MEDICAL OPERATIONAL PLAN FOR AMEU 0 To Be Held on: 0 October 0 until and including 08 October 0 Venue where event is to take place: SANDTON CONVENTION CENTRE Exhibition -; Bill Gallagher and Pavilion Venue address: Maud Street, Sandton, Johannesburg, Gauteng Nature of event: Total pax expected at event: Brief description of event: Risk rating as per SANS medical matrix score: 9 Low Risk Level of qualifications, type of medical standby at event and duty times: 0 October 0 - Day shift x BAA medic per shift - from 06:00-8:00 Exhb - 0 October 0 - Night shift x BAA medic per shift - from 8:00-06:00 Exhb - 0 October 0 - Day shift x BAA medic per shift - from 06:00-8:00 Exhb - 0 October 0 - Night shift x BAA medic per shift - from 8:00-06:00 Exhb - 0 October 0 - Day shift x BAA medic per shift - from 06:00-8:00 Bill Gallagher 0 October 0 - Night shift x BAA medic per shift - from 8:00-06:00 Bill Gallagher 0 October 0 - Day shift x BAA medic per shift - from 06:00-8:00 Exhb - 0 October 0 - Day shift x BAA medic per shift - from 06:00-8:00 Pavilion 0% 0 October 0 - Night shift x BAA medic per shift - from 8:00-06:00 Pavilion 0% 06 October 0 - Day shift x BAA medic per shift - from 06:00-8:00 Exhb - 06 October 0 - Day shift x BAA medic per shift - from 06:00-8:00 Pavilion 0% 06 October 0 - Night shift x BAA medic per shift - from 8:00-06:00 Pavilion 0% 07 October 0 - Day shift x BAA medic per shift - from 06:00-8:00 Exhb - 07 October 0 - Day shift x BAA medic per shift - from 06:00-8:00 Exhb - Medics on standby qualifications and HPCSA registration no: ALS base manager / supervising medics indirect/telephonic medical control: Elisa Ledwaba HPCSA registration number: ECT00087 Names and HPCSA registration numbers of medics on duty at the event - BLS: Themba Masemola - HPCSA registration number: BAA88 Vivian Moeketsi - HPCSA registration number: BAA060 Dumisani Ntuli - HPCSA registration number: BAA789 Grace Dlamini - HPCSA registration number: BAA600 Sello Molala - HPCSA registration number: BAA0870986 Elisa Sadike - HPCSA registration number: BAA09
INTRODUCTION This emergency medical operational plan serves to inform all relevant role players of procedures duties and responsibilities should there be a medical emergency during the event. AIM The aim of the Emergency Plan is to outline a plan of action for the efficient deployment and coordination of the on-site medical personnel to provide the earliest possible response in order to: Protect and preserve life Minimize the effects of the emergency or disaster on the event; and Continue with the event should the need arise. ANY SERIOUS MEDICAL INCIDENTS MUST BE REPORTED TO THE MEDICS ON DUTY AT THE EVENT ACTIVATION PROCEDURES IN THE CASE OF A DISASTER Any emergency or disaster that may have an impact on the event is the responsibility of the event organizer. The following procedures must be followed: When a medical incident or emergency is reported to the on-site health and safety officer, security manager on duty or event organizer, the relevant action plan must be initiated: The health and safety officer or security manager on duty will activate the First Responders (medical teams / paramedics on duty, the fire/ rescue services according to the grading of the incident) and manage the incident according to the emergency plan and the Disaster Management Protocol. FIRST RESPONDERS The first responders to any emergency will be as follow:-. Medical and ambulance personnel stationed on site at the event. Fire/ Rescue services stationed at the event. Security Manager. Head event organizer / coordinator The first responders will form the Field control post (FCP) to evaluate and manage the incident with resources available at the scene. The ambulance personnel or health and safety officer on duty at the event will decide if external assistance and resources must be activated e.g. Fire Brigade, SAPS and Ambulance Services. SECOND RESPONDERS. The secondary phase the health and safety officer on duty will activate the following role players to assist with the incident according to the Emergency Plan and Protocol. Disaster Management Fire Brigade Ambulance Service SAPS SANDF (Resource assistance) DECEASED The SAPS will handle applicable disposal of the deceased. Take into account judicial enquiries where applicable. (Crime scene investigations.) CULTURAL ASPECTS. Cultural aspects also need to be taken into account e.g. Muslims and certain groupings of Judaism must be buried before sunset.
THE DISASTER MANAGEMENT PROTOCOL INCLUDES: The purpose of this protocol is to define and describe the essential elements and procedures of the event. The purpose of the Disaster Management protocol is to provide structure and coordination for the pre- and postmanagement of emergencies and disasters. This is in order to provide for an effective and efficient response that will: Save lives Reduce risk. Reduce suffering Provide for the safety and health of all responders. This protocol is to be used by trained individuals and applied in a manner that meets the needs of each particular situation. The many different and complex situations encountered by emergency responders require a considerable amount of judgment in the application of the protocol. Emergency responders shall apply the protocol in a manner that is appropriate for the circumstances of each specific situation. IMPLEMENTATION The protocol must be applied to all incidents (public disturbance to accidents), even to minor incidents, in order to provide for familiarity with the system, to be prepared for escalation and to be aware of risks that exist. CONTROL AND CORDONING OFF AT THE SCENE If required, the scene of the incident will be cordoned off to protect all involved. The medical personnel on duty, security, SAPS and Fire Brigade will take responsibility for securing the scene and surrounding area. They will also declare the scene safe and clear away any body fluids, debris etc. The police and emergency services will also take joint responsibility for maintaining the situation and safety of all present that might have been affected by the incident. ENTRANCE CONTROL - CORDON OF THE SCENE The area where the incident took place will be cordoned off with barrier tape. No person may enter or exit the cordoned areas without the permission from the Health and Safety officer, Security manager or Incident commander. Any person without a specific task must be immediately escorted away from the scene. REASONS Scene safety. Safety implications. Protection of evidence Rescue of the injured Fire fighting Emergency treatment of the seriously injured. Prevention of ransacking. Uninformed persons can cause panic and spread incorrect information or rumors. Prevention of loss of valuable evidence.
MEDICS DUTIES AND RESPONSIBILITIES WHILE ON DUTY AT THE EVENT: The medical personnel will remain in the area allocated by the event s organizer at all times and will only be allowed to leave the allocated area to go to the bathroom and for a 0 minute lunch break during a hour shift. Any and all medical and or trauma emergencies will be attended to by the medic within his/her scope of practice as per the HPCSA protocol. The medic will hand the patient over to the ambulance service responding to the call and will remain at the function while the patient is being transported to hospital by the relevant ambulance that was called for back-up. A standby PRF (patient report form) will be completed by the medic treating the patient for all serious injuries or medical conditions or where the patient is transported to hospital. In the case where an ambulance is required to transport the patient to hospital, the medic treating the patient at the event will call said ambulance to ensure the correct level of care and the nearest available ambulance service is dispatched. EMERGENCY CONTACTS: Private ambulance on standby at event: Resqcare EMS 08-08-9 Ambulance service back up in case of ambulance transport is needed: RESQCARE EMS - 08-08-9 (Ambulance transport to the nearest appropriate medical facility will be for the patient s own account in the case where the patient is on a medical aid, the medical aid will be billed) ALTERNATIVE AMBULANCED SUPPORT AND BACK-UP: ER - 08 NETCARE 9-089 Security on duty at the event: Miktor Event Security 0-08-078 Fire station: Sandton EMS 077 South African Police: 0 Metro control ambulance: Sandton EMS 077 Government hospital for minor injuries: Hellen Joseph Hospital Private hospital for minor injuries: Sandton Medi Cinic Government hospital for major injuries: Johannesburg General Hospital Private hospital for major injuries: Netcare Millpark Hospital / Morningside Medi Clinic Event organizer: ELISA LEDWABA ECT00087 0 September 0
SANS 066 HEALTH AND SAFETY AT EVENTS 7. Provision of medical and emergency care It is recognized that medical care at events can be organized in different ways and that the most appropriate model will vary according to the medical provider and the nature of the event. A nature of estimating the minimum level of medical resources required is set out in tables,, 6 and 7. The suggested levels of resources are intended only as guidance for the MINIMUM staff requirements. Tables,, 6 and 7 are not a substitute for a full risk assessment of the event and more resources may be required based and the risk assessment. The figures presented in the tables do not take account of dedicated care for performers or VIP s. Similarly for sporting events the medical care for the participants should be determined based on guidelines provided by the relevant sporting body in conjunction with the national healthcare body (see foreword). Tables,, 6, and 7 shall be used to predict the MINIMUM medical support for the spectators. As per HPCSA rules and regulations a basic ambulance assistant (BAA) must work under supervision of registered intermediate life support (ILS), however, telephonic medical direction and indirect supervision from intermediate life support (ILS) or higher qualified EMS personnel will be accepted where or more basic life support (BAA) personnel are on duty at the same event, same venue at the same time on the same date, accept in the case of minors or young adults intermediate life support (ILS) must be present to supervise and assist basic life support (BAA) for the entire duration of such an event. Although nurses are included in the prediction of resource allocations, it is accepted that it will not always be possible to source Registered Nurses and therefore this category is highly recommended but not considered mandatory. A Registered Nurse may be replaced by an advanced life support (ALS) paramedic. Tables,, 6, and 7 are used as follows: a) Table is used to allocate a score based on the nature of the event; b) Table is used to allocate a score based on available history and pre-event intelligence; c) Table 6 is used to take into consideration additional elements that might have an effect on the likelihood of risk; and d) Table 7 is used to indicate a suggested resource requirement.
Under each item in tables,, and 6 the highest relevant score for the specific event should be selected. For example, if a low risk event such as a classical performance (score = ) has a pyrotechnic display as well (score = ), the highest score (i.e. ) should be selected. SANS 066:0 Edition Table nature of the event Item Details Score A Nature of event B Venue C Standing/seated Classical performance Public exhibition Pop/rock concert Dance event (Rave/disco) Agricultural/country show Marine Motorcycle display Aviation International event Motor sports State occasion VIP visit/summit Music festival Bonfire/pyrotechnic display New year celebrations Demonstration/march Sports event with low risk of disorder Sports event with medium risk of disorder Sports event with high risk of disorder Opposing factions involved Indoor Stadium Outdoor in confined location, e.g. a park Other outdoor, e.g. a festival Widespread public location in streets Temporary outdoor structures Includes overnight camping Seated Mixed Standing D Audience profile Full mix, in family groups Full mix, not in family groups Predominately young adults Predominately children and teenagers Predominately the elderly Add A+B+C+D Total score for table 09 8 7 7 9 6
SANS 066:0 Edition Table Event intelligence Item Details Score E History Good data, low casualty rate previously (less than 0,0%) Good data, medium casualty rate previously (0,0% to 0,%) Good data, high casualty rate previously (more than 0,%) First event, no data - F Expected numbers < 000 < 000 < 000 < 0 000 < 0 000 < 0 000 < 0 000 < 0 000 < 60 000 < 70 000 < 80 000 < 90 000 < 00 000 < 00 000 < 00 000 8 6 0 8 6 6 0 60 70 Add E+F Total score for table 7
Table 6 Example of additional considerations Item Details Score G Expected event duration (including build-up, queuing and break down) H Time of year (Outdoor events) I Proximity to definitive care (nearest suitable accident and emergency (A&E) facility) J Profile of definitive care K Additional hazards L Additional on-site facilities Less than h More than h less than h More than h Summer Autumn Winter Spring Less than 0 minutes by road More than 0 minutes by road Choice of A&E departments Large A&E departments Small A&E departments Carnival Helicopter Water hazard Parachute display Street Theatre On-site alcohol use Suturing or plastering (or both) Vending machine for over-the-counter medication Automated external defibrillator (AED) Existing full-time operational medical facilities onsite Add G+H+I+J+K subtract L Total score for table 6 7 TOTAL Total score for tables, and 6 9 0 8
8 Calculation To calculate the overall score for an event, add the total score for tables, and 6 and then use table 7 to determine the suggested MINIMUM resource requirements. Use the score from the calculation in 7. to gauge the levels of resource indicated for an event. The scores in table 7 refer to the suggested MINIMUM resources that shall be available on duty at any one time during an event and not the cumulative number of personnel deployed throughout the duration of an event. The local authority s requirements shall be taken into account. SANS 066:0 Edition Table 7 Suggested minimum resource requirements 6 7 8 9 0 Score Ambulance BLS ILS ALS Ambulance Crew Doctor Nurse Coordinator <0 0 0 0 0 0-0 0 0 0 0 6-0 0 0 0 0-6 0 0 Visit Yes 6-0 8 0 0 Visit Yes - 0 Yes 6-0 6 Yes - 0 6 Yes 6-60 6 Yes 6-6 8 Yes 66-70 0 0 Yes 7-7 6 8 6 6 Yes 76-80 8 6 8 8 6 Yes 8-8 0 80 0 0 0 Yes 86+ 0 0 6 6 Yes Medical facility ELISA LEDWABA ECT00087 9