Faculty of Medicine, Mansoura University

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Faculty of Medicine, Mansoura University Disaster
Plan for H1N1 Pandemic By
Prof. Nabil El-Morshedy Prof. Raof El-Nafees Dr.
Abdel Baset Saleh Faculty of Medicine, Mansoura
University
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Current Mansoura University Hospitals Capability

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Current Mansoura University Hospitals
CapabilityPhase 1
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???????)(Stuff) Total Beds
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ICU Stuff (Medical Equipments)
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Staff (Trained Doctors Personels)
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Current Mansoura University Hospitals
CapabilityPhase 2
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??????? ???????)(Stuff) Total Beds
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Stuff (Medical Equipments)
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Staff (Trained Doctors Personels)
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Current Mansoura University Hospitals
CapabilityPhase 3
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??????? ???????(??????? ??????)(Stuff) Total
Beds
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Stuff (Medical Equipments)
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Staff (Trained Doctors Personels)
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Current Mansoura University Hospitals
Capability3 Phases

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Suggested Resources Equipments

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  (CPAP, BiPAP)
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• Masks, Fluid Pump, End tracheal tube Drugs

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Suggested Resources Equipments

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Current Mansoura University Hospitals
CapabilityPhase 4
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Suggested Resources Equipments
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Suggested Framework for Critical Care Management
During Disaster
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Green
Yellow
Red
Black

Go Home
- No clinical symptoms or signs of Flu - No
Hx of contact to confirmed cases
Psychiatric consultation
White
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MUHs wards
Green
Yellow
Red
Black

- Clinical symptoms and signs of Flu or
Pneumonia - Hx of contact to confirmed cases
- No need for ICU admission
White
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Respiratory and Surgical ICUs

• Three of the following
• Respiratory rate 30 breaths/min
• PaO /FiO ratiob 250
• Multilobar infiltrates
• Confusion
• Uremia
• Leukopeniac
• Thrombocytopenia
• Hypothermia Hypotension

• One of the following
• Respiratory failure with Invasive mechanical
  ventilation
• Septic shock with the need for vasopressors fluid
  resuscitation

Green
Yellow
Red
Black

- No clinical symptoms and signs of Flu -
Hx of contact to confirmed cases - Need for ICU
admission
EH ICU
White
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Respiratory and Surgical ICUs
Green
Yellow
Red
Black

- Hx of Flu symptoms - Hx of contact to
confirmed cases - Died outside hospital
White
Morgue
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Respiratory and Surgical ICUs
Green
Yellow
Red
Black

- Hx of Flu symptoms - Hx of contact to
confirmed cases - Died inside hospital
White
Morgue
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Mansoura University Hospitals (Triage)
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This document provides a mechanism of triage and
process for allocation of scarce resources are
exhausted and not even EMCC can be provided for
all
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All Mansoura University Hospitals Centers must
operate uniformly and cooperate in order to
successfully implement a triage process when
resources are scarce and/or unavailable
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Therefore, training and familiarity with the
triage and allocation process will be vital.
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• Potential triggers to initiate MUH Triage
• Lack of critical equipment
• Mechanical ventilators
• Beds
• Medical gases (oxygen)
• Antibiotics
• Vasopressors
• Crystalloid
• Operating room equipment

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• Potential triggers to initiate MUH Triage
• Lack of critical infrastructure
• Security
• Isolation ability
• Personal protective equipment
• Decontamination equipment
• Power
• Staff support (food, housing, medication)

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• Potential triggers to initiate MUH Triage
• Inability to transfer patients to another
  facility (alternate care site, hospital) that
  limits ability to perform clinical care
• Lack of specially care
• Lack of adequate staff

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Research Analysis
Outcome monitoring
Supply/Demand Situation awareness
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Thank You