H Hartliniek-Eeklo Medical Fire Brigade Zomergem, BelgiumThe role of the regional hospital consists not only of adequate diagnosis and treatment of trauma patients, but also of stabilization and preparation for transport of those who need more specialized help such as neuro-and cardiac surgery.A practical analysis is made for the H Hartkliniek-Eeklo, which is a medium-size (214 beds) regional hospital situated in the north of Flanders (Belgium). Seven fire brigades protect a rather rural population of 150,000 people. They provide support in three private and four public ambulances. During 1991, 2,422 trauma patients were brought to the emergency service of the hospital with a maximum during autumn. The geographical origin and temporary distribution of these patients and also the dedication of the private ambulance services are described. A scheme is given for the hospital disaster plan. The relationship between the hospital disaster plan and work of fire-brigades, Red Cross, Government, Army, Police, and other emergency services, and their impact on its activation are also described. However, JCAHO does not make detailed recommendations concerning disaster preparedness plans. Therefore, there might be a wide variability in the level of preparedness from one institution to another. In a survey of hospitals in Osaka, Japan, 1 this was found to be the case. A similar study in the United States currently is in progress. The following are general guidelines for external hospital disaster preparedness based upon the experiences observed by studying medical response to disaster.
Guidelines for Hospital Disaster Plans2 It is suggested that hospitals focus on three important areas that frequently fail in disaster events: 1) hospital organization; 2) lifeline vulnerability (electrical, gas, and water supply); and 3) food and medical supplies. These three categories will be discussed in detail.References:
Methods:The hospital security committee includes a special group for internal disaster prevention which began its work by asking members of the fire department to conduct a detailed inspection of the hospital relative to security systems. After three unannounced visits, conclusions were reported to the fire chief and to the hospital administrator. This report will present the main problems detected, with descriptive photographs.
Results:The fire department reported 21 deficiencies; five safety problems required additional work toward achieving resolution. The remaining deficiencies involved cleaning, safety, or storage problems. A summary of these deficiencies classified by affinity groups includes: inadequate firestairs at psychiatric areas; cleaning deficiencies at laundry area; non-existent emergency exit at the patient's clinical record area; inadequate storage, conduction, and use of propane both in the laboratory area and kitchen; irregular dust placement; smoking outside of permitted areas; lack of emergency designation and non-existent alarm system in closed and deserted areas (clinical records, hospital store); ...
