Activities - Health Risk
The health risk emerges every time critical situations possibly affecting human health are created. Difficult to foresee, it can be mitigated by preparing and planning medical assistance in emergencies beforehand, in a quieter period. In the chain of medical assistance during catastrophes, the Department only acts if the local organizations are unable to deal with the event with their own resources.
The Department has outlined the “General criteria for organizing rescue work in catastrophes” published in 2001, followed by “General criteria for medicines and medical devices to be kept in a first aid post (Pma II liv.(Fap))” in 2003, by the “General criteria for psychosocial treatment in catastrophes” in 2006 to identify goals and joint organization schemes for psychological and psychiatric assistance during a catastrophe, and "Procedures and forms of medical triage” (patients subdivided by seriousness and treatment priority) published in 2007.
The Civil Protection Department also took part in drawing up civil protection norms at European level, with the purpose of standardizing, speeding up and rendering the actions of the various European civil protection systems more effective.
Said health risk-related activities also include psychosocial projects with the purpose of helping people to know and deal with the risks in their territory and to lend their assistance in returning to normal living conditions. The Over the last few years the Department has been developing a series of activities, particularly focused on assisting people with disabilities, through seminars, conferences and practical experience.
A risk to health is difficult to foresee being subsequent to other risks and calamities; planning medical and psychosocial actions in emergencies in quieter times is however particularly important to reduce the time in responding and to prevent or limit harm to persons. Practical experience in civil protection provides an opportunity to test the urgent medical assistance procedures and to see how the camp facilities effectively work in emergencies. The activities of information and education for the population also contribute towards prevention as they reinforce the actions required to impede and handle emergencies in the best way, curbing the damaging effects of the events.
Emergency planning. The “General criteria for medical assistance in catastrophes” are the instrument used by the civil protection Department to operate emergency medical assistance, even though the regional health systems are left with their own organizational independence. These criteria establish the emergency plans both for events which local systems are capable of dealing with as well as for those exceeding their responsive capacity – type C events – requiring the coordination of the Civil Protection System.
Local bodies are responsible for identifying the risks mainly affecting their territory to improve the organization of medical assistance and identify the possibility of risks associated with the principal risks, e.g. epidemics, accidents with loss of radioactive or dangerous materials, etc. Various consequences may be evaluated even when planning the responses, such as the effects of potential secondary disasters on persons or places at risk, e.g. dams or chemical plants. The variables of specific interest to characterize disasters are:
• frequency;
• intensity;
• territorial extension;
• duration;
• seasonal factors;
• rapidity of occurrence;
• possibility of forewarning.
Information and communication. It is just as important to initiate information and education activities for the population on first aid operations and on effective strategies for dealing with stress and critical situations. Experience has in fact demonstrated that the local people are the only ones to deal with the first hours after a disaster and that the great majority of the survivors are saved either because they are unharmed or because they had been rescued by casual rescue workers immediately after the event. Information activities are likewise important to improve the knowledge of risks in the territory in order to prevent and mitigate possible negative effects on health.
In relation to health risks, in 2004 the Civil Protection Department started up a system to monitor heatwaves, recording summer periods with prolonged high temperatures liable to cause health problems, especially for the more vulnerable persons.
The health intervention in emergency is determined by all actions necessary for the safety of people, and in general public health, which is part of "disaster medicine".
The Civil Protection Department has drawn up specific Criteria for the organization of health rescue and psychosocial interventions during emergencies, in which targets and procedures are set for all actors involved in the scenario of an emergency. These documents summarize the procedures for rescue and relief in “limited effect events", then manageable by local bodies, and for an "event that goes beyond the response capacity of local structures”, that requires, therefore. the intervention of the Department.
Activation of "events of limited effect. " In case of disaster, local structures are the first to get activated following emergency plans and procedures for hospital "events of limited effect" which are:
- Activating teams "before departure " of 118, the Police and Fire Department;
- establishment of a director of emergency medical, triage and Chief Director of the carriage;
- activation of the "chain of emergency health" with the mobilization of all resources provided to local maxi emergencies;
- Enabling teams' second start / delayed start ", fitted with the 'special' lots disaster";
- Opening Pma - Advance Medical Post, field structure in which resources are concentrated for the first treatment, the triage is done and are arranged medical evacuation to hospitals;
- establishment of Function 2, "human and veterinary health, social care" in CCS - rescue coordination center if it is enabled.
Intervention for the "events that are beyond the response capacity of local structures. If the event is serious, the Civil Protection Department intervenes with active team of experts to gather information and assess the damage, in order to alert the various structures, strengthening of the Operations Center 118 and implementing rescue vehicles. In these cases the coordination of actions and communications isdifficult, at least for several hours, and thus it is important to dispatch of experts in the area hit by the calamity.
To assess the situation, the team gathers information on:
- extent of the damage;
- damage to health facilities and features than those without damage;
- estimated number of dead and wounded, the prevailing nature of the injuries, the situation of victims and refugees, and the possible disease risks;
- use of resources, preferred routes, precautions for possible toxic hazards, explosives or collapse.
After the first operations, the Department provide to dispatch emergency vehicles for reconnaissance and the subdivision of the area in sectors, in accordance with available resources and the organization of a mobile command post.
If there is a high number of casualties and the local health facilities are not practicable, field health units, specialist teams, equipment and medical supplies will be sent to the areas.
After gathering information, the Operations Centre 118 starts the "chain of extraordinary medical assistance" which at first follows the procedures provided for events with limited effect and then implemented with other structures, including Umss - Mobile Units emergency health care and field hospitals.
This is the phase of rehabilitation and gradual return to normal life. At this stage, if local health facilities are still unsafe, they may be replaced temporarily by field structures designed to work for medium-long periods, such as field hospitals or medical clinics. In this way the health system ensures a regular assistance to the population.
In addition to ensuring continuity of care in post-emergency phase,psychological and psychiatric care to the population has a significant importance. It is in the post-emergency that the psychological and social consequences of the disaster start to show, affecting the responsiveness and adaptability of the individual and groups of people who cannot lead their lifestyle habits.
To encourage the return to normal habits of individuals, traders who belong to the psychosocial team work on the restoration of pre-existing social networks by creating new networks and engaging the population in different projects, including awareness raising and education on the risks and educational projects for children / teenagers.
The operators make the access to health and social services easy, providing documents on people to whom assistance has been provided in emergency and on the work, making information on risk factors and vulnerable individual and collective available.