Thursday November 13, 2008

10:00AM Earthquake occurs lasting 60 seconds, measuring 7.8 on the Richter Scale.

Inj # / Time / Message / From / To / Objectives / Expected Actions / Facilitator
1a / 10:01AM / Reminder to UCLAHospital Administration:
“A powerful earthquake just hit the Southern Californiaarea lasting nearly one minute. In your offices, you experienced significant shaking and unsecured objects have fallen onto desks, tables, and the floor. All external phones and internet connections are down.” / Hand-delivered envelope / Administrators / EC 4.13 The hospital establishes emergency communication strategies.
EP 1: Notify internal departments and initiate callback of off duty staff.
EP 2: Notify internal departments and initiate callback of off duty staff (disaster line message)
EP 3 – EP 4: Communicate with Campus EOC, UCPD, Facilities, MAC, UCOP, Public Utilities, SM UCLA, SOM, FPG, EH&S, Traffic
EP 8 – EP 11 Communicate with MAC, SM-RR, St.Johns, Cedars, DRCs
Reddinet Input
EP 14 HAM Radio, SAT phone, HEAR /
  • Conduct assessment of damage and injuries
  • Establish contact between Ronald Reagan and Santa Monica hospitals;
  • Activate Communication Plans
  • Activate EOC
  • Realize there is no telephone access and no external internet access
/ Administration by envelope
1b / 10:01AM / Reminder to all Departments/Functional Areas “A powerful earthquake just hit the Southern Californiaarea lasting nearly one minute. In your department, you experienced significant shaking and unsecured objects have fallen onto desks, tables, and the floor. All external phones and internet connections are down. Please see attached Unit assessment forms. / Hand-delivered envelope / Dept Manager/Charge RN / EC 4.13 The hospital establishes emergency communication strategies.
EP 1: Notify internal departments and initiate callback of off duty staff.
  1. EP 2: Notify internal departments and initiate callback of off duty staff (disaster line message)
/ Conduct assessment of damage and injuries
Complete Unit Disaster Assessment Form and submit to command center / Manager/ Charge RN by envelope
2 / 10:10AM / Hospital floors ask EOC for guidance:
“Hi this is the charge nurse from 6 ICU at RR/SICU 5 Tower at SM. Our patients and visiting family members are asking what is going on. What should hospital staff tell patients. What is going to happen with patients at the hospital?” / Nursing Floors / EOC /
  1. EC 4.13
  2. EP 1 – EP 6
/ EOC should advise nurse:
  • what to tell patients
  • what to tell patients families
  • what’s going on
/ SIMCELL
3 / 10:20AM / Preliminary Facilities Report: One WestRehabilitationCenter at CHS and EightTower at Santa MonicaHospital has structural damage. We may not get the official building assessment reports for a few hours. / Facilities / EOC / EC 4.13 The hospital establishes emergency communication strategies.
EC 4.14 The hospital establishes strategies for managing resources and assets during emergencies / Controller to present the preliminary report to Facilitators
4 / 10:25AM / Evacuate two target hospital units.
“This is the charge nurse from 8 Tower/ 1 West. We have structural damage. Things have been disconnected, things have fallen over, there have been some plaster cracks and we do not feel safe here. We need to evacuate 8 patients.
Patient types:
One West is stroke rehab, 8 Tower is general medical surgical] / Envelope from evacuee patient volunteers / EOC / EC.4.13;
EP 5: The hospital plans for communicating with patients and their families during emergencies, including notification when parties are relocated to alternative care sites.
EC 4.14
EP 9 Evacuating (both horizontally and vertically when necessary when the environment cannot support care, treatment and services.
EP 10: Transporting patients, their medications and equipment, ad staff to an alternative care site when the environment cannot support care, treatment and services
EP 11: Transporting pertinent information, including essential clinical and medication related information for patients to an alternative care site when the environment cannot support care, treatment and services / Evacuate patients from units
Unit director to contact EOC to initiate evacuation. / SIMCELL
5 / 10:30AM / Eight patient cards of will be presented to each Emergency Department / Patient Cards / ER Charge Nurse / 1. ER to initiate triage
2. Plan to accommodate influx of minor injury patients
3. Notify EOC of surge
6 / 10:55AM / Five patient cards will be presented to each Emergency Department / Patient Cards / ER Charge Nurse
7 / 11:00AM / Receive a phone call from MAC that 2 patients from MissionHospitalare enroute for transfer to RonaldReaganMedicalCenter / SIMCELL / Patient Placement / SIMCELL
8 / 11:00AM / Polling: OPTIONAL WHEN NECESSARY
“This is the MedicalAlertCenter calling. We want to poll the Ronald Reagan/Santa Monica Hospital. We need to know the integrity of the physical facilities, your ER capacity for incoming patients, and your inpatient bed availability.” / SIMCELL / ER Room Nurse Radio Room / EC4.18 The hospital established strategies for managing patient clinical and support activities during emergencies; Capacity Check / EOC to conduct and report assessments
9 / 11:05AM / Five patient cards will be presented to each Emergency Department / Patient Cards / ER Charge Nurse
10 / 11:15AM / Family members of patients show up to hospital information desk and ask about patients:
“Hello, this is Joe from the hospital information desk. We have family members of patients showing here asking about their family members in the hospital
They want to know if their family members are okay and we need to know what to tell them. They are asking:
  • Are their family members okay?
  • Should the families take the patients home?
  • Are the patients going to be moved
  • When will they be discharged?
  • Will they be moved?
  • Are their medical needs being met?
Please advise us what to tell them.” / SIMCELL / EOC / EC.4.13;
EP 5: The hospital plans for communicating with patients and their families during emergencies, including notification when parties are relocated to alternative care sites
EP 14 The hospital establishes back-up communication systems and technologies for the activities identified above
EC 4.15 The hospital established strategies for managing safety and security during emergencies. / EOC will advise information desk staff what to tell patients. / SIMCELL
11 / 11:20 AM / “We are unable to reach a number of hospitals in the eastern part of the County. We assume they are heavily damaged and we anticipate transferring large numbers of patients to intact facilities. Your medical center can expect to receive large numbers of the inpatients from significantly damaged hospitals and skilled nursing facilities.” / MAC / ER at Ronald Reagan/Santa Monica / SIMCELL
12 / 11:25 AM / Seven patient cards will be presented to Ronald Reagan Emergency Department
Four patient cards will be presented to Santa Monica Emergency Department / Patient Cards / Ronald Reagan
13 / 11:30AM / Supply request comes in from St. Johns hospital using radios.
[request via security, HAM, or HEAR radio] “Hello, this is [IC] from Saint JohnsHealthCenter calling. We are overwhelmed over here and need supplies from the DRC. Can you provide us with supplies Like IVs, bandages, splinting, and suture materials?” / St. JohnsHospital / Santa Monica EOC only / EC.4.13 The hospital establishes emergency communication strategies.
EP 10: Resources and assets that potentially could be shared in an emergency are assessed
EC 4.14: The hospital establishes strategies for managing resources and assets during emergencies / Hospital assesses their supplies and decides what can be provided. / St. JohnsHospital
14 / 11:50AM / Nine patient cards will be presented to Ronald Reagan Emergency Department
Three patient cards will be presented to Santa Monica Emergency Department / Patient Cards / ER Departments
15 / MAC calls that trauma patients are being transferred from ShermanOaksHospitalto free up Burn capacity. / SIMCELL / Patient Placement
16 / 12:00PM / Polling: OPTIONAL WHEN NECESSARY
“This is the MedicalAlertCenter calling. We want to poll the Ronald Reagan/Santa Monica Hospital. We need to know the integrity of the physical facilities, your ER capacity for incoming patients, and your inpatient bed availability.” / SIMCELL / ER Nurse in Radio Room / EC4.18 The hospital established strategies for managing patient clinical and support activities during emergencies; Capacity Check / EOC to conduct and report assessments
17 / 12:05PM / A runner shows up at Santa Monica Hospital- 15th street entrance security desk from the LesKelleyFamilyHealthCenter. He reports that they have many more patients than usual and are in need of wound kits, bandages and other medical supplies. What can you spare?” / Les Kelly Clinic Staff / Santa Monica Hospital- 15th street entrance security desk / EC.4.13 The hospital establishes emergency communication strategies.
EP 7: The hospital plans for communicating with purveyors of essential services, supplies, and equipment once emergency measures are initiated.
EP 10: Resources and assets that potentially could be shared in an emergency are assessed
EP 4.14: The hospital establishes strategies for managing resources and assets during emergencies / SIMCELL
18 / 12:15 / Six patient cards will be presented to Ronald Reagan Emergency Department
Three patient cards will be presented to Santa Monica Emergency Department / Patient Cards / ER Departments
19 / 12:30PM / Volunteer Doctors and Nurses show up at the ER who are not on staff. They provide their credentials. What does UCLA staff do to assess credentials? / Volunteers with simulated credentials / ER / EC 4.16; EP 1- EP-4
Follow credentialing protocol / ER charge nurse will contact the EOC and request guidance for credentialing
20 / 1245PM / Eight patient cards will be presented to Ronald Reagan Emergency Department
Three patient cards will be presented to Santa Monica Emergency Department / Patient Cards / ER Department
21 / 1:00PM / Polling: OPTIONAL WHEN NECESSARY
“This is the MedicalAlertCenter calling. We want to poll the Ronald Reagan/Santa Monica Hospital. We need to know the integrity of the physical facilities, your ER capacity for incoming patients, and your inpatient bed availability.” / SIMCELL / ER Nurse in Radio Room / EC4.18 The hospital established strategies for managing patient clinical and support activities during emergencies; Capacity Check / EOC to conduct and report assessments
22 / 1:05 PM / EMS brings one unannounced burn patients to Ronald Reagan Emergency Room. What is the response? How does ER manage this? / Patient Card / Ronald Reagan EOC and ER / EC4.18
Surge capacity, response during limited resources.
23 / 1:10PM / Hi this is charge nurse Joan from 5 MNP (SM)/ 8 West (RR) Has two nurses not on the schedule who came in to help. One brought her elderly father because he has dementia and cannot stay home alone. The other brought his two twin 3 year old children who had to be picked up from school and cannot be left at home alone.” / SIMCELL / EOC / EC 4.14
EP 5 – 6
EC 4.16 The hospital defines and manages staff roles and responsibilities / EOC to route call to labor pool.
Activate dependent care plans
24 / 1:15 PM / EMS brings one unannounced burn patients to Ronald Reagan Emergency Room. What is the response? How does ER manage this? / Patient Card / Ronald Reagan EOC and ER / EC4.18
Surge capacity, response during limited resources.
25 / 1:15PM / ER nurse Becki calls reporting that staff coming on shift are hearing the following information:
  • Large Fire in Pacoima – 2 residential blocks are on fire
  • Other fires have broken out in BoyleHeights from Eastern to the I-5. There is smoke and flames South of I-10
  • There is structural damage to the following freeways:
  • 10, 60, 605, 57, 15, with overpasses damages
  • Landslides have occurred on the 405 at the Sepulveda pass
  • There are multi-vehicle pile-ups East of downtown on I-10 freeway
  • A KNX helicopter reporter did a fly over in San Bernardino and announced, “there is nothing left down there”
/ ED Nurse / EOC / EC.4.13; EP 6: The hospital defines the circumstances and plans for communicating with the community and/or media during emergencies.
PIO communicates with JIC
EP 14 HAM Radio, SAT phone, HEAR
26 / 1:15PM / Hi this is Joe at the Information Desk, my buddy Patrick is one of the security guards. He felt the earthquake and came right over but has his pit-bull Princess in the car. He’s ready to work but needs to bring her in from the car. What should I tell him? / SIMCELL / Labor Pool
27 / 1:20PM / Eight patient cards will be presented to Ronald Reagan Emergency Department
Three patient cards will be presented to Santa Monica Emergency Department / Patient Cards / ER Department
28 / 1:30PM / Media shows up to ER for live television briefing.
Volunteer media representatives show up at the emergency room with their cameras to ER at 15th Street Entrance to Santa Monica and the ER Department security desk at Ronald Reagan. They are asking questions and want to hold a live television briefing. They are requesting that the PIO make a statement and answer their questions. The media is saying that the public needs to know what’s going on. / Volunteers / ER at each hospital / EC.4.13; EP 6: The hospital defines the circumstances and plans for communicating with the community and/or media during emergencies.
PIO communicates with JIC / ER to call EOC
EOC to work with PIOs
29 / 2:00PM / Polling: OPTIONAL WHEN NECESSARY
“This is the MedicalAlertCenter calling. We want to poll the Ronald Reagan/Santa Monica Hospital. We need to know the integrity of the physical facilities, your ER capacity for incoming patients, and your inpatient bed availability.” / SIMCELL / ER Nurse in Radio Room / EC 4.18 The hospital established strategies for managing patient clinical and support activities during emergencies;
Capacity Check / EOC to conduct and report assessments
2:00PM / End of Exercise

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