900 Disaster Plan For Respiratory Care Services 900/ Page 1 of 5

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1 900 Disaster Plan For Respiratory Care Services 900/ Page 1 of 5 Description Respiratory Care Services will aid the medical staff in continuing and emergency care in the event of a disaster. The department's primary responsibility is to insure RCS staff safety and the availability and distribution of medical gases, supplies, and the various respiratory support devices as needed. The Technical Director or designee will decide if additional staff members need to be called in. If more staff members are needed, the Disaster Call Down List will be initiated. In the event of injury or death of Respiratory Care Services personnel (regardless of location), the Director will inform the Dean's Office at SFGH (x6-8505) and the Anesthesia Department at UCSF ( ). Hospital Incident Command System (HICS) is a standardized operating procedure and disaster response template that assists medical facilities in organizing its emergency disaster response. HICS is based on an organizational chart which clearly defines a chain of command and job descriptions (Job Action Sheets). The essence of the HICS structure is based on the organization of five sections: Incident Commander and Staff; Logistics; Planning; Operations; and Finance. In brief, during a disaster the administrator of the day elects to open the Incident Command Center (room 2A6). Job duties are assigned and job action sheets are distributed to instruct responding personnel on what to do, when to do it and who to report to when the job is done. This system enables the facility disaster management team to focus on critical issues during a crisis so that management of the situation is more organized. Procedure Alert Plan The Respiratory Care Service Department will be notified of a disaster through the disaster alert system on pager Nursing personnel in the ICUs will notify the therapists assigned to their area. Therapist(s) receiving the disaster alert will notify the supervisor on duty.. Priorities - Based upon the nature of the disaster the following priorities will be covered: 1. Ensure that all staff members on duty are safe and aware of the situation. 2. Notify the Director (415) If no answer, page: (415) and/or (415) Communicate with the Command Center

2 900 Disaster Plan For Respiratory Care Services 900/ Page 2 of 5 During any Emergency or Disaster Activation or Exercise, it is important to keep the Command Center (located in 2A6) advised of your department s status. You can best do this by: a. Complete the Department Operating Status Report (DOSR, or commonly known as the Orange Sheet ) and submitting it immediately to the Command Center. b. Calling to report any significant changes (number of patients, equipment failures or deterioration of any condition, etc.) or immediate needs (personnel, equipment, supplies, security, etc.) to: i. Command Center at extension ii. If unable to get through on either of these lines, call the regular 2A6 extension at iii. During a Power Failure, call 2A6 at or If still unable to reach the Command Center, page the Disaster Coordinator at c. Send in an Updated DOSR (clearly marked UPDATE) via runner at least every 2 hours during an extended event, or when requested by the Command Center. d. You can also fax information to the Command Center at , but all significant changes or immediate needs should be communicated via phone or in person / via runner. The fax line is also likely to be busy with external communications. NOTE: The phone numbers listed are ONLY operational when the Hospital Emergency Incident Command System (HEICS) has been activated. It takes several minutes to get all of the phones set up in the Command Post. Forms are located in Section 9 of SFGH Emergency Response Plan Include in list of available resources: number of standby ventilators; number of portable oxygen cylinders; levels of necessary supplies; and status of liquid oxygen supply (See Priority 1 above). Hand deliver status report to the 2A6 Command Center within 10 minutes. 4. Ensure proper functioning of the central oxygen system. The supervisor will ensure that this is done immediately following stabilization of the ICUs. The level of liquid oxygen in inches will be reported to the Command Center at

3 900 Disaster Plan For Respiratory Care Services 900/ Page 3 of 5 ext with a one or two sentence assessment of the oxygen supply situation. This information will be obtained by calling Plant Services at ext or by runner. If there is any question about possible damage to the liquid oxygen piping system, the level should be rechecked in minutes. Normal usage is about 30 inches per day. 5. Delivery of equipment and medical care. With the exception of those already assigned to an ICU, all available therapists will go to 4E for assignment. This includes all "walk -in" therapist volunteers. One therapist may be assigned to the ED, or the designated triage area if different. The supervisor will be responsible for allocating personnel as needed. Therapists will concentrate on insuring proper application of respiratory support, supplies and devices. Therapists will also assist in the transport of critically ill patients needing oxygen and/or respiratory support. Disaster Levels The hospital Administrator on Duty and executive administrator or designee will determine what level of disaster to declare. Level 1 Disaster: Is any circumstance that overwhelms the immediately available, in-house Emergency Department resources. Emergency Communications Dispatch announces a RED ALERT as the result of a city wide Multi-casualty Incident. 1. The Respiratory Care Supervisor or Charge Therapist is to complete Department Operating Status Report (DOSR) and deliver to Command Center (2A6). 2. Mobilize personnel resources per usual 900 or 911 protocols. a. Suspend routine treatments as needed to mobilize available personnel. 3. Stage Disaster ventilators in the ED and on the 1st floor (MRI Alcove) and 5th floor (Inside 5B and outside 5R) if need is anticipated. a. 10 Savina ventilators are located in the storage room between Central Distribution and Sterile Processing. 4. Inform the RCS Director of anticipated equipment shortages. a. Initiate steps to procure rental equipment if necessary. i. UHS (510) Level 2 Disaster: Any event that MAY or has resulted in a large number of casualties that will require hospitalwide mobilization in order to continue to provide care to existing and incoming casualties. This

4 900 Disaster Plan For Respiratory Care Services 900/ Page 4 of 5 would be the result of a moderate to severe single site emergency, or multiple small multicasualty incidents. 1. Notify the RCS Director, by calling their cell phone (415) If no answer, page: (415) , or page (415) Complete Department Operating Status Report (DOSR) and deliver to Command Center (2A6). 3. Suspend all routine assessments and treatments. 4. Assess medical gas integrity. a. Initiate steps to procure additional compressed medical gases if necessary, from Airgas. Airgas Delivery: b. Initiate medical air failure procedure in 6H-NICU if needed. 5. Assess electrical hospital power systems a. If required, stage emergency power supplies to the Critical Care units. b. Stage Disaster ventilators in the ED and on the 1 st floor (MRI Alcove) and 5 th floor (Inside 5B and outside 5R) if need is anticipated. i. 10 Savina ventilators are located in the storage room between Central Distribution and Sterile Processing (GL12). 6. Assess expansion capability to maintain Trauma Center services. a. Initiate Department Disaster Phone Tree if required. 7. Follow instructions from the Command Center.

5 900 Disaster Plan For Respiratory Care Services 900/ Page 5 of 5 Level 3 Disaster: Any event that WILL result in enough damage and casualties to require an extensive, coordinated response to minimize morbidity, mortality, and human suffering at SFGH. Citywide this would only result from a devastating event disrupting all city services and systems and results in a large number of casualties over a widespread area. However a LEVEL 3 Disaster Response may be ordered at SFGH following a severe internal disaster. (i.e. a severe explosion or widespread fire at the main hospital, or extended loss of utilities.) 1. Notify the RCS Director by calling their cell phone at (415) , if no answer page: (415) or (415) Complete Department Operating Status Report and deliver to Command Center (2A6). 3. The RCS Director or a designated alternate will initiate Department Disaster Call Down List. 4. Suspend all routine assessments and treatments. 5. Assess medical gas integrity. a. Initiate steps to procure additional compressed medical gases if necessary, from Airgas. Airgas Delivery: Assess electrical hospital power systems. a. If required, stage emergency power supplies to the Critical Care units. b. Stage Disaster ventilators in the ED and on the 1st floor (MRI Alcove) and 5th floor (Inside 5B and outside 5R) if need is anticipated. i. 10 Savina ventilators are located in the storage room between Central Distribution and Sterile Processing (GL12). Follow instructions from the Command Center