HOSPITAL PREPAREDNESS AND
STOP DEATH PROGRAM
DEPARTMENT OF HEALTH
1st Edition, July 2000
Disasters / emergencies / calamities take many varied forms and may occur
gradually or suddenly, in small, medium, large or initially imperceptible magnitudes.
For the past years, it seems that disasters were like a thief in the night. It chooses
no victims and strike anywhere - at home, on travel, at work and even at play.
For the calamity-prone countries like the Philippines which is very vulnerable to
natural and even man-made disasters, disaster management must be a well planned, well-
organized, well-coordinated activity that needs to be given the utmost attention and
highest priority to preclude human suffering and tragedy.
The Department of Health through the STOP DEATH Program has been very
active in the preparedness and response when disasters / emergencies / calamities strikes.
Through the years of its existence, this Program has always been "on the go" and even
until now they are still very aggressive and pro-active. I am very proud that they have
crafted and formulated standard operating procedures to serve as guide for those working
along this field.
This manual was designed as a reference guide for those directly involved in the
response mechanism during emergencies / disaster / calamities. It also aims to provide a
practical guide for quick action when disasters strikes and for pre-disaster preparedness
planning. It will be very useful for the regions and hospitals who under the aegis of the
Department of Health are mandated by law to provide health services as a support
mechanism in the event of disasters / emergencies / calamities.
On this end, I would like to congratulate the people who conceptualized in the
coming out of such very useful operation manual. I understand that your goal of coming
out with this manual is to have a unified response mechanism to protect / preserve lives
through proper medical aid, proper provisions and mobilization of all medical resources.
Be rest assured that I am with you in all your undertakings. It is hoped therefore, that
such application will be properly taught and enhanced when the event calls for.
This manual is a guide for the disaster managers and staffs in the hospital in their
preparation of a hospital disaster preparedness and response plan appropriate to their
organization. This is a generic guideline that can be applied to any type of hospital
irregardless of size or type. This was developed after a series of meetings and workshops
with the STOP DEATH Coordinators of the 38 hospitals initially called to review the
draft. The primary objective of this manual is to guide all coordinators in the crafting of
their plan to include the important ingredients of a good and effective preparedness and
response plan during emergencies and disasters. Furthermore, it includes hospital
preparedness in cases of internal disaster, external disasters as well as a combination of
both internal and external disasters.
Most emergencies and disasters are unpredictable but are not totally expected. A
stance of readiness to respond is assumed whenever potential emergencies are foreseen.
Emergency management and control measures are usually indicated for those types of
emergencies. Preventing measures, preparedness program are likewise helpful in
mitigating or preventing the effects of such emergencies and disasters. Hospitals play a
very vital role in emergencies and disasters. The organization of the medical care is
unquestionably the focal point for coordinating the health sector’s response to this host of
complex needs, since response and prompt care is critically important for saving lives.
And since the hospitals are open 24 hours a day with ready teams for dispatch
compounded by the fact that it has the transportation (ambulances) means and the
necessary equipment and supplies makes the hospitals the very visible hallmark for the
health sector’s response during emergencies.
In the development of this manual which was taken from a lot of resource
materials compiled from previous training locally and internationally, we also reviewed
previous manuals done. Much was done and prepared by Dr. Arnel Rivera as Chairman
of the Standards Committee and his team and other data researched by Mr. Gerry Lirag. I
finally put everything together to come up with a very user friendly guideline that
hopefully could also be used by other non- DOH hospitals. It is my dream and desire that
this be a requirement before any hospital could be licensed.
TABLE OF CONTENTS
I. INTRODUCTION 1
II. GENERAL PRINCIPLE OF HOSPITAL EMERGENCY PLANNING FOR
DISASTER SITUATION 2
A. General Hospital Planning 2
B. Purpose and Objectives of the Plan 3
C. Characteristics of the Plan 3
D. Organization of the Plan 3
III. LEGAL MANDATE 4
A. P.D. 1566 4
B. Calamities and Disaster Preparedness Plan, 1988 5
C. R.A. 7160 ( Local Government Code of 1991 ) 8
D. DOH AO 6-B s of 1999 9
IV. AN EMERGENCY PLANNING PROCESS 11
A. Hospital Emergency Planning 12
B. Summary in Planning 13
V. PLAN FOR DISASTER SITUATIONS OCCURING INSIDE THE
VI. PLAN FOR DISASTER SITUATION OCCURING OUTSIDE THE 15
VII. ORGANIZING DISASTER COORDINATING COMMITTEES 16
VIII. ORGANIZATION AND MANAGEMENT STRUCTURE 17
A. HEICS – Organizational Chart 17
B. Assignment of Responsibilities 19
C. Organizing Response Teams 19
IX. ROLES AND FUNCTIONS OF HOSPITAL DISASTER RESPONSE TEAMS 21
A. In-Hospital Response Team 21
B. On-Scene Response Team 22
X. ACTIVATION / TERMINATION OF THE PLAN 23
XI. ALERT SYSTEM 25
A. Disaster Code White 25
B. Disaster Code Blue 26
C. Disaster Code Red 27
XII. TRIAGE AND COLOR TAGGING 30
XIII. COMMAND AND CONTROL 32
XIV. NETWORKING 37
XV. TRAINING 40
XVI. DRILLS AND EXERCISES 41
XVII. LOGISTICS MANAGEMENT 43
XVIII. MEDIA RELATIONS 44
XIX. UPDATING AND EVALUATING THE HOSITAL DISASTER 45
XX. TEN STEPS TO BECOME A STOP DEATH HOSPITAL 46
XXI. APPENDICES 47
1. Triage Tag 47
2. Stop Death Program Assessment Form 48
3. Mission – Incident Report Form 63
4. Medical Care Survey Form 64
5. List of Drugs and Equipment for Major Disaster 75
6. Design Consideration for disaster-prone Hospitals 76
7. Energy and Communications 80
Every type of disaster brings about it’s own special type of catastrophic features.
Some of the disaster events can be fairly predicted e.g. typhoons, floods, and droughts,
whereas earthquakes, landslides, flashfloods because of the suddenness of it’s occurrence
brings about an unexpected outcome. Man has always been vulnerable to natural hazards
but mankind has further exposed itself to various kinds of self made disasters, e.g. war,
riots, accidents, fires, industrial, technological and ecological disasters.
Hospitals play a very vital role in the management of disaster. Main objective is
to decrease mortality and morbidity and to prevent disability. The hospital phase of
disaster management has emphasis on prioritizing treatment or triage, treatment of mass
casualties, crisis management such as expansion of hospital beds to provide services to
the most number of patients at such a very short notice. Furthermore it highlights the
need of bringing the right patient to the right hospital at the right time.
Pre-hospital phase is highly important including transportation of casualties by
ambulances or carrier vehicles. Transportation and communications likewise are parts of
the ingredients for a good disaster response. Institutional preparedness of the hospital
will maximize utilization of available resources. There is a definite need for a thorough
carefully studied hospital preparedness plan by every hospital that should be put into
action upon receiving an alert call. All the activities of hospital phase of management
require coordination between all clinical as well as administrative departments.
The hospitals need special planning for both mass accident as well as damage area
management. This means that every hospital, regardless of its size or specialization
requires a practicable and well-trained plan for such cases. This does not include the
enhancement and coordination of the medical performance but also important additional
tasks, which have to be added to the daily practice.
Every hospital should have a regularly updated hospital disaster plan. The plan
should be distributed, read and understood by everyone concerned. This will avoid
confusion and chaos at the time of disaster. The purpose of the plan is:
a. To provide policy for effective response to both internal and external disaster
situations that can create impact to the operation of the hospital and may
affect hospital staff, patients, visitors and the community.
b. Identify hospital capability to handle mass casualty.
c. Identify responsibilities of individuals and departments in the event of a
d. Identify Standard Operating Guidelines for emergency activities and
II. GENERAL PRINCIPLES OF HOSPITAL EMERGENCY PLANNING FOR
It is well for those directly involved in hospital disaster operations to bear in mind the
1. Disasters can occur at any time without warning or signal. Everyone should be
prepared at all times to render emergency response.
2. Disaster victims often need quick medical assessment and prompt emergency care.
They should be attended to immediately.
3. Disaster victims are often hurt and confused. They should be treated with
compassion and caring.
4. The volume of demand and the urgency of need for medical attention are abnormally
high during disasters. Every available human and material resource must be readily
mobilized and organized for quick action.
5. The demand for updated and precise information on the status of disaster operations
and whereabouts of disaster victims is often heightened. An information center
should be set up in the hospital to collect, process, record, and relay correct and
timely information to all concerned.
6. The plan should consider any contingencies that may require changes in the health
system. This means that it should be highly flexible if it is agreed that many types of
emergency situations may occur.
7. In developing the plan, consideration should be given to the views of the medical
staff, nurses, and administrative personnel of the hospital involved; opinions of
community services (police, firefighters, volunteer groups, civil defense, etc.) should
also be taken into account.
8. The plan should be essentially objective and limited to two specific aspects: probable
demand and the resources that are available or can be mobilized.
9. The plan should be easy to understand and should be widely disseminated
10. The plan should be put into effect only when necessary.
a. GENERAL HOSPITAL PLANNING
1. An emergency or disaster occurs in a hospital when the resources for dealing with the
situation are inadequate for immediate action. In such circumstances normal
procedures should be abandoned and resources increased so as to expand hospital
2. It is the hospital’s responsibility to maintain a continuing education and training
program to ensure that proper action is taken promptly in the event of an emergency.
3. When the hospital receives more than 100 emergency cases simultaneously, it must
plan a simplified treatment system; such a system is addressed to preventing loss of
life, complications, deformities, infections and delayed treatment. This policy should
be previously discussed with the medical staff, who will decide on the actions to be
taken at the time of a disaster and develop the hospital’s disaster management plan.
b. PURPOSE AND OBJECTIVES OF THE PLAN
The purpose of a disaster plan is to make it possible to attend, promptly and
effectively, to the largest possible number of people requiring medical care, in order to
reduce the number of deaths and disabilities and bring about recovery. The principal
1. To prepare the staff and institutional resources for optimal
performance in an emergency situation of a certain magnitude.
2. To make the community aware of the importance of the “disaster
plan,” how it is executed and the benefits it provides.
3. To establish security arrangements to be implemented in the event of
an internal accident within the institution.
c. CHARACTERISTICS OF THE PLAN
1. The plan should be functional, flexible and easy to implement so that it can be
adapted to a different situations and circumstances.
2. It should be permanent and periodically updated, providing for a constant
availability of resources and of well-informed and capable personnel ready to
implement the plan.
3. The plan should be coordinated with similar plans of other institutions so that wider
coverage, greater efficiency, and a better utilization of available resources may be
4. It should form part of a regional disaster plan and contribute to the strengthening of
civil defense plans.
5. It should be comprehensive, i.e., applicable to disasters within the institution or to
external disasters of medium or high severity.
d. ORGANIZATION OF THE PLAN – LEGAL ASPECTS – NAME OF PLAN
The plan should contain a description of the legal basis whereby the Department of
Health of the country concerned is authorized to act in disaster situations, both in public
and private institutions.
III - LEGAL MANDATE
For the past 20 years, laws on disaster management have been created and
updated. It is a measure of the government to be more responsive to disasters and
emergencies. The Department of Health is a member of the National Disaster
Coordinating Council (NDCC) and the head of the Medical Service or assumes command
over the health sector. The structure at the national level is supposed to be replicated at
all levels. As such, all Hospital are expected to be aware of these laws. Knowing these
policies will guide disaster manager in making decisions in times of disaster.
For the purpose of easy identification of the legislation related to disaster
management, we intend to highlight only important laws.
A - Presidential Decree No. 1566
As early as 1978, then President Marcos signed into law the Presidential Decree
No. 1566 entitled “Strengthening the Philippine Disaster Control Capability and
Establishing the National Program on Community Disaster Preparedness”. This law
implemented the following:
1. Creation of the National Disaster Coordinating Council (NDCC)
The National Disaster Coordinating Council aimed to strengthen Philippine disaster
control capability and to establish a national program on disaster preparedness
2. Creation of the Multi-level Organizations In Charge of Disaster
This decree also created a multilevel organization starting from the National Disaster
Coordinating Council, the Regional Disaster Coordinating Council, the Provincial
Disaster Coordinating Council down to the Municipal Disaster Coordinating Council.
3. Funding for a 2% reserve for calamities
This decree authorizes the local government to program funds to be used for disaster
preparedness such as the organization of Disaster Coordinating Councils, the
establishment of physical facilities and the equipping and training of disaster action
A Disaster Coordinating Council is composed of Staff and Service Units
The Staff Unit consists of:
Intelligence and Disaster Analysis Unit
Plans and Operations Unit
Whereas the Service Unit consist of:
Communication (DOTC) & Warning Unit (PAGASA)
Transportation Unit (DOTC)
Rescue & Engineering Unit (LGU’s, AFP)
Health Unit (DOH)
Auxiliary Fire Unit (DILG-BFP)
Police Auxiliary Unit (DILG-PNP)
Relief Unit (DSWD)
Rehabilitation Unit (DSWD)
Public Information Unit (PIA)
B - Calamities and Disaster Preparedness Plan, 1988
The Department of Health is one of the agencies comprising the NDCC, which is
the lead agency in coordinating, integrating, supervising and implementing disaster
related functions. The Secretary of Health represents the Department and as part of the
national plan, it’s roles are the following:
1. Organizes disaster control group and reaction teams in all hospitals, clinics, sanitaria,
and other health institutions;
2. Provides for the provincial, city/municipal and rural health services to support all
disaster coordinating councils during emergencies;
3. Undertakes necessary measures to prevent the occurrence of communicable diseases
and other health hazards which may affect the populations;
4. Issues appropriate warning to the public on the occurrence of epidemics or other
5. Provides direct service and/or technical assistance on sanitation as may be necessary;
6. Organizes reaction teams in the department proper as well as in the offices and bureau
The Health Service Units shall be organized by the Department of Health in all regions,
provinces, cities, municipalities and barangays and shall be constituted as follows:
Chairman: Department of Health
Members: ( suggested but not limited)
Representatives of the Philippine National Red Cross
Medical and Allied Professionals
Chief of Public/Private Hospitals/Clinics/Institutions
AFP Medical Reserve Personnel on Inactive Status in the community
1. To protect life through health and medical care of the populace.
2. To preserve life through proper medical aid and provision of medical facilities
3. To minimize casualties through proper information and mobilization of all
Health Service Units shall be composed of the following sub-units:
Medical and First-Aid Unit
Field Emergency Hospital
Sanitation Service Unit
Health Supply Unit
Transportation and Ambulance Unit
a. The Secretary, Department of Health, is responsible for organizing,
training and supplying all Health Service elements in the Philippines
b. The Regional Director, Department of Health, is responsible for providing
support to the Services in the provincial, municipal and city levels.
c. The Department of Health officials in the provincial, city and municipal
levels are responsible for organizing their respective units.
d. The Local Government Heads are responsible for the operation and
support of Health Services
e. The Philippine National Red Cross and the Department of Social Welfare
and Development, within their respective capabilities, are responsible for
providing support to the Health Service.
f. The functions of the Health Service sub-units are as follows:
6.1 Medical and First-Aid Unit
a. Sorts cases at the scene of the disaster;
b. Administer first-aid;
c. Attends to the cases referred to emergency aid and stations
d. Evacuates patients to emergency hospitals; and
e. Detects and controls communicable diseases in coordination with the
other agencies specifically assigned for the purpose.
6.2 Field Emergency Unit
a. Pre-determines sites of facilities that maybe used as field hospitals;
b. Administers appropriate treatment to less serious patients and attends
to all dispensary cases; and
c. Attends to all medical cases, which should be referred to appropriate
6.3 Sanitation Service Units
a. Supervises the sanitary conditions of the community during and after
b. Enforces sanitary regulations relative to housing facilities and shelter;
c. Promulgates and implements control measures in contaminated areas
and in evacuation centers.
6.4 Health Supply Unit
a. Procures, stores and issues medical supplies and equipment during
b. Keeps an accounting of the medical and first-aid instruments and
6.5 Mortuary Unit
a. Assists in identifying and tagging the dead;
b. Certifies to the cause of death; and
c. Supervises the proper disposal of the dead
d. Keeps records of the dead, injured, and sick; and
e. Issues certificates pertaining to persons who were ill, injured and
recovered or died pursuant to existing ,laws, rules and regulations.
Note: (The first 2 legal mandates are still in effect even with the passage of the
Local Government Code but there are efforts to amend several provisions of the
law. The Local Government code in effect have transferred all health services below
the Regional level)
C - Republic Act No. 7160 (Local Government Code of 1991)
Republic Act No. 716, otherwise known as the Local Government Code of 1991
pointed out these two important guidelines in disaster management:
Transfer of responsibilities from the national to the local government
units (LGUs) thereby giving more powers, authority, responsibilities
and resources to the LGUs.
Allocation of five percent (5%) calamity fund for emergency operations
such as relief, rehabilitation, reconstruction and other works of
services in connection with the occurrence of calamities.
This act empowers the local government to make decisions and to release funds
faster since the budget from the national government are given directly to the local
government units. It also increased the calamity fund from 2% (governed by PD No.
1566) to 5%.
Immediate and direct response is the primary responsibility of the LGUs.
However, in cases where disasters have reached proportions, which is beyond the
capacity of the LGUs, the national government takes control (Under Section 105).
Section 105. Direct National Supervision and Control by the DOH.
In cases of epidemics, pestilence, and other widespread public health dangers, the
Secretary of Health may, upon the direction of the President and in consultation with the
local government unit concerned, temporarily assume direct supervision and control over
health operations in any local government unit for the duration of the emergency, but in
no case exceeding a cumulative period of six (6) months.
Chapter 11 of the Department of Health Rules and Regulations Implementing the
Local Government Code of 1991 provides the legal basis for the DOH to establish and
maintain an effective health emergency preparedness and response program.
D - DOH - Administrative Order No. 6-B s of 1999
Through Administrative Order No. 6-B dated February 12, 1999, a Health
Emergency Preparedness and Response Program within the Department was
institutionalized. This program is designed to be a comprehensive, integrated and
responsive emergency, disaster related service and research-oriented program with the
goal of promoting health emergency preparedness among the general public and
strengthening the health sector’s capability to respond to emergencies, disasters and
calamities. The program likewise gives advice and policy directions regarding health
In this administrative order, the roles and responsibilities of the regional health
office, retained hospitals and Stop DEATH coordinator were enumerated. They are as
1. HEPR (STOP D.E.A.T.H.) Units in the Regions and the Hospitals:
The units shall be an integral part of the region/hospital
For the hospital, the Stop Death Unit shall be ideally established and
situated in the Emergency Room Complex (or any room identified for that
The Unit shall be managed by the Stop Death Coordinator who will then be
reporting to the Regional Director and Hospital Director respectively. He /
She shall be supported by a staff who shall be performing their duties in
addition to their regular assignments.
Each Unit shall have the following services:
4. Social Mobilization
5. Networking and Community Involvement
2. Responsibilities of the HEPR (Stop DEATH) Coordinator:
Takes the lead in the preparation of the Emergency Preparedness Plan of the
Region/Hospital and ensure that this is disseminated and regularly updated.
Responsible for the organization and dispatching of teams to respond to
emergencies and disasters. The team coming from the Regional Office
should take charge of the public health aspects of disasters such as rapid
assessment, monitoring and social mobilization. The hospital team should be
prepared (but not limited) for trauma related disasters.
Responsible for human resource development in the region, the hospital and
the communities in their respective catchment areas.
Ensuring that the necessary equipment, supplies and medicines will be
properly stocked and available for emergencies and disasters.
Network with their region catchment areas and the communities.
Prepare the annual work and financial plan and take the lead in the
implementation of the Program’s activities.
Document all activities and report to the Program.
Coordinate with the Operation Center for all emergencies and disasters
Submit quarterly reports to the Undersecretary of Hospital and Facilities
Services attention to the Program Manager of the HEPR (Stop Death)
Develop research proposals that would aid the Program in policy directions,
program implementation and improvement.
Performs all other related activities that maybe assigned from time to time.
3. The Role of the Regional Health Offices/Hospitals:
Provide support and encouragement to all the activities of the Program. All
regional health office and retained hospitals, being part of the DOH system
should provide medical services and mitigate the sufferings of the victims of
disasters and emergencies.
Institutionalize the Program/Units in their respective Regional Health
Office and Hospitals.
Designate adequate personnel for this unit and the medical teams taking
into account the category and capability of the hospital.
Support the training activities and require all personnel to undergo Basic
Life Support and other training that will enhance the preparedness
capability of everyone.
Know and link with your communities and develop a networking
relationship with all Government Organizations, Non-Government,
Specialty Society and other People’s Organizations who are involved with
emergency and disaster.
The plan should be given a name that is easily memorized and retained, commemorating
an important event in the life of the hospital or in medicine.
IV - AN EMERGENCY PLANNING PROCESS
The planning process is a series of steps to produce an emergency plan. This
process can be applied to any community, organization or activity, e.g. for the health
sector in general, hospitals, search and rescue organizations, etc. It is primarily intended
for preparedness, but can be used for planning during response and recovery
operations. Each step of the planning process is defined briefly as follows:
Project definition determines the aim, objectives and
DEFINE scope of an emergency plan, and decides the tasks
PROJECT required, and the resources required performing these
tasks. The emergency scenarios and recommendations
from the vulnerability assessment should be used to
PLANNING develop planning objectives.
GROUP The formation of a representative-planning group is
essential to emergency planning. Without such a group
it will be difficult, if not impossible, to gather the
ANALYZE required information and to gain the commitment of
POTENTIAL key people and organizations. There may be a need to
review any existing planning group to assess its
Potential problem analysis further examines hazards,
their causes, possible preventative strategies, response
and recovery strategies, and trigger events for these
strategies. It will provide information for later steps of
The resource analysis asks: what resources are
DESCRIBE required for the response and recovery strategies, what
ROLE & is available, what is the variation between requirement
RESPONSIBILITY and availability, and who is responsible for the
A description of roles and responsibilities outlines
who does what.
The management structure concerns the command of
MANAGEMENT individual organizations and control across
Developing strategies and systems concerns specific
response and recovery strategies, and the systems that
will support these strategies.
Each step of this process must be documented. The
STRATEGIES written emergency plan will consist of the outputs of
& SYSTEMS each step of the process.
A - HOSPITAL EMERGENCY PLANNING
Hospital emergency planning is an integral part of both the multisectoral community
emergency plan and the health sector emergency plan. The process for planning is the
same as that for communities or organizations and produces many outputs, only one of
which is a written emergency plan.
Hospital emergency planning has two aspects:
Protection of the hospital, hospital services, patients and staff from harm
caused either internally or externally; and
The provision of hospital services to the community before, during and after
Consequently, hospital emergency planning should be based on the following:
A vulnerability assessment of the community to determine the likely medical needs
of the community before, during and after emergencies;
A vulnerability assessment of the hospital to determine the likely harm caused to the
hospital by both internal and external emergencies; and
An assessment of the reception and treatment capacities of the hospital.
Hospital emergency management policy may be needed in the following areas:
The interaction between the hospital and other hospitals and medical centers;
The interaction between the hospital and rescue, volunteer, and government
The assignment of major responsibilities within the hospital for emergency
prevention, preparedness and response;
The acquisition and maintenance of emergency resources; and,
The criteria for major evacuation of the hospital and for hospital relocation
There are two aspects to hospital vulnerability assessment: the vulnerability of the
community; and the vulnerability of the hospital as a service provider. Emergencies can
be purely internal, external or combined internal/external. Thus there are three basic
scenarios that hospital emergency planning must satisfy:
An emergency that disrupts the ability of the hospital to provide it’s normal
services, but that doesn’t cause harm to the community ( an internal
An emergency that causes harm to the community requiring increased medical
services, but that doesn’t disrupt the ability of the hospital to provide medical
services ( an external emergency );
An emergency that causes harm to the community requiring increased medical
services, and that also disrupts the ability of the hospital to provide medical
services ( an internal/external emergency).
Internal emergencies can be caused by a number of hazards, including fire, explosion,
hazardous material incident, food contamination, or loss of electricity supply, water
supply, or other service. Internal emergencies can quickly multiply into a number of
contingent emergencies. For example, a fire may cause injury to patients and staff
resulting in an overload on hospital services, hazardous materials incidents may lead to
fires or explosions, etc…
Community vulnerability should be assessed to determine the likely demands on a
hospital or hospital system (a series of linked hospitals and medical centers). It is
possible to develop a number of credible external emergency scenarios that may
produce unusual medical demands on a hospital.
B - SUMMARY IN PLANNING
1. Emergency planning should be based on an assessment of vulnerability.
2. An emergency plan is an agreed set of arrangements for responding to and recovering
from emergencies, involving the description of responsibilities, management
structures, strategies and resources.
3. The emergency planning process can be applied to any community, organization or
4. The process of planning is as important as a written emergency plan.
5. An appropriate planning group should develop emergency planning.
6. Potential problem analysis can determine problems, causes, preventative strategies,
response and recovery strategies, and trigger events.
7. The resources required to support preparedness, response and recovery strategies
should be analyzed.
8. The roles and responsibilities of people and organizations must be defined and
9. A management structure for emergency response and recovery should be developed
based on normal management structures.
10. A series of strategies and systems must be developed for response and recovery.
V - PLAN FOR DISASTER SITUATIONS OCCURRING INSIDE THE
The hospital should be prepared when a disaster strikes inside the hospital like
fire, earthquake etc…An intrahospital disaster plan considering all types of disasters
should include evacuation procedures.
Some of the measures to be taken include:
1. Development of a plan for assigning personnel to specific duties and
responsibilities and a system for notifying them.
2. Instructions on the use of alarm and sign systems.
3. Instructions on fire fighting methods and directions as to the location of its
4. Rapid assessment of the extent of damage to buildings and structures and the
threats to safety of patients and personnel.
5. Protecting critical facilities and lifelines.
6. Maintaining communications and security of hospital and patients.
7. Quick restoration of facilities and lifelines to maintain the service operation of
8. Specification of evacuation procedures and routes to include orderly
evacuation of patients and facilities.
9. Tapping the network to extend needed services and facilities to patients.
10. Search and rescue operation.
All the staff of the hospital should be well acquainted with the plan. Fire drills
and internal disaster exercises should be carried out at least once a year during each
hospital shift in order to:
1. Make certain that the staff on each shift is trained to carry out its assigned duties.
2. Make certain that the staff on all shifts is familiar with the hospital’s firefighting
3. Assess the efficacy of the plan. Evacuation of patients to secure areas during the drill
VI - PLAN FOR DISASTER SITUATIONS OCCURRING OUTSIDE THE
Each hospital should prepare a disaster-management plan based on it’s own
operational capacity. The operational capacity of a hospital may cover a range of
services from first aid and immediate emergency care and subsequent transfer to
The planning should include consultation and review with the local civil
authorities and with other medical institutions on establishing an effective command for
appropriate action in the area. It should envisage the training of action teams to perform
on site triage and distribute casualties in such a way as to provide the most effective
possible use of available services and capabilities.
The disaster plan should include provision for:
1. Evaluation of a hospital’s autonomy in terms of it’s services and it’s source of
electricity, gas, water, food, and medical supplies.
2. An efficient systems of alerts and staff assignments.
3. A unified medical command.
4. Conversion of all usable space into clearly defined areas for efficient triage, for
patient observation, and for immediate care.
5. Prompt removal of casualties when necessary (after preliminary medical and surgical
services have been performed) to the places where medical care facilities are more
appropriate and definitive.
6. A special medical census for disaster cases.
7. Procedures for prompt transfer of patients within the hospital.
8. Security arrangements to keep curious persons from entering triage areas and to
protect staff from hostile actions.
9. Prior establishment of a public information center. A public relations team with a
means of communication to assist in providing an organized source of information.
The hospital is responsible for keeping the community informed of its potential and
limitations in disaster situations. The local police, rescue groups, and ambulance
teams should be aware of the resources of each hospital.
VII - ORGANIZING DISASTER COORDINATING COMMITTEES:
All Department of Health Hospitals shall organize it’s own disaster coordinating
committees and formulate it’s own hospital disaster plan following the guidelines set in
The Chief of Hospital shall determine the composition of the disaster committee,
whose members shall be permanent.
To the extent possible, the committee shall include the following:
1. Chief of Hospital
2. Chief Emergency Service (ER)
3. HEPR ( STOP DEATH) Coordinator
4. Chief of Surgery
5. Chief of Anesthesia
6. Chief of Medicine
7. Chief of Orthopedics
8. Chief of Nursing Service
9. Administrative Officer
Note: This is just a suggestion and might not be applicable to all types of
hospital. Special hospitals may come up with their own members to fit their
Responsibilities of the Disaster Committee:
1. Formulate it’s own disaster preparedness and response plans based on the general
guidelines set in this STOP DEATH disaster manual.
2. Organize and train it’s own disaster response teams and ensure constant state of
readiness to respond to disasters.
3. Define standards of response and coordination during emergencies and disaster.
4. Activate the disaster plan whenever the situation warrants.
5. Set up information and communication centers to serve various sectors and the public
during disaster operations. ( Hospital OPCEN)
6. Coordinate / collaborate with the health sector involved during emergencies and
disasters; likewise be aware of their community and catchment areas.
7. Disseminate, review, assess, evaluate and update the disaster plan to accommodate
changes brought about by new information, technology changes, and lessons learned
during emergencies and disasters.
VIII - ORGANIZATION AND MANAGEMENT STRUCTURE
An appropriate and effective organization in the disaster area should result in
the survival and recuperation of as many patients as possible and
a proportional distribution of patients to several hospitals.
A - HEICS - ORGANIZATIONAL CHART
The Hospital Emergency Incident Command System (HEICS) is an example of an
emergency management system which employs a logical management structure, defined
responsibilities, clear reporting channels, and a common nomenclature to help unify
hospitals with other emergency responders. There are clear advantages to all hospitals
using this particular emergency management system.
Based upon public safety’s Incident Command System, HEICS has already proved
valuable in helping hospitals serve the community during a crisis and resume normal
operations as soon as possible.
HEICS is fast becoming the standard for health care disaster response and offers the
predictable chain of management improved documentation for improved
flexible organizational chart allows accountability and cost recovery
flexible response to specific emergencies common language to promote
prioritized response checklists communication and facilitate outside
accountability of position function assistance
cost effective emergency planning
within health care organizations
HEICS is an emergency management system made up of positions on an organizational
chart. Each position has a specific mission to address an emergency situation. Each
position represented below has an individual checklist designed to direct the assigned
individual in disaster recovery tasks. The HEICS plan includes forms to enhance this
overall system and promote accountability.
The HEICS plan is flexible. Only those positions, or functions, which are needed should
be activated. The HEICS plan allows for the addition of needed positions, as well as the
deactivating of positions at any time. This equates to promoting efficiency and cost
The activation of positions for a mass casualty incident will be different than those
activated for an earthquake or typhoon. HEICS will flex to accommodate the unique
needs of each emergency. However, it is important to keep in mind the four basic
components of ICS, which are Operations, Logistic, Planning and Finance which must
be retained at all cost.
HOSPITAL EMERGENCY INCIDENT COMMAND SYSTEM
Public Information Officer Liaison Officer
Safety and Security Officer
Logistics Chief Planning Chief Finance Chief Operations Chief
Facility Situation-Status Time Medical Care Ancillary Services Human Services
Unit Leader Unit Leader Unit Leader Director Director Director
Labor Pool Procurement
Unit Leader Unit Leader
Damage Assessment and Director Laboratory Staff Support
Control Officer Unit Leader Unit Leader
Medical Staff Claims
Unit Leader Unit Leader
Sanitation Systems Radology Psychological Support
In-Patient Areas Treatment Areas
Officer Supervisor Supervisor
Unit Leader Unit Leader
Unit Leader Unit Leader
Communications Pharmacy Dependent Care
Unit Leader Unit Leader Unit Leader
Surgical Services Triage
Unit Leader Unit Leader
Transportation Patient Tracking Cardiopulomonary
Unit Leader Officer Unit Leader
Maternal Child Immediate Treatment
Unit Leader Unit Leader
Materials Supply Patient Information
Unit Leader Officer
Critical Care Delayed Treatment
Unit Leader Unit Leader
General Nursing Care Minor Treatment
Unit Leader Unit Leader
Out Patient Services Discharge
Unit Leader Unit Leader
B - ASSIGNMENT OF RESPONSIBILITIES
Identification of Disaster Personnel
All hospital personnel should have visible identification badges to help the safety
and security director and his or her assistants identify individuals who do not belong in
the hospital or disaster area. It also will help chiefs and supervisors to identify individuals
who can assist with their needs from those who do not belong in their area. In addition to
standard hospital identification cards, key personnel as identified in the disaster plan
should have specific identifying badges. This will facilitate ease of communication
between the incident commander and his or her subordinates.
Staff and patient management consists of two phases: incident and post-
incident. During the incident, staff members must be mobilized to perform their
dedicated functions. Key personnel must report to their stations, and nonessential
employees should be put in the labor pool or separated from the affected areas. During
long disasters and cleanup operations, temporary offices and work areas need to be
implemented. The same holds true for patients. They must be removed from the area of
the disaster and placed in temporary care spaces. Part of the plan must include the
locations of the temporary workspaces and patient care areas.
After the disaster, patients and staff need to be debriefed and counseled about the
event. They may require critical incident stress debriefing to deal with the situation
caused by the disaster. Disaster management staff also should be interviewed to find
ways to improve the plan and process in the future.
C - ORGANIZING RESPONSE TEAMS
External disasters are emergency situations occurring outside the hospital, in the
community or within it’s catchment area necessitating the activation of the hospital. In
such events upon verification and considering the magnitude of the emergency the
hospital decides when to send responding teams to the site and / or prepare itself to
receive patient / victims coming from the disaster site brought in by paramedic and / or
Internal disasters are situations wherein the hospital is in itself affected by the
emergency. ( examples: fire, earthquake, etc..)
Two core disaster response teams are to be organized for this purpose.
1. THE IN-HOSPITAL RESPONSE TEAM
The In-Hospital Response Team provides immediate emergency medical
assistance to victims brought to the hospital for proper medical care. It is
composed of the following members:
a. Disaster Control Coordinator (Chief of Hospital, STOP DEATH
Coordinator, Officer of the Day )
b. Deputy Disaster Control Coordinator ( assists the Coordinator or acts as
Coordinator in the absence of the Coordinator )
c. Hospital Triage Officer ( Surgical Resident on Duty preferably the Team
d. All hospital personnel on duty
2. ON – SCENE RESPONSE TEAM
The On – Scene Response Team is a small group of specially qualified
physicians and other hospital personnel who shall rush to the scene of the
disaster as soon as ordered by the hospital’s Disaster Control Coordinator or
his Deputy. It provides quick and immediate medical assistance to disaster
victims. It is composed of the following members:
a. An On – Scene Response Officer or Team Leader
b. Surgical Resident
c. Internal Medicine Resident
e. Aide or Helper
g. Others ( depend on the situation )
IX - ROLES AND FUNCTIONS OF HOSPITAL DISASTER RESPONSE TEAMS:
A. IN-HOSPITAL RESPONSE TEAM
1. Initiate the activation of the emergency plan that will authorize respective
members of the disaster team of their duties and responsibilities.
2. Provides immediate emergency medical assistance to victims brought to the
hospital for proper medical care.
3. Classify victims and retag them as need be based on degree of injury and need for
immediate medical care. Identify who will be accommodated to the hospital based
on it’s capability and number of operating rooms and who should be transferred to
a higher level hospital;
4. Coordinate with the DOH OPCEN for reports and for possible transfer of some
5. Make available number of beds with expected number of victims. The beds to be
freed are those of elective patients who can be discharged without threat to their
safety and final recovery. All elective admissions and operations can be
postponed. In some cases, not so emergency cases can be transferred to nearby
hospitals with proper coordination.
6. Ensure that emergency drugs, supplies, necessary equipment are at their disposal
and are available.
7. Coordinate with the administrative officer, property officer, pharmacist etc… to
inform them of the expected influx of patients; likewise anticipate type of
expected patients so that necessary medicines and supplies are made available.
8. Anticipate manpower needs and shifting including nurses and other support staff
9. Assign someone to answer queries of relatives and of the press;
10. Administer appropriate patient care through:
Charting out all patients regardless of where they were seen or referred from;
Conducting patients to a suitable area for examination or treatment. Do
contamination if need be;
Noting in the chart, by the admitting section clerk, the area or the hospital
origin and any accompanying forms, notes or letters;
Initiating patient care;
Assessing patient’s condition to determine his status, including a quick
history, physical examination, vital signs, inspection of injuries, etc…
Performing basic ABC’s of first aid or resuscitation in accordance with
general principles to stabilize the patient to prevent further life-threatening
situation or condition.
Performing diagnostic tests to aid in the diagnosis and determine severity of
B. ON – SCENE RESPONSE TEAM
The on-scene response team shall rush to the disaster scene to attend to the
medical emergency needs of victims and patients on-site and to make proper
arrangements for their transport to the hospital for proper medical attention.
The following protocols should be observed:
1. The head of the team should be responsible that all necessary emergency
drugs, supplies, medical equipment etc..be available in the ambulance. All
teams should follow the principle to be self-sufficient and not be a burden to
others. Hence even food etc., should be thought of when mobilizing teams.
2. The head of the team should understand the necessary protocols for each kind
of situation. E.g. if it is fire, the team should coordinate first with the fire
marshall and not enter the facility on fire; if it is a bomb explosion, the team
should first have clearance first with the bomb squad before entering the
3. The team should be ready to be the medical on-scene commander if they are
the first to arrive in the scene with the assumption that the head is
knowledgeable on Mass Casualty Handling and understand the Incident
Command System. He shall establish a Command Post for Health Services
and take charge of operations. In the event that there is already an On-Scene
Commander he shall coordinate and report to the person in authority.
4. Mass casualty principle should be followed such as triaging etc….
5. The team should continuously coordinate with the DOH Operation Center for
additional back-up teams, for transport of patients to the appropriate hospitals
and for reporting.
6. There should be a responsible person to document everything going on during
the operation especially the record of all patients treated on-site and all those
transported to the different hospitals.
7. The team leader should coordinate with the Overall Scene Commander for
proper coordination. He should do this together with the representative
coming from the Regional Health Office or the representative coming from
the Central Office.
8. They should submit a mission incident report within 24 hours after the disaster
to the Chief of Hospital / STOP DEATH Coordinator and to the DOH
X – ACTIVATION/TERMINATION OF THE PLAN
In case of emergency the alarm has to be quick and reliable. The competence to
set the alarm in motion has to be settled as low as possible in the hierarchy. Otherwise
time is lost during early phases of the plan. It is essential that the plan designate an
individual who has the responsibility to put the hospital’s disaster plan into effect. An
alternative person or persons who have this authority should also be specified. It must be
clearly defined how the on-duty physician and nurse determine when to mobilize staff
from other departments or when to dispatch teams in cases of external disasters.
Following activation of the plan, there must be immediate mobilization of all disaster
resources likely to be needed. These include personnel, supplies, equipment,
communication and transportation.
In conclusion, alarm has to be given early and generously even upon mere
suspicion of a major accident. Delayed mobilization is irreparable. A surplus of
personnel can always be dismissed later at any time. Alerting must never be a privilege
of the director or administrator or chief of clinics.
Mobilized people will have to know where to go (defined meeting point) and
what to do. Furthermore, roles and responsibilities should be clearly defined. Command
and control as well as coordination center should be established. Competencies will
influence to a great extent the ability to act in a timely fashion. The declaration of an
emergency state in case of a major accident will be indispensable.
As such several activities may follow after the activation of the plan. The
following are examples but are not limited to the following:
Putting in place the hospital’s organization in times of disaster (HEICS)
mobilization of personnel
cancellation of leaves of personnel ( in cases of extended periods of disaster)
transfer of patients and/or premature discharge of patients from the hospital
postponement of scheduled elective admissions and operations
release of beds and operating rooms
procedures to increase the number of available beds by use of available space
preparation and reservation of rooms
protection and certain restrictions concerning visitors and patients
instructions concerning releasing of information to relatives and to the public
TERMINATING THE DISASTER PLAN
When the disaster coordinator determines that the stage of emergency no longer
exist, an announcement to terminate the disaster operation is made. The telephone
operator shall be notified that the disaster plan is no longer in effect. In turn, the operator
shall be notified that the disaster plan is no longer in effect. In turn, the operator shall
inform all units or departments of the termination of the disaster operation plan. A report
on the disaster operation may be prepared by individual units and submitted to the
Disaster Committee for evaluation.
XI - ALERT SYSTEMS
Some events, which trigger disasters, such as typhoons and volcanic eruptions, or
threats of civil disorders, may be expected several hours before they occur. Others, such
as earthquakes, may occur without warning. All hospitals must get ready to respond
whenever disasters are foreseen and/or declared.
A code alert system is adopted to describe the expected levels of preparation and
the most suitable responses by all concerned.
The hospital alert status shall be declared either by the DOH Central Office, the
Chief of Hospital or his designated STOP DEATH Coordinator or head of the disaster
committee. Moreover, the alert system is suspended by the Chief of Hospital or his
designate once the threat is no longer present or available. Furthermore, a system of
calling off the alert level should also be discussed in the plan.
A - DISASTER CODE WHITE
This is automatically declared in the following conditions:
1. a strong possibility of a military operation, e.g. a coup attempt;
2. any planned mass action or demonstration within the area;
3. forecast typhoons, the path of which way affects the area;
4. national or local elections or plebiscites;
5. national holidays or celebrations especially New Year’s Eve, Labor Day,
Independence Day, All Saint’s Day, Holy Week etc… and
6. other conditions which may be declared as disasters by the Chief of Hospital or other
Normally, schedules of back-up teams should be organized and included in the
monthly schedules with the required compositions/members and should be on call
anytime during his duty days. (This is a separate team, from those who are on regular
duty for the day). Once this code is raised the team should report to the hospital and the
alert shall continue to be in effect until cancelled by the Chief of Hospital or his
designate. There should likewise be preparation of the necessary medicines and supplies
that might be needed and anticipated. The following are the manpower requirement
2. Orthopedic surgeons;
5. O.R. nurses;
8. 2nd response team should be on call
9. emergency service personnel, nursing personnel and administrative personnel
residing at the hospital dormitory shall be placed on call status for immediate
NOTE: The composition of back-up and on-call teams would depend on the type and
level of the hospital. The suggestions here are based on a general tertiary hospital. Each
hospital can come up with their own team members. In some places like Metro Manila
there can also be designated support hospitals (usually special hospitals) who acts as a
support to a receiving hospital. E.g. San Lazaro and Fabella Hospital supporting Jose
Reyes Memorial Medical Center.
B - DISASTER CODE BLUE
Disaster code Blue is proclaimed when 20-50 casualties (red tags) are expected.
This may require the activation of the hospital network or, at the discretion of the disaster
coordinator, may only involve the hospital nearest the emergency site.
The following are to respond when Code Blue is on:
1. On- Scene Response Team;
2. Medical Officer in charge of the Emergency room;
3. All residents of the Department of Orthopedics;
4. Medical Officer in charge of the Operating room;
5. Surgical Team on duty for the day;
6. Officer in charge of supplies at the CSR;
7. Surgical Team on duty the previous day;
8. All Anaesthesiology residents;
9. Nursing supervisor on duty;
10. Operating room nurses living within, or in the vicinity of the hospital;
11. The entire security force;
12. All third and fourth year residents;
13. All OR nurses; and
14. Institutional workers on duty
C – DISASTER CODE RED
Disaster Code Red is put into effect when more than 50 (red tag) casualties are
momentarily anticipated or expected or suddenly brought to the hospital. The situation
may require that more than one hospital respond by sending an on-scene team. All
hospitals involved will be notified to activate their disaster control plans.
The following shall respond to disaster code Red:
1. All persons enumerated under Code Blue
2. All institutional workers
3. All nursing attendants
4. All nurses
5. All medical interns and clinical clerks
Situations may arise when there would be a need to change the alert status from code
white to code blue or code red. If there is a strong possibility that this may happen, the
Chief of Hospital is authorized to:
1. Cancel all leaves of personnel and for them to report to the hospital.
2. Put on standby within the hospital back-up teams for rapid deployment.
3. Take other steps necessary to respond to the emergency situation.
THE ALERT STATUS SHALL CONTINUE TO BE IN EFFECT UNTIL
CANCELLED BY THE CHIEF OF HOSPITAL OR THE STOP DEATH
STANDARD OPERATING PROCEDURES:
The following are standard protocols that must be observed and carried out in the
event of any emergencies and disasters:
1. Information Management System shall be established to handle messages
related to emergencies and disasters and shall relay the same to the DOH
Regional and/or Central Operation Center (DOH OPCEN). In effect the
hospital shall open it’s own operation center preferably in the Emergency
Room or any place designated by the Chief of Hospital.
2. Emergency Response Teams (ERT) shall be organized if within it’s catchment
area and made ready to respond as soon as possible. (ERT’s could have
monthly schedules or on call basis). The team members sent are expected to
be knowledgeable on Mass Casualty handling and the Incident Command
3. A pre-designated ambulance shall be available for dispatch at all times. All
ambulances sent to the site should be equipped with all the necessary
equipment, medicines and supplies required in emergencies. Likewise, it
should have the necessary communications that will enable it to coordinate
with it’s hospital and the DOH Regional and Central Operation Center.
4. All Emergency Response Teams shall wear the prescribed STOP DEATH
Uniform when responding to any emergency with their corresponding
STOP DEATH Coordinator - Blue Jacket with STOP DEATH seal
Medical Officers – Orange STOP DEATH Jacket
Nurses and other team members – Orange STOP DEATH Bib
5. Situations Requiring Automatic dispatch of On –Scene Response Teams
Any mass casualty situations especially within it’s catchment area
Fire or explosions involving hospitals, malls, schools, squatter areas that
usually house a large number of people during it’s operation hours. This
should be properly coordinated with the Bureau of Fire since they have also
their own EMS Teams, which could also handle these cases.
Airline Crash or sea vessel mishap with possible mass casualty within it’s
6. In responding to any emergencies or disasters a responding team should be
equipped with the necessary amenities such as tents if need be. Likewise,
they should bring with them streamers or anything that could identify them as
representatives from the Department of Health and/or the hospital they
7. During actual operations all communications shall be coursed through the
DOH Regional and/or Central Operations Center (OPCEN). The On-Site
Teams should report regularly by radio to the OPCEN. If the team assumes
the Incident Medical Commander he shall manage all the responding teams
and follow the Mass Casualty Handling System. He is responsible for
coordinating with the OPCEN for requests for additional team and for transfer
to the hospitals.
8. Furthermore, the team should coordinate with the head of the Medical
Services, most often representatives of the Regional Health Office who serves
as the Head of the Medical Services in times of disaster. The DOH Regional
Offices is responsible for coordinating with the Regional Disaster
Coordinating Center (RDCC), PDCC etc…and other agencies such as the
Local Government, the Department of Social Welfare and Development (
DSWD) the Philippine National Red Cross ( PNRC ), NGO’s etc..
9. All responding teams shall submit a Mission Incident Report to the Office of
the STOP DEATH Coordinator of it’s respective hospital who shall then
provide a copy to the Region and/or Central Operation Center as soon as
possible, on or before 24 hours after the activity.
10. All STOP DEATH Coordinators shall ensure that all teams mobilized are
knowledgeable on the procedures and protocols. He shall also be allowed to
have cash advances (based on existing orders) and ensure that the teams are
adequately equipped and provided for all their needs.
11. All emergencies and disasters should be very well documented with pictures
and write-ups together with their experiences and lessons learned. This could
serve as inputs to help them in their future planning and to improve future
responses. Researches are likewise encouraged.
XII - TRIAGE AND COLOR TAGGING
Patient classification based on severity of injury and need of Emergency Medical
Service and evacuation. ( Annex I )
1. PRIORITY FOR IN-HOSPITAL CARE
RED – Priority One: Life threatening/immediate. The patient requires immediate
attention and transport. The following factors should be used to determine when a mass
casualty incident ( MCI ) victim is a Priority One.
a. Obstruction or damage to airway
b. Disturbance of breathing – respiration above 30/min
c. Disturbance in circulation – capillary refill greater than 2 seconds or
carotid pulse weak , irregular or absent, radial pulse absent
d. Does not follow commands or altered level of consciousness
e. Need for life-saving measures ( BLS and ATLS) and urgent hospital
f. Victims whose injuries demand definitive treatment in the hospital but
which treatment may be delayed without prejudices to ultimate recovery.
YELLOW – Priority Two: Urgent. Patient has passed primary survey, but major
system injury limits delay of transport to one hour. Any one of the following factors
could take place a victim into a Priority Two category:
a. Needs to be treated within 4-6 hours otherwise they will become unstable.
b. Severe burns; burns involving hands, feet or face ( not including the
respiratory tract); burns complicated by major soft tissue trauma;
c. Hospital admission is required.
d. Moderate blood loss; Back injuries; Heat injuries with a normal level of
GREEN – Priority Three: Delayed. An injury exists but treatment can be delayed for
toww to six hours. Generally ( but not always ), anyone who can walk to a designated
area for treatment will be a Priority Three. The following injuries are example:
a. Minor injuries not threatened by ABC instability
b. Minor fractures, minor soft tissue injuries, minor burns
c. Victims whose injuries are so severe that survival cannot be expected even
under the most ideal conditions; obviously mortal wounds where death is
certain ( such as head injuries or massive burns ).
BLACK – Priority Four
a. Patient is dead.
b. Victims who are clinically dead.
c. Those who die while awaiting treatment, and those in cardiac arrest
A = Airway B = Breathing C = Circulation
BLS = Basic Life Support
ACLS = Advance Cardiac Life support
ATLS = Advanced Trauma Life support
The following information shall be hand printed on the Patient’s color Tag:
Patient’s sequence number
Name of patient
Tentative diagnosis or suspected injury
Previous treatment as stated on the tag which was placed on the patient at the
scene of the disaster
Blood type ( cross matching/signature)
Priority for Evacuation ( On-Scene)
So as to have a common standard in color tagging of victims, we follow the same color
tagging as the in-hospital.
- FIRST PRIORITY FOR EVACUATION
- NEEDS IMMEDIATE CARE
- SECOND PRIORITY FOR EVACUATION
- PATIENT NEEDS CARE. INJURIES NOT LIFE THREATENING
- THIRD PRIORITY FOR EVACUATION
- MINOR INJURIES
- LAST PRIORITY
XIII - COMMAND AND CONTROL
A command site within the hospital should be established, preferably in a pre-
designated area. This center should be able to communicate with the patient receiving
area (triage site), patient care areas, and with local EMS, police, fire, and government
authorities. Provision for multiple modes of communication (mobile phone, two-way
radio, runners, etc.) should be made. The command personnel should include at least a
physician, a nurse and an administrator.
The internal command and control of an incident at Health Services would
include ultimate control as incident commander with the Health Services Director or
designee. The Span of Control should be kept within manageable means by dividing the
incident into pieces. Under normal situations this division would be into a Medical
Commander and a Logistical Commander under the overall Incident Commander.
It is recognized that the overall Incident Commander be stationary in the
command post to make timely decisions as information and requests reach him or her. In
the command structure, the two operational commanders (Medical and Logistical) will
have the role to evaluate the entire Health Services’ conditions. These commanders need
not be completely stationary to be effective in directing their specific areas.
These individual commanders should have mobile communications in the command post
at all times.
The area commanders are the eyes and ears for the Incident Commander. It is only
through proper evaluation of the on-going incident and constant feedback to the
command post that the incident can be best managed.
A telephone call-tree shall be maintained and kept up-to-date with current staffing needs
and information. This telephone tree shall be utilized by those designated to initiate
the recall of personnel when directed by the Incident Commander.
As part of disaster planning, it is essential that certain areas of the hospital be
designated for specific functions such as reception of casualties, treatment, and discharge
of patients. The plan should be quite specific as to the function of these areas, staffing
requirements and basic supplies to be utilized. The areas to be incorporated in each plan
1. An Emergency Operation Center (EOC) must be established to provide overall
command and coordination of the hospital’s disaster response activities. These
activities include activation of the plan, coordination of hospital activities with those
at the disaster site and adjusting the plan as necessary. Good communication is
absolutely essential for these coordination activities and must be immediately
available via telephone, radio and messengers. EOC responsibilities include opening
up additional hospital wards or clinics, obtaining assistance, evacuation of
endangered patients, and assignment of staff to treatment areas and revision of
original job assignments.
STANDARD OPERATING PROCEDURES FOR EOC’S
Activation Operations Closing-down
Open EOC Message Flow File messages & other
Mobilize staff Information display
Activate communications Information processing Release staff
Prepare/post up maps & Control resource mobilization Close down
Display boards & deployment communications
Draw up support staff Drafting of situation reports Close down EOC
Roster Decision-making Organize operational
Reporting to higher authority
2. Triage. In order to maximize efficiency, entry of all patients should be restricted to
only one location, the triage area. The primary function of a disaster triage area is
rapid assessment of all incoming casualties, the assignment of priorities for
management, and classification of disposition (i.e., distribution of patients to various
other patient care areas in the hospital). Without a triage area to manage the patient
flow, the major treatment area may become overwhelmed.
3. Patient Care Stations
One suggested method of organizing patient care stations includes the
Major Trauma and Medicine
From the triage location, most if not all of the seriously injured
patients will be sent to the major trauma/medicine area (e.g.,
trauma and cardiac resuscitation, treatment of hypovolemic shock,
severe respiratory distress, etc.). This is usually physically located
in the Emergency Department.
Minor Trauma-Primary Care:
In most disaster situations, the majority of patients are not very
seriously injured. A great percentage of these will be classified as
the “walking wounded”. These low priority patients can be sent to
an “urgent care” area often designated as the Minor
Trauma/Primary Care Area for definitive care including splinting
of fractures, primary closure of lacerations and tetanus
prophylaxis. This minor trauma/primary care area can be
established in the hospital’s outpatient clinics.
c. Admission Pre-Surgical Holding:
Most trauma patients stabilized in the Major Trauma Area
(emergency department) will be sent to the Admission Pre-surgical
The number of operating rooms that can be staffed is the main
limiting factor in the provision of definitive care for a large
number of severely injured casualties. The most senior surgeon
available must take the responsibility to prioritize cases and assign
to these cases as rapidly as possible.
Many disasters can result in a large number of fatalities. This may
require that present morgue capacities need to be expanded or
other outside facilities such as church or stadium temporarily
Hospitals must have provisions for emergency treatment and
decontamination of individuals who are radioactively or
chemically contaminated. Some basic requirements for hospitals
A safe area for decontamination
A means of washing external contamination from the patients.
A method of containment of contaminated materials.
Adequate protection for persons handling the patient, and other
Disposal/cleanable medical equipment.
In the event of a disaster involving mass casualties, and even
property damage with loss of possessions, it is common for
patients to present with episodes of anxiety, depression, and
psychotic episodes. Hysterical persons whether patients, visitors or
staff, can be extremely disruptive to hospital disaster operations. A
separate isolated area must be pre-designated to receive individuals
in need of psychological intervention.
Family Waiting and Discharge Area:
As past experiences in disasters has shown, families and friends
will converge en masse to the hospital seeking information about
victims. This convergence can seriously interfere with efforts of
the hospital to respond effectively to the situation. For this reason,
a separate area must be pre-designated for family members seeking
information. This area may also be utilized to discharge in-hospital
patients and victims of the disaster.
The hospital during emergency has two major activities:
Administrative activities involve setting the hospital disaster plan into action and
a Disaster Officer should be identified who will get and give all information and take all
administrative actions and will co-ordinate with chiefs of various clinical specialties. The
hospital phase is highlighted by following activities –
Alert - all the hospital medical and paramedical staff is alerted to assemble in the hospital
Expansion of casualty area -- If it is expected that the hospital casualty will not be
enough, then the main O.P.D. hall (or some other place) shall be opened to receive the
Adequate accommodation to be arranged in various wards side rooms/ seminar
rooms / halls or any other space and later on by discharging certain categories of patients.
All existing operation theatres should be opened up.
Security arrangements by hospital staff with the help of police personnel. They
should act as traffic- controllers and direct patients and relatives to respective reception
centers. The complexity of problem gets compounded when one finds that it is not merely
the numerical load of patients, but also a large number of relations, attendants and public,
which by their natural anxiety add further liability to the management of casualties. If
required the hospital entry/exit should be controlled by Police personnel.
Management of casualties - Principle of triage is to be applied so that casualties can be
classified for priority of need and proper place of treatment. The goal of triage is two-
1. To select those patients in greatest need of medical attention and
2. To arrange for their treatment.
To ensure that a patient presents for treatment only to the appropriate forewarned medical
faculty as a means of limited personnel and supply sources.
The triage should be performed by senior clinicians and for heavy load it is suggested to
have four teams each consisting of
One General Surgeon
One Orthopedic Surgeon
Two Staff Nurses
Two Nursing Attendants
XIV - NETWORKING
It is imperative that every hospital integrates its own disaster plan with those of
community disaster management agencies. This is especially important regarding disaster
notification and communication transportation of casualties and provisions for dispatch of
hospital medical teams to a disaster site. Strong relationships with community agencies
(e.g. fire department, the local EMS, local emergency management or the civil defense
agency) are important to ensure a coordinated disaster response.
Other organizations that a hospital may interact with during the disaster planning
process may include the military, local chapters of Philippine National Red Cross and
other volunteer agencies, along with other national agencies.
Hospital disaster plan should anticipate information about specific hazards which
are of common occurrence in the community (e.g. typhoons, landslide), expert personnel
(e.g. poison control) and special supplies (e.g. antidotes) not readily available may be
needed in a particular disaster situation. Plans should consider how to rapidly access
these resources. Plans for obtaining additional shelter, food and water should also be
The hospital network is a sharing arrangement between several hospitals of
different levels and specialties in a given area to work together for the purpose of
managing medical emergencies more efficiently. The hospital network shall be
mobilized during disaster operations. The hospital also needs to develop its external
disaster plan in conjunction with other emergency facilities in the community. For
example, there should be pre-arranged memorandum of agreement with hospitals outside
the immediate area should hospital capacities be exceeded. There should also be
preplanning and prearranged referral to tertiary medical centers and special units whether
private or government institutions (e.g. burn, spinal, pediatric trauma centers).
Under the network arrangement, each hospital’s capability rating is initially
assessed by collecting the information about the hospital through a questionnaire. Using
the responses to the questionnaire, the hospital capability is evaluated in terms of
specialty manpower, existing training program, available personnel in the emergency
room capable at all times of handling specific sub-specialty problems. The hospital
capability rating also takes into account the available equipment, therapeutics and
communication facilities, infrastructures and service performance. All hospitals are
classified according to their capabilities in handling specific sub-specialty programs.
The following hospital capability ratings are recommended:
RATED 1 means that the hospital is capable of accepting all cases of this
specialty. A hospital Rated 1 is an end-hospital that will not refuse patients unless
the situation makes admission extremely difficult or impossible.
RATED 2 means that the hospital is capable of handling sub-specialty cases but
has some limitations such as bed capacity, equipment, etc.. and cannot be
expected to offer definitive care. It may also mean there are not enough full-time
consultants or residents available on a 24 hour basis or that there is no training
program and therefore no front-line personnel in this specialty.
RATED 3 means the hospital is incapable of handling cases of this sub-specialty
beyond giving primary care and resuscitation.
The rating system should be agreed upon by all concerned. A lead hospital is
assigned for each sub-specialty to coordinate the compilation of treatment protocols. All
lead hospitals are Rated 1 for their respective sub-specialties. A two-way referral system
between the lead hospital and other hospitals in the network shall be established. A team
leader for each lead hospital shall also be designated. Hospitals both private and
government should work together to form the network irrespective of specialty and
capability. There should be a clear system of referral so as to prevent patients referred to
the wrong hospital. An illustrative example of a network hospital capability-rating sheet
is shown below:
An Illustrative Example
Hospital Network Capability Rating sheet
Service Capability Hospital 1 Hospital 2 Hospital 3 Hospital 4
1. Orthopedics 2 3 1 2
2. Neurosurgery 2 3 1 2
3. Abdominal 1 1 1 1
Urology 1 2 1 1
ENT 1 2 1 2
Maxillo-Facial 1 3 1 1
Burns/Plastic 2 2 2 1
TCV 1 2 1 1
The rating of the hospital serves as a practical guide in the referral of patients. For
instance, victims of serious burns shall be referred to the hospital rated 1 on burn treatment
capability. Similarly, disaster victims requiring neurosurgical services capability shall be
referred to the lead hospital ( rated 1) in neurosurgery. The capability rating of each
hospital should be made known to all the hospitals in the network to ensure smooth and
appropriate referral of cases. Referral of patients to a hospital, which is not capable of
providing the services required, should be avoided.
A system of communication and patient referral shall be established to avoid
overloading of individual hospitals and to ensure that patients are referred to the hospital
most capable of managing the emergency.
XV - TRAINING
The medical personnel comprising the response teams should have basic and
specialty training on the specific skills needed for disaster response. The training
program should include both medical and management skills as well as team-building,
psychosocial, and human relations skills.
As a minimum, members of the on-scene response teams should have skills on
cardiopulmonary resuscitation (CPR), trauma care, patient assessment and classification,
and proper transport of patients. In most cases, members of the in-hospital disaster
response teams, being medical personnel may assume to have adequate technical training
in their respective specialties. It should, however, be confirmed that they indeed possess
the needed skills. In addition, they may still need to be trained on the procedures and
policies embodied in the hospital’s disaster operation’s plan.
All responding teams should be knowledgeable in mass casualty handling as this
is a special concept. A carefully directed training is mandatory. No personnel should be
dispatched without knowledge in this area. Treatment protocols for most common
emergency cases encountered during disaster operations should likewise be included in
the training or orientation program for the hospital disaster response team.
It may also be advisable (optional) that members of the community within the
catchment area of the hospital be included as a target group if the hospital goes into
community disaster preparedness program. Training in basic CPR and trauma care may
spell a difference because they may be the first to arrive at the scene of disaster, and the
time between onset of circulatory arrest and initiation of resuscitation is critical. Hence,
if police officer, traffic enforcers or just bystanders at the site of disaster are able to begin
CPR on those with signs of cardiac arrest before the arrival of the scene response team,
the chances for long-term survival of the patient are likely to be increased. Likewise,
skillful handling of patients with traumatic injuries may have a difference between
recuperation and an invalid state.
Lastly, people who are given the authority to command and control disaster
operations should have training in MANAGEMENT in the real sense of the word. This
would mean training in planning, organization, evaluation, monitoring, logistic and
personnel management, information systems management and a lot more. You maybe
the best surgeon or the best EMS personnel but doesn’t know how to manage your
resources might result to a second disaster.
The objectives of training and education in emergency management are:
to manage and coordinate emergencies and disasters inside the hospital and/or
within the catchment area;
handle mass casualties inside and outside the hospital;
response teams as well as hospital personnel are able to carry out the tasks
allotted to them;
the community knows the appropriate actions for different types of
emergencies, and the organizations it can turn to for assistance
XVI - DRILLS AND EXERCISES
Theoretical education has to be followed by periodical exercises. Drills can range
from full-scale community-wide simulations with moulage victims to table top triage
games to mini-drills that test only certain components of the disaster plan such as call-up
of personnel, and test of communications. Mock disasters have to be well prepared and
executed preferably without announcement. It is suggested that it should be conducted at
least twice a year (especially during Disaster Consciousness Month every July) and the
scenario should reflect incidents that are likely to occur in the hospital or in the
community. It is important that the hospital takes all precautionary measures not to alarm
the patients during disaster preparedness drills.
Objectives of drills are:
1. To train the hospital staff involved in disaster operations
2. To detect errors or flaws in the disaster plan; and
3. To minimize the time required for the hospital staff to respond to actual emergency
Drills must be well organized and coordinated, so that each participant will perform
his role and know the work he has to do. In scheduled drills the following training
sessions should be done:
1. A session to explain what each participant has to do.
2. A separate partial rehearsals for each section or group of participants (including the
3. A comprehensive rehearsal involving the entire hospital system. It is important to
make sure that all staff included in the plan participates.
A practical drill program on disaster preparedness should be developed for each
hospital. For instance, traffic routes of incoming medical emergency patients, pr escape
routes in case of internal hospital disasters are tailored to the specific condition of the
The Practice Drill should include the following:
4. Identification of key functions and information of special teams responsible for those
functions. For example, in a fire drill, the following key functions/teams may be
a. Floor nurse or disaster coordinator to direct patients and personnel
proper escape routes;
b. Fire-fighting team to try to control the spread of fire, or extinguish
fires before they spread;
c. Communication team to call the fire department, issue correct
information on the location of the fire and escape routes to take;
d. Patient evacuation team to be in charge of the orderly and
systematic transfer of patient to declared evacuation sites;
e. Critical equipment rescue team to take care of saving critical life-
f. Search and rescue team to look for, and arrange rescue of, patients
or personnel that may have been trapped or left behind; and
g. Post- assessment team to monitor the conduct of the drill and
identify weaknesses that should be corrected.
5. Briefing of all personnel on the highlight of the practice drill and the expected tasks
and behavior of all concerned.
6. Conduct of practice drill based on various types of internal as well as external disaster
situations. It is suggested that the practice drill be done twice a year.
7. Post drill assessments to determine how to further improved the practical drill
exercises and programs.
XVII – LOGISTICS MANAGEMENT
During a disaster, necessary supplies and equipment must be ready for immediate
distribution to appropriate locations in the hospital (e.g., stretchers and wheelchairs to the
receiving area). Each hospital will have to estimate the amount of medicines and supplies
that will be needed to stock over and above their regular hospital supply. In many
instances, this will not need to be increased because many hospitals and medical centers
already have a three-month supply of most of their emergency drugs/supplies. Some
investments may be expensive but are most likely well worth it.
The hospital should be in constant state of readiness to respond to any disaster.
The needed facilities and support for disaster operations should be in place and regularly
maintained. The essential medical facilities that should always be available by the On –
Scene Response Teams and In Hospital Response Teams should always be monitored.
This includes ambulance facilities that enable the Scene Response Teams to conduct
rescue operations at the site of the disaster, transport and communication facilities, and
standby power generators.
Prior arrangements should be made with suppliers of critical supplies for opening
of credit lines during disaster to ensure continuous supply of medicines and other
consumable. Likewise, arrangements have to be made with maintenance service
providers for similar credit arrangements to ensure prompt repair and/or temporary
replacement of critical medical equipment that break down during disasters.
Whether it be natural or manmade disasters or emergencies the requirement of the
sudden use of specific medical items suddenly produce a short supply. Even during
normal times with the present procurement procedures supply of the needed medicines
might be a problem. Institutions especially the hospital has to come up with procedures
for an organizational shift in times of emergencies and disaster. Logistic management
thus far could break or make responses to emergencies and disasters.
XVIII MEDIA RELATIONS
In a disaster, the hospital may become inundated by more members of the media
than by actual disaster victims. The presence of these individuals can definitely impair
the performance of an already stressed hospital staff. For this reason, members of the
press and other news media representatives should be directed to a room or office of the
hospital away from the emergency department or other areas where patient care activities
are going on. A hospital administrator or public relations specialist should closely
supervise the press room. This person should be in direct contact with the emergency
operation center. Hospital staff must leave all communication with the press to this
person and should direct any member of the media to the public relations area so as to
have consistent information given out by the hospital.
The media can be used as a communication tool to the outside world by releasing
information that informs families of potential victims and hospital personnel of the status
of the situation. Authorities can be contacted to activate the Emergency Broadcast
System to disseminate information on very short notice to a large number of people.
Information does not only include the contact between rescue staff and media at
the damage area. Information flow is also important within the hospital. Information
chaos with subsequent criticism can only be prevented by a clear information concept.
This concept consists of:
information of staff
information of neighboring hospitals and operation partners, such as
ambulances, police, etc.
information of friends and relatives,
information of media (Media always get their information - the better way
is the controlled one)
XIX. UPDATING AND EVALUATING THE HOSITAL DISASTER
The hospital disaster plan should be reviewed regularly and updated frequently to
include changes in manpower, resources, protocols and any other changes since the plan
was made. Usually the plan is reviewed after an actual disaster, after a disaster simulation
exercise or any other type of test and the changes reflects the correction of failings
detected during the exercise. Interval between one updating and the next will vary
according to the conditions in each hospital and would depend on the number of disasters
occurring on the catchment area of the hospital, on the number of simulation exercise or
drills and /or evaluations done. Ideally, it should be done once a year.
Changes normally occur in institutions including movement of staff, changes in
position, new employees even new superiors. It is along this light that evaluation of
one’s hospital preparedness plan should be reviewed regularly and evaluated to determine
if the plan is still up-to-date, if the roster of personnel and material resources are
complete and the activities are being carried out according to the plan. Furthermore, the
evaluation is being carried out to check the condition of equipment, availability of
resources such as drugs etc…
Evaluation is deemed effective if carried promptly and followed by correcting all
the errors detected during the evaluation. Hence, even if errors are noted but are not
corrected and included in the plan the evaluation is useless. However well the plan was
made and however complete it is it cannot be proven unless it is evaluated.
The real purpose of an evaluation is to measure efficiency and detect deficiencies
in order to correct them at all levels. Evaluation is carried out under the supervision of
relevant officials. Evaluation validates and complements planning. It should be
remembered by everybody that in order to check that everything is proceeding in
accordance with established plans, it must be verified that it is should not only be well
understood by everybody but intellectually and emotionally accepted by those in charge
of executing the plan.
Types of evaluation methods are simulation exercises, and drills: scheduled,
unannounced, and in-service. Best evaluation of a hospital disaster plan is one carried
out after an actual disaster, since it is then that all the factors involved come into play
under conditions of real pressure.
XX - TEN STEPS TO BECOME A STOP DEATH HOSPITAL
1. The hospital should have an institutionalized disaster preparedness and response plan,
regularly updated and disseminated to all hospital personnel;
2. The hospital should have an emergency response team that can be mobilized at once to
respond to any emergencies and disasters;
3. The hospital should have an ambulance equipped with all the needed equipment, emergency
drugs and supplies ready to attend to an unstable victim; furthermore all the personnel should
be knowledgeable of all the use of the equipment and medicines and supplies inside the
4. The emergency room of the hospital should be equipped with all the necessary equipment,
medicines, supplies and communication ready to respond to any form of mass casualty
handling; it shall be ready to receive an influx of emergency cases and be able to adapt to the
sudden change due to the emergency;
5. The hospital should be able to activate the hospital’s Emergency Operation Center (EOC)
once a disaster occurs and responsible for coordination during the disaster; the EOC should
also be equipped with all types of communication ( telephone, radios, fax machines,
computers, runners etc.) to be able to properly coordinate with all the agencies involve in
6. The hospital shall have a continuous training program for all the hospital staff but specifically
for the response team and the emergency room staff; Basic Life support ( BLS ) for all
hospital personnel; Advance Cardiac Life support ( ACLS ), Pediatric Cardiac Life support (
PCLS ) for all emergency room medical personnel; Emergency Medical Technician ( EMT )
for response team and health emergency management for all stop death coordinators;
7. The hospital should know: his community and be knowledgeable of all the hazards and the
vulnerable population in it’s area; existing members of the health sector in their respective
community; relevant government and non-government organizations to whom it can
coordinate. and network during emergencies and disasters;
8. The hospital should have an ongoing advocacy campaign to disseminate preparedness among
the general population in it’s community; it should advise the public on health issues
appropriate to the type of disaster; it should have regular seminars on emergency
preparedness; it shall have at least twice a year disaster drills to review and update the plan;
9. The hospital should follow and observe all the needed fire-safety requirements as embodied
in the Fire Code; furthermore, procedures like formation of fire marshals responsible for
ensuring evacuation of patients and important documents and equipment be in place and
10. Lastly, the hospital should exert all efforts to document all it’s experiences, do researches
pertinent to emergencies and disasters and shall serve as inputs to improve their plan or come
up with standards and protocol.
XXI - APPENDICES
STOP D.E.A.T.H. PROGRAM ASSESSMENT FORM
Date of Assessment
Name of Hospital
Name of Director
STOP DEATH Coordinator
To assess the implementation of the Stop Death Program in the Hospital.
To assess the following:
1) The Emergency Preparedness Plan of the Hospital
2) The Emergency Room capability of the Hospital.
3) The Communications capability and the existence of an Operations Center of the
4) The Transportation (Ambulance) capability of the hospital.
5) The response team of the hospital.
6) The Human Resources of the Hospital.
7) The Community Involvement of the Hospital.
8) The Advocacy activities done by the STOP DEATH Program of the Hospital.
9) The Fire Safety of the Hospital.
10) The Research Activities done related to Disaster.
11) The performance of the STOP DEATH Coordinator.
12) The Hospital Director’s perception and concerns to the STOP DEATH Program.
ASSESSMENT TOOL FOR THE STOP DEATH PROGRAM
FOR DOH RETAINED HOSPITAL
The assessment tool is designed to assist in the evaluation of the STOP DEATH
Program being implemented in the DOH retained Hospitals.
1. Emergency Preparedness Plan 20%
4% 1.1 Does the hospital have an emergency plan?
4% 1.2 Is the hospital emergency plan documented in writing?
4% 1.3 Is there a flow chart (organizational chart) for disaster situation?
4% 1.4 Is there a hospital directive in the implementation of the
emergency preparedness plan?
4% 1.5 Are the members made aware of the program and their role?
1.5.2 Medical (Chief of Clinics)
1.5.3 Administrative Division
1.5.4 Nursing Service
2. ER/AS Capability 15%
What are the equipment available at the ER/AS?
4% EMERGENCY ROOM EQUIPMENT Quantity Date Acquired Functional Non-Functional
1. Ambu Bag Adult Set Pedia Set
2. Anesthesia Machine *
3. Blood Pressure Apparatus
4. Cardiac Monitor w/ Defibrillator
5. Cervical Collars Indicate sizes
6. Crutchfield Tongs *
7. Cardiac Board
8. Floor Lamps
9. Intravenous Fluid Stands
10.Closed Tube Thoracostomy Set
12.Minor Surgical Set
15.Laryngoscope Adult Set Pedia Set
18.Mechanical Ventilator *
21.Oxygen Tanks Wall-Mounted
23.Spine Boards ( short / long )
27.Straps ( cloth )
30.Flashlight / Penlight
4% EMERGENCY ROOM DRUGS QUANTITY
1. Dopamine 200 mg. / amp.
2. Dobutamine 250 mg. / vial
3. Lidocaine 5% Vial/ Polyamps
4. Epinephrine 1 mg./ml. Amp.
5. Atropine Sulfate 1 mg./ml. Amp.
6. Magnesium Sulfate 25 mg./ml./Amp.
7. Calcium Gluconate 100 mg./ml./Amp.
8. Aminophylline 25 mg./ml/Amp.
9. Terbutaline Sulfate 0.5 mg./amp.
10. Verapamil 5 mg./2 ml./Amp.
11. Nifedipine 5 mg./cap.
12. Sodium Bicarbonate 50 mEq./vial
13. Isordil 5 mg./ tab
14. Digoxin 0.5 mg. /ml./amp.
15. Nitroglycerine 5 mg. Patch/paste
16. Furosemide 20 mg./amp.
17. Ranitidine HCl. 50 mg./amp.
18. Plain LR 500 ml. 1 liter
19. Plain NSS (0.9 NaCl) 500 ml. 1 liter
20. D5-LR 500 ml. 1 liter
21. D5-W 250 ml. 500 ml. 1 liter
22. D10-W 500 ml.
23. D5-0.3 NaCl 500 ml. 1 liter
24. D5-0.9 NaCl 500 ml. 1 liter
25. D5-NM 500 ml. 1 liter
26. D5-NR 500 ml. 1 liter
27. Mannitol 20% 250 ml. 500 ml.
29. Chlorpromazine 25 mg./ml./amp.
30. Dilantin 100mg./amp.
30. Dexamethasone 5mg./vial
32. Plasma Expander
33. Salbutamol Nebules
34. Terbutaline Nebules 0.5 mg.
35. Paracetamol 300 mg./amp.
36. Sodium Chloride 0.9% Iso. Soln. 20cc./vial
37. D- 50 -50 50 cc. / vial
38. Diphenhydramine HCl. 50 mg. / amp.
39. Diazepam 10 mg. / amp.
40. Nalbuphine HCl. 5 mg. / amp.
41. Activated Charcoal *
42. Tranexamic Acid 500 mg./ml./amp.
43. Hydrocortisone 100 mg./vial
44. Metoclopromide 10 mg./ml./amp.
45. Potasium Chloride 40 mEq./50cc. Vial
EMERGENCY ROOM SUPPLIES QUANTITY
3. Butterfly G. 25 G. 23 G. 21 G. 19
4. I.V. Catheter G. 24 G. 22 G. 20 G. 18
7. Blood Transfusion Set
8. Syringes 1 ml. 3 ml. 5 ml. 10 ml. 20 ml. 50 ml.
9. Sterile Gauze
11. Endotracheal Tube
12. Tracheostomy Tube
14. Cotton Balls
15. Cotton Pledget
17. Oxygen Mask Pedia Adult
18. Suction Catheter
20. Urinary Catheter
24. Asepto Syringe
2.2 Manpower Resources
Staff composition for the ER?
_________ Nursing Attendant
_________ Institutional Worker
3. Communication / Operation Center 10%
3% 3.1 Internal Communication
What are the forms of internal communication being used by the
_________ public address system
_________ cellular telephone
_________ others, please specify ________________
3% 3.2 External Communication
What are the forms of external communication being used by the
_________ short wave
_________ public address system
_________ fax machine
_________ cellular phone
_________ others, pls. specify ____________________
4% 3.3 Is there an operation center established for disaster response?
4. Transportation (Ambulance) 5%
1% 4.1 Is there an available ambulance in the hospital?
If yes, how many? ____________
1% 4.2 Is there an available communication equipment in the ambulance.
If yes, what kind? ____________
3% 4.3 LIST OF AMBULANCE EQUIPMENT
1. Cardiac Monitor w/ Defibrillator
2. Oxygen Mask
3. Pulse oximeter
6 Oxygen Tank w/ Regulator & O2 Meter
8. Suction Machine ,portable
9. Emergency Medical Kit w/ Drugs & Supplies
10. Spine Board w/ Straps
11. Cervical Collar (adult/pedia)
12. Stretcher ( scoop / wheeled type )
13. Minor Set
14. Tracheostomy Set
16. Fire Extinguisher
5. Response Team 5%
2% 5.1 Do you have an available response team?
1% 5.2 Composition of the emergency medical team?
_________ Nursing Aide
_________ Ambulance Driver
1% 5.3 How many response team can be mobilized to respond to disaster?
1% 5.4 Is there an available schedule of the response team?
6. Human Resources 15%
2% 6.1 Does the hospital conduct training of personnel for emergency
3% 6.2 How many have attended the BLS conducted by the hospital?
__________ Total no. of hospital personnel trained
__________ Total no. of hospital personnel. (Personnel
2% 6.3 Who is conducting the BLS training program?
__________ Red Cross
__________ Joint (Red Cross & Hospital)
__________ others, pls. specify ________
2% 6.4 Is there any available training manual for BLS.?
If yes, show us a copy.
2% 6.5 How many of the ER staff have undergone ACLS training?
__________ Total no. of E.R. staff who have ACLS
__________ Total no. of E.R. staff ( E.R. Head Nurse )
2% 6.6 Has the STOP DEATH Coordinator/Asst. Coordinator attended
the Disaster Preparedness Management Course?
If yes check if he has attended the following
_________ module I
_________ module II
_________ both module I & II
2% 6.6 What are the available training materials?
_________2. BLS training mannequin
_________3. Others, pls. specify
7. Community Involvement 10%
3% 7.1 Is there vulnerability assessment done at the community level?
If yes, show documentation.
3% 7.2 Are you involved in the community?
If yes, show documentation (pictures, memo)
3% 7.3 Do you have a directory of local officials.
If yes, show documentation.
8. Advocacy Activities 10%
2% 8.1 Are there means to create public awareness of the disaster plan of
2% 8.2 What are these measures?
___________ Hanging signs
___________ Sign boards
___________ Others, pls. specify _______________
2% 8.3 What methods are used to disseminate information to the public?
___________ Local press
___________ IEC material
___________ Public meetings
___________ Others, pls. specify _______________
2% 8.4 Are there networking activities done?
If yes, what kind of activities and show
2% 8.5 What are the agencies you have networked with?(Show
__________ Other Hospitals
__________ Local Government
__________ Others, pls. specify
9. Fire Safety
9.1 Does the hospital have an evacuation plan in case of fire?
If yes, provide a copy
9.2 Are there fire drills, simulation exercises conducted in the
If yes, show documentation
(eg. Pictures, Certificate from Bureau of Fire)
9.3 Does the Hospital have an established fire brigade?
If yes, show organizational chart.
9.4 Does the hospital have adequate fire escapes?
If no, cite reason. __________________
9.5 Are the fire escapes easily accessible?
If no, cite reason. __________________
9.6 Does the fire escapes have emergency lights?
` __________ Yes
If no, cite reason. __________________
9.6 Does the hospital have emergency lights?
If yes, is it functional.
9.7 Does the hospital have a fire alarm?
If yes, is it functional.
9.8 Does the hospital have a smoke detector?
9.9 Are the signages easily seen?
9.10 Does the hospital have a sprinkler system?
9.11 Are fire extinguishers provided in every station?
9.12 Are there fire hoses in the Hospital?
( Director ) 9.12 Provide plan of the hospital showing location of fire escape, fire
extinguishers, fire hoses.
9.13 Provide a copy of fire inspection result given by the Bureau of Fire
(Coordinator) 10. Research Activities Related to Disaster Preparedness Program
10.1 Are there research activities being conducted in relation to
STOP DEATH Program?
If yes, show / furnish copy.
11. Exit Interview with the STOP DEATH Coordinator
(STOP DEATH Central Office will be the one to rate)
11.1 Submission of Utilization Report
11.2 Submission of Accomplishment Report
11.3 Attendance in Meetings
11.4 Problems encountered
12. Exit Interview with the Hospital Director
12.1 Emphasize the objective that the purpose of the assessment is only
a survey of the STOP DEATH Program.
12.2 Recapitulate the criteria’s of the of the assessment tool.
12.3 Summary of the findings.
12.4 A copy of the report will be furnished to the director.
12.5 Ask the Director a feedback / perception to the STOP DEATH
STOP D.E.A.T.H. PROGRAM MISSION-INCIDENT REPORT
National Health and Emergency Services Network SUMMARY REPORT-COVER PAGE
Department of Health, Republic of the Philippines
OSEC, Bldg 1, DOH San Lazaro Cmpd., Sta. Cruz, Manila Classification:
Tel. No. 711-6075, 743-8401 loc. 1105, 1106, 1111, 1113 File Code :
Telefax 711-6050, 743-8301 loc. 1109, 1110
Submitted to: Routing/Copy furnished
(Name) (Position) (Office/Unit)
(Name and Signature) (Position) (Date)
Title of mission/assignment/incident : Inclusive dates/time of mission/incident
Indicate name and location of mission/assignments/incident, etc (From) (To)
Other co-participants in the mission/assignment :
Objective(s) of mission/assignment :
Enumerate the specific tasks which had to be accomplished.
Cite clearly the outcome of the mission/assignment. Include important and useful statistics.
Recommendation(s)/Action to be taken:
Enumerate the specific tasks which had to be accomplished.
This summary report shall be prepared and submitted to the DOH-Operation Center/HEMS Office not later than 48 hours or two (2) days
after completion of a specific mission or assignment. A copy of this form will serve as Report Cover Page if a detailed report is prepared
subsequently. This serves as the standard mission/incident report form of the STOP DEATH Program.
Revised: November 17, 2000
Medical Care Survey Form
The purpose of this survey is to solicit information on health care centers at the
national level and the availability of their human and material resources, in order to organize
plans and programs for medical care in the event of public disasters. It is important to obtain
detailed information in order to create a regionally-organized file of resources that makes
possible the quick deployment of those resources to meet requirements in the country’s
Medical Care Survey Form
1. General Data
1.1 Name of Medical care center
1.3 Telephone (s)
1.4 If the center has radio equipment:
i) Call letters
ii) Operating frequency
1.5 Area served (geographic)
i) Type of center:
2. Environment Structures
2.1 Hospital capacity
Indicate the total available number of:
ii) Intensive therapy beds:
iii) Infectious-case beds:
iv) Beds for burn victims:
v) Intermediate therapy beds
vi) Specialty beds (specify):
vii) Operating rooms:
ix) Others (specify):
Describe the characteristic of convertible areas and spaces that might be utilized to increase
hospital capacity in the event of an emergency or disaster. Specify the size (in square meters)
of each area or space, the services available in it (water, light, telephone, others), and provide
any other information that may be useful for assessing the suitability of each for medical care
in the event of an emergency or disaster.
Surface area m2
Water Yes No
Light Yes No
Telephone Yes No
Surface area m2
Water Yes No
Light Yes No
Telephone Yes No
Surface area m2
Water Yes No
Light Yes No
Telephone Yes No
Surface area m2
Water Yes No
Light Yes No
Telephone Yes No
Surface area m2
Water Yes No
Light Yes No
Telephone Yes No
Surface area m2
Water Yes No
Light Yes No
Telephone Yes No
The following information will make it possible to determine the length of time over
which the facilities can continue to be operated autonomously in the event of a disruption of
basic services or a supply crisis.
List of building making up the hospital’s plant
(including maintenance areas)
Building Number of Number of en- Year of con- Type of con- Number of beds Medical services
(Name/Identifi- floors trances/exits struction struction in the building in the building
Others (attach additional sheet (s)
Does the hospital have extensive and unobstructed grounds nearby where field
hospitals and/ or emergency services can be located? Include parking areas, green areas, and
others. For each area include dimensions in meters.
1. Area Location Surface area m2
2. Area Location Surface area m2
3. Area Location Surface area m2
4. Area Location Surface area m2
If the facility has a power generator, include:
a. Type of plant:
b. Capacity (kw):
c. Fuel used:
d. Fuel storage capacity:
f. Indicate whether the feeding of the plants by the electric company is
by means of an independent circuit or a circuit serving various users:
Independent Various users
g. Indicate the supply voltage (number of volts):
h. Identify the power substation supplying the hospital and give its
i. Indicate the electric company’s three substations which are closest to
the hospital and may be usable as sources of supply by direct special
line in the event of an emergency.
1) Substation Address
2) Substation Address
3) Substation Address
j. Average daily use of electricity in 24 hours Kv/24.
k. Is the hospital’s physical structure such that certain areas can be
supplied with electricity independently?
l. If yes, explain whether the normal power system has special feeder
Feeder circuits for: Yes No
Emergency units Yes No
Operating rooms Yes No
Intensive care units Yes No
Laboratory Yes No
Sterilization center Yes No
X-rays Yes No
Elevators Yes No
Kitchen (cold storage rooms) Yes No
Water pumping systems Yes No
m. Is there any emergency lighting system (batteries or stationary
1) Area Type of lighting No.
2) Area Type of lighting No.
3) Area Type of lighting No.
4) Area Type of lighting No.
5) Area Type of lighting No.
iii) Water supply
b. Capacity of tanks: liters
c. Cubic meters.
d. Reserves estimated for hours.
e. Hospital’s monthly water use: m3
f. Diameter of supply pipe(s):
g. Does the hospital have a water pumping system?
h. If yes, indicate:
Number of pumps Capacity of each
i. What would be the way of supplying water to the hospital in an
Type of disposal:
a. Freezers and refrigerators
Indicate the characteristics and capacity (cubic feet or cubic meters
b. Reserve supply of food estimated to last:
Nonperishable food: days.
Perishable food: days.
Reserve supply of drugs estimated to last: days.
3. Technical Resources
Indicate the characteristics, quantity, and capacity of available technical resources.
3.1 Surgical instruments
Indicate specialty, characteristics, and quantity of available surgical instruments:
i) General surgery boxes
ii) Trauma boxes
iii) Neurosurgery boxes
iv) Laparatomy boxes
v) Thoracotomy boxes
vi) Boxes for
vii) Boxes for
viii) Boxes for
ix) Boxes for
x) Boxes for
3.2 Sterilization systems
Indicate with respect to each system:
iii) Energy sources:
iv) Total number of sterilization systems:
v) Total capacity:
3.3 X-ray equipment
Indicate with respect to each set of x-ray equipment:
Total number of sets of x-ray equipments:
3.4 Other equipment
Indicate with respect to any other available equipments:
3.5 Blood bank
If the facility has a blood bank, indicate:
i) Capacity: liters
ii) Average reserve: liters
iii) Number of associated donors:
4. Human Resources
4.2 Nonmedical personnel
Social workers ………………..
Nursing professionals ………….
Medical technicians ……………
Social auxiliaries ……………...
Nursing auxiliaries ……………
4.3 Employees and workers
i) Number of employees
ii) Number of workers
5. Transportation and Mobilization
5.1 Number of ambulances:
5.2 Other transportations vehicles (specify):
5.3 Access and transportation facilities:
i) If there is a heliport near the facility, indicate:
a. Geographic location:
b. Distance between the heliport and the facility:
ii) If there is an airport or landing strip near the facility, indicate:
a. Geographic location:
iii) If there is a port near the facility, indicate:
a. Geographic location:
b. Distance between the port and the facility:
iv) Indicate the name and best means of access to the facility:
6. Emergency Plans
6.1 If there is an emergency plan, indicate the following (attach a copy of the plan):
i) Has the plan been put into practice?
ii) Have emergency or disaster simulation exercises been carried out?
Several times (how many?)
Periodically (how often?)
iii) If simulation exercises have been held, what have been the results?
List of Drugs and Equipment for Major Disasters
1. Antibiotic, different types of antibiotics to cover and treat infections already
established and infections expected in nonoptimal treatments of this type.
2. Oral, intramuscular, and intravascular analgesics.
3. Gauze, elastic, and plaster bandages.
4. Ferrules for immobilization, traction equipment.
5. X-ray plates of different sizes, as well as reagents for mass development of
6. Rubber or vinyl disposable gloves, preferably sterile, for the operating room
and handling of patients.
7. Vesical catheters, Foley-type No.s 10 to 18.
8. Probes for nasogastric suction, different calibers.
9. Catheters or tubes for thoracic drainage, with equipment and flasks (water-seal
10. Sterile, and preferably disposable, operating room robes, sheet, boots, caps,
and masks: these are among the most important supplies, since in a state of emergency
there may be obstacles to washing and sterilizing clothes. Disposable equipment thus
provides an acceptable solution to hospital requirements for a certain period of time.
11. Intravenous solutions and equipment for administering them, preferably in
plastic bottles and syringes. The hospital should make local arrangements for the shipment
of crystalloid solutions and equipment for administering them. It is important that national
inventories be exhausted before international aid is received.
12. Orthopedic material such as plates, pins, screws, and ferrules for managing and
13. Antiseptic solutions (iodized, with hexachlorophene).
14. Creams or pomades (Vaseline, furacin, etc.)
As will have been noted, no mention is made of a priority need for the shipment of
blood, plasma, or vaccines; these items should be sent only on specific request.
Design Consideration for disaster-prone Hospitals
The types of disasters that may occur during the useful life of the hospital are
earthquakes, fires, floods, and explosions. The frequency and intensity of these phenomena
will differ according to the building’s location. Owing to the highly important function
performed by hospitals times of disasters, the safely provisions for the protection of human
lives and equipment are the same regardless of the types of disaster.
Minimum requirements to be met by all hospitals are discussed below.
The structure should be designed in accordance with the national antiseismic
regulations. In the absence of national regulations, the use of the Uniform Building Code
(U.B.C.) of California (USA), is recommended.
It will be necessary to calculate the seismic risk over the useful life of the building,
using attenuation coefficients appropriate to the place. The structure will be designed for the
highest-intensity earthquake expected during that period.
The construction materials used should be reinforced concrete or steel, depending on
the availability and cost of each. In all cases, the parts of the structure should be reinforced to
attain a 180-minute resistance to fire (RFA 180). The inner walls and partitions should be
Stairwells should be located so as not to produce a torque effect on the structure when
it is subjected to horizontal forces.
The structure of the stairways should have the same resistance to fire specified for the
structure of the building.
Location within the property
The main façade of all building should face a public thoroughfare and another façade
should face a private street or inner court at least 10 m wide where vehicles can enter.
Isolation of areas
Anesthesia and pharmacy rooms and other areas used for storing dangerous supplies
such as chemical reagents, radioactive materials, fuel, etc., should be isolated compartments
protected with fireproof walls. In buildings four or more stories high, bedroom areas escapes
routes should be compartmentalized.
All door should open in the direction of traffic exiting through an escape route.
Automatically closing doors with “antipanic” locks should be installed in places designed to
accommodate 50 or more people. Hospital and infirmary exits should be at least 1.20 m wide.
Ward of 15 or more persons should have at least two exits, one at each end.
Ward exits should open directly onto hallways.
Hallways should be at least 1.5 m wide. A hallway along which beds or stretchers are
moved should be at least 2.40 m wide.
In buildings of two or more stories, ramps should be provided as part of the escape
route so that bed patients may be evacuated.
All door opening onto an escape route should be at least 1.10 m wide.
The following signs should be put in place: a) signs indicating the escape routes; b)
signs indicating equipment; and c) building layout diagrams. “Exit” signs should be placed at
all emergency exit doors providing access routes and stairways. These sign should be placed
over the door at a height 2.25 m above the floor.
All signs should be lit as long as the building is occupied.
All buildings should contain diagrams showing the location of the various types of
alarm and firefighting equipment. Such diagrams should be placed on each floor of the
building in places where they are visible to personnel in the building.
All firefighting equipment that can be used by the staff should have precise
instructions beside the equipment itself.
A diagram showing a person’s location in relation to escapes routes should be installed
in each area.
Fire detection, alarm, and control equipment
Ionic-type, linear-operation fire detection equipment should be installed at the rate of
one detector for every 50 m2 of floor space. The building should have an alarm center,
preferably in the basement.
The building should be equipped with ABC type portable extinguisher for every 200
m2 of floor space and at least one per floor. An extinguisher should never be more than 20 m
The fire extinguishing system should consist of a tank with a capacity of at least 30 m2
, a pumping system capable of providing a pressure of 75 lbs./inch2 , and iron piping. The
system’s distribution line should have a built-in automatic extinguisher system with automatic
sprinklers. There should be one sprinkler for every 15 m2 of floor space.
The drainage system should be of the separator type; if there is no connection to the
public sewer system, a septic tank or seepage pit should be provided.
Contaminants and/or radioactive materials
If it is necessary to dispose of this type of material within the perimeters of the
hospital, an underground reinforced concrete tank should be constructed as far away from the
building as possible. The tank should be covered by a layer of soil at least 2 m thick.
Simulation exercise for any type of disaster should be conducted at least once a year.
Each member of the hospital should be assigned a specific function to facilitate
evacuation of the building.
Energy and Communications
The following points should be checked with respect to the hospital’s electrical
1) That plans of the installation are available and up-to-date.
2) Is the switchover to the emergency power plant automatic or manual?
3) If automatic, check to see that it is operating normally; if it is not, determine
the procedure to be followed to transfer the load.
4) If the switchover is normal, step-by-step instructions for transferring the load
should be available in an accessible place.
5) How long are the emergency plant’s fuel reserves designed to last?
6) Check the equipment once a month.
7) Keep the fuel tank full.
8) Identify the equipment and installations that operate with the emergency plant.
If the hospital does not have an emergency plant, a generator with at least 40 percent
of the transformer capacity of the hospital substation should be requested. In so doing, it is
important to know the cycles (60 or 50 Hz) of the generator required, the type of connection
to the distribution line (delta or star), and the voltage of the hospital’s system. The following
steps should be taken:
1) Determine where the generator will be placed and how it will be connected.
Bear in mind noise and contamination problems.
2) Determine the fuel consumption of the generator to be installed, per-24
3) Determine how fuel is to be supplied to the generator to keep it in
4) Have a diagram showing the distribution boxes that must be disconnected
in order for the generator to function correctly.
It is imperative to know the source of electric supply for the x-ray equipment:
a) if it is connected to the main distribution box, it may be fed by either the
hospital’s emergency plant, if one exists, or by the generator furnished for the
b) if the x-ray equipment has its own feeder system, it will be necessary to
install a generator solely for that equipment; its capacity should be that of the x-ray
equipment; its capacity should be that of the x-ray equipment. Steps 1, 2, and 3
above should be considered.
If should be ascertained whether there is a special system to provide emergency
service in operating rooms and intensive care units. This system makes it possible to provide
an uninterrupted energy supply to those areas. It should be noted that the emergency system is
an alternative to those describe above and refers to a direct current system.
It is necessary to check the batteries (charge and acid) at least once a week. It is also
important to know exactly how long the batteries will continue to hold the charge with all the
equipment in operation and ascertain the source of power for charging the batteries in the
event of failure of the power distribution network. Finally, it is important to know the hospital
substation’s transformer capacity.
The hospital’s communications diagram should be available and updated. The
following should be taken into account for this purpose:
1) Determine the point of origin of the telephone trunk lines feeding the hospital.
2) Determine how the communications equipment is supplied with energy in the event
of a failure in the power distribution network:
a. whether it will be fed by the hospital’s emergency plant (the hospital’s own
generator or a borrowed one); or
b. whether it will be fed by a generator operating exclusively for hospital
c. determine the size of the generator in relation to the communications system’s
load, cycles (50 or 60 Hz), type of connection, and feeder voltage of the
d. know where the generator will be placed and how it will be connected;
e. determine the generator’s consumption of fuel in a 24-hour period and the type
of fuel it uses.
3) Locate and identify all of the hospital’s secondary telephone lines.
4) Locate all the loudspeakers of the hospital’s public address system.
5) Check the operation of the telephone switchboard and the public address system, if
any. Preferably, there should be a switchboard for the reserves loudspeakers and the
use of the switchboards should be alternated.
6) Check the operation of the blinker paging system or any hospital communication
equipment at least once every two weeks.
7) Have in mind place for locating and feeding a set of equipment for communication
with the outside world in the event of failure of the telephone lines. Preferably, the
hospital should always have equipment of this type on hand and its operation should
be checked daily.
8) It is further recommended that some battery-operated portable speakers be kept on
hand for emergencies.
City of Charlottesville, VA Fire Department, Standard Operating Procedures.
Disaster Management, A Disaster Manager’s Handbook, W. Nick Carter, A
publication of the Asian Development Bank, 1991.
Emergency Medical Services System. Module 5,.Pesigan, A., et al.
Emergency Preparedness, A Guidebook on Health Emergency Management. STOP
D.E.A.T.H., Department of Health, Manila, Philippines.
Health Services Organization in the Event of Disaster. Pan American Health
Organization, U.S.A., 1983.
Hospital Emergency Incident Command System., A Project of San Mateo County
Department of Health Services Emergency Medical Services Agency. Volume 1 and 2
http://www.emsa.ca.gov/heics3.htm. 3rd ed. June, 1998.
National Hospital Disaster Plan (Draft),, Prepared under the direction of Dr. Antonio
O. Periquet, with the participation of Dr. Antonio Limson, Dr. Margarita Galon, Dr. Romeo
Cruz, Dr. Teddy Recto, Dr. Primo Brillantes, Dr. Linda Milan, and Ms. Elynn N. Gorra,
August 11, 1992.
Protocols for Assessment of the Capacity of Health Facilities in the Western Pacific
Region in Responding to Emergencies, World Health Organization, Regional Office for the
Western Pacific, November, 1998.
DEPARTMENT OF HEALTH – DIRECTORY OF METRO MANILA HOSPITALS
Lung Center of the Philippines DR. FERNANDO MELENDRES DR. DAVID GEOLLEGUE
Quezon Blvd, Quezon CIty T – 925 2021, 925 2020 T – 926 9763 / 924 6101 loc. 803
F – 925 2021 ® - 931 2620
924 0707 P – 150 - 302636
National Kidney & Transplant DR. ENRIQUE ONA DR. ROSEMARIE LIQUETE
Institute T – 924 01 35 T – 923 0137, 924 3601 to 19 loc 246
East Avenue, Quezon CIty 922 1038 ® 645 7481, 645 4011
F – 922 5608 P – 634 3333 # 891754
924 0701 MS. MA. BELINDA EVANGELISTA
T – 926 8967, 924 3601 to 19 loc 432/
325/ 245 / 418
P– 151-8408534, 141-131862
C : 0917-7734767 / 0917-9514096 /
Philippine Children’s Medical DR. LILIAN V. LEE MS. LEILANI A. ARQUERO
Center T – 924 0836 T – 924 0870 / 924 6601 to 25 loc. 252 /
Quezon Blvd, Quezon CIty F- 924 0840 237 / 262 / 212
Email: lylee@WebQuest.Com F - 926 - 9012
® - 7131642
C - 0918-892 7686
Philippine Heart Center DR. LUDGERIO D. TORRES DR. ADRIANO DELA PAZ
East Avenue, Quezon City T – 922 0551 T- 923 1301 loc. 3203 Fax- 922 1890
F – 922 0551 ® 646 1913, 922 1890
DR. JOSETTE VILLANUEVA
T - 922 1810 (med. services)
Dr. Jose Fabella Memorial Hospital DR. RICARDO GONZALES DR. ROMEO BITUIN
Lope de Vega St., Sta. Cruz, Manila T – 735 7146 T – 734 5561 to 65 / 314 6357
F – 735 7146, 735 7144 F - 735 7146
® 726 0455
DR. ANTOINETTE PACAPAC
National Center for Mental Health DR. BERNARDINO VICENTE DR. ROMEO IMBUIDO
Nueve de Pebrero, Mandaluyong City T – 531 8578, 533 6054 T – 531 9001 loc. 351
531 9001, 533 4893 ® 531 9001 loc. 402 / 533 4759
F – 531 8682 Cell- 0918-8841655
® – 531 0513, 532 8275 DR. ROMEO SABADO
Beeper 1441-120141 T- 531-8682
National Children’s Hospital DR. MA. ISABELITA GOZON DR. EPIFANIA SIMBUL
E. Rodriguez, Quezon City T – 725 4533 T – 724 0656 to 59 / 749 9276
F – 721 9125 F – 721 9139
® 731 3456
DR. MYRNA T. VALENCIA
T – 724 0656 to 59
F – 721 9139
® 939 9779 / 930 2546
MR. EDWIN ROJAS
Cell - 0918-8271859
Philippine Orthopedic Center DR. JESUS DUEÑAS DR. EDWARD A. SARROSA
Banawe, Quezon City T – 742 5651 / 712 4746 / 712 6871 T – 711 4276 to 80 loc 254 Fax- 435 8887
732 0464 Beeper 1441-127960
F – 712 4746 Cell: 0918-5340349
Research Institute for Tropical DR. REMIGIO OLVEDA DR. NOEL MACALALAD
Medicine T – 809 7599 T – 807 2628 to 32 / 842 2079 / 850 7830
Alabang, Muntinlupa F – 842 2245 F – 842 2245 / 837 4721
Email: email@example.com ® 837 1814
San Lazaro Hospital DR. BENITO ARCA DR. MIGUEL MONTES LA’O
Quiricada St., Sta. Cruz, Manila T – 711 6979 / 309 9543 T - 732 3776 (information)
F – 711 6979 Beeper 141-616523
711 6966 (admin office) Cell: 0918-8952038
Info - 309 9539 ER- 3099541
® 364 1287 / 252 3004
DR. GREGORIO KABIGTING
T - 874 9869
Pager: 634333 ID # 227984
Amang Rodriguez Memorial DR. RUBEN FLORES DR. ROMMEL T. MENGUITO
Medical Center T – 941 6289/ 941 3441 T – 942 0245 / 942 0055 / 941 8231 /
Marikina City F – 941 6854 / 941 3441 934 5519
Beeper 141-106478 Beeper 1441-145750
® 642 5095
Dr. Jose R. Reyes Memorial Medical DR. ALICIA M. LIM DR. ARTHUR V. PLATON
Center T – 781 7052 T – 740 3785, 711 9491
Rizal Avenue, Sta. Cruz, Manila F – 732 1077 Beeper 125-1001855
® 419 9284
DR. ENRICO DE JESUS
DR. JERRY DOMINGO
East Avenue Medical Center DR. ORLANDO P. PUA DR. POTENCIANO MALVAR
East Avenue, Quezon City T – 927 9900 / 926 9740 T- 921-6480
928 0611 DR. INOCENCIO OBALLO, JR.
F – 426 4405/ 926 9740/ 924 7685 T – 924 8999 / 928 0611
F – 921 6480
C- 0918-8556923 / 0918-867788/ 0919-
® 642 6470
Quirino Memorial Medical Center DR. DOMINGO DE GUZMAN DR. ROBERTO DALMACION
Project 4, Quezon City T – 913 4758 T – 437 3662 / 438-4421
F – 913 4758 Beeper 125-1172612
C- 0912-3152330 / 0918-9121169
® 921 5343 / 927 5486
DR. JOSE ALBERT CAPUNO
Cell (0912) 313-0454
Rizal Medical Center DR. ROMEO CRUZ DR. MANUEL A. OLIVEROS
Shaw Blvd., pasig City T – 671 4216 / 671 9740 to 43 T – 671 9740/ 6710424
645 4592 / 650 1758 Beeper 1277-64508
F – 671 4216 ® 650 2318
C – 0918-8475012 C – 0917-9049568
Tondo Medical Center DR. VICTOR J. DELA CRUZ DR. ARNEL Z. RIVERA
Balot, Tondo, Manila T – 252 8661 T – 251 8419 to 23/ 252 8661/ 251 8422-23
F – 252 8661 ® 362 3408, 362 3393
C – 0919-3214433 / 0918-5314626
Las Piñas District Hospital DR. ROLAND CORTEZ DR. RODRIGO H. HAO
Las Piñas, Metro Manila T – 874 6872 to 73 / 872 1891 T – 873 1887 / 873 1891
F - 874 6873 Beeper 125-1002244
Beeper 125-1025003 ® 801 4916
C – 0919-3173608
® 931 3562
Valenzuela District Hospital DR. WINSTON GO MS. AIDA CUADRA
Polo, Valenzuela T – 874 6872 / 440 5534/ 292 2985 Cell- 0919-5564463
F – 440 5534 / 293 2936 T - 294 6711 to 18 loc. 105
TL - 294 6711 to 18
Beeper: 141- 926730
REGIONAL FIELD HEALTH OFFICES AND REGIONAL HOSPITALS
RHO-I DR. JOVENCIO ORDOÑA MS. MICHELLE F. DUMBRIQUE
San Fernando, La Union T – (072) 8884326 T – (072) 413 395
412 190 888 3395
413 478 Trng.- 413 478
F - (072) 413 395 RD - 414 326
242 4774 TSD - 242 4773
Cell: 0917-5640559 RESU- 242 4592
Email: firstname.lastname@example.org ® - 242 2346
Mariano Marcos Memorial Hospital DR. REUBEN SALVADOR DR. JESUS B. TOMAS
Batac, Ilocos Norte T – (O77) 792 3133 TO 44 T – (077) 792 3144
F- 792 3133 F- 792 3133
® (077) 776 0261
DR. WENDELL Q. CALDERON
T – (077) 792 3144
F - (077) 792 3133
® - (077) 792 3062
Ilocos Training Regional Medical Center DR. JUANITO RUBIO DR. GUALBERTO T. BASCO
San Fernando, La Union T – (072) 242 5543 / 415057 F – (072) 541 2399
242 1143 ®- 700 2272
242 3915 Beeper 125-9012658
415864 JOSEPH ABAT
412399 Cell – 0918-8655099
F – (072) 412 399
Region I Medical Center DR. GIL DEL ROSARIO DR. DOMINADOR MANZANO
Dagupan City T – (075) 523 4103 T – (075) 522 0041
F - (075) 523 3867
® - (075) 522 0702
RHO-II DR. MERCEDITAS CAVANEYRO DR. CIRILO M. PINTUCAN
Carig, Tuguegarao, Cagayan T – (078) 844 1748 T - (078) 844 5178
846 7230 844 5341(RESU)
F - (078) 844 4368 F –(078) 844 7230
844 1748 ® - (078) 844 3992
846 7230 846 7637
Email: email@example.com 844 3795
Cagayan Valley Regional Hospital DR. MANUEL ACLUBA DR. JAIME BALUBAL
Tuguegarao, Cagayan T – (078) 844 3789 T – (078) 844 3789
F- 844 3789 844 1319
®- (078) 844 1459 844 1810
Cell- 0912-3927382 844 1410
0917-9356201 844 0034
T - (078) 844 4115
Veterans Regional Hospital DR. CIRILO GALINDEZ DR. JOSELITO A. GONZALES
Bayumbong, Nueva Vizcaya T – (078) 321 2090 T- (078) 321 3561 to 64
Cell: 0917-9497153 F- 321 3560
® (078)321 2632
RHO-III DR. ETHELYN NIETO DR. NEMESIO V. SANTOS
San Fernando, Pampanga T – (045) 961 3844 to 45 T – (045) 961 3845, 961 3822
961 3822 961 3860
961 3802 (Disaster) 961 3912
F -(045) 961 3580 F – (045) 961 3580
Email: firstname.lastname@example.org 961 3802
® -(045) 931 0055
Cell – 0918-3907754
Dr. Paulino J. Garcia Memorial DR. GLORIFINO JUAN JR. DR. HUBERTO F. LAPUZ
Research and Medical Center T – (044) 463 1484 T – (044) 463 454, 463 8888
Cabanatuan City 463 1610 463 1610
F – (044) 463 1607 F – (044) 463 8286
463 4701 ® - (044) 463 0037
463 8286 Cell- 0912-3350669
Jose B. Lingad Memorial General DR. VENANCIO BANZON DR. ROBERTO AMANSEC
Hospital T – (045) 961 3921 T – (045) 961 3940
San Fernando, Pampanga F- 961 3921 963 2114
F – (045) 961 3921
RHO – IV DR. CONRADO R. GALSIM DR. AURORA ENOJADO
Project 4, Quezon City T – 913 0864 / 913 4704 / 912 9985 / T – 913-0864/ 913 4654/912-9985
913 4650 / 913 4526 to 30 ® 932 4654
F – 913 4654 F- 912-9985/913 4704
Batangas Regional Hospital DR. VICENTE GAHOL DR. ERNESTO REYES
Batangas City T – (043) 723 0165 T - (043) 723 2284 (clinic)
980 1733 F- 723 0165
723 3390 ® -(043) 723 1026
RHO-V DR. GERARDO BAYUGO DR. EDGARDO SARMIENTO
Legaspi City T – (052) 483 0693 T - (052) 483 0372
483 0363 Cell: 0918-50903360
F – (052) 245 5046
Bicol Regional Training & Teaching DR. JOSE DAEP DR. ROY RANDOLF PALANCA
Hospital Tel/fax - (052) 483 0636 T – (052) 483 0810
Legaspi City 483 0015
F - (052) 551 1234
® - (052) 483 0143
Cell – 0918-2121876
Bicol Medical Center DR. EDGARDO ESPLANA DR. REGINALDO S. PERILLO
Naga City T – (054) 811 1463 T – (054) 811 2941
F- 732 261 811 1163
F - (054) 725 041
® - (054) 726 167
RHO – VI DR. LYDIA RAMOS DR. ELIZABETH YLLAGA
Iloilo City T – (033) 321 0364 T – (033) 321 0235
327 0367 321 0364
327 0967 321 0297
321 0312 F - (033) 321 2158
F – (033) 321 1036 ® - (033) 320 2454
321 0235 329 5863
Email: email@example.com Beeper (033) 3381561 to 65
firstname.lastname@example.org ID# 6011608
Cell – 0912-8870218 / 0917-9021618
Western Visayas Medical Center DR. JOSE MARI FERMIN MS. FREIDA G. SORONGON
Mandurriao, Iloilo City T – (033) 327 7742 T– (033) 321 2841 to 48 loc. 118
321 1797 F- 321 1797
F – (033) 327 7742 ® -(033) 320 0257
Corazon Locsin Montelibano DR. DOMINGO VEGA DR. DOMINGO P. VEGA
Memorial Hospital Officer In Charge T – (034) 433 2697
Bacolod City T – (034) 433 2697 F- 433 2697
® - (034) 432 0680
Cell – 0912-5107678
RHO – VII DR. DAVID J. LOZADA JR. DR. SUSAN MADARIETA
Cebu City T – (032) 253 6355 loc. 3970 T - (032) 254 0109
F- 254 0109 DR. ENRIQUE SANCHO
Cell: 0918-90211251 / 0917-3221934 T- (032) 254-0657/254-0134
Email: email@example.com Cell- 0917-327-3070
Vicente Sotto Memorial Medical DR. EUSEBIO ALQUIZALAS DR. JOSEPH AL ALESNA
Center T - (032) 255-1595 T - (032) 253 9891 loc. 306 / 254 2612
Cebu City F- 253 9882 255-1592
Email: firstname.lastname@example.org F - (032)253 9882
Governor Celestino Gallares DR. NENITA PO DR. EDGAR O. PIZARRAS
Memorial Hospital OIC T – (038) 411 3185 - ER
Tagbilaran City T – (038) 411 4831 F- 411 4831
® (038) 411 3608
Cell - 0918-6002756
RHO – VIII DR. MILAGROS BACUS ATTY. ANNABELLE DE VEYRA, RN
Tacloban City T – (053) 323- 5027 T – (053) 323 5069
323 5297 (RESU)
F – (053) 323 5069 ® (053) 327 1629
Email: email@example.com DR. NICOLAS BAUTISTA JR.
Loa@tac.webling.com ® - (053) 322 2088
Eastern Visayas Regional Hospital DR. ADELAIDA ASPERIN DR. ALDEN TABAO
Tacloban City T – (053) 321 3363 T – (053) 325 8438
321 3129 321 3129 (tel/fax)
F- (053) 321-8724 321 3363
F – (053) 325 6470
RHO- IX DR. LOURDES LABIANO DR. MARCOS C. REDOBLE JR.
Zamboanga City T – (062) 991 3380/991-1995 T – (062) 991 1995
F- 991 3380 991 1313 (RESU)
Email: firstname.lastname@example.org F – (062) 991 3380
® - (062) 992 1540
DR. RAYMOND MAJINI
Cell- (062) 0919-4222945
Zamboanga City Medical Center DR. ROLANDO BUCOY DR. ALFONSO MONTUNO
Zamboanga City T – (062) 991 2934 T – (062) 991 1995/002-0546/991-2934
F - (062) 991 0573 991-3795
991 1313 (RHO)
F – (062) 991 0573
® - (062) 993 0565
DR. GEORGE ROJO
T - (062) 991 6998
Beeper: 125-9014543 / 125-9912492
RHO – X DR. MARIETTA FUENTES ENGR. NESTOR O. ABONITALLA
Cagayan de Oro City T – (088) 858 4627 T – (088) 858 7132
858 4001 858 7123
F – (088) 727 400/233-2306 F - (088) 858 7130
Northern Mindanao Medical Center DR. JOSE ACAYLAR DR. ENRIQUE P. SAAB
Cagayan de Oro City T – (08822) 726 362 T – (08822) 726 362
723 735 F- 728 829
856 4147 ® (08822) 857 1606
F - (08822) 728 829 Beeper 141-431035 / 125-7007863
Mayor Hilarion Ramiro Sr. Regional DR. JOSE VILLANUEVA MS. MILA P. GAMAYA
Training &Teaching Hospital T – (088) 521 0022 T – (088) 521 0022
Ozamis City 521 0440 ® 521 2745
521 3581 Cell- 0919-6031263
F - (088) 521 0022
RHO – XI DR. DOLORES CASTILLO DR. RENE LOPEZ
Davao City T – (082) 227 5903 T – (082) 226 9362 / 227 3976 (Technical)
F - (082) 221 6320 226 2493 / 227 2463
Email: email@example.com 227 4826
F - (082) 221 6320
® - (082) 299 2888
DR. ROGELIO PEÑERA
T- (082) 227-3976
Cell (0917) 7015204
Davao Regional Hospital DR. ROMULO BUSUEGO DR. SERGIO DALISAY
Tagum, Davao City T – (084) 217 3347 T – (084) 211 6900
218 2823 211 2453 (OPCEN)
Cell - 0912 – 7010747 ® - (084) 217 3573
F - (084) 400 3050 Cell : 0918-4151065,
Davao Medical Center DR. GERARDO CUNANAN DR. RICARDO AUDAN
Bajada, Davao City T – (082) 221 6574 T – (082) 227 2532
F- 221 7029 227 2731
F - (082) 227 2355
® (082)222 7253
Cell – 0918-8075405
RHO – XII DR. ROGELIO CHUA MR. LEO CHEONG
ORC, Compound, Cotabato City T – (064) 421 7436 T - (064) 421 7436 (opcen)
421 2196 421 4583
F - (064) 421 6531 F – (064) 421 4726
421 2373 421 6531
Cell - 0917-4015833 ®- 421 5148
Cell - 0919-3660094
Cotabato Regional & Medical Center DR. ARIADNE SILONGAN MR. TEOFILAMENA C. TUPAS
Cotabato City T – (064) 421 2192 T - (064) 421 7228
421 7228 421 2340
Cell - 0918-4010163 F –(064) 421 2194
®- 421 5262
Cell - 0919-4025248
RHO – CAR DR. ERIBERTO POLICAR DR. JANICE BUGTONG
Baguio City T – (074) 442 8097 T – (074) 442 7591
442 8098 442 7591
442 3809 F - (074) 442 7591
F – (074) 443 8342 444 5255
442 7591 444 5255
Luis Hora Memorial Regional DR. EDGARDO BOLOMPO DR. EDGARDO BOLOMPO
Hospital Cell: 0918-2820278 Cell: 0918-2820278
® - (074) 443 5653 ® - (074) 443 5653
DR. NENITA LIZARDO
Baguio General Hospital & Medical DR. MANUEL FACTORA DR. MANUEL QUIRINO
Center T – (074)442 3165 T – (074) 443 5678
Baguio City F - (074)442 8354 442 3765
442 8240 F - (074) 442 3165
443 8342 443 8342
® (074) 442 3787
RHO-CARAGA DR. CHARITO AWITEN DR. BRENDA A. LOPEZ
Pizarro St., Butuan City T – (085) 342 5208 T – (085) 342 5228
F - (085) 225 2970 343 1384
Email: firstname.lastname@example.org F - (085) 225 2970
DR. BRENDA A . LOPEZ Cell- 0918-8020301
Asst. Reg'l Director
CARAGA Regional Hospital DR. HILARION DAMIAO DR. MEDIATRIX G. DELA PAZ
Butuan City T – (086) 826 3157 ® - (086) 232 6339
826 2459 F - (086) 826 2459
RHO – ARMM DR. JAINAL JAMAD MR. JOSE LINO ESTARIS
Regional Complex, Cotabato City T – (064) 421 6842 T – (064) 213 988
421 6889 421 2434
421 4583 Cell: 0917-7260317
F- (064) 421 2373 MS. JULIE VILLADOLID
421 6842 / 421 4726 T – (064) 421 6889
Cell: 0918-5201066/0917-7260317 425 0218
Cell - 0919-3013960 /0918-5201066
NATIONAL CAPITAL REGION FOR DR. ELVIRA DAYRIT DR. CLARENCE CONSIGNA
HEALTH T- 743-83301 loc. 1652 T- 743-8301 loc. 1627
Email : email@example.com Beeper 145-505322
MS. IRMA JAVIER
T- 743-8301 loc. 1627