Smoke covers the scene, not a good sign. Emergency workers are on the scene trying to get survivors transported and triaged.

You are working at one of the receiving hospitals

Part 1

Respiratory Therapy Manager each question must be answered	What would you need to do to prepare their hospital staff to receive the injured? Be specific as to the role of the employee. The survivors continue to arrive for 4 hours and need to be received and triaged for an additional 12 hours.  How will you staff? How do you handle the press, the government groups, and the families? What type of help will you solicit from other hospital departments/divisions?
Pathology Laboratory Manager each question must be answered	What would you need to do to prepare their hospital staff to receive the injured? Be specific as to the role of the employee. The survivors continue to arrive for 4 hours and need to be received and triaged for an additional 12 hours.  How will you staff? How do you handle the press, the government groups, and the families? What type of help will you solicit from other hospital departments/divisions?
Emergency Department Director each question must be answered	What would you need to do to prepare their hospital staff to receive the injured? Be specific as to the role of the employee. The survivors continue to arrive for 4 hours and need to be received and triaged for an additional 12 hours.  How will you staff? How do you handle the press, the government groups, and the families? What type of help will you solicit from other hospital departments/divisions?

Answer 1

The scenario shows the people are injured (abrasions, contusion, laceration, bleeding and dislocation of body parts).

The smoke covered the area so there will be respiratory problems can be seen for some of the cases. The people will be in confused state after the crash and in shock.

There are many departments in hospital which do their work accordingly,

1. THE RESPIRATORY THERAPY MANAGER

The manager should involve in the area and arrange the things to treat the injured as well as patients respiratory issue.

Planning is necessary to respond appropriately to the disaster.

The manager should inform to the hospital Dean and call for the respiratory therapists and arrange the staff i.e., in the ratio of 1 staff:1 bed are assigned. Support the staff for local assessment and identification of the problem and to implement plans to address the needs of the patients.

Adequate number of beds to be arranged and the instruments needed for the patients are kept at beside .For example: - crash cart, oxygen cylinders (bedside oxygen supply lines), suction apparatus, personal protection and infection control equipment such as masks, gowns, gloves etc. Stretchers are have be made ready to receive the patients.

The triage is arranging the patients according to urgency of care needed.

The respiratory manager should keep the patients in the triage colored sequence

For example: - RED- RESUSCITATION (for obstructed airway stridor)

• spo2 < 80%
• respiration rate >35 or<8
• HR >130
• BP <80 SYS

ORANGE: URGENT (threatened air way)

YELLOW: LESS URGENT

GREEN: NOT URGENT

Patients with less urgent and not urgent are send to the wards for observation and those are taken care by other nursing staff.

The RED and ORANGE triage patients are if necessary intubated and send to ICU CARE UNITS.

The manager should inform the radiology department to keep ready for taking immediate chest x-rays and other needed body parts. The technical assistance and support should be provided.

The manager should establish communication networks so they can talk to other hospitals emergency managers and coordinate their response for the benefit of the affected people.

The respiratory manager should explain the press and the family members regarding the condition of the patients and the patients need emergency care so they should cooperate with the hospital so that they can save many lives rather than making the hospital staff in confused state of group visitors.

2. PATHOLOGY LABORATORY MANAGER

The laboratory has both a regulatory and ethical responsibility to the patients and its staff during a disaster situation. The responsibility includes service protection, the ability to recover quickly from an event with preparation, planning and testing.

The lab manager has to decide the best type of emergency response plan to provide services in a variety of disaster scenarios.

The manager should arrange the laboratory testing kits, instruments and staff.

Well trained laboratory staff should be placed at the triage area so that they can plan immediately according to the situation.

The investigation should be informed to the particular doctors immediately which can help to diagnose the patients.

The pathology lab manager should have network with other hospitals so that the investigation results can be obtained as soon as possible.

3. EMERGENCY DEPARTMENT DIRECTOR

The director gives instructions to the emergency department doctors, staff regarding immediate action towards patients.

Emergency technicians are placed at every area according to the triage.

Patients who need immediate resuscitation are intubated and emergency drugs are arranged from the pharmacy.

Patients who need intensive care are shifted to the ICUs according to the departments.

The director informs the duty manager to explain the situation in the emergency department to the press, government groups. They are not allowed until the instructions are passed. The family members are not allowed as a group but only one person is called to explain the condition of the patient.

The director has to connect with other hospital networks so that extra staff, required instruments and other drugs can be arranged.