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Disaster Casualty Processing Procedures

I Admissions
A. The Patient Tracking Officer will update the inpatient status board in the Incident Command Center.  Based upon this information, the Operations Section Chief will determine the extent and areas to which patients may be consolidated in order to make room for anticipated casualties.

B. Patients may be admitted from the Triage Area or from one of the Disaster Treatment Areas.  In either case, after it is determined to which nursing unit a patient is to be admitted, a bed assignment will be entered on the Disaster Tag prior to transferring the patient from the Triage Area or Disaster Treatment Area to a unit.

C. A regular patient chart will be maintained on all patients after arrival to the unit. 

D. As soon as the situation permits, or when directed, Admitting Clerks will go to the floors and locate the emergency admissions.  Necessary data will be obtained and taken to the Admitting Office where regular procedures will be completed and information checked against copies of the Disaster Tag.

E. Upon completion of admission procedures, the Admitting Clerk will take the appropriate forms to the unit and attach ID bracelets to the patients. At this time, the Disaster Tag may be removed from the patient's wrist and attached to the patient's chart.

F. Health Information Management will maintain a separate file of casualty treatment tags, as well as their normal record procedures.

NOTE: Infectious patients will be cohorted on 2-South to the greatest extent permitted by the circumstances.

II Identification and Registration: 
Disaster Tags (DT) and ID bracelets will be used to identify             casualties, and record treatment received up to the time of inpatient hospital admission. The DT is a pre-numbered, four-part tag filled out when the casualty victim first arrives at the Triage Area. A supply of these forms is included in the pre-positioned Triage Area clerical kit.

A. While the Triage Nurse is examining a patient, an Admissions Clerk will complete as much of the DT as possible. The first two copies of the DT will be given to the Registration Clerk. The hard copy will be secured to the patient's right wrist. The hard copy will not be removed from the patient until completion of treatment and release, or until completion of admission procedures.
B. The Registration Clerk will forward a copy of the DT to Admitting.  On the basis of information contained in the DT, the Registration Clerk will maintain a Victim Registration Log. The Victim Registration Log will be prepared in duplicate, and will list each person received in the Triage Area:
1.  Disaster Tag (DT) Number
2.  Date and Time
3.  Name and Address
4.  Method of Arrival
5.  Diagnosis
6.  Disaster Treatment Area to which sent

C. After necessary data has been transferred to the Victim Registration Log a copy is then forwarded to the Incident Command Center.  Every hour the original of the Victim Registration Log will be sent to the Incident Command Center, and the duplicate copy retained. A new log will be started at that time.
D. Treatment received by a patient at a Disaster Treatment Area will be entered on the treatment record (back of hard copy).  If the patient is released from a Disaster Treatment Area, the DT is sent to Medical Records.  If the patient is sent to the floor for admission from the Emergency Treatment Area, the DT will not be removed until replaced with a regular hospital ID bracelet by an Admitting Clerk, at which time the DT becomes part of the patient's chart.

III Valuables: 
Processing and treatment of casualties will not be delayed for the sole purpose of collecting and safeguarding valuables.

A. The Triage Area clerical kit contains a supply of pre-numbered receipts and envelops for use in collecting, inventorying and safeguarding valuables. Normally the Registration Clerk will perform this function in the Triage Area.
B. After being inventoried and listed, valuables will be placed in the appropriate 
envelopes and sealed.  If able to do so, the patient shall sign the form.  If the patient is unable to sign, the inventory shall be witnessed by a second party (hospital employee) who shall sign on the patient's behalf.
C. The patient's Disaster Tag number will be recorded on the receipt and envelope forms. The valuables receipt will be stapled to the DT (hard copy).
D. The sealed envelope, containing the patient's valuables, will be delivered to Admitting for placement in hospital safe.