code black - personal threat procedure · code black – personal threat procedure – fitzroy...

Effective: 10 January 2017

WACHS KIMBERLEY Fitzroy Crossing Hospital

Code Black: Personal Threat - Preparedness and Response Procedure

Table of Contents

CODE BLACK ..................................................................................................................... 2 Introduction - Principles .................................................................................................... 2 Notification of Code Black ................................................................................................ 2 Prevention of Code Black ................................................................................................. 3 Action Cards ..................................................................................................................... 3 Source Documents ........................................................................................................... 4 Acknowledgments ............................................................................................................ 5

CODE BLACK - PERSONAL THREAT .............................................................................. 6 Introduction - Principles .................................................................................................... 6

ACTION CARDS Threatened Staff / Threat to Others – Unarmed Confrontation ...................................... 10 Threatened Staff / Threat to Others – Armed Confrontation ........................................... 12 Hospital Emergency Coordinator – Unarmed Confrontation .......................................... 14 Hospital Emergency Coordinator – Armed Confrontation............................................... 16 Clinical Nurse Managers/Ward Shift Coordinator – Unarmed Confrontation .................. 18 Clinical Nurse Managers/Ward Shift Coordinator – Armed Confrontation ...................... 20 All Purpose Orderly – Unarmed Confrontation ............................................................... 22 All Purpose Orderly – Armed Confrontation ................................................................... 24 Director / Coordinator of Nursing .................................................................................... 26 Senior Medical Officer / Director of Medical Services .................................................... 27 Regional Health Disaster Coordinator ............................................................................ 29

CODE BLACK: ALPHA (INFANT/CHILD ABDUCTION) ................................................. 31 Person Finding Infant/Child Missing ............................................................................... 33

ACTION CARDS Hospital Emergency Coordinator ................................................................................... 35 Clinical Nurse Managers / Ward Shift Coordinator ......................................................... 37 Regional Health Disaster Coordinator ............................................................................ 39

CODE BLACK S: SNAKE ................................................................................................ 40 Introduction - Principles .................................................................................................. 40

ACTION CARDS Person Finding a Snake ................................................................................................. 41 Hospital Emergency Coordinator ................................................................................... 43

APPENDIX A ..................................................................................................................... 45

APPENDIX B ..................................................................................................................... 47 APPENDIX C ..................................................................................................................... 50

Date of Last Review: January 2017 of 54 Date Next Review: January 2022

Code Black – Personal Threat Procedure – Fitzroy Crossing Hospital

CODE BLACK

INTRODUCTION - PRINCIPLES The WA Country Health Service (WACHS) has a responsibility under the Occupational Safety and Health Act to hold the safety of all patients, visitors and staff as paramount. Aggression is an escalating problem within the health system that may result in staff, patient or visitor injury. Aggression management training is provided by WACHS Kimberley and is mandatory for all staff. A Code Black is a call for assistance, when any individual (staff, patient or visitor) is at personal threat of harm from an act of aggression. At all times, the first consideration is the preservation of human life with the safety of staff and patients uppermost. Under no circumstances should staff, patients or visitors place themselves at risk. There are three types of threats within the Code Black category: 1. Code Black - Personal Threat (Unarmed or Armed or Hold Up). 2. Code Black - Alpha (Abduction). 3. Code Black - S (Snake). NOTIFICATION OF CODE BLACK Staff should call for help, leave the scene and / or call a Code Black at any time they feel it is required in a personal threat situation. The alarm is raised using staff assist button, (duress alarm) and if safe to do so or by dialling 777 or attracting the attention of another staff member to raise the alarm. This automatically sends a page and/or text message to the mobile phones and pagers of the duress response team. The message will state the department you are calling from. If outside switchboard/reception hours or if the internal paging is inadequate a call should be made to ‘000’ to request Police assistance. Code Black is never announced over the Public Address system (if available) except in the case of a Code Black Alpha (infant/child abduction) where the aim is to notify staff to the possible abduction and to secure entrances and exits to the hospital.

This document can be made available in alternative formats on request for a person with a disability

Contact: Operations Manager (M.Faulkner) Directorate: Nursing and Midwifery Services TRIM Record # ED-CO-13-55330

Version: 3.00 Date Published: 11 January 2017 Copyright to this material is vested in the State of Western Australia unless otherwise indicated. Apart from any fair dealing for the purposes of private study, research, criticism or review, as permitted under the provisions of the Copyright Act 1968, no part may be reproduced or re-used for any purposes whatsoever without written permission of the State of Western Australia.



PREVENTION OF CODE BLACK The following guidelines are to assist staff in preventing and resolving Code Black Personal Threat situations as quickly and as calmly as possible: · Adhere to existing simple security precautions: § wear an official identification badge displaying a photo of the staff member, title,

name and WACHS logo. § maintain clear exit paths. § ensure security doors are kept closed (e.g. swipe card access doors).

· Ensure that all staff with patient and visitor contact have attended mandatory training. · Be alert for people behaving in an unusual manner. · Identify persons who are known to be violent and report their presence. · Ensure all staff are aware of potential aggressors. · Assess the situation and be alert to the triggers of violence. · Designate safe escape routes in your workplace. · Clearly identify “staff only areas” and maintain as such. · People who do not have a valid reason for being in the hospital should be requested

to leave. · Call Security, where available, if concerned. A collaborative multidisciplinary approach is recognised as the most effective mechanism for averting aggression. Individuals that have been trained in dealing with aggression are often better equipped to defuse a situation before it escalates. Early management of an aggressive, agitated, violent or threatening person may decrease the chance of occurrence of assaults. All staff are required to attend mandatory training. ACTION CARDS Action Cards define specific emergency response functional roles and tasks. Individual staff members can hold more than one action card role depending on the circumstances. Individuals can also be reassigned different action cards (or roles) as needed. Tasks on an action card can be amended to fit the situation by adding or deleting tasks. The key elements on action cards are:

· Title – role to be performed.

· Hospital where role is undertaken.

· The designated staff member (by position) assigned to that particular role (not named individuals).

· The staff member (successor in absence) who fills the role in the absence of the designated person.

· Who to report to – the supervisor who has direct authority over that role.

· Resources required.



Action cards have three stages for activity:

· IMMEDIATE: Deal with problem.

· ONGOING: Current problem and action taken to facilitate a safe resolution.

· STAND DOWN: A return to normal activity. There are no names of individual staff members (position titles are used) or telephone contact numbers on action cards, as these may change from time to time. Contact lists should be held by individual Team Leaders/Departmental Managers and a central list in the Local Emergency Operations Centre. Action Cards with specific detail about the role (Note: Not all action cards require these roles and not all facilities will have these positions) are attached to this procedure and include:

· Threatened Staff/Threat to Others.

· Hospital Emergency Coordinator.

· Clinical Nurse Managers/Ward Shift Coordinator.

· All Purpose Orderly.

· Security.

· Director/Coordinator of Nursing.

· Senior Medical Officer/Director of Medical Services.

· Regional Health Disaster Coordinator. The role of the Regional Health Disaster Coordinator (Regional Director) or delegated person (usually the Hospital Emergency Coordinator) is to evaluate the emergency from the information provided, to decide the level of assistance that will be required for key support services and to coordinate effective delivery. SOURCE DOCUMENTS · Australian Standard 2010, Planning for Emergencies – Health Care Facilities. AS

4083-2010. Section 5.6 For Personal Threat, Armed or Unarmed person threatening injury to others or to themselves: Response Colour Code Black Standards Australia Limited, NSW pp 21 – 22. Available from: Standards Australia Online [18 November 2012].

· Australian Standard 1997, Security for Health Care Facilities. AS 4485.1-1997. Part 1: General Requirements Standards Australia Limited, NSW. Available from: Standards Australia Online [18 November 2012].

· Australian Standard 1997, Security for Health Care Facilities. AS 4485.2-1997. Part 2: Procedures Guide Standards Australia Limited, NSW. Available from: Standards Australia Online [18 November 2012].

· Department of Health Operational Directive OD 0113/08 Media Communication [25 January 2013].


http://www.health.wa.gov.au/CircularsNew/circular.cfm?Circ_ID=12369


· Department of Health Operational Directive OD 0384/12 Code Black Alpha (Infant/Child Abduction) [30 January 2013].

· SCHS Southwest Bunbury Hospital 2013 Section 8 Code Black Procedure [October 2011].

· WA Country Health Service (2013) Snake Bite Envenoming Guideline. WACHS Snake Bite Envenoming Guideline [July 2013].

· Swan Kalamunda Health Service (Swan Health Campus) Emergency Procedures Manual Code Black [October 2011].

· Kimberley Health Region Emergency Management Policy [January 2006].

· Draft Kimberley Broome Hospital Emergency Management. Code Black: Personal Threat [September 2006].

· Kimberley Broome Hospital. Code Grey: Duress Plan System and Response [January 2006].

· Kimberley Derby Hospital Emergency Management. Section 8 Code Black Personal Threat [11 April 2011].

· Kununurra District Hospital Personal Threat Response Plan [Revised January 2011].

· Mental Health Act WA 1996 Mental Health Act WA 1996 [25 January 2011]. · Crilly, J., Chaboyer, W., Creedy, D. (2004). Violence towards emergency department

nurses by patients. Accident and Emergency Nursing, 12:7-73.

· Fems, T. (2005). Violence in the accident and emergency department - An international perspective. Accident and Emergency Nursing, 13:180-185.

· WA DoH Clinical Incident Management Policy using the Advanced Incident Management System 2006.

ACKNOWLEDGMENTS Assistance from the following organisations and individuals for their generosity of time, collaborative sharing of information, expertise and knowledge is gratefully acknowledged in the preparation of this document. In particular: · Swan Kalamunda Health Service WA. · WACHS South West - Bunbury Hospital WA. · WACHS Kimberley - Broome Hospital WA · WACHS Kimberley Derby Hospital. · WACHS Kimberley Kununurra Hospital. · Operational Managers and other members of WACHS Kimberley Regional

Executive. A special thank you to Tonia Naylor Nurse Manager Emergency Preparedness and Management Swan Kalamunda Health Service WA for her invaluable advice and collaborative sharing of documents related to Emergency (Disaster) Preparedness Response and Management.




https://healthpoint.hdwa.health.wa.gov.au/_layouts/Health.Intranet/ViewPolicyItem.aspx?ItemId=1&ItemUrl=https%3a%2f%2fhealthpoint.hdwa.health.wa.gov.au%2fpolicies%2fPolicies%2fWACHS%2fCode+Black+Procedure+-+Bunbury+Hospital.pdf&Source=https%3A%2F%2Fhealthpoint%2Ehdwa%2Ehealth%2Ewa%2Egov%2Eau%2Fpolicies%2FPages%2FPoliciesSearch%2Easpx%3Fk%3Dbunbury%2520code%2520black

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http://www.slp.wa.gov.au/legislation/statutes.nsf/main_mrtitle_580_homepage.html


CODE BLACK - PERSONAL THREAT

INTRODUCTION - PRINCIPLES A personal threat arises where there is a threat to others by an individual who is violent or threatening in manner. A personal threat may present as an unarmed or armed confrontation by an individual or group of persons. The proper management of an aggressive, agitated, violent or threatening person can decrease actual physical harm (assault). Unarmed confrontation is defined as: · Excessive noise, e.g. loud or intrusive conversation or shouting. This may include: § Threatening or abusive language involving excessive swearing or offensive remarks. § Derogatory racial or sexual remarks. § Malicious allegations relating to members of staff, other patients or visitors. § Offensive sexual gestures or behaviour.

· Wilful damage to hospital property.

· Threats or threatening behaviour.

· Verbal or physical violence. Armed confrontation is defined as: · All of the above with a weapon which includes any article that might cause injury such

as a chair, bat, IV pole, needles with/without syringes, guns and knives.

· An armed hold up is one type of armed confrontation where staff are threatened with a weapon, in order to steal property or drugs and is regarded as a significant crime.

An armed confrontation must be managed discreetly and is directed by Police if they are present. It is important to note that under no circumstances should staff, patients or visitors place themselves at risk. Hold Up is defined as: Any demand for money, personal belongings or drugs involving a personal threat situation either armed or unarmed. Response to Personal Threat A collaborative multidisciplinary approach is recognised as the most effective mechanism for averting aggression. Early management of an aggressive, agitated, violent or threatening person may decrease chance of occurrence of assaults. All staff are required to attend mandatory training. When confronted with personal threat, the best mechanism for averting aggression is for the Emergency Response (Duress) Team or staff as per local protocol (or individuals) trained in dealing with aggression to attend the scene and defuse the situation before it escalates.



Team membership will vary depending on the size of the facility but may include:

· Operations Manager (Hospital Emergency Coordinator).

· Clinical Nurse Managers/Ward Shift Coordinator.

· Clinical Nurse – Emergency Department.

· Security.

· All Purpose Orderly. Verbal de-escalation and distraction may sometimes be enough to manage the situation. This technique involves:

· Remaining calm.

· Listening to the individuals concerns in an empathic, non-confronting manner,

· Emphasising the desire to help.

· Trying to make the individual more comfortable.

· Utilising accompanying friends and relatives, if appropriate. A useful approach is to utilise the principles of LASSIE: · Listen to the problem.

· Acknowledge issues.

· Separate them.

· Seat them, Indicate options.

· Encourage compliance. Reporting of Personal Threat Situation · The alarm should be raised using a duress alarm if available and if safe to do so, by

dialling 777 (or by attracting the attention of another staff member to dial 777) state Code Black “Unarmed”, or Armed confrontation”, “Infant/Child Abduction” or “Snake” as appropriate and give your, name, title, location. Do Not hang up.

All serious personal threat (duress) situations or any involving injury to staff, patients or visitors must be documented and reported to the Operations Manager during normal hours and to the Clinical Nurse Managers/Ward Shift Coordinator on-call after hours. The following documentation is required for completion by the appropriate staff: · The Offender ID Form (Appendix A). · The WACHS Kimberley Emergency Incident Report Form (Appendix B), generally

completed by the staff member managing the incident. · A WACHS Safety Risk Report Form (Appendix C) – to be completed by all staff

affected by the Code Black and/or Employee Assistance Program can be accessed by staff seeking assistance to address psychological stress

Police are to be notified in all cases where threatening behaviour is displayed.



https://healthpoint.hdwa.health.wa.gov.au/policies/Policies/SMAHS/SMHS/SMHS%20Employee%20Assistance%20Program%20Policy%20Endorsed%200612.pdf


WACHS Kimberley supports staff who, in the event of ensuring their own safety, are unable to provide clinical care to patients. Supervisors must be informed immediately if this situation arises and the required documentation is to be completed. Duress Systems Duress strips/buttons/pendants are installed as a means of safely notifying a personal threat situation without inciting the individual causing the disturbance or placing the staff member at risk. These denote only a general duress area and should be followed by a call to 777 which will go direct to designated extensions and pagers with an automated message. Duress alarms take several forms (where fitted): · Personal Duress alarm pendant: Small plastic pendant on a lanyard with a duress

button. These are allocated to various departments and individuals within the hospital and must be worn at all times. They should not be carried in pockets as this can increase the rate of false alarms.

Duress pendants vary across the sites, some will track the person and provide the exact location of the staff member others will be limited to the area/department. Testing instructions and procedures will vary at each site depending on the type of pendant, please refer to the hospital’s pendant instructions.

· Fixed duress alarm: Button or strip fixed under desks or on walls activated by pressing the alarm. This will alert to an area only, staff will need to direct the Emergency Response (Duress) Team or staff as per local protocol on their arrival.

Response to the Duress System: · When a duress alarm is activated all staff on the Emergency Response (Duress)

Team or staff as per local protocol are to proceed immediately to the duress location point. In rare occasions a staff member may not be able to attend a duress alarm generally related to clinical priorities e.g. caring for a women in labour; “specialling” a patient.

Monitoring of the Duress System: · Monitoring will occur in a planned and programmed manner to ensure the ongoing

operation of all hardware, and required actions by response teams.

· All malfunctions/breakdowns are to be addressed as soon as practical following notification. The Operations Manager, Executive Team and staff will be notified in writing if any element of the Duress System is not working for a period of greater than two hours.

· Maintenance of the hardware will be the responsibility of the Maintenance Manager.

· Testing and reporting of faults is the responsibility of facility staff.

· All staff will receive training regarding use of duress equipment and their roles and responsibilities as a member of the Emergency Response (Duress) Team or staff as per local protocol within one month of employment. Identified “At Risk” staff are to be orientated to the system immediately on commencement of employment. If staff members have not been orientated to the duress system within one month, they must follow this up with their line manager.



· Response to all duress alarms will be monitored and reported to the Occupational Safety and Health Committee on a monthly basis by the Safety and Health representatives for the departments in which they normally work.

· Emergency Response (Duress) Team or staff as per local procedure are to have a practice session quarterly unless a more recent Duress Alarm has occurred.

Duress Pendant/Strip/Contact Button Testing: · Regular testing should be done of duress systems as per local protocols, typically

annually by maintenance staff and monthly by staff in local sites.

· The staff member testing the Duress Alarm should contact reception to send out a message on the paging system to the Emergency Response (Duress) Team or staff as per local procedure and to maintenance stating. “duress pendant test to follow, please dial 9 to acknowledge alarm”

Following this pager message, testing staff member is to press and hold the red button for two seconds.

· The duress response team are to contact reception immediately and acknowledge the alarm.

· Reception staff are to notify the testing staff member following acknowledgement of the duress response team.

· Instances of no response or faults are to be reported to the Operations Manager and Maintenance Manager immediately.

· Staff member running the duress alarm pendant testing test (usually reception staff during normal hours) is responsible for maintaining a response list and submitting this monthly to the Occupational Safety and Health Committee.

· Each facility is to regularly test all alarms (pendant/strip/button) on a rotating monthly basis so all areas are tested over a four to five week cycle as per local procedures.



CODE BLACK – PERSONAL THREAT: ACTION CARD

Title THREATENED STAFF / THREAT TO OTHERS – UNARMED CONFRONTATION

Applicable to FITZROY CROSSING HOSPITAL Location INCIDENT SITE Position Responsible STAFF MEMBER AT INCIDENT Successor in Absence Reports to HOSPITAL EMERGENCY COORDINATOR

(OPERATIONS MANAGER OR DIRECTOR/COORDINATOR OF NURSING)

Resources

Under no circumstances should staff, patients or visitors place themselves or others in further jeopardy.

Call or get assistance to call Code Black as soon as it is safe to do so.

Follow the RRRR steps when safe to do so: Raise the alarm – Remain calm – Retreat to safety – Record details.

IMMEDIATE · Raise alarm, using duress alarm (personal pendant, strip/ button under desk or on wall)

if available or when safe to do so dial 777 Code Black or attract attention of another staff member to dial 777 Code Black.

· If possible wait by phone until the Emergency Response (Duress) Team or staff as per local protocol contacts your extension to request your name and exact location and type of incident.

· If you are by yourself and doors can be closed, lock them to create a barrier between you and the threat.

· If possible manoeuvre yourself to place a physical barrier between yourself and the aggressor, e.g. a desk, bench, chair.

· If you are out of danger - stay out of danger.

· If you can leave the area safely, do so. Do not leave a colleague alone.

ONGOING · Comply with the aggressor’s instructions but only do what you are told. Do not

volunteer anything.

· Use verbal de-escalation techniques and try to keep the aggressor engaged in conversation. Let them know what you can do for them in this situation.



· Try to defuse the situation, use LASSIE: § Listen to the problem. § Acknowledge issues. § Separate them. § Seat them. § Indicate options. § Encourage compliance

· If you can leave the area safely, do so and activate a response by dialling 777 Code Black.

· If you are out of danger stay out of danger.

· Write down everything you observe when it is safe to do so prior to discussion with colleagues or other witnesses on the Offender ID Form (Appendix A) and Emergency Incident Report Form (Appendix B) when it is safe to do so.

· Report any vehicle used by the offender(s) if observed, e.g. vehicle type, colour, and registration.

STAND DOWN · Stand down will be authorised by the Hospital Emergency Coordinator. · Complete Offender ID Form (Appendix A) commence an Emergency Incident Report

Form (Appendix B) the Safety Risk Report Form (Appendix C) prior to discussion with colleagues or other witnesses and when able, complete and hand all forms to Hospital Emergency Coordinator.

· Resume normal activity.

· Attend debrief if required. MAKE NO COMMENT TO THE MEDIA – HOSPITAL EMERGENCY COORDINATOR WILL DIRECT MEDIA VIA THE WACHS COMMUNICATIONS CENTRE AND IN ABSENCE OF REGIONAL DIRECTOR IS THE MEDIA LEAD.



CODE BLACK – PERSONAL THREAT: - ACTION CARD

Title THREATENED STAFF / THREAT TO OTHERS –ARMED CONFRONTATION



Resources



Follow the RRRR steps when safe to do so: Raise the alarm – Remain calm – Retreat to safety – Record details.

IMMEDIATE · Remain calm, obey the offender’s instructions. DO NOT volunteer anything.

· Create distance and space where possible.

· If you are out of danger - stay out of danger.

· Immediately if you are able to do so, raise alarm discreetly, using duress alarm (personal pendant, button under desk or on wall) if available, dial 777 Code Black or attract attention of another staff member to dial 777.

ONGOING · Attempt verbal de-escalation with the offender.

· DO NOT attempt to disarm the offender.

· Ensure no one enters the incident area.

· Follow Police instructions once they arrive.

· Observe the offender(s) speech, mannerisms, clothing, scars and tattoos.

· Observe any vehicle used by the offender(s) vehicle type, colour and registration.

· Preserve the scene for evidence – DO NOT touch or move anything.

· Write down everything you observe when it is safe to do so prior to discussion with colleagues or other witnesses on the Offender ID Form (Appendix A) and Safety Risk Report Form (Appendix C) when it is safe to do so.



· Request witnesses to stay until Police and security arrive and approval is given to leave.

· Await debriefing instructions.


Form (Appendix B) the Safety Risk Report Form (Appendix C) prior to discussion with colleagues or other witnesses and. when able complete and hand all forms to Hospital Emergency Coordinator.






Title HOSPITAL EMERGENCY COORDINATOR (UNARMED CONFRONTATION)

Applicable to FITZROY CROSSING HOSPITAL Location INCIDENT SITE Position Responsible OPERATIONS MANAGER Successor in Absence DIRECTOR/COORDINATOR OF NURSING Reports to REGIONAL HEALTH DISASTER COORDINATOR (REGIONAL

DIRECTOR) Resources


IMMEDIATE · On notification by group page or mobile, proceed with caution to the scene as directed

by Code Black page and liaise with the Emergency Response (Duress) Team or staff as per local protocol.

· DO NOT enter the incident area alone; wait for the Emergency Response (Duress) Team or staff as per local protocol.

· Attempt verbal resolution of disturbance (if safe to do so). Use LASSIE: § Listen to the problem. § Acknowledge issues. § Separate them. § Seat them, Indicate options. § Encourage compliance.

· Notify Regional Health Disaster Coordinator (Regional Director or Executive on-call).

ONGOING · Assess situation and when appropriate issue instructions for restraints or alternative

management.

· Contact switchboard to activate the Local Emergency Operations Centre if necessary.

· Have switchboard contact External Agencies if necessary.

· Liaise with Senior Medical Officer or if unavailable, the Emergency Department Duty Medical Officer regarding medical management and initiate medical care when safe to do so if required. This may require Code Blue activation.

· If situation arose from a non-medical related incident, remain in area.



· Assess the need to involve the Police, notify switchboard to call 000 and liaise with Police on their arrival.

· Assess need to notify Hospital Executive Team.

· Assess need to evacuate incident area and review evacuation procedure in Code Orange section of this Manual.

· Ensure staff, patients and visitors remain safe.


· Assist Police with their investigations as required.

· Complete incident report and notify Hospital Executive Team.

STAND DOWN · Authorise stand down when safe to do so.

· Instruct switchboard to notify the Emergency Response (Duress) Team or staff as per local protocol of stand down by group page and by telephone to involved areas.

· Complete Offender ID Form (Appendix A) commence an Emergency Incident Report Form (Appendix B) the Safety Risk Report Form (Appendix C) prior to discussion with colleagues or other witnesses and when able, complete and hand all forms to Hospital Emergency Coordinator.

· Assist Police with investigation.


· Ensure debrief and support of involved staff (or others) is arrange. MEDIA: Arrange media briefing and prepare statement if requested by the Regional Health Disaster Coordinator. Access to WACHS Media Communications for Rural areas is 08 9222 6499 and is staffed 24 hours 7 days a week.




Title HOSPITAL EMERGENCY COORDINATOR (ARMED CONFRONTATION)


DIRECTOR) Resources


IMMEDIATE · On notification by group page, discreetly proceed to front reception and await the

arrival of the Police.

· Liaise with switchboard regarding status of confrontation (i.e. does it remain in progress, has it concluded and are there any hostages?).

· Proceed to the incident area in the company of the Police.

· Follow the instructions at the scene from Senior Police Officer.

· Proceed to incident area if notified by switchboard of offender’s exit.

ONGOING · If casualties are present, advise Emergency Department immediately post

confrontation, requesting them to await further instructions.

· Arrange for staff and equipment replacement as required.

· Assist the Police in their preliminary investigation as requested.

· Assess need to evacuate area and review evacuation procedure in Code Orange section of this Manual.

· Ensure staff complete the Offender ID Form (Appendix A) without collaboration with other witnesses.


· Ensure completion of Emergency Incident Report Form (Appendix B).


· Initiate medical care when safe to do so if required. This may require Code Blue activation.




STAND DOWN · Authorise stand down when advised by Police it is safe to do so. · Instruct switchboard to notify the Emergency Response (Duress) Team or staff as per

local protocol of stand down by group page and by telephone to involved areas.

· Complete Offender ID Form (Appendix A) commence an Emergency Incident Report Form (Appendix B) and the Safety Risk Report Form (Appendix C) prior to discussion with colleagues or other witnesses and when able, complete and hand all forms to Hospital Emergency Coordinator



· Ensure debrief and support of involved staff (or others) is arranged. MEDIA: Arrange media briefing and prepare statement if requested by the Regional Health Disaster Coordinator. Access to WACHS Media Communications for Rural areas is 08 9222 6499 and is staffed 24 hours, seven days a week.




Title CLINICAL NURSE MANAGERS/WARD SHIFT COORDINATOR (UNARMED CONFRONTATION)

Applicable to FITZROY CROSSING HOSPITAL Location INCIDENT SITE Position Responsible CLINICAL NURSE MANAGERS Successor in Absence WARD SHIFT COORDINATOR OR

MOST SENIOR NURSE ON DUTY Reports to HOSPITAL EMERGENCY COORDINATOR Resources


IMMEDIATE · Proceed with caution to the scene as directed by pager and/or mobile phone and liaise

with the Hospital Emergency Coordinator and the Emergency Response (Duress) Team or staff as per local protocol.

· Assume role of Hospital Emergency Coordinator if that person not present.

· DO NOT enter incident area alone, wait for the Emergency Response (Duress) Team or staff as per local procedure.

· Attempt verbal resolution of disturbance (if safe to do so). Use LASSIE: § Listen to the problem. § Acknowledge issues. § Separate them. § Seat them. § Indicate options. § Encourage compliance.

· Assess the need to involve the Police, notify switchboard to call 000 if not already done and liaise with Police on their arrival.

· Commence Emergency Incident Report Form (Appendix B).

ONGOING · Assess situation and when appropriate issue instructions for restraints or alternative

management.

· Liaise with Senior Medical Officer or if unavailable, the Emergency Department Duty Medical Officer regarding medical management and initiate medical care if required. This may require Code Blue activation.



· If, situation arose from a non-medical related incident, remain in area.

· Assess the need to involve the Police, notify switchboard to call 000 and liaise with Police on their arrival, assisting with their investigations as required.


· Assess need to evacuate area and review evacuation procedure as per Code Orange.


· Complete Emergency Incident Report Form (Appendix B) and notify Hospital Executive Team.





· Ensure involved staff (or others) attend debrief and receive support as appropriate. MAKE NO COMMENT TO THE MEDIA – HOSPITAL EMERGENCY COORDINATOR WILL DIRECT MEDIA VIA THE WACHS COMMUNICATIONS CENTRE AND IN ABSENCE OF REGIONAL DIRECTOR IS THE MEDIA LEAD.




Title CLINICAL NURSE MANAGERS/WARD SHIFT COORDINATOR (ARMED CONFRONTATION)

Applicable to FITZROY CROSSING HOSPITAL Location INCIDENT SITE Position Responsible CLINICAL NURSE MANAGERS Successor in Absence WARD SHIFT COORDINATOR OR

MOST SENIOR NURSE ON DUTY Reports to EMERGENCY COORDINATOR Resources


IMMEDIATE · Proceed to the front reception and await the arrival of the Police.

· Liaise with switchboard or area under threat regarding status of confrontation (i.e. does it remain in progress, has it concluded, and are there any hostages?).

· Assume role of Hospital Emergency Coordinator if that person not present.


· Follow the instructions at the scene Senior Police Officer.

· Proceed to incident area if notified by switchboard of offender’s exit.

ONGOING · Assess need to evacuate area as advised by Police and review evacuation procedure

in Code Orange section of this Manual.

· If casualties are present, advise Emergency Department immediately post confrontation, requesting them await further instructions.

· Arrange for staff and equipment replacement as required

· Assist the Police in their preliminary investigation as requested.

· Initiate medical care when safe to do so if required. This may require Code Blue activation.

· Ensure staff complete the Offender ID Form (Appendix A) prior to discussion with other witnesses.

· Ensure completion of Emergency Incident Report Form (Appendix B).




STAND DOWN

· Stand down will be authorised by the Hospital Emergency Coordinator. · Complete Offender ID Form (Appendix A) commence an Emergency Incident Report



· Ensure involved staff (or others) attend debrief and receive support as appropriate.

· Resume normal activity. MAKE NO COMMENT TO THE MEDIA – HOSPITAL EMERGENCY COORDINATOR WILL DIRECT MEDIA VIA THE WACHS COMMUNICATIONS CENTRE AND IN ABSENCE OF REGIONAL DIRECTOR IS THE MEDIA LEAD.




Title ALL PURPOSE ORDERLY (UNARMED CONFRONTATION)

Applicable to FITZROY CROSSING HOSPITAL Location INCIDENT SITE Position Responsible ALL PURPOSE ORDERLEY Successor in Absence NOT APPLICABLE Reports to HOSPITAL EMERGENCY COORDINATOR Resources


IMMEDIATE · Proceed with caution to the scene as directed by pager and liaise with the Emergency

Response (Duress) Team or staff as per local protocol.

· DO NOT enter incident area alone, wait for or staff as per local protocol.

· Await further instruction. · Assist in the restraint of individual as requested by Senior Nurse, Security Officer or

Medical Officer.

ONGOING · Liaise with Emergency Department Duty Medical Officer regarding medical

management.

· If situation arose from a non-medical related incident, remain in area.


· Assist Police (if present) with their investigations as required.

STAND DOWN


Form (Appendix B) the Safety Risk Report Form (Appendix C) prior to discussion with colleagues or other witnesses and when able complete and hand all forms to Hospital Emergency Coordinator.

· Assist Police (if present) with investigation and request witnesses to stay until Police give approval to leave.




· Ensure involved staff (or others) attend debrief and receive support as appropriate.





Title ALL PURPOSE ORDERLY (ARMED CONFRONTATION)

Applicable to FITZROY CROSSING HOSPITAL Location INCIDENT SITE Position Responsible ALL PURPOSE ORDERLEY Successor in Absence NOT APPLICABLE Reports to EMERGENCY COORDINATOR Resources


IMMEDIATE · Discreetly proceed to the front reception and await the arrival of the Police.

· Liaise with the Emergency Response (Duress) Team or staff as per local protocol regarding status of events.


· Follow the instructions at the scene from Senior Police Officer.

ONGOING · Proceed to the scene of the incident if notified of offenders exit prior to Police arrival.

· Identify key personnel for Police to liaise with.

· Await further instructions.

· Assist as required. Request all witnesses to remain until the Police arrive. Assist the Police in their investigations.

· Liaise with Emergency Department Duty Medical Officer regarding medical management.

· If, situation arose from a non-medical related incident, remain in area.


STAND DOWN






Title DIRECTOR / COORDINATOR OF NURSING

Applicable to FITZROY CROSSING HOSPITAL Location INCIDENT SITE Position Responsible DIRECTOR/COORDINATOR OF NURSING Successor in Absence CLINICAL NURSE MANAGER

OR MOST SENIOR NURSE ON DUTY Reports to HOSPITAL EMERGENCY COORDINATOR Resources

IMMEDIATE · Receive notification by internal notification system. · Consult with Hospital Emergency Coordinator, Regional Director and Senior Medical

Officer: determine if external assistance is required or if any casualties have occurred and transfer required

· Advise Hospital Emergency Coordinator of any issues requiring executive action

· Director/Coordinator of Nursing and to undertake preliminary review of clinical service activity, with a view to: § Evacuation of patients.

ONGOING · Consult regularly with Clinical Nurse Manager/Ward Shift Coordinator Senior Medical

Officer re any assistance required · Attend briefing with the Hospital Emergency Coordinator as required. · Advise and seek assistance from external agencies if required e.g. Royal Flying

Doctor Service

STAND DOWN · Attend a debrief and response plan review meeting · Assess clinical status of patients · Arrange additional counselling and support services if required for staff affected by

emergency as requested by Hospital Emergency Coordinator. MAKE NO COMMENT TO THE MEDIA – HOSPITAL EMERGENCY COORDINATOR WILL DIRECT MEDIA VIA THE WACHS COMMUNICATIONS CENTRE AND IN ABSENCE OF REGIONAL DIRECTOR IS THE MEDIA LEAD




Title SENIOR MEDICAL OFFICER / DIRECTOR OF MEDICAL SERVICES

Applicable to FITZROY CROSSING HOSPITAL Location INCIDENT SITE Position Responsible SENIOR MEDICAL OFFICER Successor in Absence EMERGENCY DEPARTMENT DISTRICT MEDICAL

OFFICER/ON CALL DISTRICT MEDICAL OFFICER Reports to HOSPITAL EMERGENCY COORDINATOR Resources



Follow the RRRR steps when safe to do so: Raise the alarm – Remain calm – Retreat to safety – Record details

IMMEDIATE · Receive notification by internal notification system. · Consult with or Clinical Nurse Managers/Ward Shift Coordinator: determine if external

assistance is required · Advise Hospital Emergency Coordinator and Regional Medical Director of any issues

requiring executive action · Provide clinical status report

ONGOING · Consult regularly with Hospital Emergency Coordinator, Regional Medical Director

and Clinical Nurse Managers/Ward Shift Coordinator re any assistance required · Attend briefing as required. · Advise and seek assistance from external agencies if required e.g. Royal Flying

Doctor Service

STAND DOWN · Stand down will be authorised by the Emergency Coordinator. · Complete Offender ID Form (Appendix A) commence an Emergency Incident Report




· Resume normal activity. · Attend debrief if required

MAKE NO COMMENT TO THE MEDIA – HOSPITAL EMERGENCY COORDINATOR WILL DIRECT MEDIA VIA THE WACHS COMMUNICATIONS CENTRE AND IN ABSENCE OF REGIONAL DIRECTOR IS THE MEDIA LEAD




Title REGIONAL HEALTH DISASTER COORDINATOR

Applicable to ALL HOSPITALS

Location LOCAL EMERGENCY OPERATIONS CENTRE

Position Responsible REGIONAL DIRECTOR

Successor in Absence NOMINATED REGIONAL EXECUTIVE MEMBER

Reports to CHIEF OPERATIONS OFFICER

Resources

IMMEDIATE · Liaise with the Hospital Emergency Coordinator at the hospital site to confirm alert and

receive briefing on severity and nature of the Code Black. · Notify Chief Operating Officer and Regional Executive members of the Code Black

and convene meetings as appropriate. · If required establish the Local Emergency Operations Centre and liaise with external

organisations if large scale evacuation possibly necessary. · Send an initial report to the WA Health Department On Call Duty Officer (08) 9328

0553 [email protected]

ONGOING · Continue to liaise with the Hospital Emergency Coordinator and receive information

(e.g. progress of the Code Black, evacuation and details of patients who may need relocating).

· Determine any resource requirements required from State Health sources or elsewhere based on reports from Hospital Emergency coordinator.

· Arrange briefing to external agencies if involvement required delegating to other senior staff as appropriate e.g. Regional Medical Director through to Royal Flying Doctors Service to coordinate patient evacuations.

· Update WA Health Department On Call Duty Officer and Chief Operating Officer as appropriate regarding assistance required.

· Support and provide assistance as necessary.

STAND DOWN · Receive reports on any service interruptions from Hospital Emergency Coordinator

and inspect incident site(s) as appropriate. · Notify WA Health Department On Call Duty Officer and Chief Operating Officer of

Stand Down Code Black status.


mailto:[email protected]


· Coordinate a debrief and Code Black plan review meeting as necessary with Hospital Emergency Coordinator, Regional Executive members and any other staff as appropriate.

· Arrange additional counselling and support services if required for staff affected by emergency as requested by Hospital Emergency Coordinator.

MEDIA: Arrange media briefing and prepare statement as appropriate. Access to WACHS Media Communications for Rural areas is 08 9222 6499 and is staffed 24 hours 7 days a week.



CODE BLACK: ALPHA (INFANT/CHILD ABDUCTION)

INTRODUCTION - PRINCIPLES Any person can be abducted. Infants and/or children are the most vulnerable to be abducted. To minimise the risk of abduction, staff are to adhere to existing simple security precautions:

· Ensure all visitors to infants and/or children are identified.

· Staff are to wear an official hospital identification badge with: § photo of staff member § title and name. § the organisation's logo.

· Ensure security doors are kept shut (e.g. swipe card access doors). To protect an infant or a child, staff members need to inform and orientate parents and visitors to the facility security procedures:

· Never leave an infant or a child unattended i.e. in their room.

· Ensure infant or a child is in a secure nursery or ward when leaving the ward etc.

· Parents and or visitors are required to return the infant or a child to the nursery on leaving the ward.

· Report to a staff member on leaving and/or returning to the ward. Staff are to be vigilant and report immediately unusual suspicious behaviour displayed by an individual(s) this includes but is not limited to:

· Repeated visits “just to see” or “hold” the infant or a child.

· Inquiries about hospital (facilities) procedures, floor lay out and staff numbers.

· Curiosity about issues such as uniforms or other means of identification of staff. Staff once alerted to suspicious behaviour or possible abduction will check the location of the infant or a child and ensure that they are placed with their mothers/parent(s) or other staff. If the infant or a child is not located a rapid sweep of the immediate vicinity is performed and the situation is reported to the Clinical Nurse Managers/Ward Shift Coordinator. The immediate responsibility lies with the Clinical Nurse Managers/Ward Shift Coordinator on duty to notify via switchboard the Emergency Coordinator and the Emergency Response (Duress) Team or staff as per local procedure.



When an infant or a child is abducted, one of the best methods of recovery is to make an immediate announcement so that staff can begin searching the building. This procedure includes checkpoints at all entrances and exits, stopping all people with infants or children and asking them for identification. Abduction is the only Code Black announced over the Public Address system (where available) It is important to note that under no circumstances should staff, mother / partner, visitors place themselves or the infant at risk. Principles – Abduction (Actual or suspected event) · Respond appropriately and rapidly to secure the ward and hospital perimeter.

· Call a Code Black – Alpha as soon as staff are aware of the event.

· Obtain clear description of the event from witnesses. · Provide at all times privacy and monitor the condition of the parent(s). · All relevant staff should be briefed immediately. · Ensure staff are posted at exit points and have visitors exit through one designated

exit from the ward and the hospital site. · Ensure a thorough search of the ward is undertaken. · Secure the scene where the infant or a child was last sighted to preserve any evidence

for the Police. · Initiate an extensive search of hospital site (campus) and grounds assisted with a

detailed current description of the missing infant or a child for accurate identification · Staff assist Police inquires and must not leave the ward. · Notify surrounding health care facilities and the Emergency Department of an infant or

a child missing and possible abduction. Provide a detailed current description of the missing infant or a child for accurate identification.

· Activate the Emergency Operations Centre and notify all staff. Principles – Communication/ Media · Ensure all relevant current information is provided along the internal chain of

command to or from the activated Local Emergency Operation Centre.

· ONLY the dedicated media spokesperson is to talk with the media. · Engage the services of WACHS Communications to affirm appropriate media release.

The Rural Media assistance contact is 08 9222 6499 staffed 24 hours 7 days a week

· Ensure all information on the abduction is cleared by the Regional Health Disaster Coordinator (Regional Director) – Kimberley or Hospital Emergency Coordinator (Operations Manager) and Police before being released.

· If necessary ensure a “hotline” for incoming calls is set up at the switchboard or other designated area.

· Ensure privacy for the parents /carer where possible.



CODE BLACK: ALPHA (INFANT/CHILD ABDUCTION) ACTION CARD

Title PERSON FINDING INFANT/CHILD MISSING



Resources



IMMEDIATE · Raise alarm using duress alarm (personal pendant, button under desk or on wall) if

available or when safe to do so dial 777 Code Black or attract attention of another staff member to dial 777.

· DO NOT TOUCH OR MOVE ANYTHING.

ONGOING · If the offender has been observed document on the Offender ID Form (Appendix A)

Assist with search of building for missing infant/child as directed.

· Write down everything you observe when it is safe to do so prior to discussion with colleagues or other witnesses on the Offender ID Form (Appendix A) and Emergency Incident Report Form (Appendix B) when it is safe to do so.

· Report any vehicle used by the offender(s) if observed, e.g. vehicle type, colour, registration etc.

· Assist Police (if present) and security.



STAND DOWN








Title HOSPITAL EMERGENCY COORDINATOR


DIRECTOR) Resources


IMMEDIATE · On notification of page Code Black – Alpha (Abduction) proceed to the area and seek

confirmation of incident from senior staff member at the incident scene.

· On confirmation use Public Address system (where available) at switchboard (or Fire Indicator Panel) and state. “ATTENTION, ATTENTION Code Black Alpha. Senior staff, please control all entry and exit points in your area, allow ONLY emergency services personnel to enter or exit. Area Wardens, Stand By for further instructions” and repeat.

· Stay at the Public Address system (where available) to communicate instructions.

· Instruct switchboard to call 000 Police.

ONGOING · Maintain communication with Clinical Nurse Manager or Director of Nursing.

· Assess situation and liaise with the Emergency Response (Duress) Team or staff as per local protocol regarding medical management if any person is injured and initiate medical care if required; this may require Code Blue activation.


· Contact Regional Health Disaster Coordinator (Regional Director or Executive on-call).


· If requested by the Regional Health Disaster Coordinator activate: § Emergency Operations Centre. § WebEOC (if available). § Notify State Health Incident Command by contacting the On-call Duty Officer.




STAND DOWN

· Stand down will be authorised by the Emergency Coordinator. · Complete Offender ID Form (Appendix A) commence an Emergency Incident Report



· Attend debrief if required. MEDIA: Arrange media briefing and prepare statement if requested by the Regional Health Disaster Coordinator. Access to WACHS Media Communications for Rural areas is 08 9222 6499 and is staffed 24 hours 7 days a week.




Title CLINICAL NURSE MANAGERS/WARD SHIFT COORDINATOR

Applicable to FITZROY CROSSING HOSPITAL Location INCIDENT SITE Position Responsible CLINICAL NURSE MANAGER Successor in Absence WARD SHIFT COORDINATOR OR

SENIOR NURSE ON DUTY IN SMALLER SITES Reports to DIRECTOR/COORDINATOR OF NURSING Resources


IMMEDIATE · Ensure last known location of infant or a child is preserved and DO NOT TOUCH OR

MOVE ANYTHING. · Obtain description of infant or a child and abductor from ward staff and witnesses.

· If the abductor has been observed ensure an Offender ID Form (Appendix A) has been completed.

ONGOING · Provide a description of the infant/child and abductor to the Emergency Response

(Duress) Team or staff as per local protocol and Police.

· Provide details of any vehicle that may have been used (if seen) – registration, colour, make, type etc.

· Take direction from the Hospital Emergency Coordinator, Senior Clinical Staff Member or Police if present.

· Assist Police with their investigations if in attendance.

· Allocate staff to support family/guardians of abducted infant or a child.

· Allocate staff to support other family/guardians present at the scene.

· Consult with Emergency Coordinator and request where possible all witnesses to remain until the Police arrive. Ask witnesses to fill in the Offender ID Form (Appendix A) and Emergency Incident Report Form (Appendix B) prior to discussion with other witnesses when able and hand to Hospital Emergency Coordinator.

· Obtain details of any vehicle that may have been used (if seen).



STAND DOWN

· Stand down will be authorised by the Emergency Coordinator following advice from Police if present.

· Complete Offender ID Form (Appendix A) commence an Emergency Incident Report Form (Appendix B) the Safety Risk Report Form (Appendix C) prior to discussion with colleagues or other witnesses and when able, complete and hand all forms to Hospital Emergency Coordinator.



· Attend debrief as appropriate. MAKE NO COMMENT TO THE MEDIA – HOSPITAL EMERGENCY COORDINATOR WILL DIRECT MEDIA VIA THE WACHS COMMUNICATIONS CENTRE AND IN ABSENCE OF REGIONAL DIRECTOR IS THE MEDIA LEAD.




Title REGIONAL HEALTH DISASTER COORDINATOR

Applicable to FITZROY CROSSING HOSPITAL

Location LOCAL EMERGENCY OPERATIONS CENTRE Position Responsible REGIONAL DIRECTOR Successor in Absence NOMINATED REGIONAL EXECUTIVE MEMBER Reports to CHIEF OPERATIONS OFFICER Resources

IMMEDIATE · Liaise with the Hospital Emergency Coordinator at the hospital site to confirm alert and

receive briefing on severity and nature of the Code Black Abduction. · Notify Chief Operating Officer and Regional Executive members of the Code Black

Abduction and convene meetings as appropriate. · If required establish the Local Emergency Operations Centre and liaise with external

organisations if large scale evacuation possibly necessary.

ONGOING

· Continue to liaise with the Hospital Emergency Coordinator and receive information (e.g. progress of the Code Black Abduction e.g. search for abducted infant/child).

· Determine any resource requirements required from State Health sources or elsewhere based on reports from Hospital Emergency coordinator.

· Arrange briefing to external agencies if involvement required delegating to other senior staff as appropriate e.g. Regional Medical Director through to Royal Flying Doctors Service to coordinate patient evacuations.

· Update Chief Operating Officer as appropriate regarding assistance required. · Support and provide assistance as necessary.

STAND DOWN

· Notify Chief Operating Officer of Stand Down Code Black status. · Coordinate a debrief and Code Black plan review meeting as necessary with Hospital

Emergency Coordinator, Regional Executive members and any other staff as appropriate.

· Arrange additional counselling and support services if required for staff affected by emergency as requested by Hospital Emergency Coordinator.

MEDIA: Arrange media briefing and prepare statement as appropriate. Access to WACHS Media Communications for Rural areas is 08 9222 6499 and is staffed 24 hours, seven days a week.



CODE BLACK S: SNAKE

INTRODUCTION - PRINCIPLES Snakes are reptiles, they are cold blooded, have scales and breathe air and are most active during hotter weather.

· During the Wet Season from October to April snake sighting are most common around gardens, inside buildings and the bushland. However Sea snakes are active most of the year and prefer shallow waters near land and sheltered waters and near estuaries.

· Snakes generally are timid and mild tempered and will attack if provoked or trapped. The best offence against snakes is to leave them alone, remove people from the area and call for assistance usually a snake handler.

· Snakes are part of our natural heritage and should not be unnecessarily exterminated or provoked.

· There are four families of land snakes present in the Kimberley; File snakes (one species), Pythons (eight species), Colubrid snakes (six species) and venomous Land snakes (23 species) and Sea snakes (22 species).

· The venomous snakes range from weak to potential deadly for humans. Venom is injected by two syringe like fangs at the front of the mouth.

· Hospitals in the Kimberley carry stocks of appropriate antivenin which neutralises snake venom when promptly administered (refer to WACHS Snake Bite Envenoming Guideline).





CODE BLACK S: SNAKE: ACTION CARD

Title PERSON FINDING A SNAKE

Applicable to FITZROY CROSSING HOSPITAL Location INCIDENT SITE Position Responsible STAFF MEMBER AT INCIDNET Successor in Absence Reports to HOSPITAL EMERGENCY COORDINATOR


Resources Under no circumstances should staff, patients or visitors place themselves or others

in further jeopardy by attempting to catch the snake. Call or get assistance to call Code Black as soon as it is safe to do so.

IMMEDIATE · Staff member who discovers a snake contact switchboard if possible, dial 777 and

activate Code Black. State: “Code Black Snake and state location of incident”.

· If you need to observe the snakes activity and position attract the attention of another staff member to raise the alarm, dial 777.

ONGOING

· If the snake is in the open leave it and observe and note the location. · If the snake moves into a garden or close to buildings note the location. · Erect signs if safe to do so in the area to warn others. · Confine the snake if the snake is in an area that can be secured e.g. cupboard. · Erect warning sign to keep people away from the vicinity of the snake. · Await the arrival of the Emergency Response (Duress) Team or staff as per local

protocol. · Provide information to the Emergency Coordinator on location and observed details of

the snake.

STAND DOWN

· Stand down will be authorised by the Hospital Emergency Coordinator once the impact of the code has resolved.

· Complete Emergency Incident Report Form (Appendix B) prior to discussion with colleagues or other witnesses when able and hand to Emergency Coordinator.



· Review procedure and provide report as required.





CODE BLACK S: SNAKE: ACTION CARD

Title HOSPITAL EMERGENCY COORDINATOR


DIRECTOR)

Under no circumstances should staff, patients or visitors place themselves or others in further jeopardy by attempting to catch the snake.

IMMEDIATE · On notification of page Code Black Snake proceed directly to location and seek

confirmation of incident from senior staff member at the incident scene.

· View current list of local snake catches.

· Assess the need to request assistance from a Snake Handler.


ONGOING · Contact switchboard dial Contact switchboard dial 777 Code Black Snake state “Code

Black Snake and state location of incident”

· Instruct switchboard to telephone affected areas with information on the snake location.

· Emergency Coordinator directs switchboard to request the contact number of a “Snake Handler” Dial 777 state: “Please contact Snake Handler (location of incident) and get back to me with details”.

STAND DOWN

· Authorise Stand down when the incident is resolved. · If standing down the Code:

· Instruct switchboard to send page to the Emergency Response (Duress) Team or staff as per local protocol. Code Black Snake: Stand Down (state location of incident).

· Instruct switchboard to telephone affected areas to notify all clear.



Complete Emergency Incident Report Form (Appendix B) and when able and hand to Emergency Coordinator.


· Arrange debrief of staff as required. MEDIA: Arrange media briefing and prepare statement if requested by the Regional Health Disaster Coordinator. Access to WACHS Media Communications for Rural areas is 08 9222 6499 and is staffed 24 hours 7 days a week.



APPENDIX A:

OFFENDER ID FORM

Separate form required for each person. To be completed immediately after incident by each staff member, also visitor(s) or patient(s) if possible. Please circle or write response as applicable. Do not guess - if you are not sure about any aspect leave blank. DO NOT consult others when completing this form.

Surname: First Name:

Address: Postcode:

Home Phone No: Bus Phone:

Name/Nickname Used: Teeth: Good / Spaced / Uneven / Bad / Missing / Protruding

Sex: Male / Female Estimated Age:

Race: Moustache: Yes / No

Colour: _________________________________

Type:___________________________________

Height: Metres_____ Cm_____ / Feet_____ Inches_____

Weight: Kg:________ Stn/Lbs:__________ Build:

Thin / Solid / Medium / Obese Beard: Yes / No

Colour: _________________________________

Type:___________________________________

Stature: Erect Slouched Stooped

Voice: Soft/ Clear/ Slangy/ Accented/ Loud/ Slurred

If Accented – State Type ________________________ Hair: Colour:_________________________________

Medium / Wavy / Thin / Short / Straight / Thick / Normal / Thick / Long / Curly / Bald

Eyes: (Colour) _____________________ (Size) _____________________ Squint Starry

Hands: Size: ____________ Missing Or Deformed Fingers:_________________ Hairy Soft Callused Gloves: Yes / No

Spectacles: Yes / No Frame Colour: _______________

Thick / Tinted / Bifocal

Nails: Short / Long / Medium / Bitten Walk: Normal / Limp / Pigeon Toe / Quick / Springy Complexion: Fair / Fresh / Pale / Suntan / Pimply / Freckled / Dark / Ruddy Ears: Shape________ Size________

Nose: Shape________ Size________ Disguise:

Mouth: Shape________ Size________

Other Distinguishing Features:

Scars or Marks (Tattoos, Scars, Skin Discolouration, Location, etc.) Describe In Full:

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________



Jewellery (describe) ______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

Clothing (including Hat, Tie, Shirt, Coat, Trousers, Dress, Skirt, Sweater, Shoes, etc.):

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

Weapon (Type): ______________________________________________________________________________________

______________________________________________________________________________________

Method and Direction of Escape:

______________________________________________________________________________________

______________________________________________________________________________________

Make of Car:______________________________

Model of Car:______________________________

Registration_________________________________

Colour _____________________________________

Method of Operation (What did the offender do, say, touch, etc.?):

Name: ________________________________ Signature: ___________________ Date: _____________ Time: ________



To be completed in an emergency situation by the Hospital Emergency Coordinator. Please complete both sides.

Broome Derby Fitzroy Crossing Halls Creek Kununurra Wyndham

Date: Time alarm raised:

Location of emergency: Time code called: þ Colour Code Called RED* BLUE (complete

MRK179) PURPLE* BLACK* (complete Safety Risk Report

form from for armed or unarmed incidents) ORANGE* YELLOW* BROWN* CBRN*

(Chemical, Biological, Radiological, Nuclear)

*specify type of emergency: _________________________________________________ Hospital Emergency Coordinator (HEC) Time Notified Time of arrival on site

HEC Notified

Emergency Services Fire & Emergency Services (FESA)

Police

Ambulance

Other Services (please specify)

APPENDIX B

WACHS KIMBERLEY EMERGENCY INCIDENT REPORT



Date/Time Record of Events and Actions Taken By Whom?



TIME CODE STOOD DOWN @____________HRS DEBRIEF / COMMENTS / EVALUATION:

RECOMMENDATIONS:

OUTCOMES:

PRINT NAME

Signature of person completing report Date

FORWARD COMPLETED REPORT TO OPS MANAGER DERBY (Exec Sponsor Emergency & Disaster Management)



APPENDIX C: SAFETY RISK FORM WACHS Safety Risk Report Form (Electronic version) Required information delineated below:

NOTE:

· Any staff member affected or injured as the result of a Code Black must fill out a WACHS Safety Risk Report Form (additional information can be added at Part E below)

· All staff must be made immediately aware of the Employee Assistance Program.






Part E – ADDITIONAL INFORMATION (Insert or refer to additional information here)
