Before the hospital can receive casualties, it must be determined whether the hospital itself has sustained any structural damage or loss of utility as a result of a disaster. Such damage may include blocked passageways; inoperable elevators; potential for fire, explosion, or building collapse; failure of any utility; loss of equipment and/or supplies, including oxygen; contamination of water; and outside access problems. Damage assessment is usually the responsibility of the plant safety officer or hospital engineer. If the structural integrity of the hospital has been compromised, it may be necessary to evacuate staff and patients. 16
Once it is ascertained that the hospital itself is safe, the hospital must determine how many casualties from the disaster site it can safely manage. This capacity may be limited by available personnel, beds, and supplies as well as by the type of disaster and the availability of other community resources. At the time of disaster notification, it is necessary to know the status of many of the hospital's capabilities, including how many beds are available, how much blood is available, how many personnel are on duty, what damage has been done, how many operating rooms are in use, and which doctors are present. Either someone must tour the hospital to accumulate this information or a form for reporting it must be available in each department ahead of time.
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