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Tornadoes and Severe Thunderstorms


MITIGATION:
WATCH – Tornados and Severe Thunderstorms

IN ECTOR COUNTY

Thunderstorms:
1.Request the PBX Operator page “Operation Weather – Code White”.
2.Request that the PBX continue to monitor the eather alert radio and keep the Incident Commander advised of any status change.
3.When the WATCH stage has expired, notify the PBX Operator to page “Operation Weather – All Clear.”


NOT IN ECTOR COUNTY

1.If the tornado WATCH does not include Ector County, the Incident Commander will not be requred to open the EOC, but may elect to do so.  Monitor for changes in the weather and respond appropriately.

Tornados:
1.Request the PBX Operator page “Operation Weather – Code White”.
2.Request that the PBX continue to monitor the eather alert radio and keep the Incident Commander advised of any status change.
3.If conditions do not warrant the oping of the EOC, the N.A.C. will continue to monitor the weather and keep the Incident Comander informed.  When conditions warrant, request that the N.A.C. open the EOC and remain there until the Incident Commander arrives and assumes control of the operation.  The Incident Commander will keep the EOC open until the weather conditions at the hospital are suc that it can be closed.
4.Continue monitoring the weather conditions at the hospital until the WATCH period has expired

PREPAREDNESS:

WARNING – THUNDERSTORMS and TORNADOES 

IN ECTOR COUNTY

When the National Weather Service issues a WARNING stage:

Thunderstroms:
1.Request the PBX Operator to page ”Operation Weather – Code Yellow.”
2.Establish contact with the Nursing Administrative Coordinator and request that he/she monitor the outside weather.

Tornados:

1.Activate the EOC.
2.Request the PBX Operator to page ”Operation Weather – Code Yellow.”
3.Contact the N.A.C. to make rounds of all nursing care units to assess response to the code and report back.
4.Initiate the ReCall system.
5.Monitor the “weather alert” and “scanner” radios until the County is cleared from the tornado “WARNING” stage.
6.When the WARNING stage has expired, notify the PBX Operator to downgrade the page to “Operation Weather – Code White.”
7.If weather conditions warrant, close the EOC, but continue to monitor until the WATCH stage has expired.

NOT IN ECTOR COUNTY

1.If the tornado WARNING does not include Ector County the Incident Commander will not be requried to open the EOC, but may elect to do so.  Monitor for changes in weather conditons and respond appropriately.

STRIKE – TORNADOES

IN ECTOR COUNTY

1.Request the PBX Operator to page “Operation Weather – Code Red”.
2.Request the N.A.C. to oversee the moveing of patients and obtain and assign additional personnel if needed.
3.If the STRIKE involves the phsyical plant, implement the Internal Disaster Plan.
4.If the STRIKE does not involve the physical plant, implement the External Disaster Plan.

NOT IN ECTOR COUNTY
1.Determine if casualties will be received by MCH contacting the appropriate authority as listed in the master Emergency Management Plan.
2.If casualties are to be received determine type and number and implement the External Disaster Plan.
3.If no casualties are anticipated, no further action is required.
4.If unanticipated casulaties present at the ED, respond in an appropriate manner and notif the N.A.C.

General Departmental Responsibilities
1.Each Department Director and/or supervisor of a specific area will be responsible for:
     a.Sufficient quantities of supplies are available
     b.Unless otherwise requested, all supervisory personnel will remain at their duty station to implement their Department-Specific Disaster Plan.
2.Specific Departmental Responsibilities are listed under responsibilities in this plan.


RESPONSE:

INTERNAL/EXTERNAL DISASTER

External disasters occur within the community that may or may not affect the hospital directly.  These may be due to natural causes such as earthquake, tornado, hurricane, flood, storm, fire, or man-made events such as mass gatherings (panic/social unrest), acts of terrorism, hazardous material incidents, and transportation accidents.  Depending upon the type of disaster, increased numbers of patients may be expected at medical facilities, either during the event or in the hours, days, or weeks to follow.  CareStar will be available to assist Medical Center Hospital and the surrounding communities during any disaster requiring immediate evacuation of patients.

Traffic Flow into the Hospital

A.All major casualties should arrive through the Emergency Ambulance and/or "Routine" Ambulance entrances.
B.Minor casualties should arrive at the Emergency Ambulatory entrance or if activated at the secondary receiving areas.
     1.Cath Lab entrance area on the west side of the emergency room entrance to station B for minor first aid treatment.
C.Injuries involving hazardous materials will be held in the designated decontamination area for disaster triage and decontamination treatment at the 1st level of the Stewart Wheatley Parking Garage.  
     1.After initial decontamination procedures, the patient will be transported to the ED Decontamination Room. 
D.All admitted casualties should be routed through the north hallway to the operational elevators for transport to the designated areas.

Triaging of Casualties

Triaging of casualties will be performed at the receiving areas.  Casualties will be directed to the appropriate diagnostic/treatment area or nursing unit.
A.Patients in critical condition or with serious fractures will be treated in the Emergency Department.
B.Seriously burned patients will be stabilized for transfer to burn centers via CareStar helicopter or other designated flight service.  
     1.Patients awaiting transfer will be transported to the PACU and/or Physical Medicine Department.
C.Patients requiring immediate surgery will be transferred to the OR Holding Area and the hallway leading to the OR.
     1.Patients awaiting surgery will be transferred to the Stewart Wheatley Medical Pavilion for pre-op.
D.Patients with suspected fractures or simple fractures only will be sent to the east (Washington Avenue) hall of the Radiology Department after triage by a physician/nurse.
     1.Patients will be cared for and made comfortable while awaiting diagnostic X-ray.
     2.Further treatment will be provided in the Admitting Lobby.
E.Minor casualties and minor burns requiring first aid only will be directed to the ED Station B Minor Treatment Area.
F.Dead on arrival (DOA) bodies will be tagged and taken to the morgue.  Bodies will be kept in the body coolers, morgue, and basement areas.

In-house Traffic Flow

A.All discharged casualties will leave through the P M & R entrance.
B.All admitted patients will be taken through the north hallway to the patient/staff elevators for transport to the appropriate nursing unit or surgery.

Specific Area Operations

1.Area:  Emergency Room Drive
2.Responsibilities:  Provide triage and emergency treatment to income casualties.
3.Staffing:
     a.Emergency Department Staff: 
          1)Disaster Triage Nurses coordinate and direct Disaster Triage Area
          2)Two (2) licensed nurses to provide immediate emergency care to incoming casualties
          3)Two (2) technicians to assist with emergency treatments
          4)One (1) unit clerk to tag incoming casualties.
     b.Emergency Department Registration: 
          1)Two (2) personnel to register and tag incoming casualties.
     c.Admitting Department: 
          1)Six (6) personnel to assist with tagging and documentation of incoming casualties.
     d.Respiratory Therapy Department: 
          1)Two (2) therapists to provide emergency treatments.
     e.Stat Laboratory: 
          1)Two (2) phlebotomists to obtain required specimens.
     f.Radiology Department: 
          1)Provide emergency radiological procedures.
     g.Security Department: 
          1)Two (2) officers to maintain crowd control.
     h.Engineering Department: 
          1)Two (2) personnel to control traffic.
     i. General Labor Pool: 
          1)Five (5) personnel to assist with patient transport to designated areas.

Minor Casualty Treatment Area

1.Location:  Emergency Department Station B.  
     a.Triaged minor casualties will be provided first aid treatment.  
     b.All discharged patients must be sent to the Discharged Patient Holding Area (PM & R) for exit via the P M & R entrance.

2.Staffing
     a.Nursing Education Department   Nurse Educators:
          1)Organize and direct minor casualty treatment
          2)Serve as a liaison with the EOC and the Emergency Department
          3)Provide direct patient care.
     b.Utilization Outcome Management and the Performance Improvement Departments:  All licensed nurses will provide direct patient care.
     c.Admitting:  two (2) personnel to help with patient tagging and documentation.
     d.Hospital Auxiliary:  two (2) personnel to escort patients to the Discharged Patient Holding Area.
     e.Pastoral Care:  two (2) clergy to provide ministerial services.
     f.Nursing Labor Pool:
          1)Three (3) licensed nurses for direct patient care
          2)Three (3) nurses' aides to assist with patient care.

Discharged Patient Holding Area

1.Location:  P M & R. 
     a.Calm, supportive environment will be provided for discharged patients.
     b.Patients will exit the hospital through the Engineering Entrance.  
     c.Listing will be maintained of all discharged patients waiting final disposition.

2.Staffing:
     a.Nursing Labor Pool:
          1)A “Charge Nurse” for the Discharged Patient Holding Area
          2)Two (2) staff nurses.
     b.Pastoral Care:  two (2) clergy to provide ministerial services.
     c.Utilization and Outcomes Management:  two (2) social workers to coordinate discharges and transfers as needed.
     d.Hospital Auxiliary:  six (6) auxiliary personnel to escort discharged patients to the Engineering Entrance.
     e.General Labor Pool:  six (6) personnel to provide clerical support and patient transport support.

Staff Allocation (Nursing and General)
1.Location:  Small Dining Room adjacent to the Employee Cafeteria.
     a.Labor Pool will provide personnel in support of requesting departments.
          1)Nursing Services designee will direct the Nursing Allocation Pool.
          2)Personnel Operations Manger will direct the General Labor Allocation Pool.
     b.All non-assigned personnel will report to the Staff Allocation Pool.

News Media Center
1.Location:  Boardroom in Administration.
     a.This area will receive all calls from press, radio, and television.
     b.All press releases will be issued from this area.

2.Staffing
     a.Media Management Sector will man this area.
     b.Public Information Officer will act as a liaison between the Incident Commander and the media.

Family/Visitor Information

1.Location:  Auditorium 
     a.All family members and other visitors will be directed to this central waiting area. 
     b.Calm environment and supportive counseling as required.  
     c.List of incoming wounded and in house patients will be posted.  
          1)Information which may be released includes:
               a)Patient name
               b)Patient condition
               c)Patient location.

2.Staffing:
     a.Utilization and Outcomes Management:  two (2) social workers to:
          1)Direct the Family Holding Area
          2)Serve as liaison with EOC
          3)Offer supportive counseling services.
     b.Pastoral Care:  Four (4) clergy shall be available to provide ministerial services.
     c.Performance Improvement:  non-licensed personnel will report to the telephone area in the west end of the Auditorium.
          1)Assume responsibility for receiving internal/external telephone communications.
     d.Auxiliary:  two (2) Auxiliary personnel to provide escort for family members to patient rooms.

Dependant Care

1.Location:  Diabetes Center, First Methodist Church and/or Bronco Building on 3rd and Golder.
     a.All family members of staff will be directed to one of these locations.
     b.Establish temporary housing 
     c.Provide bedding and food as required.  

2.Staffing:
     a.General Labor Pool: six (6) workers to:
1)Direct the Family Holding Area
2)Serve as liaison with EOC
     b.Pastoral Care:  Four (4) clergy shall be available to provide ministerial services.
     c.Auxiliary:  six (6) Auxiliary personnel to provide child care of MCH employee dependants.

General Staff Allocation Pool 

1.Six employees will be dispatched to:
     a.Obtain portable blackboard
     b.Serve as message note takers/runners between:
          *EOC 
          *Discharged Patient Holding Area
          *Emergency Department Registration
          *Minor Casualty Treatment Area
          *Admitting Office.

Housing of staff and family if needed:
Medical Center Hospital is aware that sometimes weather may make it impossible for staff members and patients to leave or enter the facility. In order to plan for appropriate staffing levels for our patients, MCH will:
1.Transportation will be provided for any staff member within the city limits of Odessa and/or Ector County. 
2.If the staff member needs transportation, they should call 640-2600 to arrange for transportation to or from MCH if driving conditions are hazardous.
3.Engineering or Security will take you home or pick you up.

If you live outside the Odessa/Ector County area: 
1.Overnight accommodations will be set up in the Ann Roden Deadrrick Cardiac Rehabilitation Center on 5th and Washington
2.Employees will be provided with sleeping arrangements and meals.
3.Arrangements can be made by calling 640-2600.

Flexible staffing for Clinical Personnel:
1.If you work in a clinical department that cancels procedures early due to weather conditions, contact Nursing Operations at 640-1138 before leaving for re-assignment.
2.This will enable MCH to make sure that all clinical areas are covered with the appropriate number of staff before anyone goes home.

Essential Staffing needs of other departments:
1.Department directors are asked to make sure their areas are covered with essential staffing to handle the work load that is expected.
2.Each department director will determine staffing levels to maintain adequate staffing during the duration of the event.

RECOVERY:

Deactivation of the Internal/External Disaster Plan

1.Only the Administrator shall have the authority to deactivate the External Disaster Plan when all actions and duties relating to the disaster have been completed.

2.Administrator will notify the PBX Operator to page the “All Clear”.

3.Once the patient load has been disseminated throughout the facility, operations will begin to return to normal. 

4.All patients that are moved into the normal stream of patients form the disaster will be tracked for the duration of their stay at Medical Center Hospital.

5.Emotional debriefing of staff will be available during the recovery phase. Hospital chaplains and Social Services will be available to assist.

6.Staff debriefing will occur to discuss the event and develop after action plans for improvement.

7.An evaluation of the response will be performed to determine if proper response was achieved. Follow up on the after action plans will outline improvements needed.

8.Documentation of all aspects of the event will be maintained for potential reimbursement.