Welcome to ZZ Cape Fear Valley Health System

Patient Surge

A patient surge may occur all at once as a result of an identifiable incident or over a period of time. Both can lead to a mass casualty situation and have an impact on the care provided within the health system.

If the surge of patients exceeds the capacity of the ED, the Physician-in-Charge, in coordination with the Lead Charge Nurse, the House Supervisor, and the Administrator on Call, will determine whether or not to call a Code Triage or Code Triage Standby to activate the EOP.

Once activated, the ED Physician-in-Charge will:

Determine number and type of additional resources are needed in the ED;

Communicate the additional needs to Incident Command;

Initiate the ED phone tree to recall staff, if on-duty, internal resources are not sufficient.

The ED Lead Charge Nurse will:

Identify an RN, an MD, Patient Registration, and ancillary staff (as needed) to initiate an alternate triage area in the EMS garage (if required);

Assess the impact of the situation on electronic triage and registration processes and initiate downtime procedures if necessary;

Ensure staff triage patients according to the Emergency Severity Index and start treatment based on the severity of injury or illness.

Coordinate with bed placement to clear ED treatment rooms of patients awaiting to be admitted;

Ensure a patient representative is available to keep patients, families and visitors informed.

Coordinate with Security if the situation requires additional officers.

The ED Medical Director or his or her designee will advise the Incident Commander when the situation is under control in order to clear the code and return to normal operations.

Infectious Patients
An influx of infectious patients may occur as a result of any number of events, but are usually either natural or man-made: natural events, such as pandemic flu or seasonal flu strains or man-made events, such as bio-terrorism or intentional contamination of a water or food source.

Responsibilities include:

Infection Prevention and Control Department Staff are responsible for identifying proper placement of patients and coordinating with state and federal agencies on the management of infectious patients.

Healthcare providers and workers are responsible for abiding to isolation precautions and quarantine sanctions if implemented by state or federal agencies.

For complete details for specific infectious disease refer to the Epidemiological Response Plan located in the Infection Prevention and Control on-line manual. (Follow link to the Infoweb, CFVHS Policies, Infection Control).

Lab Services – In the event of a patient surge, the Laboratory will (in addition to the above):

Suspend all routine testing until all STAT and priority testing is completed.

Call in additional staff to perform testing and establish rotating coverage if necessary.

Determine if testing needs to be performed at another facility such as HRSH, HPN or a reference laboratory.

US Patent Numbers 7,720,998 B2, 7,836,207