Victorian State health emergency response plan (SHERP)

see also:

• Vic. State Health Emergency Response Plan SHERP official website
• disaster medicine
• Victorian medical assistance teams for disaster Mx (VMAT)
• there are other Victorian plans or gudelines available to assist SHERP:
  • Communicable Disease Incident and Emergency Operational Response Plan
  • Food Incident and Emergency Operational Response Plan
  • Water Incident and Emergency Operational Response Plan
  • CBRNE Incident and Emergency Operational Response Plan
  • Epidemic Thunderstorm Asthma Preparedness and Operational Response Plan
  • Ambulance Victoria Emergency Response Plan
  • ESTA Critical Incident Response Plan (CIRP)
  • Heat Health Plan for Victoria (2015)
  • State Smoke Framework (2016)
  • Victorian Medical Assistance Team (VMAT) Policy (2015)
  • Victorian Medical Assistance Team Protocol (2016)
  • DHHS Public Information and Warnings Business Rules and Decision‑making Guide (2017)
  • DHHS First Wave Notification
  • Epidemic Thunderstorm Asthma Warnings Protocol
  • Guidelines for multiple burns casualties (2015)
  • Victorian health management plan for pandemic influenza (2014)
  • Mass Casualty and Pre-hospital Operational Response Plan
  • Additional Capability and Capacity Operational Response Plan
  • Regional Health Emergency Operational Response Plan
  • Public Events and Mass Gatherings Guidelines
  • Code Brown Guidelines
  • Emergency Incident Casualty Data Collection Protocol
  • Key Function Descriptions
  • Primary Health Networks Guidelines
• there are national plans available to assist SHERP:
  • AEMA
    • The Australian Emergency Management Arrangements, which provide an overview of how Commonwealth, state, territory and local governments collectively approach the management of emergencies, including catastrophic disaster events.
  • AHMPPI
    • The Australian Health Management Plan for Pandemic Influenza, a national health plan for responding to an influenza pandemic based on international best practice and evidence. It outlines the measures that the health sector will consider in response to an influenza pandemic. This plan may call on elements of SHERP4 in support.
  • AUSASSISTPLAN
    • Outlines the coordination arrangements for the provision of Australian Government assistance, be it financial, technical or physical, to an overseas disaster in countries eligible for official development assistance (ODA) as well as for non ODA countries.
  • AUSTRAUMAPLAN
    • Provides an agreed framework and mechanisms for the effective national coordination, response and recovery arrangements for mass casualty incidents of national consequence resulting from trauma. Includes the Severe Burn Injury annex (AUSBURNPLAN).
  • COMDISPLAN
    • Coordination arrangements for the provision of Australian Government physical assistance to states and territories in the event of a disaster where the jurisdiction’s own resources are exhausted or unavailable.
  • NatHealth arrangements
    • The National health emergency response arrangements, which direct how the Australian health sector (incorporating state and territory health authorities and relevant Commonwealth agencies) would work cooperatively and collaboratively to contribute to the response to, and recovery from, emergencies of national consequence.
  • National arrangements for mass casualty transport
    • The national arrangements to plan for and coordinate medical transport within Australia in response to a mass casualty event.
  • NATCATDISPLAN
    • Describes the national coordination arrangements for supporting states, territories and the Commonwealth governments in responding to and recovering from catastrophic natural disasters in Australia.
  • National counter terrorism plan
    • This plan outlines responsibilities, authorities and the mechanisms to prevent (or if they occur, manage) acts of terrorism and their consequences within Australia.
  • OSMASSCASPLAN
    • The National response plan for mass casualty incidents involving Australians overseas, which details the primary response arrangements to overseas incidents involving Australian nationals and other approved persons.

• two key lines of communications within SHERP:
  • ‘health command’ in the pre-hospital environment
  • ‘health coordination’ (hospital / health service coordination) as a function of the Department of Health coordinating health and aged care services
• incident control is at 3 levels:
  • local incident tier at the site
    • Incident controller
      • Incident Health Commander (prehospital) - a nominated ambulance manager
        • will form an Health Incident Management Team (I-HIMT) composed of themselves and Hospital Commanders from affected facilities
      • Hospital Commander (health services) - the local hospital CEO or delegated member of staff
        • 1 or 2 Hospital Incident Management Team(s) (HoIMT)
          • planning
          • operation
          • logistics
          • see also:
            • Field Emergency Medical Officer (FEMO) program
            • Victorian medical assistance teams for disaster Mx (VMAT)
  • regional incident tier
    • Regional controller
      • Regional Health Commander (prehospital) - a rostered ambulance manager
        • will form a Regional tier HIMT (R-HIMT)
      • Regional Health Coordinator (health services) - the relevant Director Health and Aged Care or their authorised delegate
  • state incident tier:
    • State health and medical commander:
      • State Health Commander (prehospital)
      • State Health Coordinator (health services) ph: 1300 790 733
• incident notification mechanisms:
  • public health incident (eg. communicable disease outbreak)
  • from AV where increased number of calls occur
  • health system demand (eg. Code Brown activation, ED demand, increased volume of GP presentations)
  • other systems such as terrorism control agency
• incident management levels:
  • level 1
    • medium impact on normal operations; resolved through use of local or initial response resources
  • level 2
    • major impact on normal operations; more complex management of emergency response in size, resources or risk
  • level 3
    • severe impact on normal operations; complexities requiring substantial management of response
• incident notification format:
  • Exact location
  • Type of incident
  • Hazards
  • Access and egress
  • Number of patients
  • Emergency services at scene or required
• incident health impact level
  • depends upon:
    • geographical scale
    • severity of illness or injury
• document all events and decisions
  • maintain a date and time record of all actions, requests and decisions made
• The Control Agency has the responsibility to manage community information
  • Health personnel at the incident site should not speak to the media or release any information
  • about casualties. The Controller is responsible for all media management.
  • The chief executive officer or their delegate is responsible for coordinating media management for each health service.

• this power is given under Section 23(1) the Emergency Management Act 1986 and can be declared if there is a reasonable possibility of significant and widespread danger to life or property in Victoria.
• this generally applies to a defined region of the state in disaster situations
• this allows the Government to:
  • formally evacuate townships and areas
  • take possession of private property to respond to the emergency
  • control movement in and out of a declared disaster area
  • direct any of its agencies to perform or stop performing “any function, power, duty or responsibility”
  • arrest people who refuse to evacuate or follow police orders

• safety
  • all health responders are responsible for their own personal safety and, where possible, that of people under their care. Each agency or organisation is also responsible for ensuring the safety of their personnel and people under their care.
• disaster response triage
  • red: priority 1 for transport, move to a casualty clearing post
  • yellow: priority 2 for transport, move to a casualty clearing post
  • green: walking wounded, priority 3 for transport, move to a casualty clearing post or possible discharge from scene
  • grey: uninjured survivor may need psychological support; move to a relief centre
  • black: deceased; no treatment; leave in-situ at scene for Coronial investigation
• casualty clearing point located safely away from hazard and with plenty of space

• as per State major trauma and burns protocols
• redirect lower acuity cases in ED to primary healthcare (GPs)
• Code Brown external disaster called
  • at WH: Code Brown (mass casualty) Plan (docx)