EMERGENCY EMERGENCY RESPONSERESPONSERESPONSERESPONSEDecember December 2222nd, nd, 20032003Dr Pierre H. MarionDr Pierre H. MarionDr Pierre H. MarionDr Pierre H. Marion

HDEC Medical CoordinatorHDEC Medical Coordinator

DefinitionsDefinitionsDefinitionsDefinitions

Initial situation is the INCIDENTInitial situation is the INCIDENTInitial situation is the INCIDENTInitial situation is the INCIDENTFor illness or injury the medical assessment For illness or injury the medical assessment states whether it is an EMERGENCY or notstates whether it is an EMERGENCY or notstates whether it is an EMERGENCY or notstates whether it is an EMERGENCY or notNonNon--medical situation (fire, explosion, gas medical situation (fire, explosion, gas leak, structure collapse etc) is always anleak, structure collapse etc) is always anleak, structure collapse etc) is always an leak, structure collapse etc) is always an URGENCYURGENCYDepending on the INFORMATION receivedDepending on the INFORMATION receivedDepending on the INFORMATION received Depending on the INFORMATION received from witnesses, Emergency Response Team from witnesses, Emergency Response Team can provide more accurate supportcan provide more accurate supportp ppp pp

ACCIDENTSACCIDENTSACCIDENTSACCIDENTS

ROAD TRAFFIC ACCIDENTROAD TRAFFIC ACCIDENTROAD TRAFFIC ACCIDENTROAD TRAFFIC ACCIDENT

ACCIDENTACCIDENTACCIDENT ACCIDENT RESULTRESULT

……

WORKWORK--RELATED ACCIDENTRELATED ACCIDENTWORKWORK RELATED ACCIDENTRELATED ACCIDENT

ILLNESSESILLNESSES

UNCONSCIOUS PERSONUNCONSCIOUS PERSONUNCONSCIOUS PERSONUNCONSCIOUS PERSON

EMERGENCY RESPONSE TEAMEMERGENCY RESPONSE TEAME.R.TE.R.T

Two types of teams are involvedTwo types of teams are involvedTwo types of teams are involvedTwo types of teams are involvedMedical team: provides all required cares on Medical team: provides all required cares on incident scene according to patient/casualtyincident scene according to patient/casualtyincident scene according to patient/casualty incident scene according to patient/casualty condition. Team is also to support Fire fighting condition. Team is also to support Fire fighting team as requiredteam as requiredteam as requiredteam as requiredFire fighting team: intervenes for any nonFire fighting team: intervenes for any non--

di l i id d f id didi l i id d f id dimedical incident and for accident needing medical incident and for accident needing rescue and/or extricationrescue and/or extrication

ADDITIONAL SUPPORTADDITIONAL SUPPORTADDITIONAL SUPPORTADDITIONAL SUPPORT

Following sections support E R T withFollowing sections support E R T withFollowing sections support E.R.T withFollowing sections support E.R.T withspecific missionsspecific missions

S i h i id dS i h i id dH.S.E section: to secure the incident scene and H.S.E section: to secure the incident scene and investigate investigate Security: to secure the area, control the Security: to secure the area, control the spectators and assist H.S.E for investigationspectators and assist H.S.E for investigation

PROGRESSPROGRESSPROGRESSPROGRESS

Incident occursIncident occursIncident occursIncident occursPatient/casualty or witness alerts E.R.TPatient/casualty or witness alerts E.R.T

C l O h llC l O h llE.R.T Control Room Operator gathers all E.R.T Control Room Operator gathers all relevant information and transfers to Medical relevant information and transfers to Medical

ffi Fi fi h i l d i dffi Fi fi h i l d i dofficer or Fire fighting team leader as requiredofficer or Fire fighting team leader as requiredOperator notifies H.S.E and SecurityOperator notifies H.S.E and SecurityTeam responds according to situationTeam responds according to situation

PROGRESSPROGRESSPROGRESSPROGRESS

PREVIOUS PROGRESS DESCRIPTION PREVIOUS PROGRESS DESCRIPTION INDUCES SEVERAL MAJOR ISSUESINDUCES SEVERAL MAJOR ISSUES

ALERTALERTALERTALERTCommunication : emergency numbers should figure Communication : emergency numbers should figure on gate pass card back side and near all telephoneson gate pass card back side and near all telephoneson gate pass card back side and near all telephoneson gate pass card back side and near all telephonesCommunication means: if no telephone is available Communication means: if no telephone is available i h i i i di d li i ffii h i i i di d li i ffiin the vicinity, use radio or send liaison officerin the vicinity, use radio or send liaison officerSafety Officer who notices there is no answer shall Safety Officer who notices there is no answer shall relay informationrelay informationMessage: identify yourself, give your location, Message: identify yourself, give your location, g y y , g y ,g y y , g y ,describe incident and number of concerned personsdescribe incident and number of concerned personsNotify if any immediate additional hazardNotify if any immediate additional hazardNotify if any immediate additional hazardNotify if any immediate additional hazard

ALERTALERTEMERGENCY NUMBERSEMERGENCY NUMBERS

Fire fighting team Plant Area:Fire fighting team Plant Area: 11191119First aid room Plant Area:First aid room Plant Area: 15511551

Both above numbers can be used without Both above numbers can be used without distinctiondistinction

Fire fighting team Iranian Camp:Fire fighting team Iranian Camp: 30123012, , 31193119Clinic Iranian Camp:Clinic Iranian Camp: 30053005 30063006Clinic Iranian Camp:Clinic Iranian Camp: 30053005, , 30063006

ANY ALERT ON ANY NUMBER WILL BEANY ALERT ON ANY NUMBER WILL BEANY ALERT ON ANY NUMBER WILL BE ANY ALERT ON ANY NUMBER WILL BE FORWARDED ACCORDINGLYFORWARDED ACCORDINGLY

RELEVANT INFORMATIONRELEVANT INFORMATIONRELEVANT INFORMATIONRELEVANT INFORMATIONMEDICAL OR NONMEDICAL OR NON--MEDICAL SITUATIONMEDICAL SITUATION

Time of accident/incident:Time of accident/incident: When?When?Exact location:Exact location: Where?Where?CircumstancesCircumstances:: How?How?Personnel involved:Personnel involved: Who?Who?Number of persons involved:Number of persons involved: How many?How many?Material involved:Material involved: What?What?Material involved:Material involved: What?What?Action takenAction taken If you are first aid If you are first aid

trainedtrainedtrainedtrainedAdditional hazardAdditional hazard

RELEVANT INFORMATIONRELEVANT INFORMATIONRELEVANT INFORMATIONRELEVANT INFORMATION

YOU MIGHT FEEL THAT ANSWERING ALLYOU MIGHT FEEL THAT ANSWERING ALLYOU MIGHT FEEL THAT ANSWERING ALL YOU MIGHT FEEL THAT ANSWERING ALL QUESTIONS IS WASTING TIMEQUESTIONS IS WASTING TIME

The more details we get the more accurate theThe more details we get the more accurate theThe more details we get, the more accurate the The more details we get, the more accurate the response can beresponse can beK i h l i id d l fK i h l i id d l fKnowing the exact location avoids delays for Knowing the exact location avoids delays for reaching the placereaching the placeKnowing how many casualties are involved or Knowing how many casualties are involved or fire extent allows mobilising immediately fire extent allows mobilising immediately backback--up teamsup teams

CHECKLISTCHECKLIST –– INJURYINJURYCHECKLIST CHECKLIST INJURYINJURYDRAFTDRAFT

CHECKLISTCHECKLIST –– ILLNESSILLNESSCHECKLIST CHECKLIST ILLNESSILLNESSDRAFTDRAFT

RESPONSERESPONSERESPONSERESPONSEMEDICAL SITUATIONMEDICAL SITUATION

Medical team proceeds to accident/incident sceneMedical team proceeds to accident/incident sceneDuring medical assessment time, immediate care isDuring medical assessment time, immediate care isDuring medical assessment time, immediate care is During medical assessment time, immediate care is provided as requiredprovided as requiredPatient/casualty is stabilised on the field andPatient/casualty is stabilised on the field andPatient/casualty is stabilised on the field and Patient/casualty is stabilised on the field and transported to first aid room or clinictransported to first aid room or clinicC l t i i t li i iC l t i i t li i iComplementary care provision at clinic, ongoing Complementary care provision at clinic, ongoing assessment and medical evacuation as requiredassessment and medical evacuation as required

MEDICAL RESPONSEMEDICAL RESPONSEMEDICAL RESPONSEMEDICAL RESPONSE

RESPONSERESPONSERESPONSERESPONSENONNON--MEDICAL SITUATIONMEDICAL SITUATION

Fi fi h i d i idFi fi h i d i idFire fighting team proceeds to incident sceneFire fighting team proceeds to incident sceneTeam leader assesses general situation and Team leader assesses general situation and additional hazard and takes action accordinglyadditional hazard and takes action accordinglySecure incident sceneSecure incident sceneIf first on scene, provide first aid as requiredIf first on scene, provide first aid as requiredIn case of trapped casualty (road traffic accidentIn case of trapped casualty (road traffic accidentIn case of trapped casualty (road traffic accident, In case of trapped casualty (road traffic accident, scaffolding collapse etc) start extrication process scaffolding collapse etc) start extrication process and await medical support for casualty safeand await medical support for casualty safeand await medical support for casualty safe and await medical support for casualty safe extractionextraction

NONNON--MEDICAL RESPONSEMEDICAL RESPONSENONNON MEDICAL RESPONSEMEDICAL RESPONSE

HOW CAN YOU HELP?HOW CAN YOU HELP?YOU SHOULDYOU SHOULD

Assess the incident sceneAssess the incident sceneAssess the incident sceneAssess the incident sceneSecure the incident sceneSecure the incident scene

id i f i d lid i f i d lProvide accurate information and alertProvide accurate information and alertProvide first aid if you are trainedProvide first aid if you are trained

INCIDENT SCENE ASSESSMENTINCIDENT SCENE ASSESSMENTINCIDENT SCENE ASSESSMENTINCIDENT SCENE ASSESSMENT

Is there any additional hazard?Is there any additional hazard?Is there any additional hazard?Is there any additional hazard?Is there any immediate aggravation risk?Is there any immediate aggravation risk?

S d d t ffi id tS d d t ffi id tSecondary road traffic accidentSecondary road traffic accidentCar fire or explosionCar fire or explosionWall crashWall crashGas leakGas leakEtcEtc

ADDITIONAL HAZARDADDITIONAL HAZARDADDITIONAL HAZARDADDITIONAL HAZARD

ADDITIONAL HAZARDADDITIONAL HAZARDADDITIONAL HAZARDADDITIONAL HAZARD

PROTECTIONPROTECTIONPROTECTIONPROTECTION

Protect yourselfProtect yourselfDisconnect mains supplyDisconnect mains supplyDo not enter a confined space if gas suspectedDo not enter a confined space if gas suspected

Protect attendantsProtect attendantsMove them awayMove them awayMove them awayMove them away

FIREMEN PROTECTIONFIREMEN PROTECTIONBREATHING APPARATUSBREATHING APPARATUS

PROTECTIONPROTECTIONPROTECTIONPROTECTION

Protect patient/casualtyProtect patient/casualtyProtect patient/casualtyProtect patient/casualtyRemove harmful objectsRemove harmful objectsSecure unstable objectsSecure unstable objectsSecure unstable objectsSecure unstable objects

Protect incident sceneProtect incident sceneSignpostingSignpostingDisconnect car batteryDisconnect car batteryExtinguish starting fire if matching extinguisher Extinguish starting fire if matching extinguisher availableavailable

PROTECTIONPROTECTIONPROTECTIONPROTECTION

ALERT QUALITYALERT QUALITYALERT QUALITYALERT QUALITY

When available make use of checklists forWhen available make use of checklists forWhen available, make use of checklists for When available, make use of checklists for injury or illnessinjury or illnessFamiliarise with checklistsFamiliarise with checklistsFamiliarise with checklistsFamiliarise with checklistsFamiliarise with communication meansFamiliarise with communication meansRequest for assistance around you (Safety Request for assistance around you (Safety officer, supervisor etc)officer, supervisor etc)

FIRST AIDFIRST AIDFIRST AIDFIRST AID

ATTEND FIRST AID TRAININGSATTEND FIRST AID TRAININGSATTEND FIRST AID TRAININGSATTEND FIRST AID TRAININGSEach heartbeat pumps about Each heartbeat pumps about 450 450 ml bloodml bloodHuman body contains averageHuman body contains average 66 litres bloodlitres bloodHuman body contains average Human body contains average 66 litres bloodlitres bloodBlood loss in case of artery injury will be Blood loss in case of artery injury will be complete in aboutcomplete in about 1212 heartbeats i eheartbeats i e 1010complete in about complete in about 1212 heartbeats, i.e. heartbeats, i.e. 1010secondssecondsResult is deathResult is deathResult is deathResult is deathImmediate direct compression might save Immediate direct compression might save casualty’s lifecasualty’s lifecasualty s lifecasualty s life

DIRECT COMPRESSIONDIRECT COMPRESSIONDIRECT COMPRESSIONDIRECT COMPRESSION

FIRST AIDFIRST AIDFIRST AIDFIRST AID

DO NOT MOVE CASUALTYDO NOT MOVE CASUALTYDO NOT MOVE CASUALTYDO NOT MOVE CASUALTYIF NO IMMEDIATE HAZARDIF NO IMMEDIATE HAZARD

f i k i i l l d i di hf i k i i l l d i di hIf risk is vital, real and immediate, then move If risk is vital, real and immediate, then move safely the casualtysafely the casualtyDo not put yourself at riskDo not put yourself at riskFollow recommendations provided during first Follow recommendations provided during first p gp gaid trainings regarding emergency movingaid trainings regarding emergency movingProtect the spineProtect the spineProtect the spineProtect the spine

FIRST AIDFIRST AIDFIRST AIDFIRST AID

DO NOT DO WHAT YOU HAVE NOTDO NOT DO WHAT YOU HAVE NOTDO NOT DO WHAT YOU HAVE NOT DO NOT DO WHAT YOU HAVE NOT BEEN TRAINED FORBEEN TRAINED FORDO NOT PUT YOURSELF AT RISKDO NOT PUT YOURSELF AT RISKDO NOT PUT YOURSELF AT RISKDO NOT PUT YOURSELF AT RISKDO NOT INDUCE SECONDARY INJURIESDO NOT INDUCE SECONDARY INJURIESBE BASIC IN YOUR ACTIONBE BASIC IN YOUR ACTION

CONCLUSIONSCONCLUSIONSCONCLUSIONSCONCLUSIONS

Emergency Response is the result of aEmergency Response is the result of aEmergency Response is the result of a Emergency Response is the result of a comprehensive chaincomprehensive chainWhenever one single link is defective itWhenever one single link is defective itWhenever one single link is defective, it Whenever one single link is defective, it impairs the whole chain efficiencyimpairs the whole chain efficiencyThi i h ll ibl lThi i h ll ibl lThis is why all responsible personnel present This is why all responsible personnel present on site should be involved in emergency on site should be involved in emergency responseresponseThis is why safety induction and first aid This is why safety induction and first aid training are that importanttraining are that important

RECOMMENDATIONSRECOMMENDATIONSRECOMMENDATIONSRECOMMENDATIONS

Instruct your senior employees to attend firstInstruct your senior employees to attend firstInstruct your senior employees to attend first Instruct your senior employees to attend first aid trainings, beginning with your HSE aid trainings, beginning with your HSE managers and supervisors and your safety managers and supervisors and your safety g p y yg p y yofficersofficersFollow HYUNDAI/ENI recommendations Follow HYUNDAI/ENI recommendations regarding safetyregarding safetyDo not transport patient/casualty by yourselfDo not transport patient/casualty by yourselfp p y y yp p y y yClear up access to each structure and allow Clear up access to each structure and allow E.R.T reaching the incident sceneE.R.T reaching the incident scenegg

I HAD A DREAMI HAD A DREAMI HAD A DREAMI HAD A DREAMEverybody on site was following safety regulationsEverybody on site was following safety regulationsy y g y gy y g y gThere had not been any serious incident since three There had not been any serious incident since three monthsmonthsThere was no need of emergency responseThere was no need of emergency responseWe were working in an ideal worldWe were working in an ideal world

AND I WOKE UP …AND I WOKE UP …I was definitely not Martin Luther King!I was definitely not Martin Luther King!

THANK YOU FOR YOURTHANK YOU FOR YOURTHANK YOU FOR YOUR THANK YOU FOR YOUR ATTENTIONATTENTION

HOPE SEING YOU SOON ATHOPE SEING YOU SOON ATHOPE SEING YOU SOON AT HOPE SEING YOU SOON AT HDEC TRAINING CENTREHDEC TRAINING CENTRE