Code Alert System

7/29/2019 Code Alert System

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Code Alert System Nov

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HARMONIZATION OF CODE ALERT SYSTEM

DOHHEMS CENTRAL OFFICE HOSPITAL CENTER FOR HEALTH DEVELOPMENT

CODE WHITE1. Conditions for Adopting Code White:

Strong possibility of a military operation e.g.coup attempt/ armed conflict which have anational implication

Any planned mass action or demonstrationwhich have a national implication

Forecast Typhoons (signal 2 up) National or local elections and other political

exercises National events, holidays or celebrations with

potential for MCI Any emergency with potentially 1-50

casualties (deaths, injuries) Notification of reliable information of terrorist/

attack activities

Unconfirmed report of reemerging diseaseseg. bird flu or SARS Any other hazard that may result to

emergency

1. Conditions for Adopting Code White: Strong possibility of a military operation

within the area/ region e.g. coup attempt Any planned mass action or demonstration

within the catchment area Forecast Typhoons, (signal 2 up) the path

of which will affect the area National or local elections and other

political exercises National events, holidays, or celebrations in

the area with potential for MCI Any emergency with potentially 1-50

casualties (deaths, injuries) Unconfirmed report of reemerging diseases

eg. bird flu, SARS within the region Any other hazard that may result to

emergency

1.Conditions for Adopting Code White: Strong possibility of a military operation

e.g. coup attempt within the region Presence of hazards that pose a public

threat such as epidemics, chemical,biological and radiological threat, etc.

Notification of on-going epidemic by LGU,with adequate measures by local healthpersonnel.

Any planned mass action ordemonstration in the area

Forecast Typhoons (signal 2 up) the pathof which will affect the area

National or local elections and otherpolitical exercises

National events, holidays or celebrationswith potential for MCI

Any emergency with 1-50 casualties(deaths, injuries)

Unconfirmed report reemerging diseaseseg. of bird flu, SARS within the region

Any other hazard that may result toemergency


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CODE WHITE2. Human Resource requirements for

responding to the System: Emergency Officer on Duty (EOD) 1 and 2 Driver and Security Guard to assist at the

Operation Center Reliever 1 and 2 (next day EODs) on stand

by Response Division Chief or alternate oncontinuous monitoring and will serve asMedical Controller for Mass Casualty Incident.

EOD to inform National Epidemiology Centerregarding the case for confirmatory report.

2. Human Resource requirements forresponding to the Code:

Manpower

First response team ready for dispatch toinclude the following: 2 doctors preferably Surgeon,

Internist, anesthesiologist, etc. 2 nurses First Aider/ EMT Driver

Second response team should be on call The following should be available for

immediate treatment of incoming patients General Surgeons Orthopedic Surgeons Anesthesiologists Internists O.R. Nurses Ophthalmologists Otorhinolaryngologists Infectious Specialists

Emergency service personnel, nursingpersonnel and administrative personnelresiding at the hospital dormitory shall beplaced on call status for immediatemobilization

2. Manpower requirements for respondingto the Code:

2 Emergency Officers on Duty Driver Regional HEMS Coordinator on call and on

proactive monitoring

One Rapid Assessment Team ready fordispatch to include the following: DOH Representative Nurse Driver


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CODE WHITE3. Other requirements: EOD 1 to check all medicines, supplies

available EOD 1 & 2 to do proactive monitoring EOD to alert the region, hospitals and other

facilities that might be affected or needed to

respond or receive patients. Response Division Chief or HEMS Director toalert key officials as needed

3. Other requirements: The Hospitals Operation Center should

be activated. It should continuously reportand coordinate with the Regional and DOHCentral Operation Center

Medicines and Supplies

Ensure that emergency medicines(especially for trauma needs) be madeavailable at the emergency room

Medicines and supplies in the operatingrooms should likewise be reviewed andincreased to meet sudden requirements

Other needs such as x-ray plates,laboratory requirements, etc. should bemade available and not required to bepurchased by victims

Personnel department to prepare formobilization of additional staff

Finance department to ensure availability offunds in cases of emergency purchases

and the like Logistics department to coordinate with

possible suppliers for additionalrequirements

Dietary department to open and meet theneed of the victims as well as the healthpersonnel on duty

Security force to institute measures andstricter rules in the hospital

Activate Bird Flu Plan/ SARS Plan etc. Enforce and monitor use of Personal

protective equipment for all healthpersonnel.

Triage system should be activated

3. Other requirements: The Regional Operation Center should

be activated on 24 hours and the DOH-Continuously report and coordinate withHEMS Operation Center

Do proactive monitoring for any development

Report to HEMS-OPCEN daily and asnecessary Require update from field as necessary Finance Division to ensure availability of funds

in cases of emergency purchases and the like Supply section to coordinate with possible

suppliers for additional requirements Transport section to ensure availability of

vehicles Monitor and assess continuously for

requirements of other teams (medical,surveillance, environmental, health promotion,psychosocial etc.). These teams are onstandby/ on call for immediate mobilization.

Intensify IEC campaign through healthadvisories

Coordinate regularly with affected LGUs Coordinate with Regional hospitals for back-up

teams Monitor stock level of needed drugs/ supplies,

preposition as needed Activate Bird Flu Plan Mobilization of RESU team to conduct

investigation.


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CODE BLUE1. Conditions for Adopting Code Blue Any condition mentioned in Code White

plus any of the two below:

Mobilization of DOH resources is needed(manpower, materials, etc.)

30-50% health facilities in the areas affectedor damaged

No capability of the LGU and/ or lack ofresources of the Region to respond to theaffected area

Magnitude of the disaster based ongeographic coverage and number of affectedpopulation (more than 30%)

Any Mass Casualty Incident (MCI) with 50-100 casualties irrespective of color code

High case fatality rate for epidemics

Confirmed human to human for avian flu orSARS

1. Conditions for Adopting Code Blue: Anyof the following conditions: When 20-50 casualties (red tags) are

expected or suddenly brought to thehospital

Any internal emergency/ disaster in thehospital which brings down their operatingcapacity (i.e vital areas) to 50% or whichwould require evacuation of patients andsetting up of a Field Hospital

For conditions other than MCI, the in flux ofpatients is beyond the capacity of thehospital to handle

Confirmed/Documented report ofreemerging diseases (SARS, human tohuman avian flu) in the area

Conditions for Adopting Code Blue:Any of the following conditions:

Expected 50-100 casualties irrespectiveof tags for MCI.

Declaration of epidemic;confirmed/documented report ofreemerging diseases (SARS, human tohuman avian flu) within the region

Declaration of calamity in any provincein the region

Presence of evacuation centers estimatedto last for more than a week which haspublic health implications

Magnitude of the disaster based ongeographic coverage and number ofaffected population (more than 30% )

Any conditions that would requiremobilization of resources of the entireregion


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DOH HEMS CENTRAL OFFICE HOSPITAL CENTER FOR HEALTH DEVELOPMENTCODE BLUE 2. Manpower requirements for responding to

the Code: Response Division Chief or alternate as team

leader should be physically present at OPCEN EOD 1 and 2 Driver and Security Guard to assist at the

Operation Center Incoming EODs on call for immediate

mobilization

Logistics Officer or alternate to go on duty At least one DOH representative to go on

duty to NDCC if required and/or

requested

2. Manpower requirements for respondingto the Code: HEMS Coordinator to be physically present

at the hospital On-Scene Response Team Medical Officer in charge of the Emergency

Room All residents of the Department of

Orthopedics Medical Officer in charge of the Operating

Room Surgical Team on duty for the day Surgical team on duty the previous day Mental health professionals All anesthesiology residents Toxicologist, chemical experts for poisoning

and/ or chemical cases (if available) All third and fourth year residents Administrative Officer of designate Nursing supervisor on duty All OR nurses Social workers Dietary personnel Officer in charge of supplies at the CSR The entire security force and Institutional workers on duty

Manpower requirements for responding tothe Code:

RHEMS Coordinator to be physically presentat OPCEN

Rapid Assessment Teams and otherappropriate teams (RAT)

Three (3) teams on standby (environmental/surveillance/ medical)

EOD 1 and 2 Logistics Officer Finance Officer as necessary Health Promotions Officer as necessary DriverAll other regional staff on standby for

immediate mobilizationAll DOH REPS in the affected area should be

available at the LGU



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CODE BLUE Other requirements: Coordinate with the following: Implementing agencies (hospitals,

region, central office) for possibledispatching of teams or experts

NDCC and other sectors for otherconcerns e.g. transportation, etc.

MMD regarding supplies available at DOH Different DOH Central Offices for

personnel augmentation to the OperationCenter and for other technical support

Prepare possible drugs and medicines neededfor movement to affected area

If needed drugs/medicines not available,prepare emergency purchase

Check all possible means of transportation ex.With NDCC, air cargo, etc.

Anticipate need of medical teams and otherexperts

Prepare all needed reports and presentationrequired especially for emergency NDCCmeetings

Orient staff to be deployed to NDCC andthose additional staff to augment the OPCEN

In cases of long term emergencies, plan forsupport to the affected region.

Activate Code Blue for HEMS and preparenecessary documentation

Initiate the conduct of coordinative meetingof the national clusters: Health, Nutrition andWASH

Other requirements:All those mentioned in Code White plus

Activate Hospital Emergency IncidentCommand System (HEICS)

Other needs of victims apart from medicinesand supplies depending on the disaster

should as much as possible be made available The Chief of Hospital/ Medical Center or his

designate should make proper coordinationwith other hospitals for networking and/ orpossible transfer of patients.

Incident Command should assign a SafetyOfficer, Liaison officer, Public Information

Officer to coordinate with other agencies andserves as the spokesperson of the hospital

Social Service section should prepareassistance to victims in coordination withmental professionals of the Hospital ifavailable and the Department of Social

Welfare; in addition they should lead inproviding information to relatives of victims

Mortuary section should anticipate deadvictims brought to the hospital for proper careand identification

The security team in anticipation of possibleinflux or patients, relatives, responders,police, press etc. should ensure smooth flowof traffic inside the compound especially forthe ambulances.

Should report regularly to HEMS OPCEN andas much as possible regular report to media

Other requirements:All those mentioned in Code White plus:

Activate the Regional EmergencyIncident Command System (REICS)

Operation Center on 24/7 with adequatepersonnel and logistical support to

receive, evaluate, analyze all reports. Mobilize teams to affected areas for Rapid

Assessment in coordination with the DOH Rep Regional Director or his designate to make

proper coordination with RDCC and otheragencies like DSWD, DEPED etc. fornetworking and other requirements

Incident Command should assign neededstaff in Operations, Logistics, Planning andAdministrative to assist affected LGUs

Public Information Officer to prepare andhave regular media conference or pressrelease.

Continuous IEC campaign through healthadvisories especially in evacuation centers.

May need to activate also a Field EOC asneeded to coordinate health activities

Oversees operation of Management of MassDead together with the Health unit of theLGU concerned

Leads in coordinative meetings of thedifferent cluster under the DOH: Health,Nutrition and WASH.

Provides technical support to LGUs Mobilize other requirements as needed such

as psychosocial team etc.

Regularly coordinate with DOH-HEMSOPCEN for reports and other needs.


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CODE RED 1. Conditions for Adopting Code Red Any natural, manmade or technological where

all of the following are present

Declaration of disaster to the affected area 100 or more casualties in one area Health personnel in the region not capable to

handle entire operation Mobilization of the health sector needed Mobilization of key offices in DOH Uncontrolled human to human transmission

of SARS/Avian flu

1. Conditions for Adopting Code Red

Any of the following is present:

When more than 50 (red tag) casualties aresuddenly brought to the hospital

An emergency wherein the service of thehospital is paralyzed due to 50% of themanpower are victims of the disaster

Hospital is structurally damaged requiringevacuation and/or transfer of patients l

Conditions requiring mandatory quarantine ofhospital and its personnel (e.g. sars, avianflu); Uncontrolled human to humantransmission of SARS/Avian flu in the area

1. Conditions for adopting Code RedAny of the following is present:

Conditions resulting to mass dead andmissing

Disaster declared in 2 or more provincesin the region/ 30% of the Cities in MetroManila.

Major Facility or Hospital such as theProvincial/ City/ Hospital in area are notable to provide optimal services due todamages or 50% of staff are affected

Mobilization of entire regional resourcesnot enough and thus require externalsupport

Uncontrolled epidemic/outbreak Uncontrolled human to human

transmission of SARS/Avian Flu withinthe region

2. Manpower requirements for responding tothe Code:

The HEMS Office personnel and staff augmentationfrom other offices shall be divided into 3 teams to goon a 24 hour duty rotation every 3 days. The team is

composed of the following: Team Leader 2 Data Collector/ Encoder Logistics Communication Administrative Officer Support Staff/ Clerk Driver At least 1 staff to be assigned at OCD OPCEN

on 24 hours duty

2. Manpower requirements for responding tothe Code:

All personnel enumerated under Code Blue All medical interns and clinical clerks All nurses All nursing attendants All institutional workers All administrative staff

2. Manpower requirements for respondingto the Code:

Mobilize all regional staff as needed onrotation basis

Establish surveillance system in allevacuation centers

All other teans deployed in affected area


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CODE RED Other requirements HEMS to represent the Department of

Health to NDCC and other agencies.

Leads in the coordination with internationalpartners in the Health, Nutrition and WASHClusters.

Leads in the coordination with all membersof the health sectors

Leads in the coordination with donoragencies both international and local.

Prepares updated reports for use ofSecretary, and other partners

Assists in the preparation of therehabilitation and recovery plan; representthe DOH in the national DANA team

HEMS OPCEN to serve as DOH CommandPost for SARS/Avian Flu

Activate Crisis Committee who serves as thetechnical, operations arm and preparesrecommendation to the Execom of DOH tobe chaired by the Undersecretary for PolicyDevelopment Team for Service Delivery andto be assisted by the Directors of HEMS,NEC, NCDPC, NCHFD, Finance,Administrative and MMD

Other requirementsAll those mentioned in Code Blue plusThe Chief of Hospital/ Medical Center Chiefs can

cancel all types of leaves and can order allpersonnel to report to the hospitalThe Chiefs of Hospital/ Medical Center Chiefs

can temporarily stop all elective admissions andsurgeries and network with other hospitals

The Chief of Hospital/ Medical Center Chiefsshould anticipate requests ofadditional manpower and specialists notavailable in his hospital. He is further authorized

to accept medical volunteers and otherprofessionals to augment its manpowerresources rather than transferring patients

based on some agreements.Networking with other hospitals for

augmentation of resources and transfer ofpatients in special cases

Answers all queries of the media pertaining topatients in the hospital

Anticipate evacuation and/or use of fieldhospital; closure and/or quarantine of thehospital

The Chief of Hospital/Medical Center Chief tospecifically be concerned with safety andsecurity of not only the patients but thepersonnel

Other requirementsAll those mentioned in Code Blue plus: The CHD Director can cancel all types of

leaves and can order all personnel to reportto the CHD.The CHD Director can stop all operations not

related to the disaster.The CHD Director should anticipate request ofadditional manpower and specialists notavailable in his CHD. He is further authorized toaccept volunteers and other professionals toaugment its manpower based on some

agreements. Continue networking with RDCC and itsClusters (Health, Nutrition, WASH). Public Information campaign.Handles queries from media.For reemerging diseases, to provide

leadership together with the LGU in decisionslike quarantine of the area and otherdecisions in preventing spread of theepidemic

Provide updated report to HEMS CentralOPCEN.


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Procedures in implementing the Code Alert The HEMS Code Alert shall be declared by the

HEMS Director or by the Division Chief(Response or Preparedness)

Announced through telephone brigade Administrative Officer to prepare Office

Order/ Department Personnel Order HEMS Director or the Division Chief

(Response or Preparedness) lifts the CodeAlert and make necessary announcement

Procedures in implementing the CodeAlertThe Hospital Code Alert shall be declared by

the Secretary of Health or by the Director ofHEMS for external emergencies and/orincidents affecting national security ; by the

Medical Center Chiefs; Chiefs of Hospital;HHEMS Coordinator; Head of the DisasterCommittee of the Hospital emergencies withintheir catchments area or region

Chiefs of Hospital/Medical Center Chiefs toautomatically declare code white duringnational events and activities especially withthe potential of an MCI

Each hospital shall prepare its ownprocedures in declaring and lifting the Code

The alert level is raised, lowered or suspendedby the Secretary of Health, Director of HEMS forexternal emergencies and national events; therespective Medical Center Chiefs/ Chiefs ofHospital or their designates for emergencieswithin their catchments areas or region

Conditions to raise or supend the alert levelOnce the threat is increased or is no longer

present

Arrival of patients in the hospitals to warrantthe raising of the alert level; likewise alert canbe suspended when no significant incident ismonitored and the hazard or condition(typhoon, election, bombing etc.) is finishedand/or contained

Procedures in implementing the CodeAlertThe Regional Code Alert shall be declared

by the Secretary of Health or Director ofHEMS for emergencies with nationalimplications; Regional Director and RHEMS

Coordinator for internal (regional)Regional Directors to automatically declare

code white during national events andactivities especially with the potential of an

MCIThe alert is raised, lowered or suspended

by the Secretary of Health, HEMS Directorfor emergencies with national implications;by the respective Regional Director or

RHEMS Coordinator for internal (regional)emergencies Each Region shall prepare its own

procedures in declaring and lifting the Code

Conditions to raise or suspend the alert levelOnce the threat is increased or is no longer

present

Documents

Code Alert System