الفهرس Only 14 pages are availabe for public view
 |  | from | 95 |  |  |
| | | from | 95 | | |
Abstract
The disruption of hospital systems during a city-wide crisis that produces mass casualties can quickly overwhelm hospital emergency resources and hinder the provision of both basic and sophisticated medical care, such as that provided in the intensive care unit .Events that precipitate such an internal crisis include natural disasters, such as floods or earthquakes, and human acts, such as enemy attack during wartime. These could result in widespread loss of vital systems including electricity; communications systems; critical services, such as pharmacy, laboratories, and blood bank; ventilation and monitoring systems; water; and evacuation systems.
The internal crisis may be defined, as a sudden-onset event that disrupts or poses the immediate danger of disrupting hospital operations (processes) and patients’ care sufficiently to endanger patients, visitors, or staff, and undermining the integrity of the facility as a steward of public safety. By contrast, an internal disaster is a crisis that has gone out of control, leading to multiple casualties, severe destruction, or both.
The internal disaster put the hospital and its staff in the position of victims, a prospect that many practitioners may prefer to think of as quite remote. The therapy for this attitude should be not alarmism, but better data.
Some hospitals’ plans are:
1- Modes of resilience.
2- Models for different hazards.
3- Response of Thai Hospital to Tsunami disaster.
4- Response of Memorial Hermann Hospitals to face tropical storm Allison.
5- Hospital evacuation: Issues and complexities.The following data were collected before and after transport of critically ill patients: blood pressure, heart rate, body temperature, oxygen saturation, arterial blood gases, serum lactic acid, plasma haemoglobin concentration, blood glucose, mechanical ventilation settings, use of vasopressor/inotropic medication, and presence of venous and arterial catheters. Ambulance personnel completed forms description haemodynamic and ventilatory data during transport. Blood sampling data acquisition on arrival were performed with the patient still on the ambulance stretcher, before changes to the road’ therapy were instituted. Immediately thereafter, the patient moved to the ICU bed and connected to the ICU ventilator. Data were instantly noted on a simple data sheet, and checked and collected by research nurse. Hazards that lead to hospital evacuation are fire, utility failure, earthquake, flood, hazardous materials, human threat, hurricane and weather.