Health System Info

In a mass disaster, surely there will be victims. They are classified into:
▶ Non-injured : may have psychological trauma
▶ Injured : physical & psychological trauma
▶ Dead : how many? who? causes?

An event will be called a mass disaster if the number of dead victims is more than 12 in a single event.

So, what we should do when there's dead bodies everywhere?... (caused by the disaster)

Well, surely we have to identify whose bodies are them.

What if there are dead bodies which can't be recognized? Be it severely burnt, damaged facial/physical characteristics, or even... skeletonized!

Introducing... the DVI *tadaaa* ...

It's the DISASTER VICTIM IDENTIFICATION. There are 5 steps to be done:

... ... ... ... ... ... ... ... ...

1) In the Scene of Incident
❧  Secure - Police border line
❧  Collect - Evidences, bodies evacuation
❧  Documentation - Photograph, labelling
❧  Team members : Police, MD, SAR, army, trained volunteers
❧  Work scheme:
❧  Collect PM data - photo, medical exam, fingerprinting, forensic odontology & anthropology, DNA
❧  Prevent PM changes
❧  Work scheme:


... ... ... ... ... ... ... ... ...
3) Ante Mortem (AM)
❧ Collect AM data: from family, neighbours and friends.
❧ Data analysis
❧ Resume






... ... ... ... ... ... ... ... ...
4) Reconciliation
❧ To compare & cross-match between PM & AM data.
❧ Identification - Forensic pathologist, dentist, fingerprint, recognize the property, photographer.

... ... ... ... ... ... ... ... ...
5) Returning to the Family / Burial
❧ Ensure care, do reconstruction if needed for best cosmetic/condition.
❧ Medicolegal & administrative procedures - death certificates, insurances.
❧ Mass / Temporary burial, or return the body to the family.


The end.
What we should know here is that, the success indicator of a disaster victim identification work is not the speed, but the accuracy. However, the good speed may add up a DVI level of quality, given that their accuracy level is maintained good or even better. ッ

℘.s. Knowledge is power.
and He is the Most Powerful, for He knows everything :)

If a baby were born,
what important identification document should be issued?
✔ a birth certificate .......

Then the baby grew up,
what important identification document should be issued?
✔ an identification card .......

When his/her time has come to the end,
what important identification document should be issued?
✔ a DEATH CERTIFICATE .......

Why should a death certificate be issued when there's a death of a person?
✏ to prevent from being buried illegally
✏ pension
✏ insurance
✏ inheritance
✏ debt
✏ law
✏ et cetera


MD roles?
☛ Determine the death (circulation, respiration & neurology stop, plus no secondary post-mortem changes after 2 hours incubation period - this is needed to exclude coma)
☛ Autopsy (done if difficult to find out the cause of death)
☛ Forensic Identification (if unidentified, or to confirm identification)

Let's see what are the details that should be written in a death certificate:
❧ Name
❧ Age (at time of death)
❧ Gender
❧ Address
❧ Date of death
❧ Cause of death

However in Indonesia, there's no standard guidelines taken. Most of the death certificates here don't have the 'cause of death' part. It will only be written if the late person was a patient who had died after receiving a long term care & treatment in a hospital. Oh, here's an example of the 'cause of death' part.


Cause of Death??
❦ Written in 'chain of events'. For example, events occurred minutes, hours, days and years before the time of death, which may be linked to each others, and resulted death of the person.


Knowledge is power.
and He is the Most Powerful, for He knows everything :)

Before I continue writing about this, perhaps some of you wondered what 'Mx' is. Well, it's a short medical abbreviation for the term 'management' ...

Right, now we're talking about Disaster Phase. What's the most important in this phase?

RAPID RESPONSES !!
Yes, rapid responses should be the utmost priority when there's a disaster occurred.

So, what we must have to ensure a rapid response? It's the Action Plan! I mean, the Disaster Plan!!

We may divide the big Disaster Plan into Pre-Hospital, Hospital and Regional Disaster Plans.

Let's see one by one. Brief points!

---[Pre-Hospital]----------------------

✩ DISASTER PLAN:
-- Major incident
-- Exact location
-- Type of injury
-- Hazard
-- Access
-- No. of cases
-- Emergency services, present & required

✩ MEDICAL RESPONSES:
-- Triage
-- Treatment (Resuscitate & Stabilize)
-- Transfer & Transport


---[Hospital Disaster Plan]----------------------------------------------------------------------------------

✩ MANAGEMENT SUPPORT
-- Command
-- Safety
-- Communication
-- Assessment

✩ MEDICAL SUPPORT
-- Triage / Re-triage
-- Treatment (Resuscitate & Stabilize & Definitive Treatment)
-- Transport, Transfer & Refer


---[Regional Disaster Plan]---------------------------------------------------------------------------------

-- Coordinating Team
-- Medical team
-- Surveillance
-- Management back up
-- Logistic

Example:
[sorry, this part is to be remained in Indonesian language]

[click to enlarge]

Then, the management between regions will be under the Sectoral Management. The link between Pra Hospital DP in different regions will be under the Pusbankes-118.

Among important medical skills used in Pusbankes-118 (Emergency Service) services are:
-- Advanced Trauma Life Support
-- Advanced Cardiac Life Support
-- Basic Life Support
-- Emergency Physician
-- General Emergency Life Support

Knowledge is power.
and He is the Most Powerful, for He knows everything :)

DISASTER, what's that?
Can a volcano eruption, or earthquakes, or tsunami, or flood, or an airplane crash, or landslides, or a hurricane, called 'disaster'??

Haha, usually, that's what we heard from the news and et cetera. However actually, those events can't alway be called a disaster.

Why? Let's define the meaning of a 'disaster'.

Disaster is a "sudden ecological phenomenon of sufficient magnitude to require external assistence" -World Health organization [WHO]

So, an event like an earthquake with 7.0 Richter, cannot be called as a disaster if it happens in a place where nobody lives there, because there's no external assistance needed to counteract with the effects & damages caused by the earthquake. It is just an event.

It will only be called as a disaster only if the 7.0R earthquake happened in a big city, with a big population. Imagine how many damages there would be.. How many lives would have gone with it.. How many recoveries needed to be done.. Until local people and the governor would require external assistance, then the event should be called as a DISASTER.

Now that we understand the meaning of a disaster. Now the question is, how to cope with it? Any plans?? Imagine if suddenly a disaster occurred in your place (nauzubillahiminzalik).. What would you do? (or at least the government do..)

Okay, here's the plan...


owh, before that, let's learn a little bit about those terms...


Hazard -------- Something that contents energy, which may results something bad to happen.
Mitigation ---- Effort(s) to lessen the impact of an event.
Risk(s) -------- Probability that something negative will occur.
Preparedness - Effort(s) to increase resilience.
Event --------- Realization of hazard.
Impact -------- Contact between an event & society.
Damage ------ Negative results from the impact of an event.
Resilience ---- The 'daya tahan' in Indonesian & Malaysian language.
Capacity ------ Numbers affected from the event / needed to be protected.
Absorbing Capacity -- Capacity to absorb the power of an event (e.g. earthquake-proof buildings).
Buffering Capacity --- Capacity of reservation (e.g. keeping rice for famine preparation).
Response ------- Capability of local people to response to the after-effect of the event.
Disaster -------- Events that require external assistence.
Recovery ------- To make things back to normal (like previously).
Development -- To rebuilt, better than before.

Generally, the Disaster Management includes Prevention, Mitigation & Preparedness in PreDisaster phase, Responses in Disaster phase, and Recovery & Development in PostDisaster phase.

Knowledge is power.
and He is the Most Powerful, for He knows everything :)

*credits to all of the photographers! ...all of those photos were found in the internet.

Knowledge is power.
and He is the Most Powerful, for He knows everything.
:)