Biomedical Engineering Reference
In-Depth Information
departments as part of good management have an
organizational plan as to who has authority at what
levels. The larger the department the more impor-
tant these lines of authority are. These lines of
authority are maintained in a disaster situation. The
person in charge of the department assures all staff
is accounted for and then responds reports to the
hospital command center.
A simple checklist (Table 16.1), can be used
by the senior person to initiate the Clinical Engi-
neering Department Incident Response Plan. This
checklist is just an example. Every department
should have a list that is tailored to its staffing
levels, facility, and responsibility. This checklist
should be reviewed and modified after every drill
and actual disaster.
In the ideal situation, all staff are accounted
for and collects in one location. The person
in charge designates someone responsible for
the collection point. This person remains at the
collection point (main shop) for the immediate
duration of the incident. Someone is assigned
the responsibilities to answer the telephone and
record all issues. If the telephone is not func-
tioning, then that person becomes a runner from
the hospital command center to the collection
point. The department specific response plans also
provide suggestions for other activities, such as
support to the Emergency Department. Teams
to critical care and other areas to assure opera-
tion of equipment and to assist, in general, with
disaster needs.
During the normal work day most critical
patients are located in areas undergoing treatment
(endoscopy, operating rooms, labor, and delivery,
etc.) and critical care areas (intensive care units,
post anesthesia care units, etc). Clinical Engi-
neering staff should be sent from the collection
point to these areas of patient intensity. Most Clin-
ical Engineering staff have areas of specialization,
anesthesia, operating room, ventilators, etc. The
technical staff responsible for these areas should
check in, be recorded as to where they are going,
and then assume a sweep of these critical areas to
assure that patient technology is functioning appro-
priately. Significant issues (medical gas failure,
power outages affecting patient care, etc.) should
be immediately reported to the hospital command
center. Upon completion of their initial “sweeps”
technical staff should report back to the collection
point to provide information on what was observed
and receive a new assignment.
If the event is one that will result in injuries to
the public then staff should be assigned specifically
to support the Emergency Department.
For every predetermined protocol, vendors crit-
ical for patient operations should be contacted to
immediately respond to the hospital to support any
potential failures of medical technology.
Depending on the magnitude of the disaster staff
will be worried about their families. Staff may
also be assigned to a clinical area for an extended
amount of time (specifically, operating room and
emergency department). It is important that staff
are rotated and receive frequent breaks, food and
ability to activate their family disaster plan and
contact loved ones.
Disasters create a significant amount of activi-
ties in a short period of time. With some planning
and a couple of drills, it is very easy to accom-
plish. Planning is an ongoing activity. It includes
assuring that everyone knows who is off and called
in sick on any given day. Whenever staff leaves
the main hospital campus for an off-site meeting,
off-site clinic, etc. that information is known. Staff
are familiar with the ICS, with family emergency
planning and with the Clinical Engineering Depart-
mental Disaster Plan.
Many hospitals have responded to significant
events and done very well. Staff know who is
in charge, and everyone has radios and alpha-
numeric pagers. In a crisis, everyone checks in on
the radio and is assigned (almost by default) to
their areas of responsibility. Satellite shops closest
to ICUs have responsibility for those units. The
person in charge reports to the hospital command
center, states everyone in Clinical Engineering is
accounted for and provides information on what
has been observed.
If all disasters occurred during normal work
hours, or if they were known in advance, like
hurricanes it would be great. Unfortunately, that
is not realistic. Departments need to have plans
for after hours disasters. Some such as tornados
