[The hospital emergency plan - basics and general structure].

A hospital emergency plan commonly consists of three main chapters dealing with the general aspects of emergency operation and the special aspects of external and internal emergencies. The extent of these chapters is restricted to general understanding and is completed by special instructions (emergency action plan, staff lists, material lists, situation plans) for each department. Due to its security significance, the emergency plan is handled confidential. External emergencies include mass casualty incidents, incidents with a large number of intoxicated patients, the care of patients with dangerous infectious diseases and NBC emergencies. Internal emergencies include fire and other environmental threats, the breakdown of the electrical power and water supply, the breakdown of the telephone system and other situations like bomb threat and taking of hostages. Any emergency call is sent to a special emergency phone, and a defined, experienced physician decides to activate the emergency plan. With the change from routine to emergency service, a chain of command is installed. The hospital staff deals with administrational and organizational aspects, whereas the medical staff is in charge of immediate patients' care. For each external emergency, the deployment of personnel and material and the basic organizational aspects are ordered. Comparable preparations are given for internal emergencies. To achieve realistic emergency planning, repeated evaluations and practical exercises are necessary. Furthermore, a basic independence of the hospital with respect to stocks, preparation and sterilization of instruments and catering is essential to ensure its function even under adverse conditions.