Medical Emergency Preparedness and Response Plan - 00

HSE MANAGEMENT
PROCEDURES & PLANS
MEDICAL EMERGENCY PREPAREDNESS AND

RESPONSE PLAN
“TO INSERT PROJECT NAME”
“To Insert Project Doc. Number”
Response
Rev Date Revision Description Originator Reviewer/Endorser Approver
Code
Giovanni Iannotti/
A 16/07/2020 Issued For Review
Emanuele Stallone
Document
Control No.
Bonatti code: XXXXXX-XXX-XX-XXXXX Rev. A

HSE MANAGEMENT XXXX-XX-XXXXX-XX-XXXX
PROCEDURES & PLANS REVISION: A
MEPRP DATE: 16/07/2020
Unclassified Page 2 OF 29
Bonatti code XXXXXX-XXX-XX-XXXXX Revision: A
AUTHORIZATION
APPROVED BY: _________________ DATE: _______________________

NAME:
TITLE: PROJECT DIRECTOR
ENDORSEMENT
ENDORSED BY: __________________ DATE: _______________________

NAME:
TITLE: PROJECT MANAGER
REVIEW
REVIEWED BY: __________________ DATE: _______________________

NAME:
TITLE: PROJECT HSE MANAGER
PREPARATION
PREPARED BY: ____ GIOVANNI IANNOTTI ____ DATE: _____16/07/2020________

NAME:
TITLE: CHIEF MEDICAL OFFICER
PREPARED BY: ____ EMANUELE STALLONE ____ DATE: _____16/07/2020________

NAME:
TITLE: HSE - CORPORATE
REVISION MODIFICATION LOG
Revision Section Description

A ALL Issued for Review
HOLD LIST
No table of figures entries found.
TABLE OF CONTENTS
1. INTRODUCTION....................................................................................................................6
1.1................................................................................................................. GENERAL
6
1.2.........................................................................................SCOPE AND PURPOSE
6
2. REFERENCES.......................................................................................................................7
3. DEFINITIONS, ACRONYMS and ABBREVIATIONS.................................................................8
4. RESPONSIBILITIES...............................................................................................................9
4.1....................................................................................BRANCH MANAGER (BM)
9
4.2.......................................................PROJECT DIRECTOR/MANAGER (PD/PM)
9
4.3....................................................................PROJECT HSE MANAGER (HSEM)
10
4.4..........................................................................................................HR MANAGER
10
4.5.........................................EMERGENCY RESPONSE TEAM LEADER (ERTL)
10
4.6......................................MEDICAL EMERGENCY RESPONSE TEAM (MERT)
11
4.7.....................................................................PROJECT DOCTOR / PARAMEDIC
11
4.8........................................................................PROJECT SECURITY MANAGER
12
4.9...........................................................................................................SUPERVISOR
12
4.10................................................................................................. ALL PERSONNEL
13
5. EMERGENCY MANAGEMENT.............................................................................................13
6. INCIDENT MANAGEMENT PROCESS.................................................................................15
6.1........................................................................................MEDICAL EMERGENCY
16
6.2............................................................INCIDENTS OUTSIDE WORKING AREA
22
6.3....................................................................MULTIPLE CASUALTY SITUATION
23
6.4..............................................................................................................FATALITIES
24
7. EMERGENCY RESPONSE TRAINING AND EXERCISES......................................................24
8. COMMUNICATION...............................................................................................................24
9. APPENDICES......................................................................................................................25
APPENDIX 1 – MEDICAL EMERGENCY FLOW CHART..........................................................26
APPENDIX: 2 EMERGENCY CONTACT LIST...........................................................................27
APPENDIX 3 - Triage Categories..............................................................................................28
APPENDIX 4: MERT Organization Chart..................................................................................29
LIST OF FIGURES
Figure Number Page Description
LIST OF TABLES
Tabel Number Page Description

1 16 Summary of Incident Category
LIST OF EMBEDDED FILES
Embedded Page Description

Files
NA
1. INTRODUCTION
1.1 GENERAL
This WORK forms part of the (Name of the Project). (Description of the Project)
Figure 1: Project Location

(Insert an aerial photo of the Project)
1.2 SCOPE AND PURPOSE

This Medical Emergency Response Plan (ERP) aims to detail the organizational
responsibilities, actions, reporting requirements and the resources available to ensure
effective and timely management of Medical emergencies.
This is achieved by:

• Describing procedures to deal with Medical emergencies;
• Defining the roles and responsibilities of Contractor Emergency Response Team
(ERT) personnel;
• Describing the interface with (Client name).
The main objectives of this MERP are as follows:

• Protection of human life;
• Control any incident and prevention of escalation.
In order to maintain an effective Medical Emergency Response, the following will be ensured:
• Clear assignment of responsibilities to deal with an emergency;
• Effective communication for the co-ordination of tasks during an emergency.
The contents of the MERP are directed to Contractor and its Subcontractors who are
involved with the Project. This MERP is a living document and shall be reviewed by
Contractor HSE Manager and revised according to recommendations throughout the
execution of the Project yearly, or as required by the Project.
2. REFERENCES
(Insert here the local references applicable to the Project)
International References
• OHSAS 18001 Occupational Health and Safety Management Systems
Requirements;
• IPIECA/OGP Report No. 343 Managing health for field operations in oil & gas
activities;
• OGP Report No. 6.44/222 Standards for local medical support;
• OGP Report No. 6.46/228 Health Assessment of Fitness to Work in the E&P
Industry;
• OGP 517 Incident management system for the oil and gas industry
• OGP 578 Multiple Casualty Planning and Preparation 2017
• OGP Report No. 2012su Health & safety incident reporting system users’ guide;
• OGP Report No. 423 HSE management – guidelines for working together in
a contract environment;
• OGP Report No. 432 Managing HSE in a Geophysical Contract;
• OGP Report No. 452 Shaping Safety Culture through Safety Leadership;
COMPANY documents:
• (Insert here the client’s documents)
CONTRACTOR documents:
• (Insert here the Project’s documents)
3. DEFINITIONS, ACRONYMS and ABBREVIATIONS
PROJECT (Project specific)

COMPANY (Project specific)
CONTRACTOR (Project specific)
Accident Any unfortunate event which results in the loss of goods, kinds or life. It is an unplanned
event which can cause a major loss to the individuals involved.
ALARP As Low As Reasonably Practicable
CPR Cardio Pulmonary Resuscitation consists in the manual application of chest compressions
and ventilations to patients in cardiac arrest, done in an effort to maintain viability until
advanced help arrives. This procedure is an essential component of basic life support
(BLS) and advanced cardiac life support (ALS).
Crisis An emergency the effects and repercussions of which require exceptional and urgent
measures in order to be managed and resolved. It cannot be addressed locally but requires
the involvement of Contractor Crisis Unit for the coordination of Emergency management
activities and / or the mobilization of internal and / or external personnel and equipment.
Crisis Development and application of the organizational capability to deal with crises, i.e.
management abnormal and unstable situations that threaten the organization’s strategic objectives,
reputation or viability
Emergency An unforeseen combination of circumstances or the resulting state that calls for immediate
action, an urgent need for assistance or relief.
Emergency Person responsible for the management of emergencies. Functionally the Emergency
Coordinator Coordinator does not necessarily coincide with the HSE focal point. He is in fact identified
and appointed by the Branch Manager / Project Responsible Person with due consideration
for operational needs, as well as for local and international governing aspects related to
emergency management.
Emergency Series of actions based on plans, protocols and guidelines aimed at addressing, mitigating
Response and resolving the emergency.
MERP Medical Emergency Response Plan
MERT Medical Emergency Response Team
ERTL Emergency Response Team Leader
HCU Health Care Unit
HSE Health, Environment and Safety
HR Human Resource
ICU Intensive Care Unit
INCIDENT Anything that occurs. This thing can have either positive or negative implications and may
be planned or unplanned.
IMS Incident Management System
IP Injured / Ill Person
Level 1 Event that can be effectively addressed locally using personnel and equipment available at
Emergency site.
Level 2 Event that can be addressed locally with the support of personnel and third party
Emergency equipment made available by the Branch or Authorities and Public Administrations at
peripheral level.
Level 3 Event which cannot be addressed locally and which can lead to serious danger for the Site
Emergency and/or the local area and which requires assistance and support from the relevant
Corporate functions and/or Authorities and Public Administrations at central level.
LSA Life Saving Actions
MEDEVAC Medical Evacuation
OSC On Scene Commander / Usually, Qualified Person from the first responding crew that is
most capable of managing the incident.
PPE Personal Protective Equipment
QUALIFIED Who, by possession of a recognized degree, certificate, or professional standing, or who by
extensive knowledge, training, and experience, has successfully demonstrated their ability
to solve or resolve problems relating to the subject matter, the work, or the project.
SERT Site Emergency Response Team

SWA Stop Work Authority
4. RESPONSIBILITIES
4.1 BRANCH MANAGER (BM)

The Branch Manager shall ensure that a MERP is prepared and effectively implemented for
all the activities carried out in the Project.
He shall ensure that suitable and sufficient resources are provided to implement this Plan for
the Level 1 and Level 2 Emergencies. In addition, He shall liaise with the relevant
Responsible Person of the Head Quarters in Parma in order to effectively manage the Level
3 Emergencies and Crisis situation.
For all levels of emergency or for crisis situations, the Branch Manager guarantees adequate
information flows to the Head Quarter in Parma, supplying all updates on management of the
emergency or crisis.
The Branch Manager plays a vital role in operational management, in terms of:
• Information management;
• Monitoring of crisis management activities;
• Remedial measures;
• Verifying and approving the operational emergency plans for the sites within their
remits;
• Ensuring that the personnel involved in management of emergencies are
constantly trained and informed as to their tasks and responsibilities;
• Collaborating with the legal representatives of any Bonatti entities present in the
country for a correct and coordinated management of emergency and crisis
situations.
The BM shall appoint a Responsible Person in charge of the communication with Authorities
and press, as required by the Emergency Levels. Communication with Authorities, media,
etc. will be coordinated with COMPANY.
4.2 PROJECT DIRECTOR/MANAGER (PD/PM)

The PM is responsible for:
• Ensuring the preparation and the effective implementation of the Project specific
MERP;
• Appointing in writing the ERTL and the MERT;
• Activating the Medevac for an IP, as per Doctor decision;
• Ensuring that the MERT has suitable and sufficient resources and equipment to
manage the Project emergencies of Level 1;
• Liaising with the HR function in order to efficiently manage the Level 2
Emergencies (e. g.: for an effective logistic support);
• Enforcing the implementation of the Project MERP also by the Subcontractors;

• Keeping informed the BM about the development of any significant incident in
order to evaluate any potential escalation to Level 3 or Crisis level emergency;
The ERTL in CONTRACTOR’s Project organization shall be the Project Director / Manager,
and/or appointed personnel, as aforementioned.
4.3 PROJECT HSE MANAGER (HSEM)

The Project HSEM is responsible for:
• Preparing the MERP and monitoring its effective implementation in the working
areas;
• Monitoring the effective implementation of Projects MERP also through regular
inspection and HSE Audits;
• Monitoring that a comprehensive Medical Emergency Drills schedule is prepared
and followed in order to verify the preparedness of the MERT and that the related
reports are prepared and shared within the Country and Head Quarters
Responsible Persons;
• Supporting the site MERT in case of emergency;
• Reviewing and updating this plan on a regular basis;
4.4 HR MANAGER
The HR Manager shall be responsible for:
• Ensuring that all the logistical support is in place to evacuate any IP to the
Primary and Secondary HCU, as required;
• Ensuring the accommodation for temporary hospitalization and treatment of the
IP, in liaison with the Medical Team;
• Arrange for travel documentation needed in case of MEDEVAC;
• Inform Corporate HR Department and next of kin in the event of major injury /
fatality;
4.5 EMERGENCY RESPONSE TEAM LEADER (ERTL)

The ERTL has overall management authority during an emergency. He/ She assesses
emergencies and render personnel and facilities safe by the implementation of the MERP.
The Emergency Response Team Leader is responsible for:
• Initiating and maintaining overall control of the Medical Emergency Response
during emergencies and giving clear instruction to MERT and the Personnel;
• Ensuring that the Logistic provides resources, services and support required by
the incident;
• Initiating, maintaining and controlling the communications process within the IMS
organization;
• Establishing the size of the IMS organization needed and monitoring the its
effectiveness;
• Case management (maintain all communication links/logistic/security);

• Notifying the Medical Team in the event of an Illness / Injury;
• Coordinating Medical evacuation as necessary;
• Assessing any potential escalation of the emergency, defining priorities and
actions;
• Maintaining the timeline of events related to the emergency;
• Authorizing the release of information outside the Company.
The ERTL will consider the following three major priorities when identifying the required
resources and structuring the IMS organization:
• Safety: protecting emergency responders, incident victims and the public.
• Incident control: minimizing the impacts of the incident on the area surrounding
the scene, and maximizing the response effort while using resources efficiently.
• Protecting the environment and property: minimizing damage to the environment
and property while achieving the objectives established for the incident.
4.6 MEDICAL EMERGENCY RESPONSE TEAM (MERT)

The Project Medical Emergency Response Team (MERT) consists of Doctor, Nurse,
Paramedic, First Aiders, Ambulance Driver, Stretcher Team.
The MERT members will be qualified according to OGP 343 - Managing health for field
operations in Oil and Gas activities and (Project Specific guidelines).
The Medical Emergency Response Team shall communicate closely with the ERTL who
coordinates the response efforts.
The MERT will be provided with suitable and sufficient communication equipment in order to
maintain contact with the ERTL throughout the incident.
Technical specialists may be part of the MERT in order to provide support to response teams
within the IMS organization, depending on where their services are required. These
specialists provide technical advice and support to address specific aspects of an incident
response. Examples of technical specialists’ expertise include safety, industrial hygiene,
Confined Space Rescue Team, Work at Height Rescue Team.
4.7 PROJECT DOCTOR / PARAMEDIC

The Project Doctor / Paramedic, supported by the 3 rd party Assistant Centre and his onsite
Medical Team shall:
• Intervene in case of illness / Injury, in order to stabilize the IP;
• Be familiar with Emergency Contact Numbers and Medical Arrangements;
• Coordinating Nurses, cooperating with Site Manager, HR, and COMPANY
Medical staff for the MEDEVAC operations;
• Manage the medical facilities and resources in order to ensure that coverage of
the project in accordance with OGP Report No. 6.44/222 ‘’Standards for local
medical support’’;
• Manage the emergencies, stabilizing patients before evacuation to Hospital,

following internationally accepted principles and protocols.
• Immediate response to accidents and multiple traumas applying the principles of
European Trauma Course, Pre Hospital Trauma Life Support and Advanced
Trauma Life Support.
• Mobilize the Ambulance Driver at the scene of the emergency;
• Decide for the Medevac of the IP to the Primary HCU, informing the PM about his
decision;
• Maintain contact and communication with the ERTL;
• Maintain all Medical Equipment present in the clinic, in the ambulance or at site in
good working conditions, in compliance with local legislation, contractual
requirement and OGP guidelines.
• Perform regular training (e.g., first aid) and participate in emergency drills on site;
• Escort/accompaniment of injured/ill persons to secondary medical facilities and
provide oversight during the injury/illness case management process;
• During a medical emergency, notify the COMPANY Construction Manager
regarding on site resource availability to provide response to ongoing critical
work. If the ambulance is dedicated to an emergency, then designate a back-up
vehicle, if available.
Requirements and extensive responsibilities for health personnel are listed into (Project
specific).
4.8 PROJECT SECURITY MANAGER

The Project Security Manager will be responsible for the following:
• Cooperate with Medevac process;
• Cooperate with International SOS Team;
• Monitor security activities involved in the medevac as required by the situation
4.9 SUPERVISOR
The Supervisor, in response to an emergency, shall:
• Check area under his responsibility and ensure all workforce have reacted
accordingly to the emergency situation;
• Ensure all work has been stopped and permits are returned/cancelled, as
applicable;
• Ensure that the workers under his/her supervision are present at the Muster
Point;
• Do not allow any persons to re-enter the work location;
• Standby to receive further communications by the ERTL.
4.10 ALL PERSONNEL

All personnel have the responsibility to:
• Stay calm, follow instructions and cooperate;
• In case an emergency occurs, warn anyone in the immediate area that may be in
danger and ensure a Supervisor / HSE has been informed.
• All personnel must respond promptly to an emergency situation (or drill), stop
safely their work and proceed to their muster point, as required;
• Ensure, where it is safe to do so, that all equipment is isolated and made safe;
• Return to work when the All Clear is given by the ERTL.
5. EMERGENCY MANAGEMENT
Whenever an emergency overcomes the site capability to efficiently manage it, an escalation
to a higher level involving additional Responsible Persons occurs, as indicate in the below
table.
LEVEL OF
DEFINITION RESPONSIBILITIES EXAMPLE
EMERGENCY
Event that can be effectively addressed

Minor Injury /
1 locally using personnel and equipment Project management
illness
available at site.
Illness / Injury
Event that can be addressed locally with
requiring
the additional support of personnel and
Project / Branch hospitalization,
2 external equipment / structure made
management requiring support
available by the Branch, Clients and
by Clients or local
authorities at peripheral level.
Authorities
Event which cannot be addressed locally
and which can lead to serious danger for
Branch Management /
the Site and/or the local area and which Major Illness or
3 Bonatti Corporate
requires assistance and support from the Injury
Crisis Unit
relevant Corporate functions and/or
Authorities at central level.
A very serious emergency the effects and
repercussions of which increase and
prolong over time and which requires
exceptional and urgent measures in order
to be managed and brought within the
limits of normality. Cannot be addressed Bonatti Corporate
CRISIS Multicasualties
locally but requires the involvement of Crisis Unit
Bonatti’s Crisis Unit for the coordination of
Emergency management activities and of
internal and external personnel and
equipment available locally or provided by
the relevant Corporate functions
Table 1- Summary of Incidents Categories
Emergency Level 1
An emergency situation, which is managed solely by Contractor or its Sub-contractor and

overseen by management ERT and where no other outside assistance is required.
Examples are: minor injury or illness not requiring a Medevac.
The incident does not have any effect outside the Project fences and external agencies are
unlikely to be involved.
Emergency Level 2
Event that can be addressed locally with the additional support of personnel and external
equipment / structure made available by the Contractor Branch, COMPANY or Authorities at
peripheral level.
Examples are: Illness / Injury requiring hospitalization to a Primary / Secondary HCU

requiring support by COMPANY or local Authorities to be efficiently controlled.
Emergency Level 3
Event which cannot be addressed locally and which can lead to serious danger for the Site
and/or the local area and which requires assistance and support from the Contractor Branch
Management functions (eventually with the support of the Contractor Corporate
Management) and/or Authorities at central level.
Example are an emergency condition involving multiple casualties, death beyond the
resources of the site emergency services, incidents with National Impact on Contractor
reputation.
Crisis
A very serious emergency the effects and repercussions of which increase and prolong over
time and which requires exceptional and urgent measures in order to be managed and
brought within the limits of normality. Cannot be addressed locally but requires the
involvement of Contractor’s Crisis Unit for the coordination of Emergency management
activities and of internal and external personnel and equipment available locally or provided
by the relevant Corporate functions. Examples may be: multiple casualties, incidents with
International impact on Contractor reputation.
6. INCIDENT MANAGEMENT PROCESS

Regardless of the size of the incident, the response process begins with incident detection,
notification and activation of response personnel and other resources, and establishment of
the incident command.
EMERGENCY
OCCURRED
Notification to ERTL and First

intervention
Activation of response by the

ERTL
Assessment for further

action / escalation of the
emergency
Incident briefing
Notifying the appropriate Responsible Person that an incident has occurred is the first step in
the initial response for all incidents. Notification information should include verification of the
type of incident and its exact geographic location.
Notification protocol as indicated in the document (Project specific) will be activated.
Once notification has occurred, incident command is established by the first arriving
responder, and the responding organizations activate and dispatch qualified personnel to the
response.
Depending on the severity of the incident, there may be notification requirements to inform
governmental entities and organizations of the occurrence of the incident.
Factors to be considered in establishing the appropriate IMS organization include:

• Time/date of incident;
• Location of and access to the incident;

• Medical assistance for injuries or fatalities;
• Potential health or safety risks to the public;
• Need for search and rescue operations;
• Management issues such as human resources, legal, media, etc.;
• Need for specialized expertise, such as source control;
• Site security; and
• Changing physical conditions such as weather.
First responders who provide front-line tactical response shall be trained specifically for the
tasks involved. They include First Aiders, Search-and-Rescue Team, Work at height Rescue
Team.
6.1 MEDICAL EMERGENCY

Medical Evacuation will be required every time the IP condition exceed the capability of the
onsite medical facility.
Here below are the steps to be taken in case of any general & trauma medical emergency:
• Remove the casualty from any danger only if his/her position is life threatening
and provided that the rescuer’s safety is not at risk. Any unnecessary movement
may worsen the injury.
• Call Doctor / Paramedic and ambulance immediately.
• Provide first aid only if trained.
• Assist the casualty until medical team arrives.
• Evacuation of the IP to the clinic.
• Stabilization of the IP.
• Evacuation of the IP to the Primary HCU and repatriation, if required.
Contractor will be accountable for the Medevac and in charge of the onsite Medical Support
(Primary care – Emergency Care) and Emergency Evacuation, lasting all Project life. Medical
Evacuation is addressed to Center of Medical excellence approved by CONTRACTOR
supported by Medical Service Provider.
(Insert here a step by step description of the Project specific MERP)
According to many factors (e.g. level of emergency, security and weather conditions, hospital
capability) Medical Evacuation may be addressed inside or outside the country.
Furthermore, repatriation may be arranged after patient discharge. Anyone evacuated from
construction site due to illness or injury shall not return to work without a fitness to Work
certificate.
CONTRACTOR will provide emergency response procedures/plans based on specific

medical emergency risk assessment, when required.
The Project medical center (Clinic) located in Contractor camp will be staffed and furnished
as per Contract requirements with the following items of emergency related equipment:
• Mobile phones will also be issued to medical staff.
• White board and pens for listing emergency information.
• First aid Responder bag.
• Stretchers.
• Ambulance equipped with necessary equipment.
Here below the minimum requirements for First Aid training:

• Level I — Basic first aid
o Scene assessment and prevention of secondary accident (including self
protection).
o contents and use of Level i first aid kit.
o priorities ("ABC" - Airway, Breathing and Circulation).
o emergency call-out procedures.
o relevant safety data sheets.
o prevention of blood-borne pathogens and other associated hazards.
o basic hygiene.
o use and application of the recovery position.
o cardio-Pulmonary Resuscitation (CPR) possibly including use of an
automatic external defibrillator (AED).
o basic control of external bleeding.
o application of simple dressings.
o application of simple splints.
o eye washing of foreign bodies and chemical splashes.
o initial treatment of thermal or chemical injuries.
o ability to provide clear details of injury/illness.
• Level 2 — Advanced first aid (In addition to Level I):

o contents and use of Level 2 first aid kit.
o management of bleeding.
o management of simple wounds.
o management of an unconscious person.
o treatment for shock, hypothermia, heat injury, immersion, burns.
o various types of dressings.
o immobilisation of injured parts.
o transportation of an injured or ill person.
o communication and delegation in an emergency.
o specific workplace risks.
o simple record keeping.
The minimum contents of a Regular Responder Bag (emergency bag) is:
PPE
Gloves non sterile - Small 5 Pair
Gloves non sterile - Medium 5 Pair
Gloves non sterile - Large 5 Pair
Face Mask surgical 5
Face Mask N-95 2
Face mask with shield 1
Goggles 1
Safety Glasses 1
Hand Sanitizer 1
Medical Waste Bag 1
Gloves sterile - Small 2
Gloves sterile - Medium 2
Gloves sterile - Large 2
Plastic Apron 1
Diagnostics
Aneroid Spyhgmomanometer & std. cuff 1
Lge. cuff for aneroid Sphygmomanometer 1
Digital thermometer 1
Digital thermometer disposable covers 10
Thermometer - oral 1
Thermometer sheath - oral 10
Stethoscope 1
Pupil torch 1
Glucometer 1
Diagnostic strips for glucometer 10
Lancets for glucometer 10
Alcohol swabs 10
Rescue scissors 1
Pulse oximeter 1
Airway
Oropharyngeal airway #3 1
Bag Valve Mask with reservior 1
Adult Mask for BVM 1
Bacterial Filter 2
Oxygen tubing 1
Flexible catheter mount 1
PEEP Valve 1
T-piece 1
Oxygen Mask Non Rebreather 1
Oxygen Mask Hudsen 50% 1
Oxygen Mask Nebulizer 1
Oxygen Nasal Cannula 1
Nasopharyngeal Airway 7mm 1

Nasopharyngeal Airway 8mm 1
Laryngeal Mask Airway Size 4 1
Laryngeal Mask Airway Size 5 1
Laryngoscope handle & batteries 1
Laryngoscope Blade Size 2 1
Spare laryngoscope bulb 1
Spare batteries for laryngoscope 1
Endotrachael tube Size 5 1
Gum Elastic Bougie 1
Introducer 1
20 ml syringe 1
Endotrachael tube holder 1
Lubricant sachets 3
Tape 2.5cm wide 1
Manual suction unit (hand suction) 1
Soft suction catheter size 12 1
Soft suction catheter size 14 1
Yankeur suction catheter 1
Suction tubing 1
Magills Forceps - Large 1
Ashemans Chest Seal 2
Chest decompression Needle 1
Chest drain kit 1
Mini Tracheostomy kit 1
Circulation
Syringe - 50ml catheter tip 1
Syringe - 50ml luer lock 1
Syringe - 10ml luer lock(SLIP) 1
Syringe - 5ml luer lock(SLIP) 1
Hypodermic safety syringe & needle10ml 1
Hypodermic safety syringe & needle 5ml 2
Fluid - ringers lactate 1000ml 2
Fluid - 5% Glucose in water 1000ml 2
Fluid - sodium chloride 1000ml 2
Fluid - gelofusine 500ml 2
Administration set - 20 drops/ml leur lock 2
Administration set - 60 drops/ml leur lock 2

Administration set - high capacity 1
Safety IV catheters 14g 3
Intraosseous needle 1
Tourniquet 2
IV dressing / Tegerderm 5
3 way stopcock 3
Micropore tape 2.5cm 1
Alcohol swabs 10
Pressure infusor 1
Emergency Medications
Adenosine 5
Adrenalin Ampoules ( 1:1000) 5
Amiodarone 3
Aspirin Tablets (500mg) 10
Atropine Sulphate Ampoules (1mg) 5
Calcium Chloride Ampoules (10ml) 1
Clopidogrel Tablets 10
Flumazenil Ampoules 1
Furosemide Ampoules (20mg) 5
Glucose 50% Solution (50ml) 1
GTN Spray 1
Hydrocortisone (100mg) 1
Lignocaine 2% 3
Magnesium Sulphate Ampoules 1
Metoclopramide Ampoules 1
Nalaxone Ampoules 2
Promethazine Ampoules 2
Salbutamol Ampoules(DULAN) 5
Salbutamol Inhaler 3
Sodium Bicarbonate Ampoules 2
Water for Injection 4
Xylocaine Spray 1
Controlled Medications *Controlled Medications To Be Stored as per the L3 MS Pharmacy & Dispensing
Procedure
Diazepam Ampoules 2
Midazolam Ampoules 2
Morphine Ampoules 2
Tramadol Ampoules 2
Burns / Dressings
Burn gel sheet multipack 1
Emergency blanket 2
Clingwrap 1
Gauze swabs sterile 10x10cm (5 Pack) 5
Crepe bandage 10cm 3

Crepe bandage 7.5cm 3
Crepe bandage 5cm 3
Dressing with bandage - Size 8 3
Dressing with bandage - Size 9 2
Dressing - Multiabsorbent 30cm x 45cm 1
Triangular bandage 2
Eye pads - sterile 2
Bandaids 20
Micropore tape 2.5cm 1
Adhesive fabric dressing - 4cm x 1m 2
SAM splints Large 2
SAM Splints Small 1
Other
Note pad & pen 1
Marker Pen 1
Triage Tags 1
Urine bag 1
Ryles tube Size 12 1
Ryles tube Size 14 1
Foleys Catheter size 12 1
Foleys Catheter size 14 1
A First aid kit will be available and maintained by the First Aiders.
The first aid kit will contain a dressing register that is completed with every minor injury that is
treated.
Copies of the dressing register will be submitted to Contractor HSE Officer on a weekly basis.
The first aid kit will be numbered and placed on a register for monthly inspections.
The first aid box will contain at least the following (to be adapted to Project’s specific risks):
1 Adhesive Skin closure 3 x 75mm X 1

2 Adhesive Tape Paper 1.25cm x 5m X 1
3 Adhesive Tape Paper 2.5cm x 5m X 1
4 Alcohol Wipes X 10
5 Antiseptic Cream Tube X 1
6 Burnaid Sachet 3.5g X 5
7 CAT tourniquet X 2
8 Conforming Bandage w10cm X 1
9 Conforming Bandage w5cm X 3
10 Conforming Bandage w7.5cm X 3
11 Disposable Splinter Probe Pk10 X 1
12 Emergency Thermal Blanket X 2
13 Eye Pads (Sterile) pk5 X 1
14 Eye wash bottle (sterile, full) X 1
15 Fabric Dressing Strip 7.2cm x 1m X 1
16 Fine Forceps 12.5cm X 1
17 First Aider Splint 900 x 100mm X 1

18 Gauze Sterile Pieces 7.5cm x 7.5cm Pk5 X 5
19 Instant Cold Pack Small X 1
20 Instant glucose tube X 1
21 Medium Support Crepe Bandage w10cm X 2
22 Medium Support Crepe Bandage w7.5cm X 1
23 Nitrile Gloves Pairs Pk5 X 1
24 Non Adherent Dressing 10 x 10cm X 3
25 Non Adherent Dressing 5 x 5cm X 3
26 Non-Adherent Dressing 7.5 x 10cm X 3
27 Plasters assorted box X 1
28 Povidone Iodine small bottle X 1
29 Quick-clot / combat gauze X 3
30 Safety Pins Assorted Pk12 X 1
31 Sodium Chloride Pods 20ml Each X 8
32 Trauma Scissors X 1
33 Triangular Cloth Bandage - 110cm x 155cm X 1
34 Water-Jel burn dressing 4’’x16’’ X 1
35 Water-Jel burn dressing 8’’x18’’ X 1
37 Water-Jel burn dressing f12’’ x 16’’ facial X 1
38 Biohazard waste bag
Responsible First-Aiders will be clearly identified with emergency contact numbers and kept
in the supervisor’s safety file on site. The minimum PPE for first aiders is gloves and a one
way CPR mask/respirator.
All medical support, first aid, and advanced first aid responders shall be offered a Hepatitis B
vaccination. A declination form shall be retained for persons who decline immunization.
6.2 INCIDENTS OUTSIDE WORKING AREA

In case of incident outside the camp construction boundaries, the driver, or other person at
the incident location, will notify the ERTL that, in coordination with the Contractor Security
Dept., will mobilize the ambulance and the rescue vehicle from the nearest location with
Doctor onboard.
Each car shall have a first aid kit and the drivers shall have first aid training.
Time-lines for the provision of Basic Life Support and immediate First Aid
Response time Responder Site of heath care
< 4 minutes On Scene First Site of incident (field)
Aider.
< 20 minutes Advanced First Site of incident or field first-aid station
Aider
< 1 hours Doctor, Advanced Designated primary health-care unit
paramedic or
emergency trained
registered nurse.
<2 – 8 hours Referral to Secondary and tertiary health-care unit

medical facility
Whenever the patient is stabilized and comfortable to be transported to nearest airport,

he/she will be transported by road in an ambulance equipped with Advanced Life Support
material and equipment and manned with a qualified ALS paramedic or Doctor.
Where the stabilization of patient and transportation by road is of high risk to patient a
helicopter will be made available for the transport. Due to the limitation in terms of range for
helicopters, the IP will be delivered to the nearest center of medical excellence. The Doctor in
consultation with ERTL will decide on best possible route, destination and manner of
transportation.
6.3 MULTIPLE CASUALTY SITUATION
A Multiple Casualty situation is where the location, number, severity or type of live casualties
requires extraordinary resources or overwhelms current infrastructure.
The severity or type of casualty is decided at the triage sites and may change from time to
time. These levels of severity are referred to as RED (Cat-1, immediate), YELLOW (Cat-2,
urgent), or GREEN (Cat-3 delayed).
Triage principles must be applied wherever or whenever the number of casualties exceeds
the skilled medical help immediately available. Thus Triage should take place during
management of multiple casualty incidents ranging from simple multiple casualty personnel
transfer accidents to more complex disasters encompassing greater numbers of casualties.
Typical Triage sieve is used in major casualty accidents in order to sort patients into those
who need critical attention and immediate transportation to the hospital and those with less
serious injuries, as follows:
• The Doctor assigns the priority by appropriate color code and indicating the
destination for further treatment
• The Triage officer gives appropriate color coding according to the IP’s condition
• Triage sorts the injured into four priority groups:
o P1 RED – Immediate priority: those casualties who require immediate
lifesaving procedures
o P2 YELLOW – Urgent priority: those casualties who require urgent
treatment
o P3 GREEN – Delayed priority: those casualties who can wait for delayed
treatment
o P4 BLACK – Dead casualty.
Additional facilities to recover the IPs will be identified in the (project specific) (e. g.
Messroom, Meeting room) and list will be available in the clinic.
Triage flow is detailed in Appendix 3
A complete and specific Multiple Casualty Situation will be present on site.
6.4 FATALITIES
In case of any fatality, the following procedure shall be followed:
• Contact ERTL immediately.
• ERTL contact Project Director, Project Manager and Project HSE Manager
immediately. He will contact Branch Manager.
• Initiate incident notification protocol.
• Project Manager will inform the COMPANY (in the event of a fatality COMPANY
is provided with immediate notification) and Authorities as required.
• Contact Security to assist with crowd control.
• Remove all people from area of incident to a distance where no pictures can be
taken.
• Cover body with tarpaulin or other means to prevent pictures being taken – do
not touch or move the body.
• Place barricade around area.
• Remove all persons from location.
• Place barricade around area and secure the scene. Do not disturb any
equipment until directed by the CPY Construction Manage.
7. EMERGENCY RESPONSE TRAINING AND EXERCISES

To ensure all personnel are fully conversant with the Project’s Medical Emergency Response
requirements, the training and emergency exercises detailed in (Project specific).
8. COMMUNICATION
Communication during emergency situation shall be kept as described in this document. Any
contact with non-involved parties shall be avoided. Communication with Media will be
eventually agreed with Company.
In the event of any incident, personnel will immediately notify his/her Supervisor, who will
activate the Emergency Response Team (organization chart in Appendix 4), contacting the
ERTL via mobile phone or radio.
The ERTL will start the process as per Appendix 1.
9. APPENDICES
Appendix 1 – Emergency Flow Chart
Appendix 2 – Emergency Contact list
Appendix 3 - Cambridge Cruciform Triage Categories
Appendix 4 – MERT Organization Chart
APPENDIX 1 – MEDICAL EMERGENCY FLOW CHART
Medical Emergency
Doctor Intervention and IP.
Injury / illnes requiring further medical care. IP

Injury / illness addressed onsite. Potential in- stabilization. The doctor requires a Medical
patient care evacuation.
ERTL activate MEDEVAC plan cooperating with

Events communication and reporting 3rd party Medical Service, BM and Bonatti Crisis
Team.
Patient discharge from camp / MEDEVAC is addressed locally to Pemba or

local clinic. internationally to Johannesburg
IP treatment and monitoring. Communication

with Client and Authority, as required.
Patient Discharge from the Hospital.

Patient returns home or at work.
APPENDIX: 2 EMERGENCY CONTACT LIST
TITLE CONTACT NUMBER
Branch Manager
Project Director
Project Manager
ERTL
Project HSE Manager
HR Manager
Security Manager
Project Doctor/ Paramedic
Project Doctor/ Paramedic
The above list could be modified during the Project

APPENDIX 3 - Triage Categories
APPENDIX 4: MERT Organization Chart
ERTL
Project Doctor
- Nurse - Land Transportation

- Air Transportation
- Paramedic
- Ambulance Driver
- First Aiders

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HSE MANAGEMENT

PROCEDURES & PLANS

MEDICAL EMERGENCY PREPAREDNESS AND

“TO INSERT PROJECT NAME”

“To Insert Project Doc. Number”

Bonatti code: XXXXXX-XXX-XX-XXXXX Rev. A

APPROVED BY: _________________ DATE: _______________________

ENDORSED BY: __________________ DATE: _______________________

REVIEWED BY: __________________ DATE: _______________________

PREPARED BY: ____ GIOVANNI IANNOTTI ____ DATE: _____16/07/2020________

PREPARED BY: ____ EMANUELE STALLONE ____ DATE: _____16/07/2020________

REVISION MODIFICATION LOG

Revision Section Description

Figure Number Page Description

Tabel Number Page Description

LIST OF EMBEDDED FILES

Embedded Page Description

Figure 1: Project Location

1.2 SCOPE AND PURPOSE

This is achieved by:

The main objectives of this MERP are as follows:

(Insert here the local references applicable to the Project)

3. DEFINITIONS, ACRONYMS and ABBREVIATIONS

PROJECT (Project specific)

SERT Site Emergency Response Team

4.1 BRANCH MANAGER (BM)

4.2 PROJECT DIRECTOR/MANAGER (PD/PM)

• Enforcing the implementation of the Project MERP also by the Subcontractors;

4.3 PROJECT HSE MANAGER (HSEM)

4.5 EMERGENCY RESPONSE TEAM LEADER (ERTL)

• Case management (maintain all communication links/logistic/security);

4.6 MEDICAL EMERGENCY RESPONSE TEAM (MERT)

4.7 PROJECT DOCTOR / PARAMEDIC

• Manage the emergencies, stabilizing patients before evacuation to Hospital,

4.8 PROJECT SECURITY MANAGER

4.10 ALL PERSONNEL

Event that can be effectively addressed

An emergency situation, which is managed solely by Contractor or its Sub-contractor and

Examples are: minor injury or illness not requiring a Medevac.

Examples are: Illness / Injury requiring hospitalization to a Primary / Secondary HCU

6. INCIDENT MANAGEMENT PROCESS

Notification to ERTL and First

Activation of response by the

Assessment for further

Factors to be considered in establishing the appropriate IMS organization include:

• Location of and access to the incident;

6.1 MEDICAL EMERGENCY

(Insert here a step by step description of the Project specific MERP)

CONTRACTOR will provide emergency response procedures/plans based on specific

Here below the minimum requirements for First Aid training:

• Level 2 — Advanced first aid (In addition to Level I):

The minimum contents of a Regular Responder Bag (emergency bag) is:

Nasopharyngeal Airway 7mm 1

Administration set - 60 drops/ml leur lock 2

Crepe bandage 10cm 3

1 Adhesive Skin closure 3 x 75mm X 1

17 First Aider Splint 900 x 100mm X 1

6.2 INCIDENTS OUTSIDE WORKING AREA

<2 – 8 hours Referral to Secondary and tertiary health-care unit

APPROVED BY: _ DATE: _______

ENDORSED BY: DATE: _____

REVIEWED BY: DATE: _____

PREPARED BY: __ GIOVANNI IANNOTTI DATE: _16/07/2020______

PREPARED BY: __ EMANUELE STALLONE DATE: _16/07/2020______