Health Emergency Preparedness, Response and Recovery …lcp.gov.ph/images/Brochures/LCP-Health Emergency Plan_Revised... · page ii lung center of the philippines emergency preparedness,

Health Emergency Preparedness, Response and Recovery Plan

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33

2014

Lung Center of the Philippines


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LUNG CENTER OF THE PHILIPPINES

EMERGENCY PREPAREDNESS, RESPONSE AND

RECOVERY PLAN

TABLE OF CONTENTS

I. Background 1

II. Plan Description 2

III. Goals and Objectives 3

IV. Planning Group 4

V. Management Structures 7

VI. Roles and Responsibilities 8

VII. Hospital Emergency Preparedness Plan 9

A. Hazards assessment 9

B. Vulnerabilities reduction 21

C. Capacity development 22

D. Fire emergency plan 30

VIII. Hospital Emergency Response Plan 36

A. Organization 36

B. System activation 37

C. Resource mobilization 38

D. Partnership 38

IX. Hospital Recovery and Reconstruction Plan 38

A. Damage assessment and needs analysis 38

B. Provision of services 38

C. Psychosocial support 39

D. Restoration of utilized/damaged resources and services 39

E. Planning Matrix 40

X. Annexes

A. Directory of contact persons 45

B. Hospital Map & Pre-emergency evacuation designated area 46

C. LCP Organizational Chart 47

D. Glossary 48

E. Risk assessment form for all hazard 53

F. Risk assessment form for highly infectious disease 76

G. Flow chart for referral of emerging and re-emerging respiratory

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disease 81

H. Protocols on the triage of emerging and re-emerging respiratory

disease

I. Advice form for home quarantine 83

J. Triage screening form 84

K. Protocols in response to trauma emergencies outside the hospital 85

L. Protocols in response to earthquake incident 86

M. Protocols in the conduct of fire drill 88

N. Protocols in response to fire incident 90

O. Protocols in the activation of HEICS 92

P. Incident Command System Organization 93

Q. Hospital policies, guidelines, protocols 110

R. Post Mission Report 117

S. Hospital Floor Plan 118

T. Metro Manila DOH Zoning Plan 122

U. Reference 123


Lung Center of the Philippines Page 1

I. Background

The Lung Center of the Philippines is a government owned and controlled

corporation and established through Presidential Decree No. 1823 on January

16, 1981, to address respiratory diseases which were already recognized as the

leading cause of illnesses and deaths in the country. Lung Center is situated in

the district of Diliman, Quezon City, Metro Manila, with 12 hectares of prime

property. On January 23, 1982, the portals of the institution were first opened to

the public. It has since provided tertiary level care services to around 30,000

problematic and difficult cases annually and admitted 6,000 patients per year; it

has a bed capacity of 250. Around 70% of these are service patients and 30%

are pay patients. It has a complementary manpower consisting of 65 Physicians,

177 Nurses, 98 Nursing Attendants, 1 Dentist, 6 nutritionist-dietician, 41 Medical

Technologist, 17 Radiology Technologist, 3 Social Workers, 2 Mechanical

Engineers, 1 Electrical Engineer, 3 Driver and 3 Security Guard. Janitorial,

Maintenance Engineering and other Clerks are under contractual status. With

regards to health statistics, the leading causes of mortality and morbidity are (1)

Malignant Neoplasm of Trachea, Bronchus and Lung; (2) Respiratory TB

(MDRTB, TB Bronchiectasis, PTB); (3) Chronic lower respiratory diseases

(COPD, Bronchial Asthma, Bronchiectasis); (4) Pneumonia; (5) remainder of

diseases of the respiratory system (Aspiration pneumonia, ARDS, Interstitial

Lung Diseases, Pneumothorax). Other Services include:

1. PHDU – Programs:

a. DOTS

b. MDRTB

c. Sagip Baga

2. ER – OPD Specialty Clinics

a. HEMS Program

b. Surgery, Asthma, COPD

c. Smoking Cessation, Pain Clinic

d. Cancer support, Oncology

3. Services Areas for In-Patients

a. OR, ER, PACU-SICU, MICU, STU, IMCU, Pediatrics, Sleep

Lab, SRS, Laboratory, X-ray (CT-Scan, Ultrasound), VATS,

Pharmacy

b. Dietary, Social Services, Linen, PPSD and General Services



All personnel have an annual medical check-up on their birth month.

Influenza and hepatitis are also given.

Lung Center focuses on the promotion of health of the majority of the Filipino

people and kept abreast with the technological advances in the field of medical

services.

But on that unfortunate event of May 18, 1998, Lung Center was gutted by

fire and 90 percent of its complex totally burned to the grounds including loss of

lives. Lung Center is in a state of shock for several years, affecting and

displacing hundreds of hospital personnel and patients.

The Lung Center suffered and tremendous reversals as a result of the 1998

fire, but its services, particularly to its numerous outpatients, never stopped. It

continued to give out-patient medical services even in a temporary field tents. Its

recovery took 2-4 years utmost, recalling gradually administrative and nursing

staff to manned small number of units. With the construction of the new building,

the design for safety focuses on multiple and easily accessible fire exits/ramps,

electronic fire/smoke detection and sprinkler system.

In the face of global threats to bio-terrorism and pandemic threats of

diseases, specifically Severe Acute Respiratory Syndrome (SARS), Avian H5N1

also known as Bird Flu and the Pandemic H1N1, Lung Center has risen up to the

challenge, that is why as early as 2004, the Center has put up its Isolation Units

and Bird Flu Facility, specifically made to confine highly infectious patients.

II. Plan Description

The Lung Center of the Philippines Health Emergency Preparedness,

Response and Recovery Plan defines the direction of the hospital in preparing for

effective and efficient response and recovery in any event of emergency or

disaster within its facilities and/or its catchment areas. The planning process

includes all-hazards preparedness, based on a comprehensive hazards

vulnerability analysis, in the response to an internal or external event.

Its processes are directed primarily in reducing morbidity and mortality, while

preserving basic community service. The hospital’s function in basic community

service will be fulfilled by protecting the patients, visitors, staff, and facility while



maintaining services, providing care to victims, and providing coordination and

control with other agencies. The plan is intended to enhance the ability of a

hospital to implement preparedness, mitigation and business continuity activities.

The plan also includes the hospital incident management system that should

provide for the establishment of a hospital incident command system with

position description that identifies mission, functions, and responsibilities within

the incident response organizational structure.

The Recovery or Rehabilitation Plan contains the strategies and activities in

mainstreaming and/or restoring the facility and its services back to its prepared

position for any forthcoming eventuality.

III. Goals and Objectives

Goal:

To enhance the hospital’s capacity for prompt and effective attendance to

the largest possible number of people requiring medical and health care in a

health emergency or disaster ultimately reducing mortality, morbidity and

disability and promoting their early recovery.

Objectives:

1. To provide policy for effective response to both internal and external

disaster situations that will affect the operation of the hospital and its staff,

visitors, patients and the community.

2. To identify the hospital’s capability to handle mass casualty in all

scenarios.

3. To identify responsibilities of individuals and departments in a disaster

situation.

4. To identify Standard Operating Guidelines/Procedures, protocols for

emergency activities and responses.

5. To continuously improve risk reduction framework of the hospital.

6. To promote health emergency preparedness through networking, inter

hospital collaboration, technical assistance, training, public information,

advocacy, research and development.

7. To document best practices and lessons learned during simulation

exercises, emergencies and disasters.



IV. Planning Group

Composition of the Lung Center Health Emergency Preparedness

Response and Recovery (HEPRR) Planning Group/Committee:

1. Executive Director

2. Deputy Director for Hospital Support Services

3. Deputy Director for Medical Services

4. Department Manager, Nursing

5. Finance Division

6. Property and Procurement Division

7. General Services Division

8. HEMS Coordinator and Asst. HEMS Coordinator

9. Representative from the Quezon City Disaster Coordinating Council

10. Representative from the Quezon City Medical Society Chapter

11. Representative from the Philippine National Red Cross, Quezon City

Chapter



General functions of Planning Group:

A. Develops, reviews, update the Lung Center of the Philippines Health

Emergency Preparedness, Response and Recovery (HEPRR) Plan.

B. Gathers required information and gain commitment of key people and

organization.

C. Initiates testing of the plan for its functionality and adaptability to multi-

hazard situation.

D. Develop annual operational plan and other plans relevant to health

emergencies and disasters.

Specific functions:

1. Executive Director/Deputy Directors

a. Has the final authority for the implementation of the planning group.

b. Approves the plan provisions and all subsequent revisions.

c. Assures that adequate resources are available to support

emergency management activities.

d. Monitors the effectiveness of response activities during

emergencies and take actions to ensure that all appropriate

procedures are followed.

e. Assures continued compliance with the provisions of LCP policy on

emergency precautions and response.

2. Department Manager, Nursing

a. Ensures that all nursing staffs are trained in all aspect of health

emergency management and participates in the conduct of drills.

b. Ensures that all nursing units are adequately staffed and supplied.

c. Maintains and monitor the quality of nursing service being provided.

d. Ensures all nursing actions and decisions are documented.

e. Observes all nursing staff for signs of stress and inappropriate

behavior and report concerns to psychosocial personnel in-charge.

f. Ensures rotation of nursing personnel to prevent burnout.

g. Responsible to make necessary guidelines for volunteer nursing

staff.

h. Brief the Executive Director/Deputy Directors routinely on the status

of the hospital operations especially on the status of all patients,

problems encountered, resources needed.



3. Finance and Budget Division, Head

a. Responsible for the monitoring of institution financial assets.

b. Approve incident financial status report relative to personnel,

supplies and miscellaneous expenses.

c. Updates the Executive Director/Deputy Directors and other unit

leaders pertinent to financial status.

4. Property and Procurement Division, Head

a. Responsible for the control, anticipation and provision of logistical

needs during emergencies and disaster.

b. Coordinate with companies regarding stock level, available supply

and equipment.

c. Coordinate frequently with the finance chief regarding monetary

assistance.

5. General Services Division, Head

a. Responsible for providing technical advice and assistance.

b. Responsible for maintaining safety and security for the hospital.

c. Responsible for the maintenance and provisions of transportation.

d. Responsible for communication need, sufficient potable water

supplies and uninterrupted electrical supplies.

6. HEMS Coordinator/Asst. Coordinator

a. Organizes hospital emergency response team.

b. Conducts regular fire/earthquake safety seminar

c. Conducts regular disaster drills whether it is a table top or actual

drill in the hospital.

d. Evaluate the conduct of drill and makes necessary

recommendations to the management.

e. Responsible for the training of the HEMS members and the

communities relative to health emergency management.

f. Coordinate other training program not being offered by the hospital

to ensure continued competence in emergency response.

g. Network with members of the Health Sector responding to

emergencies and disasters within hospital’s catchment area and

the communities, as well as other agencies responding to


7. Representative from other society (PCCP, QC Disaster Coordinating

Council, PNRC, BFD)

a. Assist in the formulation of health related policies, guidelines and

procedures pertaining to community wide emergencies and

disasters.



b. Provide medical and manpower assistance especially in mass

casualty situations.

c. Assist in the conducts trainings and seminars not being offered by

institution.

d. Provide assistance on the evaluation during the conduct of drills.

V. Management Structures

EMERGENCY COMMAND STRUCTURE

During an emergency, management structure is of prime importance as it shows

the specific chain of command, control and coordination. These management

structures show the flow of reporting, coordination and communication. The hospital in

responding to an incident at Code Blue alert now activates the Hospital Emergency

Incident Command System (HEICS) which involves and organizational shift to an

emergency mode. During an emergency/disaster, as the hospital is in an emergency

mode, other staff of the hospital may assume roles and functions as needed in an

emergency. The HEMS Coordinator may assume the role of the Incident Commander,

an operation head or a spokesman as deemed necessary by the hospital chief.



The HEICS has basic personnel consisting of an Incident Commander, Operation

Officer, Planning Officer, Finance Officer and Logistic Officer; three other personnel –

Security Officer, Liaison Officer and Public Information Officer – serve as staff to the

Incident Commander and altogether compose the command staff.

These command structure may be revised according to the need of the facility

and available human resources. If the facility is not affected by the disaster, a

designated group shifts to an emergency/disaster mode for the HEICS, while the rest of

the staff conduct normal or regular hospital transaction/services.

If the hospital raises its alert status to Code Blue, normal office transactions are

suspended and the hospital is shifted to emergency/disaster mode.

VI. Roles and Responsibilities

Lung Center of the Philippines is primarily a responding hospital; it has

limitations as to its existing mandate with regards in receiving patients.

LUNG CENTER CAPABILITY RATING SHEET

SERVICES RATING Remarks

1. TCVS 1 Specialty

2. NEURO-SURGERY 2

3. ABDOMINAL 2

4. UROLOGY 2

5. EENT 2

6. MAXILLO-FACIAL 2

7. BURNS/PLASTIC SURGERY 3

8. ORTHOPEDIC 2

Legend:

Rated 1 - means that the hospital is capable of accepting all

cases of his specialty. A hospital Rated 1 is an end-

hospital that will not refuse patients unless the

situation makes admission extremely difficult or

impossible.

Rated 2 - means that the hospital is capable of handling sub-

specialty cases but has some limitations such as bed

capacity, equipment, etc, and cannot be expected to

offer definitive care. It may also mean there are not

enough full time consultants and residents available

on a 24 hour basis or that there is no training



program and therefore no frontline personnel in this

specialty.

Rated 3 - means that the hospital is incapable of handling

cases of this sub-specialty beyond giving primary

care and resuscitation.

LCP main responsibilities in times of emergencies and disasters are:

1. Observe all the requirements and standards (hospital emergency plan,

HEICS, Code Alert, etc.) needed to respond to an internal or external


2. Ensure enhancement of their facilities to respond to the needs of the

communities especially during emergencies.

3. Provision of Mental Health and Psychosocial support to direct and indirect

victims including the responders.

4. Network with other hospitals in the area to optimize resources and

coordinate transferring of victims to the appropriate facility.

5. Report all health emergencies to the DOH-HEMS Operation Center, and

document all incidents reported.

VII. Hospital Emergency Preparedness Plan

A. Hazards assessment

1. Identification of all potential hazards inside and outside the vicinity

of the hospital.

Hospital Service Areas

Hazards Vulnerable Areas

1. Fire 1.1 General Services Area

1.2 Pathology Department

1.3 Radiology Department

1.4 Dietary Section

2. Earthquake 2.1 All infrastructures

2.2 Pathology

2.3 Radiology

2.4 Dietary

2.5 General Services



3. Flood 3.1 Emergency Room

3.2 Out-Patient Department

3.3 General Services including Motorpool

3.4 St. Therese Unit

3.5 Dietary

3.6 Radiology

4. Typhoon 4.1 All 4th floor areas

4.2 All 3rd floor wards

5. Hazardous

Material Spills

5.1 Pathology Department

5.2 General Services including Motorpool

HAZARDS MAPS









Legend: S – Severity, F – Frequency, E – Extent, D – Duration, M – Manageability

Scoring: 1 – Low and Easy, 2 – Moderate, 3 – Severe and Difficult

HAZARD SEVERITY FREQUENCY EXTENT DURATION MANAGEABILITY TOTAL

NATURAL 1. Typhoons 2. Floods 3.Earthquake

2 2 4

1 3 2

1 2 3

1 2 1

4 4 3

1 5 7

BIOLOGICAL 1. Dengue 2. Nosocomial Infection 3. Water Borne Dse. 4. Food Poisoning

3 3

2

2

1 2

2

2

1 2

2

2

3 2

3

3

5 4

5

5

3 5

4

4

TECHNOLOGICAL 1.Radio-Nuclear accident 2. chemical Spill 3. Hazardous waste 4. Power Supply Failure 5. Elevator System Failure 6. HVAC Failure 7. Telecom. failure 8. Fire

2

1 2

2

2

2 2

2

1

1 1

1

1

1 1

1

1

1 1

2

1

1 2

3

1

1 1

2

1

1 2

2

1

1 1

5

5

5 5

4

4

3 4

2

0

0 2

4

SOCIETAL 1.Bomb Threat 2. Hostage Taking 3. Mass Gathering 4. Bombing

4 3

2

3

1 1

1

1

2 2

1

3

2 2

1

3

3 3

4

3

6 5

1

7





















2. Preventive strategies

a. Activities includes:

1) Continuous monitoring and updating of preparedness

capability in terms of policies, guidelines and

procedures.

2) Strengthening human resource capability by

encouraging continuous training.

3) Conduct a table top or an actual drill at least quarterly

or semi-annual.

4) Conduct post evaluation of the drill and make

appropriate recommendations for improvement

identifying what went wrong and what went right.

5) Team building among LCP-HEMS responders

b. Identifying resource requirements for all types of hazards.

1) Technical expertise on occupational safety, lectures

on first aid, basic life support, mass casualty handling

and incident command system.

2) Identifying alternative portable electric generators and

water pumps

3) Alternative source of electricity like solar power

devices.

4) Stockpiling of medicines and supplies.

5) Stockpiling of gasoline and diesel fuel for at least 5-10

days without compromising hospital safety.

6) Proper utilization of HEMS sub-allotted fund for

hospital capacity building activities.

7) Appropriate inclusion of specific supplies and

materials in annual procurement plan for proper

allocation and budgeting.

8) Networking with other government and private

agencies.

c. Assigning point person to monitor the different activities and

to source out any deficiencies in terms of resource

utilization.

1) General Services Chief as the Safety Officer in-

charge. – Monitoring of all potential hazards and

vulnerable areas and take action immediately.



2) HEMS Coordinator – updating of hospital

preparedness, response and recovery plan

3) Asst. HEMS Coordinator – in-charge for the

monitoring and training of all hospital staff on

emergency preparedness and response.

4) Infection Control Nurse – monitoring of all potentially

infectious diseases through active surveillance

approach and reporting immediate concern to higher

authorities.

B. Vulnerabilities reduction

1. Vulnerable areas in times of emergencies and disasters.

a. Radiology Department

b. Pathology Department

c. General Services Division

2. All identified areas must be able to follow the guidelines in

assessing health facilities in responding to health emergency in

order to effectively reduce morbidity and mortality among its

personnel and clients. Vulnerability is categorized as:

a. Structural – Related to the construction of the facility.

b. Non-Structural – The non-structural elements of a building

include ceilings, windows, doors, mechanical, electrical,

plumbing equipment and installation.

c. Functional – There are three aspects:

1) Deals with general physical lay-out of a facility,

including location, accessibility and distribution of

areas within the facility.

2) Individual services: medical (supplies and equipment)

and non-medical (utilities, transportation and

communication vital to continuous operation of

facility).

3) Public service and safety measures.

d. Human Resources – Includes:

1) Organization of the health facility (e.g., emergency

planning group, subcommittees)

2) Inventory and mobilization of personnel

3) Preparedness activities for the personnel (e.g.,

hazards and vulnerability analysis, drills and training,



C. Capacity development

1. Training

a. All ER personnel must attend the Basic Life Support Training

(BLS), Advance Cardiac Life Support Training (ACLS),

Pediatric Advance Life Support Training (PALS) and

Emergency Medical Responder Course (EMR)

b. All hospital personnel must attend the following training:

1) Basic Life Support Training

2) First Aide Course

3) Fire & Earthquake Seminar

4) Incident Command System and Mass Casualty

Management Seminar

c. All identified high risk area personnel must attend special

training to resolve any immediate threat to hospital

operations. This training shall include:

1) Hospital Emergency Awareness and Response

Training

2) Special handling of highly flammable substance

3) Fire suppressant training

4) Radiological emergency training

5) Use of special personnel protective equipment (PPE)

for biological hazards and hazardous materials.

6) Basic water sanitation training

2. Purchase of emergency equipments.

a. Purchase of at least 10 radio communication equipments.

1) Executive Director - 1

2) Deputy Directors – 2

3) HEMS Coordinator – 1

4) Head of Communication Section – 1

5) Department Manager Nursing – 1

6) Senior House Officer – 1

7) ER – 1

8) GSD Head – 1

9) Security - 1

b. Purchase of at least 2 portable generators capable of

delivering 500KVA each

c. Purchase of alternate water pumps.



d. Purchase of alternate solar power devices.

3. Provision of temporary shelters for patients and staffs.

a. Purchase of 10 tents that can accommodate at least 20

patients at a time.

b. Identify areas where to construct the field hospital (Please

see maps for the possible locations of tents)

c. Provisions of portalets (portable toilets).

4. Alarm Code and Alert Status.

a. Hospital Alarm Code

1) Code 98 – Fire Incident

2) Code 55 – Evacuation Alert

b. Medical Emergency Code Alert

1) Code 82 – Adult Cardiac Arrest

2) Code 41 – Pediatric Cardiac Arrest

c. Security Alert

1) Code 77 – Internal Hospital Violence or potential

violence

d. Hospital Code Alert Level

Code Alert Level Conditions for adopting color code alert

a. Code White Strong possibility of a military operation within the

area, example: coup attempt.

Any planned mass action or demonstration within

the catchment area.

Forecast typhoons (Signal No. 2 up) the path of

which will affect the area.

National or local elections and other political

exercises.

National events, holidays, or celebrations in the

area with potential for MCI (Mass Casualty

Incident).

Any emergency with potentially 10-50 casualties

(deaths, injuries).

Any other hazards that may result in emergency.

Unconfirmed report of re-emerging diseases,

example: Avian Influenza, SARS, Pandemic H1NI

Human Resource

requirement for

responding to the

Code White

First response team ready for dispatch to include

the following:

2 doctors preferably Surgeon, Internist and

Anesthesiologist.

2 Nurses

First Aider/EMR

Driver



Second response team should be on call

The following should be available for immediate

treatment of incoming patients:

- General Surgeons

- Orthopedic Surgeons

- Anesthesiologist

- Internist

- O.R. Nurses

- Ophthalmologists

- Otorhinolaryngologists

- Infectious Specialists

Emergency service personnel, nursing personnel

and administrative personnel residing at the hospital

dormitory shall be placed on call status for

immediate mobilization.

Other requirements

for responding to

Code White

The Hospital Operations Center should be

activated. It should continuously report and

coordinate with the DOH Central Operation Center.

Medicines and Supplies

- Ensures that emergency medicines (especially

for trauma needs) be made available at the

emergency room.

- Medicines and supplies in the operating rooms

should likewise be reviewed and increased to

meet sudden requirements.

- Other needs such as X-ray plates, laboratory

requirements, etc. should be made available

and not required to be purchased by victims.

- Personnel department to prepare for

mobilization of additional staff.

- Finance department to ensure availability of

funds in cases of emergency purchases and the

like.

- Logistics department to coordinate with possible

suppliers for additional requirements.

- Dietary department to open and meet the need

of the victims as well as the health personnel on

duty.

- Security force to institute measures and stricter

rules in the hospital.

- Activate Bird Flu Plan (Avian Influenza), SARS

Plan, Pandemic H1N1 Plan, etc.

- Enforce and monitor use of personnel (PPE) for

all health personnel.

- Triage system should be activated.



b. Code Blue Any of the following conditions

- When 20-50 casualties (red tags) are suddenly

brought to the hospital.

- Any internal emergency/disaster in the hospital

which brings down their operating capacity (ex.

Vital areas) to 50% or which would require

evacuation of patients and setting up of a

Field Hospital.

- For conditions other than MCI, the influx of

patients is beyond the capacity of the hospital to

handle.

- Confirmed/documented report of re-emerging

diseases (SARS, Human to Human Avian

Influenza, Pandemic H1N1) within the

catchment area.

Human Resource

requirement for

responding to the

Code Blue

HEMS Coordinator to be physically present at the

hospital.

On-scene Response Team

Medical Officer in charge of the Emergency Room

All Medical Fellows should be present

Medical Officer in charge of the Operating Room

Surgical Team on duty for the day

Surgical Team on duty the previous day

Mental Health Personnel (if available)

All Anesthesia Fellow should be present

Toxicologist/Chemical Experts (if available)

Administrative Officer or designate

Nursing supervisor on duty

All OR nurses

Social workers

Dietary personnel

Officer in charge of supplies at the CSSR

The entire security force

Housekeeping personnel

Other requirements

for responding to

Code Blue

All those mentioned in Code White plus:

- Activate Hospital Emergency Incident

Command System (HEICS).

- Other needs of victims apart from medicines

and supplies depending on the disasters should

as much as possible be made available

- The Executive Director of his designate should

make proper coordination with other hospitals

for networking and/or possible transfer of

patients.

- Incident Commander should assign a Safety



Officer, Liaison Officer to coordinate with other

agencies, and Public Information Officer to

serve as the authorize spokesperson of the

hospital.

- Social Service section should prepare

assistance to victims in coordination with mental

health professionals of the hospital, if available,

and they should lead in providing information to

relatives of victims.

- Mortuary section should anticipate dead victims

brought to the hospital for proper care and

identification.

- The security team, in anticipation of possible

influx or patients, relatives, responders, police,

press, etc. should ensure smooth flow of traffic

inside the compound especially for the

ambulances.

- Should report regularly to HEMS Operation

Center and as much as possible have regular

press releases or briefings.

c. Code Red Any of the following conditions

- When more than 50 (red tags) casualties are

suddenly brought to the hospital.

- An emergency wherein the services of the

hospital is paralyzed since 50% of the

manpower are themselves victims of the

disaster.

- Hospital is structurally damaged requiring

evacuation and/or transfer of patients.

- Conditions requiring mandatory quarantine of

hospital and its personnel (ex., SARS, Avian

Infuenza, Pandemic H1N1); uncontrolled human

to human transmission of SARS/Avian Flu,

Pandemic H1N1 within the catchment area.

Human Resource

requirement for

responding to the

Code Red

All personnel enumerated under Code Blue

All medical personnel

All nurses

- All nursing attendants

- All administrative staff

- All housekeeping personnel

Other requirements

for responding to

Code Red

All those mentioned in Code Blue plus:

- The Executive Director can cancel all types of

leave and can order all personnel to report to



the hospital

- The Executive Director can temporarily stop all

elective admissions and surgeries and network

with other hospitals.

- The Executive Director should anticipate

request for additional manpower and specialists

not available in his hospital. He is further

authorize to accept medical volunteers and

other professional to augment the hospital’s

manpower resources rather than transferring

patients based on some agreements.

- Networking with other hospitals for

augmentation of resources and transfer of

patients in special cases.

- Answer all queries of the media pertaining to

patients in the hospital.

- Anticipate evacuation and/or use of field

hospital; closure and/or quarantine of the

hospital.

- The Executive Director specifically be

concerned with safety and security, not only of

the patients but of the personnel as well.

c. Guidelines in implementing the Tri-Color Code Alert

1. The Hospital Code Alert shall be declared by the

Secretary of Health or by the Director of HEMS for

external emergencies.

2. The Medical Center Chief or the Hospital HEMS

Coordinator of the hospital shall declare the code alert

based on his assessment of the emergency within his

catchment area.

3. The Medical Center Chief shall automatically declare

a Code White Alert during national events and

activities especially with the potential of an MCI (Mass

Casualty Incident).

4. The alert level is raised, lowered or suspended by the

Secretary of Health, Director of HEMS for external

emergencies and national events.

5. The alert level status (raised, lowered or suspended)

within the hospital catchment area shall be the

responsibility of the Medical Center Chief or his

designates.



d. Determining Priority for Case Management

1. Use of Color Tag for Prioritization of care

i. Categories

a. RED – Immediate: Priority One (Life-

threatening Conditions). The condition is

life-threatening and the patient requires

immediate attention and transport. The

following conditions should be present

for a Mass Casualty Incident (MCI)

victim to be classified Priority One.

1) Obstruction or damage to airway.

2) Disturbance of breathing –

respiration above 30/min.

3) Disturbance in circulation –

capillary refill greater than 2

seconds or carotid pulse weak,

irregular or absent, radial pulse

absent.

4) Does not follow commands or

altered level of consciousness.

5) Need for life-saving measures

(BLS and ATLS) and urgent

hospital admission.

6) Victims whose injuries demand

definitive treatment in the hospital

but which treatment may be

delayed without prejudice to

ultimate recovery

b. YELLOW – Urgent: Priority Two. Patient

has passed primary survey, but with

major system injury, may delay transport

to one hour. Any one of the following

conditions could place a victim into a

Priority Two Category:

1) Needs to be treated within one

hour; otherwise they will become

unstable.

2) Severe burns; burns involving

hands, feet or face (not including



the respiratory tract); burns

complicated by major soft tissues

trauma.

3) Hospital admission is required.

4) Moderate blood loss; back

injuries; head injuries with a

normal level of consciousness.

c. GREEN – Delayed: Priority Three. An

injury exists but treatment can be

delayed for four to six hours. Generally,

anyone who can walk (walking

wounded) to a designated area for

treatment will be a Priority Three. The

following injuries are examples:

1) Minor injuries not threatened by

airway, breathing and circulatory

instability

2) Minor fractures, minor soft tissue

injuries, minor burns.

3) May or may not be admitted.

d. BLACK or WHITE – Dead: Last Priority.

Condition are the following:

1) Patient is dead.

2) Those who die awaiting

treatment, and those in cardiac

arrest following trauma.

Special Note: For Moslem communities, white

tag will be used for dead Moslems.



2. The prescribe color tag is the ribbon for practical

reasons.

5. Commencing quarterly or semi-annual drills to different scenarios.

a. Table top Drill

b. Actual Drill

D. THE FIRE EMERGENCY PLAN

The main concern in any fire emergency plan is to:

1) Stop and prevent spread of fire

2) Evacuate patients/personnel, records and equipment.

3) Allay panic

4) Be able to render emergency treatment for various forms of

fire related injuries i.e., wound or inhalation injuries.

Every hospital personnel should be aware of the following

instructions in case of fire

1. General Instructions

a. Notification

1) Notify the telephone operator (local 444, 401 right

away the source of fire, exact location and possibly

the extent. Speak in a moderate tone of voice so that

the patient will not overhear and become frightened.

2) Notify the Charge Nurse who shall in turn notify the

Nursing Department Manager/Supervisor

3) Notify the Safety Committee and activate the Fire

Brigade

b. Evacuation strategies



1) Removal/Evacuation of Patients

i. Do not move patients unless with specific

instruction from the safety officer.

ii. Move patients with utmost caution bring along

their charts and medications.

iii. When patients are moved out from the room,

close the doors and windows.

iv. Everyone should know the location of the exits

nearest to the room to be evacuated, the

location of the keys to the exits, or the exit to

be used, ensure that exits are free from any

obstruction.

v. Evacuation priorities shall be as follows

1. FIRST those nearest the source

of fire or posed with

greatest danger or those

farthest from safety

2. SECOND helpless patients, use

available stretcher. If

none, roll in top covers

and carry with help by

grasping blanket under the

patient.

3. THIRD wheelchairs patient, wrap

in blankets and wheel out

towards exit

4. FOURTH walking patients; wrap in

blanker and lead towards

exit.

c. Removal/Evacuation of Equipment/Instruments/Supplies

All equipments should have been color coded at the

time they were installed in the unit. Color codes are used for

priority of evacuation. Color tags should be luminous or

reflectors.

1) RED FIRST PRIORITY

Equipment that contains

flammable gases such as

Oxygen

Halothane, Nitrous Oxide, etc.



Containers that contains

flammable liquids, such as

petroleum, gasoline, alcohol

2) GREEN SECOND PRIORITY

Equipments needed life

support especially of patients

already evacuated

Expensive equipments

3) YELLOW THIRD PRIORITY

All others

d. Stop the fire

1) What everyone should know

i. Location of the fire extinguisher in the unit.

How to operate them.

1. Pull the pin

2. Aim the extinguisher with nozzle

pointing at the base of the flames.

3. Squeeze the hand trigger as you hold

the extinguisher upright

4. Sweep the extinguisher from side to

side, covering the area/base of the

flames.

ii. Location of fire hydrants/hose/water source

iii. When and how to use wet blankets or rugs

when necessary. Place wet blankets under the

floor to keep out the smoke.

2) Turn-off at once all oxygen tanks in operations and

electrical devices

3) Close al doors and windows

e. Allay fear and panic

The greatest danger in hospital fires is panic caused by fear

or smoke. BE CALM! Fear and panic can do as much

damage as fire. Patients usually become aware of the

existence of fire. Reassure them that the alarm has been



turned on and that the emergency plan has been activated.

DO NOT BECOME ALARMED YOURSELF.

2. Specific Instructions

a. Nursing Department Manager/Supervisor

1) Once notified by the Head Nurse/Charge Nurse and

once on the scene she shall assume responsibility

2) Keep someone on the telephone all the time for

further instructions and coordination and to relay

instructions.

3) She shall direct the removal of the patients when

authorized and shall do so according to priority.

4) She shall coordinate and give instructions to other

units or employees who have come to help.

5) She shall have a complete list of all patients in the

unit immediately and shall make all patients are

accounted for along with their charts and medications.

6) She makes sure that all EXITS are free from any

obstructions.

b. Other Departments

1) Radiology/Laboratories

i. Turn of all electrical machinery

ii. Remove patients

iii. Close doors and windows

iv. Report to the Command Post for instructions

2) Linen/Housekeeping

i. Turn off all electrical machinery

ii. Close doors and windows

iii. Assemble blankets, linens and gowns

iv. Remain alert at the telephone for instruction as

where to deliver

3) Operating Room

i. Turn off all gases, electrical machineries and

closed all tanks with combustible gases


iii. Get ready for first aid or immediate wound care

4) Emergency Room/OPD

i. Turn off all gases, electrical machineries and

closed all tanks with combustible gases.




iii. Get ready for first aid or immediate wound care

5) Motorpool

i. Double check if all ambulances are all in

running conditions

ii. Double check ambulance equipments

iii. Awaits instruction from a staging

officer/transport supervisor

6) Dietary

i. Turn off gas and electrical machinery including

ventilation fans


iii. Report to Command Post for any instructions

7) Engineering Section

i. Turn off air conditioning system and any other

equipment with blower fans

ii. Switch off all circuit breakers in the floor where

the fire is raging and those next or above it.

8) Communications (PABX (Switchboard Operators)

i. Upon receiving notice of fire, verify through the

engineering personnel, if positive call fire

department with telephone numbers 928-3974,

928-8363 or 117.

ii. Post a very conspicuous place in the

switchboard the telephone numbers of fire and

police department

iii. Meralco – 531-1111

iv. Engineering and Maintenance section local

number 201 and 208

v. Call police and in-house security services

vi. Notify other key personnel in the Hospital

Emergency Plan

vii. Notify dormitory

viii. Call all hospital units

ix. Keep line open in unit where fire is located

x. Seek assistance from the Command Post to

assist in transmitting calls.

xi. Sound the alarm code for fire Code 98, if

instructed by higher authorities

9) Accounting and Billing Section



i. Get all cash together in one receptacle

ii. Get all valuable from safe, gather all ledgers

and important books ready be removed

iii. Gather all accounts receivable cards ready to

be removed

iv. Keep track of file containing names and

accounts of patients in the hospital

10) Information Technology Section

i. Backs-up all the hospital transaction records

daily

11) Medical Records

i. Evacuate all hospital and patients records

accordingly

ii. Backs-up all hospital record accordingly

12) Security

i. Cordon the area.

ii. Assure safe passage of patients thru exits

iii. Prevent loss of personal property thru pilferage

and looting.

iv. Coordinate with fire and law enforcement

officer as soon as they arrive at the scene and

direct them to the Incident Commander.

c. Disaster Control Committee

As soon as the Hospital Emergency Plan has been

activated to Code Blue, the Incident Commander (Hospital

Director, Deputy Director, HEMS Coordinator, Senior House

Officer) is expected to coordinate the activity in a large as

scale.

1) He makes sure that the notice of fire has been

relayed to the fire station and police department.

2) Let other department know as to the progress of the

fire so they can prepare to remove other patients as

necessary or can assure patients that the fire has

been controlled.

3) Shall proceed with networking with other hospital if

necessary by first informing the Department of Health-

Operation Center of the status of the fire incident.

4) Shall monitor number of casualties and the extent of

injury



5) Shall monitor the extent of the fire and water damage.

6) Makes sure that the Command Post is established as

well as the Treatment Area, Triage Area, Staging

Area as well.

7) Can direct as to where to send employees to help

where they are most needed.

8) Give orders for removal of patients when necessary

9) Maintains coordination with other member of the

emergency command structures and other key

hospital personnel.

VIII. Hospital Emergency Response Plan

A. Organization

EMERGENCY COMMAND STRUCTURE



B. System activation and termination

1. Activation and termination of alarm status is designated to the

following:

a. Hospital Director

b. Deputy Director

c. HEMS Coordinator

d. Senior House Officer (after office hours)

2. The incident commander is always the hospital director or to his

duly designate personnel, on the other hand the officer of the day

or the senior house officer will act on the latter’s behalf after office

hours.

3. The incident commander will immediately form his command staff

as shown in the organizational structure. The roles and

responsibilities are shown on Annexes p. 91

4. With the declaration of the alert, the plan is activated. Depending

on the alert level status, corresponding human resource and other

requirements are mobilized.

5. Under Code Blue, the Hospital Emergency Incident Command

System (HEICS) is immediately established using the six-step

response.

a. Step 1 – Assume command. The pre-assigned incident

commander must assume command based on the

emergency plan.

b. Step 2 – Assess the situation. Assess magnitude of the

incident form sources like the DOH-Operation Center and

other reliable network.

c. Step 3 – Identify critical areas. These include emergency

rooms, decontamination, triage, treatment, security, media,

etc.

d. Step 4 – Activate of Identify the Operations Center.

Coordinate with DOH-HEMS Operation Center; assign staff

and ensure communication system is in place.

e. Step 5 – Identify the Safety Officer. The Safety Officer is the

one to go around the compound to ensure safety of the staff,

the hospital, and the patients.

f. Step 6 – Secure the hospital and critical areas. Identify area

for ambulances, points of ingress and egress.



C. Resource mobilization

1. All resource mobilization will be decided by the incident commander

upon recommendation by his command staff

a. Purchases of necessary supplies and materials will be

decided by the command staff based on priorities.

b. Review of MOA with other agencies

2. Construction of field hospital in case one is needed for patients and

staff in the pre-designated area. (Please see Annexes B. Hospital

Map)

a. Tents must be constructed as soonest possible time to

prevent delays in providing hospital services.

b. This temporary shelter must be supplied with adequate

water and electricity

c. Portable toilets must be closely monitored by sanitary

inspector assigned.

D. Partnership through Memorandum of Agreement (MOA)

1. As part of DOH-HEMS network with other government hospital and

NGO within the catchment area

a. East Avenue Medical Center

b. National Kidney and Transplant Institute

c. Philippine Heart Center

d. Philippine Children’s Medical Center

e. Philippine National Red Cross, Quezon City Chapter

f. Bureau of Fire, Quezon City

2. Private hospital

3. Medical Societies

4. Drug Store (Mercury Drug, South Star Drug)

5. Medical supplies and equipment distributor

6. Media

IX. Hospital Recovery and Reconstruction Plan

A. Damage assessment and needs analysis

1. Depending of type of calamities, all structures must be check prior

to re-occupying the facilities.

2. All damaged structures must be checked by a structural engineer

and make necessary recommendation.

3. Damage assessment must be reported to the appropriate authority,

estimating the cost of damages to the facilities.



4. All the incurred cost during response must be fully documented

indicating the name of patients seen, the services rendered and the

supplies and medications given.

5. Appropriate networking must be fully utilized not only for

augmentation purposes but for maximizing the special services

each medical center/hospital has to offer.

B. Provision of services

1. Hospital operation must continue to provide basic medical services.

2. Surveillance of the water and sanitation, food safety, emergent and

re-emergent endemic diseases and nutritional status.

C. Psychosocial support and recognition to personnel

1. Psychosocial support must be given to victims of calamity as well

as to the medical, nursing and support staff of the hospital.

2. There must be point person to monitor hospital staff that shows

signs of increasing anxiety and take immediate actions.

3. Awarding and recognition rites for responders

4. Provision of overtime compensation for responders.

5. Provision of assistance to hospital personnel who were also

affected by the calamity.

6. Re-training of hospital staff on technical and administrative

procedures.

D. Restoration of utilized/damaged resources and services

1. Evaluation, clean-up and/or repair of damages to the hospital

building/facilities/equipment.

2. Accounting and recording of available materials, medicines,

supplies and equipment.

3. Requisitioning and replenishment of utilized materials and logistics

4. Decontamination of areas, ambulance and equipment.





X. Annexes

A. Directory of contact persons

Name Designation Contact No./s

Dr. Jose Luis J. Danguilan Executive Director 0917-8220690

Dr. Rey Desales Deputy Director for Hospital

Support Services

0917-8376920

Dr. Raoul Villarete Deputy Director for Medical

Services

0919-7461807

Dr. Jaime Mendoza Department Manager III, ER-

Out Patient Department

0916-3751974

Mrs. Elvira N. Baura Department Manager II,

Nursing Service

0919-4452198

Mr. Albilio Cano Department Manager II,

Corporate Services

0917-8397185

Dr. Benilda Galvez Infection Control Coordinator 0918-9158378

Mrs. Heminia Tolentino Infection Control Nurse 0921-2656355

Dr. David F. Geollegue HEMS Coordinator 0927-4407329

Mr. Gerardo I. Lirag Asst. HEMS Coordinator 0917-6106534

Ms. Angie Roxas Division Chief, Accounting

and Budget

0928-5050758

Mrs. Consolacion Balderosa Division Chief, Property and

Procurement

0919-8202527

Mrs. Carol Manduraoi Division Chief, Cashier 0917-6265248

Engr. Conrado Yangat Division Chief, GSD 0919-5877499

Engr. Boyet Panlaqui Asst Chief, GSD 0927-9794857

Ms. Heidi Basobas Division Chief, Pharmacy 0917-8962363

Mrs. Donnabelle Arcillo Chief, Social Service 0922-8247115



B. Hospital Map



C. LCP Organizational Chart



D. Glossary

All-hazard – An approach to emergency management based on the

recognition that there are common elements in the management of

responses to virtually all emergencies, and that by standardizing a

management system to address the common elements, greater

capacity is generated to address the unique characteristics of different

events

Burn-out syndrome – A state of exhaustion, irritability and fatigue which

markedly decreases worker’s effectiveness and capability

Capacity/readiness – An assessment of local capacity to respond to an

emergency (a risk modifier)

Casualty – Victims both dead and injured, physically and/or

psychologically

Command post – Form of site-level emergency operations center,

assembled as needed by the first agencies to respond to an event

Community – Consist of people, property, services, livelihoods and

environment; a legally constituted administrative local government unit

of a country, e.g. municipality or district, that is small enough to be

able to indentify its own leaders (to make participation meaningful)

and large enough to control its resources, e.g., village, district, etc

Coordination – Bringing together of organization and elements to ensure

effective counter-disaster response. It is primarily concerned with the

systematic acquisition and application of resources (organization,

manpower and equipment) in accordance with the requirements

imposed by the threat of impact of disaster.

Crisis – A state brought about by adverse life experience wherein the

normal coping mechanism or problem solving is not working

Critical Incident – Any event causing unusually strong overwhelming

emotional reactions which have the potential to interfere with work

during the event or thereafter in the majority of those exposed

Disaster – Any actual threat to public safety and/or public health where

local government and the emergency services are unable to meet the

immediate needs of the community; and event in which the local

emergency management measures are insufficient to cope with a

hazard, whether due to lack of time, capacity or resources, resulting in

unacceptable levels of damage or numbers of casualties; an

emergency in which the local administrative authorities cannot cope



with the impact of the scale of the hazard and therefore the event is

managed from outside of the affected communities; any major

emergency where response is also constrained by damage or

destruction to infrastructure (i.e., the lack of resources plus loss of

infrastructure overwhelms local capacity and event management from

outside the affected area is needed to direct and support local

response efforts

Disaster recovery – The coordinated process of supporting disaster-

affected communities in the reconstruction of the physical

infrastructure and restoration of emotional, social, economic and

physical well-being

Donation – Act of liberality whereby a foreign or local donor disposes

gratuitously of cash, goods or articles, including health and medical-

related items, to address unforeseen, impending, occurring or

experienced emergency and disaster situations, in favor of the

Government of the Philippines which accepts them

Donor – All persons, countries or agencies that may contract and dispose

of cash, goods or articles, including health and medical-related items,

to address unforeseen, impending, occurring or experienced

emergency and disaster situations

Emergency – Any situation in which there is imminent or actual disruption

or damage to communities, i.e., any actual threat to public health and

safety

Emergency management – A management process that is applied to

deal with the actual or implied effects of hazards

Emergency operation center – A place activated for the duration of an

emergency within which personnel responsible for planning,

organizing, acquiring and allocating resources and providing direction

and control can focus these activities on response to the emergency

Emergency preparedness – An integrated program of long-term,

multisectoral development activities whose goal are the strengthening

of the overall capacity and capability of a country to ready to manage

efficiently

Hazard – Any potential threat to public safety and/or public health; any

phenomenon which has the potential to cause disruption or damaged

to people, their property, their services or their environment. i.e., their

communities. The four classes of hazards are natural, technological,

biological and societal hazards.



Health Emergency Management Sector – An organization of agencies

with a health unit primarily devoted to and united to provide state-of-

the-art, appropriate and acceptable technical assistance and/or direct

services on health emergency preparedness and response to any

entity – international or national

Incident Medical Commander – The highest representative of the

Department of Health or Local Health Office as designated by the

city/town local executive (depending on the extent of the disaster) who

shall serve as the liaison officer of the Health Sector to the Command

Post headed by the Incident Commander. For regional disaster, it

should be headed by the highest representative from the DOH CHD.

Major emergency – Any emergency where response is constrained by

insufficient resources to meet immediate needs

Mass casualty incident – Any event resulting in a number of victims

large enough to disrupt the normal course of administrative,

emergency and health services

Mass casualty management – Management of victims of a mass

casualty event to minimize loss of lives and disabilities

Mass Casualty Management System – Groups of units, organizations

and sectors that work jointly through standard consensus procedures

to minimize disabilities and loss of life in a mass casualty event

through the efficient use of all existing resources

Medical controller – A designated senior Department of Health Officer

appointed to assume the overall direction of the medical response to a

mass casualty incidents and disasters. Control is established from a

designated Operation Center, either in the Central Operations Center

or the Regional Operations Center

Mental health – A state of well-being in which the individual realizes his or

her own abilities, can cope with the normal stresses of life, can work

productively and fruitfully, and is able to make a contribution to his or

her community

Networking – An approach to broaden the resources available to a

person to achieve his personal and professional goals while

supporting others to achieve theirs

Preparedness – Measures taken to strengthen the capacity of the

emergency services to respond in an emergency. Emergency

preparedness is done at all levels.



Rapid health assessment – The collection of subjective and objective

information to measure damaged and identify those basic needs of

the affected population that require immediate response

Risk – Anticipated consequences of a specific hazards affecting a specific

community (at a specific time); the level of loss of damage that can be

predicted to result from a particular hazard affecting a particular place

at a particular time; probable consequences to public safety of a

community being exposed to a hazard (i.e., death, injury, disease,

disability, damage, destruction, displacement)

Type of hazard determines the kind of risk, e.g., floods cause few

deaths but earthquake cause many.

Vulnerabilities and capacity to respond determine how much risk is

in the community, i.e., how many deaths are likely, where they will

occur and the kind of people likely to be killed (e.g., old disabled)

Risk management – A comprehensive strategy for reducing risk to public

safety be preventing exposure to hazards (target group – hazards),

reducing vulnerabilities (target group – elements of community), and

enhancing preparedness, i.e., response capacities (target group –

response agencies); a strategy for identifying potential threats and

managing both the source of threats and their consequences

Strategic – Deals with the concepts of relatively long term and big picture

in relation to the pattern or plan that integrates an organization’s major

goals, policies and action sequences into a cohesive whole. Concept

is always relative – what a local level of government sees as strategic

from their perspective is likely perceived as tactical from the

perspective of a more senior government.

Stress – A state where one’s coping mechanism is not enough to

maintain balance or equilibrium

Surge capacity – The health care system’s ability to rapidly expand

beyond normal services to meet the increased demand for qualified

personnel, medical care and public health in the event of large-scale

public emergencies or disasters (Agency for Healthcare Research and

Quality, USA, 2005)

Terrorism – The premeditated use or threatened use of violence or

means of destruction perpetrated against innocent civilians or non-

combatants, or against civilian and government properties, usually

intended to influence an audience (Memorandum No, 21)

Triage – The process of sorting victims needing immediate transport to

health facilities and those whose care can be prioritized.



Vulnerabilities – Factors that increase the risks arising from a specific

hazard in a specific community (risk modifiers)

Weapons of mass destruction – Radiological, nuclear, biological or

chemical elements in nature used for large-scale damage to life and

property, usually by those perpetrating terrorist activities



E. Risk Assessment Form















































F. Risk Assessment Form for Highly Infectious Diseases (SARS, Avian Flu-

H5N1, Pandemic Flu, H1N1, Mers-Cov, etc.)











G. Flow chart for referral of highly infectious diseases (SARS, H5N1,

Pandemic Flu, H1N1, Mers-Cov, etc.)



H. Protocols on the Triage of Emerging / Re-Emerging Respiratory Infections

(SARS, Avian Flu, Pandemic Flu, H1N1, MERS-Cov, etc.)



I. Advice Form for Home Quarantine



J. Triage Screening Form



K. Protocols in response to trauma emergencies outside the hospital



L. Protocols in Response to Earthquake Incident





M. Protocols in the conduct of fire drill





N. Protocols in Response to Fire Incident





O. Protocols in the Activation of the Hospital Emergency Incident Command

System (HEICS)



P. Incident Command System Organization

JOB ACTION SHEETS

INCIDENT COMMANDER

(Field or Facility)

Mission Perform overall direction for the field and /or facility

operations and if needed, authorize evacuation.

Qualifications Must be an Emergency Manager for field; Hospital

Director for Facilities or his designate.

Preferably has experience in handling “on-scene”

Mass Casualty Incident for Field; has experience in

management situations for facilities.

Must possess good communication skills.

Must have leadership qualities.

Must be a good coordinator, must have good

command and control abilities.

Functions &

Responsibilities

Initiate the Incident Command System (ICS) by

assuming the role of the Incident Commander and

put any identification mark.

Designate a Command Post to include required

logistical needs.

Carefully assess the situation and the magnitude of

the casualties.

Secure the area, preventing entry of unauthorized

people and designate staging and transport area

for Field Operations.

Depending on the number of responders and the

magnitude of the emergency, fill up the

organization assignment list, the needed positions

relevant to the situation.

In major MCI, the following should be filled up:

Safety Officer, Liaison Officer, Public

Information Officer, Operations Manager, Triage

Officer, Treatment Officer, Staging Officer,

Transport Officer and Morgue Officer.

The Planning Officer, Logistic Officer and

Administrative Officer complements and



completes the positions in severe MCI

necessitating the support of major agencies and

requiring long period of operations.

Announce an action plan meeting and identify the

general objective of the operations including

alternatives, and the incident communication plan.

Assign someone as Documentation Recorder/Aide.

Authorize resources as needed or requested by

managers.

Designate routine briefing with managers to receive

status report and update the action plan regarding

the continuance and termination of the action plan.

Communicate status to higher authority.

Approve media releases.

Identifications Proper signage (hard hat with mark of Incident

Commander or a vest)

SAFETY AND SECURITY OFFICER

Mission Monitor and have authority over the safety of rescue

operations and hazardous conditions. Organize and

enforce scene/facility protection and traffic security.

Qualifications Knowledgeable on safety precautions, procedures.

Preferably with various training in emergencies

relating to bombing, fire, hazardous, materials,

structural assessment, security procedures and

safety or responding personnel.

Has had an experience in emergencies and

disasters.

Good decision-making abilities.

Has sound knowledge in evacuation procedures.

Functions &

Responsibilities

Obtain appointment and briefing from the Incident

Commander.

Implement the emergency lockdown policy and

personnel identification policy.

Establish Security Command Post.

Remove unauthorized persons from restricted

areas.

Establish ambulance entry and exit route in



cooperation with Transportation and Staging

Officer.

Secure the Command Post, Advance Medical Post,

Triage and Treatment Areas including the Morgue

Area and all other sensitive or strategic areas from

unauthorized access.

Full understand the importance of his roles

especially in the safety of the responders.

Secure and post non-entry signs around unsafe

areas.

Always alert to identify and report all hazards and

unsafe conditions to the Incident Commander.

Secure areas evacuated to and from, to limit

unauthorized personnel access.

Initiate contact with fire, police agencies through

the Liaison Officer, when necessary.

Advise the Incident Commander and others

immediately of any unsafe, hazardous or security-

related conditions.

Confer with Public Information Officer to establish

areas for media personnel.

Establish routine briefing with Incident Commander.

Provide vehicular and pedestrian traffic control.

Secure food, water, medical, and blood resources.

Document all actions and observations

Can order stoppage of operation if unsafe.

Identifications Use of any identification hat or vest.

PUBLIC INFORMATION OFFICER (PIO)

Mission Provide information to the public and the media.

Qualifications Knowledgeable on communication aspect

especially in collating relevant information needed

Knowledgeable in media handling.

Preferably with experience in emergencies and

disasters.

Preferably with understanding of Mass Casualty

Management.

Good communication skills and interpersonal



relationships.

Sensitive on restriction in contents of news and

patient care activities.

Functions &

Responsibilities


Commander.

Ensure that all news releases have the approval of

the Incident Commander.

Responsible for collating relevant information

needed to inform the public and for media.

Releases; obtain progress reports from respective

areas as appropriate.

Issue an initial incident information report to the

news media especially on the casualty status and

the actions being done.

Schedule press conferences on a regular basis.

Inform on-site media of the physical areas that they

have access to, and those which are restricted.

Coordinate with Safety and Security Officer.

Contact other scene agencies to coordinate

released information.

Direct calls from those who wish to volunteer to

Liaison Officer. Contact Operations to determine

request to be made to the public via the media.

Identifications Proper signage (hard hat with mark of Public

Information Officer or a vest)

LIAISON OFFICER

Mission Functions as incident contact person for

representatives from other agencies (government or

private).

Qualifications Preferably with experience in liaison procedures

and coordination.

Good or excellent public relation skills.

Preferably with understanding of Mass Casualty

Management.

Understand the bureaucracy and working

relationships of the different government as well as

private agencies responding to emergencies and



disasters.

Good grasp of patient care and management in

mass casualty situation; informed on inter-hospital

emergency communication network, municipal

operation centers and/or province, region or

national as appropriate.

Knowledgeable on the inventory of resources

available in the area/country.

Understand municipal (provincial, regional,

national) organizational charts to determine

appropriate contacts and message routing.

Functions &

Responsibilities


Commander.

In coordination with the Public Information Officer

should always be knowledgeable on the following:

The number of “Immediate” and “Delayed”

patients that can be received and treated

immediately (Patient Care Capacity); also the

status of all other victims, especially in mass

dead situations

Any current or anticipated shortage or

personnel, supplies, etc.

Number of patients transferred to hospitals.

Any resources which are requested by each

area (i.e., staff, equipment, supplies)

Establish contact with liaison counterparts of each

assisting and cooperating agency.

Keep appropriate agency Liaison Officers updated

on changes and development of response to

incident.

Request assistance and information as needed

through the different networks of government and

private organizations responding to emergencies

and disasters.

Respond to request and complaints from incident

personnel regarding inter-organization problems.

Prepare to assist Labor Pool with problems

encountered in the volunteer credentialing process.



Identifications Use of any identification (hat or vest)

LOGISTIC SECTION CHIEF

Mission Organize and direct those associated with

maintenance of the physical environment, and

adequate levels of food, shelter, supplies and other

resources needed to support the objectives of the

incident.

Qualifications Preferably with experience in logistics

management.

Preferably with experience in emergencies and

disasters.

Understands the bureaucracy and working

relationships of the different units in government

especially in procurement and emergency

purchases.

Good grasp of procurement procedures;

knowledgeable in accessing supplies, medicines

and equipment needed during emergencies.

Good coordination with pharmaceuticals,

companies and suppliers and knowledgeable on

database of available resources in the market.

Functions &

Responsibilities


Commander.

Establish Logistics Section Center in proximity to

the Command Post.

Brief all his staff on current situation; outline action

plan and designate time for next briefing.

Attend damage assessment meeting with Incident

Commander.

Coordinate with companies regarding stock level;

available supply and equipment.

Anticipate needed logistical requirements.

Obtain information and updates regularly; maintain

current status of all areas; communicate frequently

with Emergency Incident Commander.

Obtain needed supplies with assistance of the

Finance Section Chief and Liaison Unit Leader.

Identifications Proper signage (hat or vest).



PLANNING SECTION CHIEF

Mission Organize and direct all aspects of Planning Section

operations. Ensure the distribution of critical

information/data. Compile scenario/resource

projections from all areas and effect long-range

planning. Document all activities.

Qualifications Preferably senior official with adequate knowledge

in planning and decision-making.

Have had experiences in emergencies and disaster

situations in addition to crises management.

Adequate knowledge of the government

bureaucracy and the role of the different

government entities responding to emergencies

and disasters..

Good coordination and networking skills.

Functions &

Responsibilities


Commander; have regular updates as appropriate.

Brief members of the staff after meeting with

Incident Commander.

Provide for a Planning/Information Center.

Recruit a documentation aide from the Labor Pool.

Appoint Planning Unit Leaders, Situation Status

Leader, and Labor.

Pool and other appropriate positions as needed.

Ensure that all appropriate agencies are

represented in this section.

Ensure the formulation and documentation of an

incident-specific action plan. Distribute copies to

Incident Commander and all areas.

Call for projection reports (Action Plan) from the

Planning Unit Leaders for scenarios 4, 8, 24, and

48 hours from time of incident onset. Adjust time for

receiving projection reports as necessary.

Instruct staff to document/update status reports

from all areas for use in decision-making and for

reference in post-disaster evaluation and recovery



assistance applications.

Schedule planning meetings to include Planning

Section Unit Leaders, Section Chiefs and the

Incident Commander for continued update of the

Action Plan.

Coordinate with the Liaison Officer and Labor

especially with regards to manpower requirements.


FINANCE SECTION CHIEF

Mission Monitor the utilization of financial assets. Oversee the

acquisition of supplies and services necessary to carry

out the objective of the incident. Supervises the

documentation of expenditures relevant to the

emergency incident.

Qualifications Preferably a senior official with adequate

knowledge in financial management.

Had experiences in emergencies and disaster

situation

Adequate knowledge on the government

bureaucracy and the role of the different

government entities responding to emergencies

and disasters.

Good resource manager; knowledgeable on

tapping other resources.

Functions &

Responsibilities


Commander.

Appoint members of his staff preferably the

following: Time Unit Leader, Procurement Unit

Leader, Claims Unit Leader, Cost Unit Leader and

other appropriate positions as he desires.

Establish a Financial Section Operation Center.

Ensure adequate documentation/recording

personnel. His station need not be within the area

of incident.

Confer with Unit Leaders after meeting with

Incident Commander and develop an action plan.

Approve a “cost-to-date” incident financial status



report eight hours summarizing financial data

relative to personnel, supplies and miscellaneous

expenses.

Obtain briefings and updates from Incident

Commander as appropriate. Relate pertinent

financial status reports to appropriate chiefs and

unit leaders.

Schedule planning meetings to include Finance

Section Unit Leaders to discuss updating the

section’s incident action plan and termination

procedures.


OPERATIONS SECTION CHIEF

Mission Organize and direct aspects relating to the Operations.

Carry out directives of the Incident Commander.

Qualifications Knowledgeable on Operation Procedures;

understands well the organizational chart in MCI.

Preferably has experience in handling “on-scene”

Mass Casualty Incident with varied knowledge of all

types of operations (Search and Rescue, Fire,

Medical etc.)

Must be a crisis manager and with leadership skills.

Good communicator and can stand pressures.

Must know capabilities of people for proper

assignments.

Functions &

Responsibilities


Commander.

Responsible for all specific sections of the

operations (ex. Medical, Search and Rescue, Fire

Suppression and others) depending on the incident

Establish Operations Section in the Command Post

preferably with the Incident Commander.

Brief all Operation Officers on current situation and

develop the section’s initial plan.

Designate times for briefings and updates with all

Operations Officers to develop/update section’s

action plan.



Ensure that all areas are adequately staffed and

supplied.

Brief the Emergency Incident Commander routinely

on the status of the Operations Section especially

on the status of all patients, problems encountered,

resources needed, etc.

Ensure that all actions and decisions are

documented.

Observe all staff and personnel for signs of stress

and inappropriate behavior and report concerns to

Psychosocial Supervisor. Ensure rotation of all

personnel to prevent burnout among personnel.


TREATMENT TEAM LEADER

Mission Responsible for the management of the Treatment

Area and assigning of responsible supervisor for

specific areas (RED, YELLOW and GREEN

subsections). Assure treatment of casualties according

to triage categories. Provide for a controlled patient

discharge and transfer to appropriate hospitals.

Qualifications Preferably a general

surgeon/trauma/emergency/anesthesia/family

medicine physician.

Knowledgeable on Mass Casualty Management

and the organization chart.

Should have “on-scene” experience in MCI;

knowledgeable on triaging and skilled in field care

and field operation.

Skilled in emergency procedures, especially in life

sustaining and stabilization of patients.

Good in personnel management, especially in

stress situations.

Functions &

Responsibilities

Receive appointment and briefing from the Incident

Commander, Operation Chief/Field Medical

Commander.

Organize the treatment area, assigning all

members to their specific assignments and



responsibilities. In cases of WMD, treatment area

should be at the cold zone.

Appoint Unit Leaders for the following treatment

areas in pre-establish locations: Second Triage;

Immediate Treatment (RED); Delayed Treatment

(YELLOW); Minor Treatment (GREEN); Discharge.

Supervise the receiving of patient from the Initial

Triaging from the site, re-triage the victims and

institute measures to stabilize the victims; ensure

that all victims are continuously monitored.

Assess problems and treatment needs, and

customize the staffing and supplies in each area.

Receive, coordinate and forward request for

personnel and supplies to the Field Medical

Commander and/or Staging Officer.

Contact the Safety and Security Officer for any

security needs in the area.

Establish 2-way communication (radio or runner)

with Field Medical Commander, Triage, Transport

and Staging Officers.

Coordinate with Transport Officer, decide on the

order of transfer of victims, the mode of transport,

escort and place of transfer.

Document everything with regards to every

individual patient brought to the area using the

individual treatment form.

Regularly report to the Field Medical Commander.

Observe and assist any staff that exhibits signs of

stress and fatigue. Report any concerns to

Psychosocial Supervisor. Provide for staff rest

periods and relief.


TRIAGE TEAM LEADER

(INITIAL)

Mission Sort casualties at the site according to priority of

injuries, and transfer (according to tagging priorities) to

the treatment area.



Qualifications Any of the following:

Doctor of Medicine preferably trained in

emergency medical care and triaging.

Nurse, paramedic with appropriate training in

emergency, medical care and basic triaging.

Knowledgeable on mass casualty management and

has had experience in “on-site” mass casualty

incident; skilled in field care and field operations.

Functions &

Responsibilities

Receive appointment and briefing from the Field

Medical Commander or previously designated by

the Incident Commander.

Assess first the safety in entering the incident area;

note abnormalities in the surrounding, any

untoward manifestations of the victims and

approximate number of casualties and the type of

injuries.

Protect self by using the appropriate Personal

Protective Equipment (PPE)

In cases of WMD, ensure that decontamination is

present before entering the incident site.

Report first to authority and request for additional

help before proceeding to actual triaging.

Quickly brief members of the Triage Team and

assign areas for triaging.

Tag the appropriate color to every patient as

follows:

RED – immediate stabilization necessary

YELLOW – close monitoring, care can be

delayed

GREEN – minor; delayed treatment or no

treatment

BLUE – near or almost dead

BLACK - dead

Document important things to consider in the site

for purposes of evidence by use of camera, by

mapping or sketching, etc. especially in WMD.

Ask first all walking wounded to go to an identified

place.



Provide and administer life sustaining support to

the patient in extreme cases (only for bleeding and

respiratory problems).

Bring patients to the Treatment Area accordingly to

priority.

Assess problem, triage treatment needs relative to

specific incident.

Identify a Morgue Manager and a Morgue Area for

black-coded victims.

Coordinate with Field Medical Commander and

Treatment Team Leader to report number and

types of casualties, including equipment needs.

Contact the Safety and Security Officer regarding

security and traffic flow needs in the Triage Area.

End his services once all patients are out of his

area and receive another assignment from the

Field Medical Commander.


TRANSPORT GROUP SUPERVISOR

Mission Coordinate the transfer for patient received from the

Treatment Area to the appropriate hospitals.

Qualifications Preferably a paramedic, nurse or doctor with basic

training in Basic Life Support.

Experience and knowledgeable in Mass Casualty

Management.

Skilled in ambulance traffic control; skilled in radio

communications.

Sound knowledge of country’s transportations

resources.

Sound knowledge of access routes to health care

facilities.

Familiar with terrain, road maps, alternate routes.

Has sufficient knowledge in the return time of the

ambulance.

Functions &

Responsibilities


Commander/Field Medical Commander.

Establish immediately an ambulance loading zone,



observing principles on way of traffic flow; identify

access routes and communicate traffic flow to

drivers.

Coordinate and supervise transport of victims from

the Treatment Area.

Ascertain all information relating to receiving

hospital (as to type of facility, bed availability,

hospital capability, contact ER medical officer, etc.).

Supervise all available ambulance drivers; assign

appropriate vehicle in accordance with status of

patients.

Receive request for transportation; Maintain a log

of the whereabouts of all vehicles under his control.

Ensure all patients transferred are tagged and with

their treatment form.

Brief ambulance crew as to the condition of the

patient, care required, access routes, traffic flow,

location of the receiving hospital and the

procedures in the endorsement of the patient.

Coordinate regularly with the Treatment Team

Leader/Staging Officer and report all patients

transferred and when the last person is

transported.

Document all activities in his area, including a

complete record of all patients.


STAGING OFFICER

Mission Coordinate all resources arriving at the scene. For

manpower resources, referring them to appropriate

area of assignment. For transportation resources,

organizing them and dispatching them as required.

Qualifications At least a paramedic or an EMT.

Preferably with knowledge in Mass Casualty

Management and understand the organizational

chart.

Functions &

Responsibilities


Commander/Operation Section Chief.



Identify suitable place for the Staging Area usually

away from the incident.

Organize, classify all transportation resources.

Coordinate with Transport Supervisor.

Dispatch appropriate vehicle as requested by

Transport Supervisor.

Coordinate with appropriate agencies with regards

to traffic flow and access routes within the site.

Direct all incoming responding teams to the Field

Medical Commander

Document all resources.

Identifications Any identification mark (hat or vest).

FIELD MEDICAL COMMANDER

Mission Organize, prioritize and assign officers under its

jurisdiction to areas where medical care is being

delivered. Advice the Operations Section

Chief/Incident Commander on issues related to

handling of the victims.

Qualifications Must be a Doctor of Medicine.

Must possess managerial skills in disaster.

Preferably with training and experience in MCI

management situations.

Knowledgeable in the hospital capability and

networking; having sound knowledge of country’s

health resources.

Skilled in pre-hospital care; skilled in radio

communications

Skilled in staff management; skilled in logistical

operations.

In the absence of the above the first who arrives at

the scene preferably on the of following:

Municipal Health Officer, City Health Officer,

any Emergency Health Physician

Emergency Critical Nurse (in the absence of an

MD)

Private MD with experience in emergency care

Can first assume the position and later endorse



(face to face) providing an orderly transfer of

command to the next incoming qualified medical

personnel.

Functions &

Responsibilities

Receive appointment from the Incident

Commander/Operations Section Chief.

Identify the suitable site for the Advance Medical

Post and inform everybody.

Responsible for the different members of his team

(if not yet identified): Triage Officer, Treatment

Officer, Transport Officer, Mortuary Officer.

Responsible that all the needed medical resources

be mobilized and available.

Report and coordinate with the Operations/Incident

Commander; likewise attend meetings and press

conferences.

Ensure the welfare and safety of the medical team,

including relief and sustenance (decking,

scheduling, pullback, etc)

Conduct regular meetings with his designated

officers in the area.

Anticipate other concern and regularly confer with

the Operation Officer/Incident Commander.

Responsible that all the necessary recording of the

events be done and all required reports to all the

authorities be submitted on time.

Evaluate the whole activity and make the

necessary recommendations to improve future

responses.

Coordinate and regularly report to the Medical

Controller of the DOH Operation Center/Regional

Operation Center.


MORGUE MANAGER

Mission Collect, protect and identify deceased patients.

Qualifications Doctor of Medicine aided by a social worker, a

psychosocial support officer.

For medico-legal cases forensic experts from the



PNP Crime Laboratory or the National Bureau of

Investigation will be part of the team.

Functions &

Responsibilities

Receive appointment and briefing from the Triage

Officer/Field Medical Commander.

Identify and establish the Morgue Area; coordinate

with the Triage Officer and Treatment Officer.

Maintain master list of deceased patients with time

of arrival.

Assure that all personal belongings are kept with

deceased patients and are secured.

Assure that all deceased patients in Morgue Area

are covered, tagged and identified when possible.

Provide a system or procedures for identifying and

endorsing the body of the deceased to authorized

members of the family.

In medico –legal cases consult with PNP and NBI

with regards to procedures necessary for proper

identification and for evidence collection and

preservation.

Keep Triage/Treatment Officers appraised of

number of deceased.

Contact the Safety and Security Officer for any

morgue security needs.

Arrange for frequent rest and recovery periods as

well as relief for staff.

Schedule meetings with the Psychological Support

Unit Leader to allow for staff debriefing.

Observe and assist any staff that exhibit signs of

stress or fatigue. Report any concerns to the

Treatment Area Supervisor.

Review and approve the area documenter’s

recording of actions/decisions in the Morgue Area.




Q. Hospital policies, guidelines, protocols, and other issuances relevant to

emergency or disaster management

1. Lung Center of the Philippines Policy on Health Emergency

and Disaster Management

a. General Objectives

The hospital prior to a health emergency event

undertakes development activities to enhance its capacity to

manage all types of hazard and systematically carry out

response to recovery, ensuring a better level of function in

health emergency management.

b. Legal Framework

DOH Administrative Order No. 6-B of 1999:

Institutionalization of a Health Emergency Preparedness and

Response Program within the Department of Health and

DOH Administrative Order No. 168 s 2004. It stated that all

hospital must have a working and updated health emergency

preparedness, response and recovery plan as a basic

requirement by the Bureau of Licensing of the Department of

Health.

c. Rationale

This aimed to promote health emergency

preparedness among the general public and strengthen

health sector’s capability to respond to emergency and

disaster. The administrative order likewise gives advice and

policy directions regarding health emergencies. It embodies

the framework of Health Emergency Management (HEM).

HEM strategies, organizational structure, human resource

development, support systems and roles and responsibilities

of HEMS, DOH offices, and attached agencies, and other

health sector.

d. Statement of Policy

1) All hospital personnel must have a full knowledge and

understanding of the Hospital Health Emergency

Preparedness, Response and Recovery Plan



Guidelines

a. Before a Health Emergency Preparedness Response

and Recovery can be perceived a reality, a planning

committee must be formed and must be supported by

a Center Order.

b. Members of the committee must be equally

represented to the different main section of the

organization and this must be headed by the

Executive Director or by the Deputy Director. The

members are:

i. Medical

ii. Nursing

iii. Pathology

iv. Radiology

v. Infection Control

vi. GSD

vii. Finance

viii. HEMS

ix. Representative from Medical Specialty Society,

PNRC and BFP

c. The committee’s function is as follows:

i. Review existing HEPRR plan and makes

necessary updates

ii. Review roles and responsibility of members of

the committee

iii. Assignment of major responsibilities within the

hospital for emergency prevention, preparedness

and response.

iv. Selecting priorities for the acquisition of

emergency supplies and medicines.

v. Initiates testing of the plan for its functionality

and adaptability to a multi hazards situations.



d. The committee will meet Quarterly, first Tuesday of

the Week.

e. The committee chair will be responsible for the

dissemination of the hospital emergency plan.

f. The plan must be included in the orientation of newly

hired employees.

g. Orientation for all employees must be done gradually

with adequate testing, monitoring and evaluation.

2) All hospital personnel must attend the Basic Life Support

Training.

Guidelines:

a. Basic Life Support Training has two main courses

namely:

i. BLS for Healthcare Provider

ii. BLS for Lay Rescuer

b. Hospital personnel will be classified into Healthcare

Provider and Lay Rescuer

c. Personnel that are included in the medical services

are classified as healthcare provider, and on the other

hand personnel that are part of administrative section

are classified as lay rescuer.

d. BLS is a two-day course training whether participants

are healthcare or lay.

e. BLS trainers are all DOH certified and have

undergone DOH BLS Training of Trainer Course.

f. BLS training expenses are charged to the DOH-

HEMS sub-allotted funds.

g. The conduct of BLS training is done every last

Thursday and Friday of a month except January and

December.

h. All personnel must undergo medical screening prior to

the training.



i. Personnel who are fit and failed to attend the course

will be rescheduled the next available month.

j. The BLS training program is in collaboration with the

Professional Education and Training Services and

LCP Health Emergency Management Staff.

k. BLS training program is also open to the public who

meet some basic requirements such as age limit,

medical conditions.

l. Participants from other Government agencies are free

of charge provided they must ask written permission

to the executive director of the hospital and available

slot are still open.

m. Reservation are entertain provided that five days prior

to the said training the fee must be settled otherwise

the slot will be given to others.

3) All hospital personnel must know the Hospital Emergency

Incident Command System and the basic on Mass

Casualty Management.

Guidelines

a. A lecture will provided by HEMS on Hospital

Emergency Incident Command System and on Mass

Casualty Management.

b. After the said conduct of series of lectures, a table top

exercise will be given to simulate an incident.

c. An actual drill may be given to test state of readiness

and understanding of the system.

4) All hospital personnel must participate in the conduct of

fire/earthquake seminar and drill.

Guidelines

a. Fire and Earthquake Seminar/Drill is a requirement for

one institution to operate legally.



b. Fire and Earthquake Seminar/Drill is conducted by the

bureau of fire department semi-annually that is every

first week of June and November.

c. The seminar is a two day seminar with didactic lecture

on the first day and practical demonstrations on the

second day.

d. Failure to attend such seminar is an insubordination

of a direct order.

e. The actual drills are announced the next month after

the seminar.

f. The drills are the responsibility of the GSD in

coordination with the PETS and HEMS.

g. An honorarium will be given to the invited lecturer

other than the DOH personnel provided that the latter

must give his/her resume as per requirement by the

Commission on Audit.



2. Lung Center of the Philippines Policy on Fire Safety

a. General Objectives

It is necessary that LUNG CENTER OF THE

PHILIPPINES should recognize and accept that fire and

foremost consideration and that functioning fire safety

system in building and structures should be ensured.

Preparedness of hospitals and other health facilities

must be put in place at all times.

b. Legal Framework

The design, construction and maintenance of

buildings, structures and facilities shall adhere to all

applicable provisions of the Fire Code of the Philippines.

Electrical systems, equipment and installation

mentioned in the Fire Code shall conform to the provisions of

the Philippine Electrical Code. Likewise, mechanical

systems, equipment and installation mentioned in the Fire

Code shall conform to the provisions of the Philippine

Mechanical Engineering Code.

c. Rationale

The built environment in hospitals and other health

facilities is becoming more complex as these institutions plan

and design their buildings and structures to response to the

demands of their growing bed capacity and service capability

and advance technology for quality healthcare services

delivery.

However with the continuing physical development in

hospitals and other healthcare facilities, comes the

corresponding responsibility of keeping the buildings and

structures properly maintained and safe especially against

man-made disasters.

Fire, which can be the most devastating but

preventable ma-made disaster to happen to hospitals and

other healthcare facilities, may result in loss of lives, loss of

essential equipments, damaged to infrastructures and

displacement of hospital employees. It can suspend

infrastructure projects, waste hard fought resources, and



they make our citizens suffer unnecessarily through the long

rehabilitation or reconstruction period.

d. Policy

The management of the Lung Center of the

Philippines holds in high regards the safety, welfare and

health of its employee, patients, and other clients.

Accordingly, it is the policy of the institution to integrate

safety in every work stage and to promote and maintain a

good working environment to safety guards all personnel,

facilities and equipments.



R. Post Mission Report



S. Hospital Floor Plan









T. Metro Manila DOH HEMS Zoning Plan for Emergency Response



U. References

1. Guidelines on Hospital Health Emergency Management, 2nd Edition.

Department of Health-Health Emergency Management Staff. 2008.

2. Guidelines for Health Emergency Management, Operation Center, 2nd

Edition. Department of Health-Health Emergency Management Staff.

2008.

3. Guidelines on Hospital Health Emergency Management for the

Centers for Health Development, 2nd Edition. Department of Health-

Health Emergency Management Staff. 2008.

4. Safe Hospitals in Emergencies and Disasters. Philippine Indicators,

2nd Edition. Department of Health-Health Emergency Management

Staff. 2009

Documents

Health Emergency Preparedness, Response and Recovery …lcp.gov.ph/images/Brochures/LCP-Health Emergency Plan_Revised... · page ii lung center of the philippines emergency preparedness,