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EXERCISE NEPTUNE Live Casualty Exercise 2017 Author: Ben Collins, Emergency Preparedness Officer

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EXERCISE NEPTUNE Live Casualty Exercise 2017 Author: Ben Collins, Emergency Preparedness Officer Northern Devon Healthcare NHS Trust EXERCISE NEPTUNE Live Casualty Exercise 2017 Author: Ben Collins, Emergency Preparedness Officer Exercise Neptune Page 1 Northern Devon Healthcare NHS Trust Contents Contents ............................................................................................................................................................ 2 Foreword ........................................................................................................................................................... 4 Introduction ...................................................................................................................................................... 5 Scenario & Injects ............................................................................................................................................ 10 Objective 1: Safety ........................................................................................................................................... 14 Objective 2: Containment ................................................................................................................................. 17 Objective 3: Triage ........................................................................................................................................... 20 Objective 4: Decontamination .......................................................................................................................... 22 Objective 5: Patient Experience ........................................................................................................................ 29 Objective 6: Business Continuity ....................................................................................................................... 33 Objective 7: Live Exercise ................................................................................................................................. 35 Evaluation ....................................................................................................................................................... 36 Appendix ......................................................................................................................................................... 42 Exercise Neptune Page 2 Northern Devon Healthcare NHS Trust Exercise Neptune video You can watch the video and get first-hand accounts of what happened online at: www.northdevonhealth.nhs.uk/exerciseneptune Exercise Neptune Page 3 Northern Devon Healthcare NHS Trust Foreword The patients and communities that we serve expect us to be there for them when they need it, irrespective of the circumstances we face. As such, we as a Trust must do all that we can to ensure we are well prepared to respond to any disruptive challenges or emergencies that may arise. One of the potential challenges we may face in the future may involve patients who have been contaminated with a hazardous or dangerous material, such as those which are chemical, biological, radiological, nuclear or explosive (CBRNE) in nature. To support staff in responding to this potential Image 1: Andy Ibbs, Director of Operations & Strategy challenge, the Trust has invested heavily over the Exercise Neptune involved staff from across the past 3 years in developing its emergency hospital working together and demonstrated procedures for incidents involving hazardous or what can be achieved when our values of CBRNE materials. As an outcome of this work, the diversity, integrity, compassion, excellence and Trust now has in place a documented “CBRNE support are well applied. Plan”, for which the relevant staff have all been trained, and an extensive range of equipment and Alongside our own staff, Exercise Neptune would facilities to support the safe decontamination of not have been possible without the support of patients has been put in place. Devon & Somerset Fire & Rescue Service and students from Petroc College in Barnstaple who The most recent audit of the Trust’s CBRNE kindly volunteered to play the contaminated arrangements, carried out in December 2016, casualties. reflected the Trust’s recent investment, identifying it was now “fully compliant” against all Exercise Neptune generated a great deal of measures and noted the “significant investment learning for the Trust, both in terms of what in staff training” the Trust has made over the past worked well and where improvements are still 3 years. required. Following the successful audit outcomes in This report has been written to ensure that the December 2016, the next step in developing our Trust has an accurate record of what happened preparedness was to test our plans. during the exercise and will be presented to both the Local Health Resilience Group and the Local On the 30th March 2017, the Trust ran Exercise Resilience Forum to ensure the lessons we have Neptune, a live-play emergency exercise which learned can be shared with our partner involved the presentation of 45 contaminated organisations. casualties at the Trust’s emergency department at North Devon District Hospital. If you have any questions regarding this exercise report, please contact the Associate Director of Operations – Unscheduled Care. Exercise Neptune Page 4 Northern Devon Healthcare NHS Trust Introduction Requirement to Exercise In accordance with NHS guidance, all NHS organisations are required to undertake a six monthly communication test, an annual tabletop exercise and a live-play exercise every three years. Aim The aim of Exercise Neptune was to enable Northern Devon Healthcare NHS Trust (the Trust) to fulfil its requirement to hold a live exercise once every three years, as set out in NHS England’s Emergency Preparedness, Resilience and Response Framework 2015, by testing its plan for incidents involving chemical, biological, radiological, nuclear and/or explosive (CBRNE) material(s) Image 2: Devon & Somerset Fire & Rescue Service’s Detection Exercise Objectives Identification Monitoring (DIM) Team try to identify the contaminant The objectives of Exercise Neptune were as a) To assess the effectiveness of a physical follows: cordon/s to protect staff, patients and visitors from potentially contaminated 1) To provide hospital staff the opportunity to patients; practice the SAFETY precautions set out in the CBRNEe Plan; 3) To provide hospital staff with the opportunity to TRIAGE contaminated patients prior to a) To provide hospital staff the opportunity them being decontaminated; to put on the personal protective equipment required to support the 4) To provide hospital staff the opportunity to containment, triage and decontamination put in to practice the DECONTAMINATION of patients; procedures set out in the CBRNEe Plan; b) To provide hospital staff the opportunity a) To provide hospital staff with the to experience what it’s like to work inside opportunity to practice the dry the powered respirator protective suits decontamination of patients; (PRPS); b) To provide hospital staff with the 2) To provide hospital staff the opportunity to opportunity to deploy the CBRNE put in to practice the CONTAINMENT decontamination tent and to test the procedures set out in the CBRNEe Plan; working order of its equipment; c) To provide hospital staff with the opportunity to practice the wet decontamination of patients; Exercise Neptune Page 5 Northern Devon Healthcare NHS Trust d) To provide Devon and Somerset Fire and b) To make and formally record decisions Rescue Service (DSFRS) the opportunity to over and above those made within normal deploy their mass decontamination running of the organisation; equipment on the North Devon District Hospital (NDDH) site; c) To undertake dynamic and formal risk assessments; e) To provide Devon and Somerset Fire and Rescue Service (DSFRS) the opportunity to d) To mobilise resources; practice the wet decontamination of patients on the North Devon District e) To accelerate patient pathways; Hospital (NDDH) site; f) To undertake a formal debrief; f) To provide an opportunity for hospital g) To publish a post-event report for formal staff to work alongside Devon and presentation at the Local Health Somerset Fire and Rescue Service (DSFRS) Resilience Partnership (LHRP); to deliver the wet decontamination of patients; 5) To gain a greater understanding of the patient experience whilst undergoing decontamination; 6) To better understand the potential disruption that may be caused in activating the CBRNE Plan, with respect to: a) The safe and sustainable operation of the Trust’s emergency department; b) The flow of ambulances in to and out of the Trust’s emergency department; c) The safe level of staffing in the Trust’s emergency department and the wider Trust; d) The deployment of Devon and Somerset Fire and Rescue Service’s (DSFRS) mass decontamination equipment on the North Devon District Hospital (NDDH) site; 7) To fulfil NHS England (South)’s “Live Exercise Success Criteria”: a) To establish a command and control structure (operational, tactical, strategic); Exercise Neptune Page 6 Northern Devon Healthcare NHS Trust Exercise Scope The Trust’s CBRNEe Plan sets out how a CBRNEe-related incident may require the involvement of hospital resources to support the safety, containment, triage, decontamination and treatment of casualties, as set out in Figure 1 below: Pre-hospital Outside Hospital Inside Hospital Post-Discharge Scene Management Safety Treatment Aftermath Treatment at Scene Containment Recovery Patient Transport Triage Surveillance Decontamination
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