Health Management in Disaster

Dr. Zafrullah Khany Jasa, dr.SpAn.KNA

Any emergency that disrupts normal
community function causing concern for
the safety of its citizens including their
lives and property.
 All-Hazards
Man-made Natural
Fires Earthquake
Explosive devices Landslides
Firearms Avalanche
Structural collapse Volcano
Transportation event Tornado
Air, Rail, Roadway, Water Hurricanes, floods
Industrial HAZMAT Fires
WMD NBC events Meteors
Etc 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
4. Firefighting Resources
5. Emergency Management 12. Energy
6. Mass care, Housing and 13. Public Safety and Security
Human Services
14. Long-Term Recovery
7. Resource Support
8. Public Health and Medical 15. Public Affairs
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 RS Wilayah 3 RS RS
2 Puskes
1
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
1. Jenis pasien gawat darurat yang diberi pertolongan
(Trauma, bedah, medik, obstetrik, pediatrik)

2. Kerangka rujukan
Puskesmas RS Kelas C RS Kelas A / B

3. Jenis 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
Defenitif terapi
2
awal

3 Defenitif terapi
akhir

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
TERIMA KASIH