POINTS TO CONSIDER DURING PREPARATION OF HOSPITAL DISASTER PLAN: REVIEW Erdal Tekin* MD Department of Emergency, Palandoken Government Hospital, Erzurum, Turkey. *Corresponding Author Original Research Paper Medical Science General Information and Definitions World Health Organization (WHO) describes the disaster as sudden and unexpected ecological situations, which exceed resources and capacities of the institutions, disrupt the normal functioning, and (1,2,3) necessitate external assistance . Disasters can be classified as either natural and technological or according to their occurrence and origins (4) (Table 1) . Table 1: Classification of Disasters The extraordinary circumstances covers all situations, in which daily healthcare services are inadequate, and the healthcare demands of the region cannot be supplied, necessitating national and international assistance. Disaster medicine is the medical branch that intervenes to save as much disaster-victims as possible, by optimizing the use of disproportion between suddenly occurring healthcare demands during (5) the disaster and the resources in the disaster-affected community . Disasters, emerging at unexpected places and times, create harmful effects on living creatures. The region or country, in which the disaster occurs, cannot compete with these harmful effects alone and external assistance may be unable to reach the disaster region throughout the (6) first 24-72 hours . Disaster plans at national, local, and institutional levels should be made, taking all types of disasters into consideration. Hospitals are the most referred institutions during disasters, with subsequent big commotion. Additionally, they might have been directly affected by the disaster. All-time preparedness of hospitals and other healthcare institutions will reduce the damage and chaos, when faced with such events. Therefore, to be successful in diagnosis and treatment of admitted sick and injured patients, to minimize problems that may arise in the hospital, or to intervene in an in-hospital event rapidly, every hospital should have an understandable, simple, affordable, easily accessible and applicable, written hospital disaster (7,8,9) plan (HDP) . History of Formation of Disaster Plan Disaster plan was initially developed and used in the United States by firefighters in 1970, with the name of FIRESCOPE (Firefighting Resources of California Organized for Potential Emergencies) in fires occurring in California. In 1987, Northern California Hospital and Institution Committee created the earthquake preparedness guide with the name of Incident Command System (ICS) for hospitals, by considering this system as a reference. It was revised as Hospital Emergency Incident Command System (HEICS) in 1991 by Orange City Emergency Medical System (EMS). Then, it was revised again in 1992 as HEICS-II, AND İN 1998 AS HEICS-III. In August 2006, it was introduced as Hospital Incident Command System (HICS). In (10,11,12) March 2014, the final HICS guide was published . In Turkey, the sensitivity for disaster increased following 1999 Marmara earthquake. Following revision of HDP in 2000, it was first implemented in 9 September University, Medical Faculty Hospital. Ever since, the Ministry of Health and medical associations tell HDP in detail. The HDP of Ministry of Health recommended for hospitals in 2007 and required for accreditation shows similarities with HICS. The fact that HDP was mentioned by the Ministry of Health in its issued circular letter in 2010 has led to the encouragement of hospital administrations in preparation of HDP. Most recently, in 2015, by issuing the regulation for implementation of hospital disaster and emergency plans, the compliance of our country with the systems used throughout the world on the disaster preparedness and disaster (13,14,15) medicine topics was tried to be achieved . Hospital Emergency Incident Command System (HEICS) HEICS organization defines the duties and responsibilities of hospital staff before, during, and after the disaster in detail. In HEICS organization, there is a reliable chain of command. Within this chain of command, “who will report to whom” is stated together with the priorities and timing. Moreover, since it is a flexible system, it can be activated according to the characteristics of the disaster or the emergency condition and it can be applied in all small or large hospitals with various capacities. This organization chart consists of president of the HDP, public relations authority, interinstitutional coordination officer, occupational safety officer, medical /technical advisory board, chief of operation, chief of planning, chief of logistics, and chief of finance (Figure 1). The number of attendants in this organization chart can be increased or reduced according to the disaster severity, and the hospital size, together with the staff's and hospital's level of being affected. However, we suggest starting with at least nine administrators at the outset of the disaster, for continuation of operations. The number of attendants in this organization chart may be increased according to demand, thereafter. All administrators in this chart work in tandem with each other, and they are directed by a single KEYWORDS : Hospital Disaster Plan, Triage, First Aid and Healthcare Services during Disaster Disasters are sudden and unexpected ecological situations, which exceed resources and capacities of the institutions, disrupt the normal functioning, and necessitate external assistance. Different classifications of disasters are present according to their types of occurrence and origins. A short history of emergence of disaster plan will be mentioned. The properties of the hospital emergency command system and commission for preparation will be highlighted. We suggest starting with at least nine administrators at the outset of the disaster, for continuation of operations. These are as follows: president of the hospital disaster plan, public relations authority, interinstitutional coordination officer, occupational safety officer, medical /technical advisory board, chief of operation, chief of planning, chief of logistics, and chief of finance. This number may be increased according to demand, thereafter. The healthcare services that will be provided during disaster environment will be explained together with triage. To use simple triage/rapid treatment system, which provides a simple and fast treatment opportunity for patients, and color-code system recommended by the Ministry of Health seems to be more advantageous in the disaster field and its details are discussed. ABSTRACT Atıf Bayramoğlu MD Department of Emergency, Ataturk University Medical Faculty, Erzurum, Turkey. The Formation of Origin According to Origin Suddenly Developing Disasters (Earthquake, floods, raw, storms, nuclear, and chemical accidents, etc.) Geological disasters (earthquakes, landslides, rock falls etc.) Slow Developing Disasters (Drought and hunger, erosion, desertification, global warming, epidemic diseases, etc.) Meteorological Disasters (floods, drought, storm, global warming, desertification etc.) Technological disasters (Nuclear and chemical accidents, traffic accidents, industrial accidents, etc.) Human-induced disasters (fires, environmental pollution, terrorist acts, wars, etc.) 30 INDIAN JOURNAL OF APPLIED RESEARCH Volume-8 | Issue-3 | March-2018 | PRINT ISSN No 2249-555X