The victims are admitted in the Major Incident Hospital via the ambulance port. The patient will be transported on a bed or a trauma stretcher. The nursing coordinator carries a red cap. After registration by means of a wrist band and distributing a medical file the patient will bee screened by a physician shortly. The medical coordinator is recognizable by a green cap. The physician determines the patient to the seriousness of the injury in priority 1, 2 or 3, the so called "triage".
Urgency 1, a live threatening injury that require immediate treatment, patient goes to the Red sluice of the Triage and Treatment Room
Urgency 2, severe affection which have to be treated within six hours, patient goes to sluice Yellow of the Triage and Treatment Room
Urgency 3, no life threatening, minimal treatment needed, patients go to the green sluice of the Triage and Treatment Room. With a large number of urgency 3 patients a sport room of the Psychiatry Department will be used.
Victims who are dead are transported to a temporary morgue.
After patient judgement the patient will be carried to the Intensive Care department (12 beds in location NB), Medium Care department (30 beds in location NG) or to the Low Care department (20 beds in location NG; in location NH or NI 100 beds each). Besides that, they may use the X-ray department (location NE). If the patient has to be operated immediately, it will take place in the OR of the UMC Utrecht. For a MRI or CT-scan examination the UMC Utrecht will be used.
The victims will be transferred to a normal hospital bed in the UMC/CMH or another hospital as soon as possible. Exceptions are patients that are possibly infected with the MRSA bacterium or a particular zymosis; these patients stay longer in the Major Incident Hospital.
In every department a co-ordinating physician is present, recognizable by a green cap and a co-ordinating nurse, recognizable by a red cap, a administrative co-operator, nurses, volunteers of the Red Cross and volunteers of the UMC Utrecht for the patient transport.
When the Emergency Response Programme is activated, the centre of the UMC Utrecht calls a nurse of every nurse department, one nurse per ICU. The Commanding Team calls up additional personnel via the automated personnel alert system. The personnel can be contacted via the national civillian mobile telephone network. Via a modem connection with the national civilian mobile telephone network the Commanding Team knows the number of available personnel and the time in which they may be present. Dependent on this information call trees may be deactivated or additional call trees may be activated.
Besides medical and nursing personnel also logistic personnel, paramedical personnel, social workers etc. are called.
Patients meeting:After relief of victims a patients meeting takes place as soon as possible. The chairman of the Commanding Team presides the patients meeting. After that a daily (08:30 h) patients meeting is held whereby all medical disciplines have their contribution. Except for acute problems, the policy is only determined for the next 24 hours during this meeting. The co-ordinating physician watches over this process to prevent fellow workers adjust policy on ad hoc basis.
Heads meeting:A number of hours before the relief a heads meeting is held if possible, and then daily (10:00 h) a heads meeting conducted by the manager of care. During this meeting personnel and logistic subjects are discussed. Participants are representatives of logistic services and a representative of the nursing management of the UMC Utrecht and the CMH.