Aims & Objectives

Methods & Methodology Results

Conclusion

For further details Contact: Dr. Srihari Cattamanchi, 10-/2, Gandhi Road Extn, Chittoor -517001. A.P. India. Mob: +919994616329. Email: c.srihari@gmail.com Printed by

DISASTER DRILL - ASSESSMENT OF DISASTER PREPAREDNESS OF A TERTIARY CARE UNIVERSITY HOSPITAL, SOUTH INDIA.

Dr. Srihari Cattamanchi*, Dr. Trichur V. Ramakrishnan.Sri Ramachandra Medical College & Research Institute, Porur, Chennai – 600116. T.N. India.

• To objectively identify specific strengths and weaknesses of hospital & ED in response to a disaster.

• To assess disaster preparedness of Hospital & identify areas where improvement can be made.

• To provide a learning opportunity for disaster drill participants, and promote integration of lessons learned.

• To assess improvement in disaster preparedness in subsequent disaster drills.

Design:A prospective, observational,

analytical study.

Settings: During disaster drill conducted by Emergency department of Sri Ramachandra Medical College & Research Institute, a tertiary care university hospital & trauma centre, in chennai, S.India.

Instrument: By applying the Johns Hopkins/AHRQ drill performance evaluation tool, two hundred questions from the tool were coded as indicating better versus poorer preparedness.

Statistical Analysis: A “raw performance” score & the Kuder-Richardson inter-item consistency coefficient were analyzed.

Biannual disaster drill over 2 years involving three scenarios with multiple potential casualties

• 21 victims from bus accident into a gorge (21/07/2008)

• 49 victims from an explosion at public venue (29/09/2008)

• 25 victims from bus accident at busy roadway (08/01/2009)

• 23 Victims from mini bus head on collision with truck in near by village (12/09/2009)

Methodology: Before the drill, 3 emergency medicine PG’s & 3 External observers received a 4-hour training session, & later deployed to specific zones during drill.

FIRST DRILL• Initial drill was low key one.• Major deficiencies were noted .• A good control maintained over the

surge capacity. • Deficiency on availability of disaster

plan, identification of drill participants, streamlining of received information by command centre, Other agencies co – ordination and availability of communication systems

SECOND DRILL• Second drill was conducted with 49

victims from an explosion .• The ED was unable to address surge

capacity.

• Other areas were identified temporarily and minor injured (Green triage) patients were transferred there.• Lack of inter departmental coordination• Previous drill deficiences were rectified• The Police and other external agencies

were not involved.• Press was not involved in the drill.• All these factors lead to panic in the

hospital & city due to the drill.

THIRD DRILL• Third drill was with 25 victims. • Inter departmental coordination was

deficient.• All external agencies were informed.• Communication equipments were

upgraded.

FOURTH DRILL• Fourth drill was with 23 victims.• Involved both the press and the police.• Majority of deficiency were rectified

and most effeciently rectified.• Major problem was inter-departmental

coordination which was lacking behind.• Adequate supplies were available.

• Disaster preparedness and surge capacity appeared limited due to failure to integrate inter-departmental training & planning even though enough equipment and materials were available.

• The disaster exercise had greatest benefit for individuals and departments involved directly.

• The drill prompted wide review and upgrade of disaster plans at various departmental levels and hospital as a whole.

• Deficiencies were identified and ways to rectify them were discussed along with intense in – house educational program on disaster preparedness and response.

EMCON 2009 Guwahati