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Health Management in Disaster

Dr. Zafrullah Khany Jasa, dr.SpAn.KNA


Disaster

Any emergency that disrupts normal


community function causing concern for the
safety of its citizens including their lives and
property.
All-Hazards
Man-made
Fires
Explosive devices
Firearms
Structural collapse
Transportation event Natural
Air, Rail, Roadway, Water Earthquake
Industrial HAZMAT Landslides
WMD NBC events Avalanche
Etc Volcano
Tornado
Hurricanes, floods
Fires
Meteors
Etc
Disaster Response- ESF
Emergency Support Functions
(ESF)
1. Transportation 9. Urban Search and Rescue
2. Communications 10. Hazardous Materials
3. Public Works and 11. Agriculture and Natural
Engineering Resources
4. Firefighting
12. Energy
5. Emergency Management
6. Mass care, Housing and 13. Public Safety and Security
Human Services 14. Long-Term Recovery
7. Resource Support 15. Public Affairs
8. Public Health and Medical
Services
Plans must be simple and
flexible. They should be made
by the people who are going
to execute them.
george patton
Response
a. Notification
b. Evacuation/extrication
c. Search and rescue
d. Coordination
e. Immediate needs assessment
f. Shelter/protection
g. Implementing existing disaster plans
County Health Departments
Pre-hospital
Outpatient Services
Hospitals
Pharmacies
Laboratories
Mortuary Services

Health Care System


Emergency Response Phase

1. Search and rescue


2. Emergency medical services
3. Immediate health service
mobilization
4. Preliminary needs assessment
Indonesia

Respon terhadap becana:

SPGDT
Sistem Penanggulangan Gawat Darurat
Terpadu
SPGDT / B (Sistem Penanggulangan Gawat Darurat Terpadu - Bencana

Evakuasi Medik (Medical)

Tim
Bencana
Multi Disiplin

Didaerah
X X X X Hansip Bencana
4 Wilayah
RS 3 RS 2 RS 1 Puskes
Rujukan Propinsi Kabupaten mas

(PusKoDal (Pos (Pos Depan) (Pos Lapangan)


Med) Belakang)
Pusat Koodinasi
Dan Pengendalian
Medik
Transportasi
Komunikasi
Pendanaan

(SISTIM PENDUKUNG)
APA PASIEN GAWAT DARURAT ITU ?

Adalah pasien yang perlu pertolongan tepat,


cermat, cepat untuk mencegah kematian / kecacatan

Doktrin dasar :
Time saving is life saving
Waktu adalah nyawa

Ukuran keberhasilan
Response time
Waktu tanggap
SIFAT DASAR PERTOLONGAN GAWAT DARURAT

1. Pertolongan harus
tepat-cermat-cepat 3. Yang harus dikembangkan
adalah :
2. Gawat darurat dapat Sistem pelayanan gawat
terjadi kapan saja dimana darurat terpadu (SPGDT)
saja pada siapa saja
enis pasien gawat darurat yang diberi pertolongan
Trauma, bedah, medik, obstetrik, pediatrik)

Kerangka rujukan
uskesmas RS Kelas C RS Kelas A / B

enis SDM
Multi profesi (dokter, perawat)
Multi disiplin (berbasis dokter spesialis)
Multi sektor (kesehatan non kesehatan)
FASILITAS IRD DAN ARUS PASIEN

Pra hospital Ruang penerimaan


Sistem ambulans
Ruang triage

Pulang
Ruang resusitasi Ruang tindakan Gawat darurat
ringan
(Diagnosis)
Pulang
Laboratorium radiologi

Bank darah Kamar bedah

Ruang observasi intensive


Pulang
(ICU waktu pendek)
Pasien gawat darurat
berat

Ruang rawat inap Ruang perawatan intensive (ICU)


Dr. Bedah
Dr. Obgyn
Perdarahan
Perdarahan post partum
trauma
SHOCK Resusitasi
KARENA 1 Stabilisasi
PERDARAHAN Dr.
Umum
Defenitif terapi
2
awal

3 Defenitif terapi Dr.


akhir Spesialis

Dr. Penyakit Perdarahan


Dalam G.I.

PEMBAGIAN PERAN DR. UMUM DR.SPESIALIS


Priority Public Health
Interventions

Water and sanitation


Surveillance and Health Information
Systems
Nutrition
Communicable disease control
Immunization
KELOMPOK KELOMPOK KELOMPOK
PENGUNGSI PENGUNGSI PENGUNGSI
(CLUSTER) (CLUSTER) (CLUSTER)

POSKO POSKO

POSKO
KESLAT HUBUNGAN
KESEHATAN RADIO MEDIK
LAPANGAN
PUSKESMAS BANGSAL PERAWATAN
DARURAT

SATLAK SATGAS RS. KLAS C BANGSAL PERAWATAN


II KES II PERAWATAN DARURAT

SATKORLAK SATGAS RS KLAS BANGSAL PERAWATAN


I KES I A/B DARURAT

PUSDALSIS
KESNAS

RUJUKAN : 1. ALIH INFORMASI (KONSULTASI)


2. ALIH PASIEN (KIRIM PASIEN)
3. ALIH ILMU (PELATIHAN)
4. ALIH LOGISTIK (BANTUAN ALAT / OBAT)
Deadly Misconceptions
It wont happen
here

It wont happen to
me

Someone else will


take care of it
Be Ware,..