英国面临重大灾害时紧急救援的组织与管理

作者:安德鲁. 发布时间:07 20 2011 3:43PM 来源:中国急救网

       自1968年开始从事救护车急救专业, 先后在此专业的各个领域担任过执行, 控制, 培训, 教育及急救计划的管理职位. 为国家急救计划协会的成员. 及健康与救护发展学会急救培训课程组主任.

        作为英国救护车服务系统重要成员, Mr. Parr曾参与许多国内及欧洲的多项重要组织管理项目, 包括英国急救人员标准素质培训, 参与制定欧共体国家救护车辆及设备配置的通用标准, 曾多次负责英国国内最高安全级别的国家政府年度会议的医疗保障计划与管理,并主持参与与法国共同签定关于英吉利海峡海上灾难救助应急反应的联合草案.

        Mr. Parr 还亲自参与了许多重大事件的救援管理, 如: 恐怖炸弹袭击, 洪灾, 紧急救援撤退, 隧道失火…经常在英国和法国的大型学术会议及研讨会上发表演讲, 并参加了9.11恐怖袭击事件后在纽约紧急召开的急救准备研讨会.

    HOW THE UNITED KINGDOM AMBULANCE SERVICE PREPARES FOR A RESPONSE TO A MAJOR INCIDENT

    Introduction:

    The ambulance service in the United Kingdom, although made up of a number of individual services, forms part of the National Health Service. All parts of the National Health Service, whether it be hospitals, clinics, family doctors or ambulance services, are required to deliver their services to strict sta n dards imposed by the Government Department of Health.

    An element of the sta n dards for providing ambulance services relates to having an ability to respond to a “Major Incident”. A “Major Incident” is carefully defined together with the expectations in terms of level a n d sta n dard of response which would be considered appropriate.

    National Guidance on Planning Major Incidents is issued by the Department of Health to all parts of the National Health Service, including the ambulance service.


    Preparations:

    Emergency Planning is seen as an important core function by ambulance services.

    All ambulance services have a dedicated manager who is responsible for the “Emergency Planning” function. For larger services the Emergency Planning Manager would have a number of staff to assist.

    There are a number of legal a n d advisory frameworks in which the process of emergency planning is conducted.

    The main influence for these frameworks comes from the following:

    Civil Contingencies Act 2004;

    Planning for Major Incidents – The NHS Guidance;

    As part of the process, all health providers are required to produce a Major Incident Plan which gives the detail of how they will respond to a Major Incident occurring within their operational area.

     

     


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    Civil Contingencies Act 2004:

    The Civil Contingencies Act 2004 places all responders to a Major Incident into one of two categories. The ambulance service is classed as a Category 1 responder which also includes police a n d fire, local authorities, hospitals a n d some other agencies. Category 2 responders are drawn e.g. from the Public Utility companies a n d transport companies. The Act places seven Civil Protection duties on all Category 1 responders. These are :

    To carry out risk assessments
    To maintain emergency plans
    Co-operation with other responders
    Information sharing with other responders
    Communicating with the public (Warning a n d informing)
    To have in place Business Continuity Management Plans
    Local Authorities are required to promote Business Continuity Management to local businesses.

    Planning for Major Incidents  -  The NHS Guidance:

    This document sets out guidance a n d policy to help ambulance services to plan for major incidents a n d seeks to ensure that nationally there are plans in place together with the capability to respond.


    Integrated Emergency Management:

    The underlying principle which encompasses all emergency planning activity is Integrated Emergency Management. There are six activities underpinning Integrated Emergency Management :

    Anticipation
    Assessment
    Prevention
    Preparation
    Response
    Recovery Management


    Anticipation:

    Anticipation is sometimes referred to as Horizon Scanning a n d is a process whereby Category 1 responders should aim to be aware of new hazards a n d threats.

    Assessment:

    This duty involves assessing the risks of emergencies happening within or affecting a geographical operational area. This process is useful in determining whether a threat or hazard may require an emergency plan or a business continuity management plan to be enacted.


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    Prevention:

    Prevention to some extent is covered by other legislation, however Category 1 responders may take actions to prevent an emergency which is about to happen.

    Preparation:

    This process involves the preparation of plans, ensuring that there is the necessary logistical support in place a n d that all personnel who play a part in the response are aware of their role a n d have been trained. Preparation also seeks to ensure that all emergency plans are capable of being initiated into a response.

    Response:

    The response deals with the immediate effects of the specific emergency or Major Incident but also looks at ensuring that a Category 1 responder is able to provide core services during the emergency. All response elements to a Major Incident are required to be regularly practised.

    Recovery Management:

    The recovery phase may take months or even years to complete, as it seeks to address the enduring human, physical, environmental, social a n d economic consequences of Major Incidents. Experience has shown that the recovery effort is not just a matter for the statutory agencies (police, fire, ambulance), but will involve many other bodies, both public a n d private.

    Integrated Emergency Management seeks to ensure that all services a n d agencies plan together, train together a n d respond together. The ambulance service is fully involved at all levels in the principles of Integrated Emergency Management.

    Ambulance Service Preparations:

    A number of inter-agency emergency planning groups are established a n d meet regularly. The ambulance service is represented on each group. All meetings are fully documented a n d demonstrate the level a n d extent of the pre-planning taking place. The emergency planning groups deal with specific hazards a n d threats, for example there are groups which look at Maritime Major Incidents, Flooding Incidents, Health Incidents (outbreaks of infectious diseases etc.), Chemical, Biological, Radiological a n d Nuclear Incidents. Further groups provide the opportunity for a whole range of organisations who would be responding to a Major Incident to discuss their own plans a n d more importantly how they would integrate with each other. Responders such as Voluntary Organisations, Statutory Bodies a n d the Military all have the opportunity to meet together on a regular basis.

     


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    The groupings of responders meet on a local, c o u n ty-wide a n d regional-wide basis with representatives from every level from within each of the responder organisations even up to Chief Executive level having a part to play in the planning process.

    The ambulance service shares it response plans with all other responder organisations through a web-based internet site.

    Once an operational area has been risk assessed then the equipment a n d resources that would be required to respond can be planned. All ambulance services have a national list of core responsibilities at a Major Incident. These range from providing an on-site comma n d a n d control structure, communications a n d the triage, treatment a n d transport of patients. Ambulance services are responsible for providing on-site facilities for the triage a n d treatment of casualties through a Casualty Clearing Station a n d for the on-site decontamination of casualties where necessary. Ambulance services hold specific vehicles a n d equipment for these purposes.

    The ambulance service Major Incident Plans are regularly reviewed a n d updated a n d all personnel who have a part to play in the response have regular training a n d all response scenarios are regularly exercised.

    作者:安德鲁. 帕尔
    a n drew Parr
    Head of Emergency Preparedness a n d Resilience
    Sussex Ambulance Service NHS Trust.

    英国赫特福德(Hertfordshire) 大学急救计划及灾难管理专业理学硕士,
    现任英国苏塞克斯(Sussex,UK)NHS集团救护车服务中心急救准备及恢复部主任.




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