Medical Emergency Response Medical Emergency Response * Hendro Wartatmo * Hendro Wartatmo 1
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Medical Emergency ResponseMedical Emergency Response
* Hendro Wartatmo* Hendro Wartatmo
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Medical Emergency Response(s)Medical Emergency Response(s)Medical Emergency Response(s)Medical Emergency Response(s)
Fase Akut :
- 30 hari pasca kejadian( Bisa ) Berakhir pada saat yg tidak bersamaan- ( Bisa ) Berakhir pada saat yg tidak bersamaanuntuk tiap sektor
Disaster / Bencana
Major Incident / Musibah Masal
Epidemi / Wabah2
Medical Emergency ResponseMedical Emergency Response
Damagearea
TransportationTransfer
Hospitalisationarea area- Transferarea
3
Red Cross/Red Crescent
HospitalHospitalHealth Post
Community
HospitalHospital
Field Hospital
Health Center
4
( Intra ) Hospital Response( Intra ) Hospital Response
CC ddHospitalisationarea
•• C C ommandommand
•• S S afetyafety
•• CC ommunicationommunicationManagementSuportC C ommunicationommunication
•• A A ssessmentssessmentSuport
Medical•• T T riageriage
TT Suport•• T T reatmentreatment
•• T T ransportransport
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•• C C ommandommand
Hospital Hospital •• S S afetyafety
•• C C ommunicationommunication ppDisaster Disaster
PlPl
•• A A ssessmentssessment
•• TT riageriage PlanPlanT T riageriage
•• T T reatmentreatment
•• TT ransportransportT T ransportransport
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Disaster PlanDisaster PlanDisaster PlanDisaster Plan
•• Contingency PlanContingency PlanContingency PlanContingency Plan•• “ Plan B ““ Plan B “
B kB k hh d kd k•• BukanBukan hanyahanya dokumendokumen ::–– PernahPernah dilatihkandilatihkan–– Ada proses Ada proses evaluasievaluasi kontinyukontinyu–– RealistisRealistis
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Medical Emergency Response
DamageTransportationT f
Hospitalisation
Medical Emergency Response
area- Transferarea
Pr H pit l M di l R p nPre-Hospital Medical Response: - Triase- Resusitasi- StabilisasiStabilisasi- Transportasi
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Medical Emergency Response
DamageTransportationHospitalisation
g y p
area- Transferarea
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Initial AssessmentInitial AssessmentInitial AssessmentInitial Assessment
•• M = major incident standby / declaredM = major incident standby / declaredM major incident standby / declaredM major incident standby / declared•• E = exact locationE = exact location
T f i jT f i j•• T = type of injuryT = type of injury•• H = hazard, present and potentialH = hazard, present and potential•• A = AccessA = Access•• N = number of casualtiesN = number of casualtiesN number of casualtiesN number of casualties•• E = emergency services, present and requiredE = emergency services, present and required
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Trunkey’s curveTrunkey’s curveTrunkey s curveTrunkey s curve
Trauma deaths
I di t
0 1 2 3 4 5 6 1 2 3 4
Immediatedeaths
Early deaths Late deaths
hours weeks11
Control &C di ti
Pusbankes – 118Pra Hospital DP ( regional ) Regional Management
Coordination ( sectoral )
P H it l( I t ) H it l Pre Hospital DP ( Local )
( Intra ) Hospital Response
Control &Control &Coordination( regional )
SectoralManagement
Medical Emergency Response 12
Disaster PlanDisaster Plan
Pre HospitalPre Hospital HospitalHospital RegionalRegionalPre Hospital Pre Hospital Disaster PlanDisaster Plan
Hospital Hospital Disaster PlanDisaster Plan
M = major incident •• CC ommandommand
RegionalRegionalDisaster PlanDisaster Plan
C di iC di iM = major incident E = exact locationT = type of injuryH = hazard,
•• C C ommandommand
•• S S afetyafety
•• C C ommunicationommunication
•• A A ssessmentssessment
•• Coordinating Coordinating TeamTeam
•• Medical teamMedical team
•• SurveillanceSurveillanceA = AccessN = number of casE = emergency services present and
•• T T riageriage
•• T T reatmentreatment
•• T T ransportransport
•• Management Management back upback up
•• LogistikLogistikservices, present and required
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PartisipasiPartisipasi masyarakatmasyarakat pd pd ll bbpenanggulanganpenanggulangan bencanabencana
•• Tingkat Tingkat pengendalipengendali•• Tingkat Tingkat pimpinanpimpinan satuansatuan kerjakerja
•• MilitaryMilitary•• GovernmentGovernmentgg p pp p jj
•• Tingkat Tingkat pelaksanapelaksana •• Non Government Non Government Organization ( NGO )Organization ( NGO )
•• Private SectorPrivate Sector
•• FaseFase tanggaptanggap daruratdarurat•• FaseFase PemulihanPemulihan
•• AcademiaAcademia
•• FaseFase KesiagaanKesiagaan •• ProfesionalProfesional, ,
•• PetugasPetugas, ,
•• RelawanRelawan
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Lesson Learnt from Merapi eruption, 1994Lesson Learnt from Merapi eruption, 1994p p , 994p p , 994
N i ti tt d d b di l l d i tiNo victims attended by medical personnel during evacuation
No pre-hospital emergency systemNo pre hospital emergency system
Time needed : 2 yearsLeader : Director of GenHospNational meeting : 4National meeting : 4Local meeting : ?Strategy : joint corp..
Pusbankes - 118
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Pusbankes – 118
•• ATLS* ( 1996 )ATLS* ( 1996 )
•• ACLS* ( 1996 )ACLS* ( 1996 )
•• Basic Life Support ( 1996 )Basic Life Support ( 1996 )
•• Emergency Physician ( 2000 )Emergency Physician ( 2000 ) ::•• General Emergency Life Support ( 2002 )General Emergency Life Support ( 2002 )
•• Road accidentRoad accidentAi l hAi l h•• Airplane crashAirplane crash
•• RiotRiot•• FireFire
1994 - 2003
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SolidarityMeulaboh, 2004
SolidarityHumanity
Isolated City:Blocked communicationBlocked communicationDestroyed land roads
Destroyed runwayInsecure situation
Delay of Responses
DistanceFinance
Professionalism
Low resilience Lack of buffering & absorbing capacity
No pre-existing emergency system / networking
Lack of Health Services No preparedness
Relatively Slow RecoveryAnd Development 17
- Good transportation- Good communicationGood communication
- Pre-existing of emergency services networking
- Quick response of local, regional and international team
Bantul, 2006and international team
Rapid - Wrong scenario for
Preparedness pResponses
butUncoordinated
Works
- Large number of victims- Bantul as “ open “ area
Works
Quick recovery 18
Lessons Learnt :Lessons Learnt :Lessons Learnt :Lessons Learnt :
•• “ The problem of disaster response was not “ The problem of disaster response was not lack of any single resources but inadequate lack of any single resources but inadequate y g qy g qmanagement “.management “.
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SummarySummarySummarySummary
1.1. Disaster Responses must be relied on Local capacities.Disaster Responses must be relied on Local capacities.Local networking is mandatory.Local networking is mandatory.
2.2. All aids activities should be conducted to support the All aids activities should be conducted to support the local capacities, not to replaced it.local capacities, not to replaced it.
3.3. Evaluation and Development of the National concept Evaluation and Development of the National concept and guideline on DRR must be performed and guideline on DRR must be performed systematicallysystematicallysystematically .systematically .
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Thank YouThank You
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