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Friday, November 22, 2019

SOP OF FIRE AND NON-FIRE EMERGENCIES



SOP OF FIRE AND NON-FIRE EMERGENCIES

1.     Fire Safety Protocol:

Fire Preventive Measures:
·            Fire risk areas in the Hospital are identified as given below: - Generator Room; Substation; Medical Gas storage room and medical record room.
·            At these places, First Aid fire appliances are provided.
·            In case of any fire incident the following action is to be taken: - Try to put it off; Shout for help in case not being able to put it off; if it is an electrical fire, inform Tel (Extn. 30) or cutting off the power supply.
·            In case of fire in the hospital building and surrounding areas following action is to be taken:- Immediately try to put it off; If not extinguished ,shout to help; Switch off the electrical supply; Inform tele. nos. (Extn. 30) or (Extn. 30); Shift the patient to safer places. If fire has not been extinguished, without panic direct the patients to safer locations through fire escape route.
·            Use fire escape route for going out of the hospital building (Fire /Emergency escape route is drawn and displayed at all floors important locations for information of patient and staff).

Fire Fighting Instructions:
·            The fire-fighting is an emergency requirement and this is called as CODE RED in this hospital it will be alerted through Public Announcement system/bell/fire alarm.
·            Fire accidents may occur any time. If these fire accidents are not attended immediately it can cause loss to life and property. In case a fire incident is noticed at this hospital area, the following action is to be taken:-

v Try to put off electric equipment.
v Shout for help in case assistance is required. If unable to put off inform Tel. Ext. No: 30 about the type of fire and location of fire. Security person will activate “Code Red” signal and assemble the fire fighting team consisting of the following personnel on duty at this hospital. Security person will inform all the above personnel and reach the fire site without delay. If it is an electrical fire the electric supply should be switched off by informing duty electrician. Water will be used if it is confirmed as solid fire. If evacuation is required, the evacuation plan is to be activated.

The Security person will maintain a record of the fire accident by noting the date, time of call and time of dousing the fire and loss of life or property if any. If the fire is not controllable the matter to be informed to civil fire station for immediate help while informing give type of fire and correct location of fire. The fire fighting team shall reach to the place of fire without delay and organize fire fighting after getting this warning of “Code Red ”

Fire Prevention Points:
a)         Do not store inflammable materials like petrol, LPG, in the hospital building and rooms.
b)         Do not use kerosene stove, burners, gas stoves in the hospital rooms and department.
c)          The spirit lamp used in the laboratory should be placed in a safe place and put off after use.
d)         Do not use the candles / oil lamp to light the rooms department.
e)         Do not store the loose papers files and old record in card board boxes.
f)           The old record room should be properly ventilated and electrical line protected against the fire.
g)         All important departments will be provided with the first aid fire appliance.
h)         Do not leave the remains of used match stick, candles or cloth pieces etc in the floor area.
i)           Extinguish and throw these items in dust bin only.
j)           Put off electrical supply to the rooms in case any spark is noticed and inform duty electrician.
k)         While refueling the diesel tank of generator take fire precautions and do not bring any lighted material near to the refueling point.
l)           Put off all light fans and electrical equipment and remove the equipment connection from the plug while locking the room after the work.

Emergency Evacuation Plan /Emergency Exit: Ground Floor Occupants:

In the event of fire or other emergencies which warrant the evacuation of patients and duty personnel please be guided by the following evacuation plan:

o   Alert all inmates one by one and room by room of the emergency situation without causing undue panic and commotion while informing the matter.
o   Evacuate all the patients first with the help of stretcher, trolleys or by the wheeled cots.
o   The medical documents of the particular patient should be sent along as well.
o   The only route to be used for evacuation of such patients should be the hospital Staircase.
o   The lifts should not be used in such situations.
o   Ambulatory or semi-ambulatory patients should be evacuated one by one using wheel chairs.
o   The patient’s medical documents should be sent along.
o   Evacuation should be done in an orderly manner without causing confusion or panic.
o   These patients will occupy the vacant beds on the other floors except the affected area.
o   Casualty observation beds or crisis management beds on the ground floor shall also be used.
o   The duty personnel will leave the emergency affected floor last after ensuring that all the patients, their personal belongings and medical documents are safely evacuated.

Fire Fighting Training:
·            The Fire Fighting Team organizes mock fire and emergency drills once in every six month with the help and guidance from the local fire fighting force.
·            All staff takes part the drill which gives emphasis of safe evacuation of the patients and occupants in the affected areas or hospital in general, as the fire-fighting and containment activity is under progress.

2. Earthquake management
General information about an earthquake:
An earthquake occurs when a few large and many  rigid plates that forms the earth’s crust move against one another, squeezing and stretching the rocks at the plates edges. Under tremendous pressure, the rocks break, causing an earthquake. The magnitude of an earthquake is measured on a scale called “Richter scale”.
Protection during earth quake:
When an earthquake occurs, first warning may be a shaking sensation if you are in a building. It may also be followed with noise or roar. You may find yourself completely topsy-turvy. It may last a few seconds or go on for a few minutes. Breaking glass and things falling around could hurt you. Be prepared for aftershocks.
We can't prevent an earthquake. But we can:
a)     Be prepared for injury.
b)    Be prepared to minimize damage to your building.
c)     Be prepared to manage for till help arrives.
Safe areas: -Under heavy tables or desks, inside corridor, corners of rooms or archways.
Dangerous areas: - Near window or mirrors, under any objects that can fall, the kitchen-where the stove, refrigerator or contents of cupboards may move violently, doorways because the shaking may slam the door on you. 

During the Earthquake:

Preparations for an earthquake include knowing what to do while it is happening.  You should move to safer area and stay there.

a)     If you're inside your building, stay there.   Protect your head and face.  Doors may slam on you if you are in doorway.  Avoid areas near windows.
b)    If you are in a yard outside your building, stay there and get clear of buildings and wires that could fall on you.
c)     Don't go outside where you may be hit by falling debris - pavements next to tall buildings are particularly dangerous. 
d)    If you are in a vehicle, pull over to the side (leave the road clear) away from bridges, over bridges and buildings.  Stay in your vehicle.
e)     Remain in protected place until the shaking stops.  Anticipate after shocks - they may occur after the first quake.
f)      Try to remain calm and help others.
After the earthquake:
a)     Preparation of an earthquake also includes knowing dos and don’ts after the shaking stops. There is a danger from aftershocks, fire, falling building materials, debris, etc.
b)    Remain calm. You may have to take charge of others. Take care of life threatening situations first.
c)     Remember, you may be on your own for prolonged time.
d)    Check your building for structural damage and other hazards.
e)     Check yourself and others nearby for injuries. Administer first aid quickly and carefully.
f)      If you are evacuating, locate and take your pack of emergency supplies with you.
g)    Use a torch to check utilities and not shut them off unless damaged. Leaking gas will smell. Don't light matches or turn on light switches until you are sure there are no gas leaks or flammable liquids.
h)    Wear sturdy shoes, if there's debris, particularly broken glass
i)      Carefully cleanup any spilled hazardous material.
j)      Turn on your battery-powered radio (or car radio) and listen for broadcast emergency instructions.
k)    Don't use your telephone, except in an extreme emergency.
l)      Don't use your vehicle, except in an extreme emergency.
m)  Stay at least ten meters from uprooted power lines.

3.       Safety precaution to be taken when a nuclear attack takes place
 If you are indoors, exit the building as rapidly as possible.
a)       Once outside, if you think that you may have been exposed to toxic substance, remove your clothes immediately, which may save your life.
b)      Taking out your clothes may remove 80 percent of the contamination hazards.
c)       Look for a nearby water tap or fountain, pool or other source of water and quickly and thoroughly rinse any skin part that may have been exposed.
d)      Fire brigades on arrival in area may spray water on every one affected to decontaminate.
e)       Remain calm.
f)        Medical attention shall be needed.
g)      Evacuate most seriously exposed individuals.
h)      If you happen to be in open and outdoor, you may observe birds and small animals falling to the ground due to poisonous gas. You must immediately move indoors and create a physical barrier between you and toxic cloud. A building protection is preferred; however, getting inside your car will also help you.
i)        Shut all doors and windows of the house and put off fans and air conditioners.
j)        Try to plug flow of air or wind to you rooms.
k)      Stay indoors.
l)        Listen to Radio, TV News and Announcements.
m)    Authority will notify you when it is safe to come out.
n)      Have a bath immediately on entry to the house and keep your cloth in a plastic bag, it will help remove any contamination that might have occurred before you were able to get indoors.
o)      You may keep gas mask handy.  


4.       Actions to be taken in certain other Emergencies:
Sr. no
Event type
Action to be taken
1
Terrorist attack

If there is any attack by terrorists then first the patients have to be moved to a safe place. Patients who want to leave the premises can do so, but should be very careful. Care to be taken that panic does not spread among patients. Inform legal authorities at once.
2
Civil disorders
Care to be taken that panic does not spread among patients. Inform legal authorities at once. Arrangement can be made, if safe, to send people to their homes, else families can be informed and people can stay indoors until situation settles down. Police protection can be sought if situation gets too serious.
3
Invasion of stray animals / insects
Care to be taken that panic does not spread among patients. After all the animals/ insects have been sent out of the building, all doors & entrances to be closed immediately to prevent further invasion. Pigeon holes, water inlets and outlets should be cleared regularly. Pest control should be strictly followed to prevent the menace from growing. If anyone is bitten / hurt by an animal or insect, first aid is to be administered and the victim should be shifted to another hospital for treatment. Oxygen is to be given if the victim has difficulty in breathing.
4
Anti social behavior by patients /relatives
The management should be informed first in case any patient / relative is displaying unacceptable behavior or using profane language. Talk calmly to the patient / relative first. If the behavior is still persistent, inform the patient that legal help may be taken by the institution. In case of a minor incident, the help of security can be taken, if it is a major one, legal authorities should be informed.
5
Infrastructural collapse
Clear out the complete area first by removing heavy objects / collapsed walls, etc. Check if anyone is trapped under the debris. Outside help (fire station) to be sought immediately if the damage is serious. Clear out the area as soon as possible. Care to be taken that no glass or sharp objects are lying around in that place. Plans of reinforcing / rebuilding the structure to be considered.
6
Sudden flooding
All water outlets to be opened up in the area where flooding has taken place. Manual help to be taken to drain out the water. Electricity to be immediately shut off in that floor / complete unit. Elderly people, vulnerable people & children should be evacuated first. Lift should not be used. Water should be pumped out completely using evacuation pumps.

The organization has liaison with the public authorities for helping in any emergencies arising from man-made or natural disasters. The affected people are then taken to other hospitals for complete medical care and treatment.


SOP for Destruction of Patient Record, Data & Information (MRD)


SOP for Destruction of Patient Record, Data & Information (MRD)

Sr. No.
Process Flow
Responsibility
1
At the end of the retention period, a list of obsolete record is prepared.
Administrator & Director
2
A notice is displayed at the reception and newspaper indicating the intention of JBCC to destroy medical records of a particular period. 
Administrator & Director
3
An appeal in above is made to patients desiring to collect the records within one month.
Administrator & Director
4
At the end of the above referred period, the record is destroyed by shredding in front of at least two responsible employees of JBCC and one member from general society.
Administrator & Director
5
Record of above is maintained.
Administrator & Director