Austraumaplan: Final November 2011

Appendix 6 - Response Actions under Austraumaplan

Page last updated: 30 November 2011

A6.1 Standby Phase Actions

Department of Health and Ageing

A6.1.1 Notification to the Australian Government Department of Health and Ageing (DoHA) contact officer should occur immediately.

A6.1.2 This notification should be to the DoHA National Incident Room (NIR):
t: (+61) 2 6289 3030 - 24 hours
f: (+61) 2 6289 3041

A6.1.3 DoHA will place the NIR on standby.

A6.1.4 DoHA will notify AHPC members and convene a teleconference of the AHPC at the earliest opportunity to advise of the situation. AHPC members will be asked to prepare a jurisdictional capacity template form prior to the teleconference (see Appendix 4). Affected jurisdiction will prepare “affected jurisdiction template” prior to teleconference (see Appendix 5). The AHPC core group can be expanded to include key clinical stakeholders/subject matter experts as required, this includes requesting activation of the AMTCG through AGD-EMA.

A6.1.5 DoHA through the NIR will actively liaise with other Australian Government agencies.

A6.1.6 The NIR will continue to gather operational intelligence, develop a list of possible trigger points for escalation, and commence operational planning for discussion at AHPC teleconferences.

Affected (Primary) Jurisdiction

A6.1.7 The affected jurisdiction will:
  1. Continue management of incident;
  2. Advise Australian Government of requirements;
  3. Teleconference with AHPC;
  4. Requests for assistance to State/Territory Emergency Management Controller; and
  5. State Emergency Controller requests tasking through AGD EMA.

Continued Management of incident will include

A6.1.8 Command, control, coordination and communication (C4) arrangements are implemented to ensure scene management, activation of state health/burn disaster plan, liaison with hospital emergency departments, critical care and burn injury service. This will entail establishment of health and ambulance emergency operations centres (EOCs). In a large incident it is likely that the State/Territory Emergency Operations Centre would also be activated, ensuring a whole of government approach to the incident.

A6.1.9 The affected jurisdiction will be required to ensure appropriate pre-hospital response and incident site management in accordance with the state/territory disaster plans. This includes the functions of triage, treatment and transport with the establishment of a casualty clearing station at the scene. The safety of first responders must be ensured through close liaison with other combat agencies especially police and fire services. This particularly applies to a terrorist or security based incident.

6.1.10 As accurate information is always difficult to obtain in the early phases of an incident, a Medical Assessment Element may be sent to the scene as soon as possible to gather intelligence. In many jurisdictions this role is carried out by a designated Field Health Commander with appropriate support. It is essential that this role is intelligence gathering and communication only. It does not involve patient care.Top of Page

A6.1.11 Primary triage will be performed. All jurisdictions use similar triage methods as follows:
  • Category One (RED)
  • Category Two (YELLOW)
  • Category Three (GREEN)
A6.1.12 In a large-scale incident, the incident site can be bolstered as necessary with health disaster teams. This may also be necessary in protracted incidents and/or when the incident occurs in a remote area. When this is necessary, consideration may be given to deploying an Advance Assessment Team which should include trauma, retrieval, burn, emergency medicine and disaster management expertise.

A6.1.13 Ambulance officers within a casualty clearing station will primarily undertake treatment. In a large-scale incident site, field medical teams consisting of appropriately trained critical care staff may bolster the casualty clearing station. Treatment must be implemented consistent with best management guidelines. Ideally clinical staff deployed to the site should have specific training in this area as well as in disaster response management. The management of the site will be dependent on the provision of logistics and supply, centrally coordinated through the EOC.

6.1.14 The affected jurisdiction, by necessity, must provide timely and appropriate “surging-up” of hospital and in-patient trauma management infrastructure. This will necessitate the major trauma service being able to acutely expand to meet the demand for a minimum period of up to 24 hours. This will require the provision of extra beds, extra trained staff and operating suite and intensive care infrastructure, including ventilators.

A6.1.15 Secondary triage will occur to ensure that all patients’ clinical conditions are monitored so that optimal care is received.

A6.1.16 Urban Search and Rescue (USAR) may be required for example in situations of structural collapse. Specific jurisdiction based USAR capacity should manage this in the first instance.

Australian Government

A6.1.17 Liaison by the DoHA NIR (email or via phone on +61 2 6289 3030) with relevant Australian Government agencies and jurisdictions to establish current situation, confirm capabilities.

A6.1.18 DoHA will activate the NIR (if this has not already occurred).

A6.1.19 DoHA will convene further teleconference(s) of the AHPC to discuss the incident, provide further definition of the incident and allow non-affected jurisdictions to progress making arrangements to assist if required.

States and Territories (not directly affected)

A6.1.20 Will:
  1. Update bed and equipment status
  2. Identify staff to respond if required (consider using AUSMAT members)
  3. Liaise with Mass Casualty Services
  4. Liaise with locally based patient transport services
  5. Liaise with local specialist capability as required e.g. USAR
  6. Participate in teleconferences with AHPC and advise of available resource status to contribute to national summary of available resources
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A6.2 Response Phase Actions

Department of Health and Ageing

A6.2.1 Through the AHPC escalate AUSTRAUMAPLAN to Response phase after request for assistance received from affected jurisdiction(s) or tasking received from Commonwealth Government.

A6.2.2 Coordinates deployment of Australian and/or jurisdictional health assets in support of the MCINC.

A6.2.3 Coordinate movement of patients from an affected jurisdiction if required (may be coordinated through the AMTCG).

Affected (primary) Jurisdiction(s)

A6.2.4 Continue management of the incident including operational management of assets and staff sent from other jurisdictions.

A6.2.5 Continue to advise Australian Government of requirements, and to teleconference with AHPC.

Australian Government

A6.2.6 Via AHPC and NIR, the Australian Government would receive advice from the affected jurisdiction regarding requirements.

A6.2.7 The National Critical Care and Trauma Response Centre (NCCTRC) at Royal Darwin Hospital may be activated to act as a stabilisation hub for MCINC in Northern Australia or overseas. AUSTRAUMAPLAN can act as a supporting document to OSMASSCASPLAN in such an international event. The arrangements in AUSTRAUMAPLAN are particularly relevant in planning for patient distribution, the support of any established staging area and ensuring appropriate clinical coordination through the AHPC. Requests for state and territory assistance will be through AGD EMA to the state and territory emergency operations centres, consistent with the arrangements in OSMASSCASPLAN.

States and Territories (not directly affected)

A6.2.8 Advice from AHPC will assist AGD EMA to coordinate physical assistance from, and to, states and territories that are not directly affected. Assistance, if requested, will be tasked through AGD EMA via the relevant state or territory emergency controller.

A6.2.9 State and territories not directly affected will participate in AHPC teleconferences and update jurisdictional capacity templates as required or requested.

A6.3 Stand down Phase Actions

A6.3.1 The AHPC will declare a stand down of the AUSTRAUMAPLAN only after all agencies have been cleared of any further tasking by the AGD-EMA IMF. This code-word (Stand Down) will be issued by DoHA through the NIR. The AUSTRAUMAPLAN will be stood down when all consequence management activities requiring national coordination have been completed and all affected facilities and jurisdictions are able to resume normal business.

A6.3.2 Following Stand Down, formal debriefing processes are to be completed. This could include local, state, and national debriefs. The AHPC will debrief health response coordination through the three phases of AUSTRAUMAPLAN, and disseminate a post activation report and recommendations to all AHPC members.

A6.3.3 Ongoing recovery activities, by necessity, may still occur once the AUSTRAUMAPLAN has been Stood down, and may be facilitated by the NIR as required.