code alert system
TRANSCRIPT
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HARMONIZATION OF CODE ALERT SYSTEM
DOHHEMS CENTRAL OFFICE HOSPITAL CENTER FOR HEALTH DEVELOPMENT
CODE WHITE1. Conditions for Adopting Code White:
Strong possibility of a military operation e.g.coup attempt/ armed conflict which have anational implication
Any planned mass action or demonstrationwhich have a national implication
Forecast Typhoons (signal 2 up) National or local elections and other political
exercises National events, holidays or celebrations with
potential for MCI Any emergency with potentially 1-50
casualties (deaths, injuries) Notification of reliable information of terrorist/
attack activities
Unconfirmed report of reemerging diseaseseg. bird flu or SARS Any other hazard that may result to
emergency
1. Conditions for Adopting Code White: Strong possibility of a military operation
within the area/ region e.g. coup attempt Any planned mass action or demonstration
within the catchment area Forecast Typhoons, (signal 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 Any emergency with potentially 1-50
casualties (deaths, injuries) Unconfirmed report of reemerging diseases
eg. bird flu, SARS within the region Any other hazard that may result to
emergency
1.Conditions for Adopting Code White: Strong possibility of a military operation
e.g. coup attempt within the region Presence of hazards that pose a public
threat such as epidemics, chemical,biological and radiological threat, etc.
Notification of on-going epidemic by LGU,with adequate measures by local healthpersonnel.
Any planned mass action ordemonstration in the area
Forecast Typhoons (signal 2 up) the pathof which will affect the area
National or local elections and otherpolitical exercises
National events, holidays or celebrationswith potential for MCI
Any emergency with 1-50 casualties(deaths, injuries)
Unconfirmed report reemerging diseaseseg. of bird flu, SARS within the region
Any other hazard that may result toemergency
DOHHEMS CENTRAL OFFICE HOSPITAL CENTER FOR HEALTH DEVELOPMENT
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CODE WHITE2. Human Resource requirements for
responding to the System: Emergency Officer on Duty (EOD) 1 and 2 Driver and Security Guard to assist at the
Operation Center Reliever 1 and 2 (next day EODs) on stand
by Response Division Chief or alternate oncontinuous monitoring and will serve asMedical Controller for Mass Casualty Incident.
EOD to inform National Epidemiology Centerregarding the case for confirmatory report.
2. Human Resource requirements forresponding to the Code:
Manpower
First response team ready for dispatch toinclude the following: 2 doctors preferably Surgeon,
Internist, anesthesiologist, etc. 2 nurses First Aider/ EMT Driver
Second response team should be on call The following should be available for
immediate treatment of incoming patients General Surgeons Orthopedic Surgeons Anesthesiologists Internists O.R. Nurses Ophthalmologists Otorhinolaryngologists Infectious Specialists
Emergency service personnel, nursingpersonnel and administrative personnelresiding at the hospital dormitory shall beplaced on call status for immediatemobilization
2. Manpower requirements for respondingto the Code:
2 Emergency Officers on Duty Driver Regional HEMS Coordinator on call and on
proactive monitoring
One Rapid Assessment Team ready fordispatch to include the following: DOH Representative Nurse Driver
DOHHEMS CENTRAL OFFICE HOSPITAL CENTER FOR HEALTH DEVELOPMENT
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CODE WHITE3. Other requirements: EOD 1 to check all medicines, supplies
available EOD 1 & 2 to do proactive monitoring EOD to alert the region, hospitals and other
facilities that might be affected or needed to
respond or receive patients. Response Division Chief or HEMS Director toalert key officials as needed
3. Other requirements: The Hospitals Operation Center should
be activated. It should continuously reportand coordinate with the Regional and DOHCentral Operation Center
Medicines and Supplies
Ensure that emergency medicines(especially for trauma needs) be madeavailable at the emergency room
Medicines and supplies in the operatingrooms should likewise be reviewed andincreased to meet sudden requirements
Other needs such as x-ray plates,laboratory requirements, etc. should bemade available and not required to bepurchased by victims
Personnel department to prepare formobilization of additional staff
Finance department to ensure availability offunds in cases of emergency purchases
and the like Logistics department to coordinate with
possible suppliers for additionalrequirements
Dietary department to open and meet theneed of the victims as well as the healthpersonnel on duty
Security force to institute measures andstricter rules in the hospital
Activate Bird Flu Plan/ SARS Plan etc. Enforce and monitor use of Personal
protective equipment for all healthpersonnel.
Triage system should be activated
3. Other requirements: The Regional Operation Center should
be activated on 24 hours and the DOH-Continuously report and coordinate withHEMS Operation Center
Do proactive monitoring for any development
Report to HEMS-OPCEN daily and asnecessary Require update from field as necessary Finance Division to ensure availability of funds
in cases of emergency purchases and the like Supply section to coordinate with possible
suppliers for additional requirements Transport section to ensure availability of
vehicles Monitor and assess continuously for
requirements of other teams (medical,surveillance, environmental, health promotion,psychosocial etc.). These teams are onstandby/ on call for immediate mobilization.
Intensify IEC campaign through healthadvisories
Coordinate regularly with affected LGUs Coordinate with Regional hospitals for back-up
teams Monitor stock level of needed drugs/ supplies,
preposition as needed Activate Bird Flu Plan Mobilization of RESU team to conduct
investigation.
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DOHHEMS CENTRAL OFFICE HOSPITAL CENTER FOR HEALTH DEVELOPMENT
CODE BLUE1. Conditions for Adopting Code Blue Any condition mentioned in Code White
plus any of the two below:
Mobilization of DOH resources is needed(manpower, materials, etc.)
30-50% health facilities in the areas affectedor damaged
No capability of the LGU and/ or lack ofresources of the Region to respond to theaffected area
Magnitude of the disaster based ongeographic coverage and number of affectedpopulation (more than 30%)
Any Mass Casualty Incident (MCI) with 50-100 casualties irrespective of color code
High case fatality rate for epidemics
Confirmed human to human for avian flu orSARS
1. Conditions for Adopting Code Blue: Anyof the following conditions: When 20-50 casualties (red tags) are
expected or suddenly brought to thehospital
Any internal emergency/ disaster in thehospital which brings down their operatingcapacity (i.e vital areas) to 50% or whichwould require evacuation of patients andsetting up of a Field Hospital
For conditions other than MCI, the in flux ofpatients is beyond the capacity of thehospital to handle
Confirmed/Documented report ofreemerging diseases (SARS, human tohuman avian flu) in the area
Conditions for Adopting Code Blue:Any of the following conditions:
Expected 50-100 casualties irrespectiveof tags for MCI.
Declaration of epidemic;confirmed/documented report ofreemerging diseases (SARS, human tohuman avian flu) within the region
Declaration of calamity in any provincein the region
Presence of evacuation centers estimatedto last for more than a week which haspublic health implications
Magnitude of the disaster based ongeographic coverage and number ofaffected population (more than 30% )
Any conditions that would requiremobilization of resources of the entireregion
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DOH HEMS CENTRAL OFFICE HOSPITAL CENTER FOR HEALTH DEVELOPMENTCODE BLUE 2. Manpower requirements for responding to
the Code: Response Division Chief or alternate as team
leader should be physically present at OPCEN EOD 1 and 2 Driver and Security Guard to assist at the
Operation Center Incoming EODs on call for immediate
mobilization
Logistics Officer or alternate to go on duty At least one DOH representative to go on
duty to NDCC if required and/or
requested
2. Manpower requirements for respondingto the Code: HEMS Coordinator to be physically present
at the hospital On-Scene Response Team Medical Officer in charge of the Emergency
Room All residents of the Department of
Orthopedics Medical Officer in charge of the Operating
Room Surgical Team on duty for the day Surgical team on duty the previous day Mental health professionals All anesthesiology residents Toxicologist, chemical experts for poisoning
and/ or chemical cases (if available) All third and fourth year residents Administrative Officer of designate Nursing supervisor on duty All OR nurses Social workers Dietary personnel Officer in charge of supplies at the CSR The entire security force and Institutional workers on duty
Manpower requirements for responding tothe Code:
RHEMS Coordinator to be physically presentat OPCEN
Rapid Assessment Teams and otherappropriate teams (RAT)
Three (3) teams on standby (environmental/surveillance/ medical)
EOD 1 and 2 Logistics Officer Finance Officer as necessary Health Promotions Officer as necessary DriverAll other regional staff on standby for
immediate mobilizationAll DOH REPS in the affected area should be
available at the LGU
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CODE BLUE Other requirements: Coordinate with the following: Implementing agencies (hospitals,
region, central office) for possibledispatching of teams or experts
NDCC and other sectors for otherconcerns e.g. transportation, etc.
MMD regarding supplies available at DOH Different DOH Central Offices for
personnel augmentation to the OperationCenter and for other technical support
Prepare possible drugs and medicines neededfor movement to affected area
If needed drugs/medicines not available,prepare emergency purchase
Check all possible means of transportation ex.With NDCC, air cargo, etc.
Anticipate need of medical teams and otherexperts
Prepare all needed reports and presentationrequired especially for emergency NDCCmeetings
Orient staff to be deployed to NDCC andthose additional staff to augment the OPCEN
In cases of long term emergencies, plan forsupport to the affected region.
Activate Code Blue for HEMS and preparenecessary documentation
Initiate the conduct of coordinative meetingof the national clusters: Health, Nutrition andWASH
Other requirements:All those mentioned in Code White plus
Activate Hospital Emergency IncidentCommand System (HEICS)
Other needs of victims apart from medicinesand supplies depending on the disaster
should as much as possible be made available The Chief of Hospital/ Medical Center or his
designate should make proper coordinationwith other hospitals for networking and/ orpossible transfer of patients.
Incident Command should assign a SafetyOfficer, Liaison officer, Public Information
Officer to coordinate with other agencies andserves as the spokesperson of the hospital
Social Service section should prepareassistance to victims in coordination withmental professionals of the Hospital ifavailable and the Department of Social
Welfare; in addition they should lead inproviding information to relatives of victims
Mortuary section should anticipate deadvictims brought to the hospital for proper careand identification
The security team in anticipation of possibleinflux or patients, relatives, responders,police, press etc. should ensure smooth flowof traffic inside the compound especially forthe ambulances.
Should report regularly to HEMS OPCEN andas much as possible regular report to media
Other requirements:All those mentioned in Code White plus:
Activate the Regional EmergencyIncident Command System (REICS)
Operation Center on 24/7 with adequatepersonnel and logistical support to
receive, evaluate, analyze all reports. Mobilize teams to affected areas for Rapid
Assessment in coordination with the DOH Rep Regional Director or his designate to make
proper coordination with RDCC and otheragencies like DSWD, DEPED etc. fornetworking and other requirements
Incident Command should assign neededstaff in Operations, Logistics, Planning andAdministrative to assist affected LGUs
Public Information Officer to prepare andhave regular media conference or pressrelease.
Continuous IEC campaign through healthadvisories especially in evacuation centers.
May need to activate also a Field EOC asneeded to coordinate health activities
Oversees operation of Management of MassDead together with the Health unit of theLGU concerned
Leads in coordinative meetings of thedifferent cluster under the DOH: Health,Nutrition and WASH.
Provides technical support to LGUs Mobilize other requirements as needed such
as psychosocial team etc.
Regularly coordinate with DOH-HEMSOPCEN for reports and other needs.
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DOHHEMS CENTRAL OFFICE HOSPITAL CENTER FOR HEALTH DEVELOPMENT
CODE RED 1. Conditions for Adopting Code Red Any natural, manmade or technological where
all of the following are present
Declaration of disaster to the affected area 100 or more casualties in one area Health personnel in the region not capable to
handle entire operation Mobilization of the health sector needed Mobilization of key offices in DOH Uncontrolled human to human transmission
of SARS/Avian flu
1. Conditions for Adopting Code Red
Any of the following is present:
When more than 50 (red tag) casualties aresuddenly brought to the hospital
An emergency wherein the service of thehospital is paralyzed due to 50% of themanpower are victims of the disaster
Hospital is structurally damaged requiringevacuation and/or transfer of patients l
Conditions requiring mandatory quarantine ofhospital and its personnel (e.g. sars, avianflu); Uncontrolled human to humantransmission of SARS/Avian flu in the area
1. Conditions for adopting Code RedAny of the following is present:
Conditions resulting to mass dead andmissing
Disaster declared in 2 or more provincesin the region/ 30% of the Cities in MetroManila.
Major Facility or Hospital such as theProvincial/ City/ Hospital in area are notable to provide optimal services due todamages or 50% of staff are affected
Mobilization of entire regional resourcesnot enough and thus require externalsupport
Uncontrolled epidemic/outbreak Uncontrolled human to human
transmission of SARS/Avian Flu withinthe region
2. Manpower requirements for responding tothe Code:
The HEMS Office personnel and staff augmentationfrom other offices shall be divided into 3 teams to goon a 24 hour duty rotation every 3 days. The team is
composed of the following: Team Leader 2 Data Collector/ Encoder Logistics Communication Administrative Officer Support Staff/ Clerk Driver At least 1 staff to be assigned at OCD OPCEN
on 24 hours duty
2. Manpower requirements for responding tothe Code:
All personnel enumerated under Code Blue All medical interns and clinical clerks All nurses All nursing attendants All institutional workers All administrative staff
2. Manpower requirements for respondingto the Code:
Mobilize all regional staff as needed onrotation basis
Establish surveillance system in allevacuation centers
All other teans deployed in affected area
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DOHHEMS CENTRAL OFFICE HOSPITAL CENTER FOR HEALTH DEVELOPMENT
CODE RED Other requirements HEMS to represent the Department of
Health to NDCC and other agencies.
Leads in the coordination with internationalpartners in the Health, Nutrition and WASHClusters.
Leads in the coordination with all membersof the health sectors
Leads in the coordination with donoragencies both international and local.
Prepares updated reports for use ofSecretary, and other partners
Assists in the preparation of therehabilitation and recovery plan; representthe DOH in the national DANA team
HEMS OPCEN to serve as DOH CommandPost for SARS/Avian Flu
Activate Crisis Committee who serves as thetechnical, operations arm and preparesrecommendation to the Execom of DOH tobe chaired by the Undersecretary for PolicyDevelopment Team for Service Delivery andto be assisted by the Directors of HEMS,NEC, NCDPC, NCHFD, Finance,Administrative and MMD
Other requirementsAll those mentioned in Code Blue plusThe Chief of Hospital/ Medical Center Chiefs can
cancel all types of leaves and can order allpersonnel to report to the hospitalThe Chiefs of Hospital/ Medical Center Chiefs
can temporarily stop all elective admissions andsurgeries and network with other hospitals
The Chief of Hospital/ Medical Center Chiefsshould anticipate requests ofadditional manpower and specialists notavailable in his hospital. He is further authorized
to accept medical volunteers and otherprofessionals to augment its manpowerresources rather than transferring patients
based on some agreements.Networking with other hospitals for
augmentation of resources and transfer ofpatients in special cases
Answers all queries of the media pertaining topatients in the hospital
Anticipate evacuation and/or use of fieldhospital; closure and/or quarantine of thehospital
The Chief of Hospital/Medical Center Chief tospecifically be concerned with safety andsecurity of not only the patients but thepersonnel
Other requirementsAll those mentioned in Code Blue plus: The CHD Director can cancel all types of
leaves and can order all personnel to reportto the CHD.The CHD Director can stop all operations not
related to the disaster.The CHD Director should anticipate request ofadditional manpower and specialists notavailable in his CHD. He is further authorized toaccept volunteers and other professionals toaugment its manpower based on some
agreements. Continue networking with RDCC and itsClusters (Health, Nutrition, WASH). Public Information campaign.Handles queries from media.For reemerging diseases, to provide
leadership together with the LGU in decisionslike quarantine of the area and otherdecisions in preventing spread of theepidemic
Provide updated report to HEMS CentralOPCEN.
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DOHHEMS CENTRAL OFFICE HOSPITAL CENTER FOR HEALTH DEVELOPMENT
Procedures in implementing the Code Alert The HEMS Code Alert shall be declared by the
HEMS Director or by the Division Chief(Response or Preparedness)
Announced through telephone brigade Administrative Officer to prepare Office
Order/ Department Personnel Order HEMS Director or the Division Chief
(Response or Preparedness) lifts the CodeAlert and make necessary announcement
Procedures in implementing the CodeAlertThe Hospital Code Alert shall be declared by
the Secretary of Health or by the Director ofHEMS for external emergencies and/orincidents affecting national security ; by the
Medical Center Chiefs; Chiefs of Hospital;HHEMS Coordinator; Head of the DisasterCommittee of the Hospital emergencies withintheir catchments area or region
Chiefs of Hospital/Medical Center Chiefs toautomatically declare code white duringnational events and activities especially withthe potential of an MCI
Each hospital shall prepare its ownprocedures in declaring and lifting the Code
The alert level is raised, lowered or suspendedby the Secretary of Health, Director of HEMS forexternal emergencies and national events; therespective Medical Center Chiefs/ Chiefs ofHospital or their designates for emergencieswithin their catchments areas or region
Conditions to raise or supend the alert levelOnce the threat is increased or is no longer
present
Arrival of patients in the hospitals to warrantthe raising of the alert level; likewise alert canbe suspended when no significant incident ismonitored and the hazard or condition(typhoon, election, bombing etc.) is finishedand/or contained
Procedures in implementing the CodeAlertThe Regional Code Alert shall be declared
by the Secretary of Health or Director ofHEMS for emergencies with nationalimplications; Regional Director and RHEMS
Coordinator for internal (regional)Regional Directors to automatically declare
code white during national events andactivities especially with the potential of an
MCIThe alert is raised, lowered or suspended
by the Secretary of Health, HEMS Directorfor emergencies with national implications;by the respective Regional Director or
RHEMS Coordinator for internal (regional)emergencies Each Region shall prepare its own
procedures in declaring and lifting the Code
Conditions to raise or suspend the alert levelOnce the threat is increased or is no longer
present