Financial Disclosure I, Les Fryman, have no relevant financial or nonfinancial relationships in the products or services described, reviewed, evaluated or compared in this presentation.
Objectives Brief history of natural disasters in Kentucky. Most prevalent natural disasters in recent history. What are the most prevailing chemicals released in natural disasters. Hospital preparation for these events Hospital operations for those contaminated patients.
How About Some Data Natural Hazards were the cause of approximately 16,600 Hazardous Materials Releases reported by the NRC between 1990 and 2008. That is 3% of all Hazardous Materials Releases that were reported. Rain induced were the most at 26% Hurricanes – 20% Winds, Storms and other weather related phenomenon account for another 25%
Disasters A single natural hazard event may effect a large area and many industries The response to the natural disaster itself may divert resources that otherwise would be available. Source of data from the NRCs Incident Reporting Information System. (IRIS) Natural Disasters make up 75% of FEMA declared disasters.
History of Natural Disasters Where does Kentucky rank in the nation as far as declared natural disasters? #8 Since 1953 there have been: 56 Disaster Declarations 4 Emergency Declarations 6 Fire Management Assistance Declarations
Most Prevalent Disasters in Kentucky Severe Storms, Straight-Line Winds, Severe Winds, etc… Since 1957 – 43 Major Disaster Declarations From 1950-2010 – 2,071 extreme wind events 26 Considered Strong Wind Events Zeus
Most Prevalent Disasters in Kentucky Floods, Rockslides, and Mudslides Since 1957 – Mentioned in 39 Natural Disaster Declarations. From 1950-2010 604 Extreme Flooding Events 0 Extreme Landslides Poseidon
Number of Releases Associated with Various Natural Phenomena
Most Prevalent Hazardous Materials Released In Natural Disasters ChemicalProcessIDLH% in Spills Nitrogen OxideFlare Stack Emissions 20ppm13 BenzeneFlare Stack Emissions 500ppm8 PCBsDielectric and coolant fluids 0.5ppb in drinking water 5 Sulfur DioxideByproduct or Sulfuric Acid Production 100ppm5 Hydrogen Sulfide Sewer Gas Breakdown of organic material 10ppm4 Ammonia, Anhydrous Refrigeration systems at storage tanks 300ppm4
Quantity of Materials Released Range from drops to millions of liters. Most spills are less than 400 liters spilled Other spills were well over 40,000 liters. Total volume from 1990-2008 = 29 million liters spilled
Volume of petroleum released by Natechs, 1990-2008
Hospital Preparedness Golden Rule with Preparedness: IF YOU FAIL TO PREPARE……THEN PREPARE TO FAIL!!!! First Receiver Programs for Hospitals JCAHO Recommendation It is no longer sufficient to develop disaster plans and dust them off if a threat appears imminent. Rather, a system of preparedness across communities must be in place everyday.
JCAHO Recommendation JCAHO requires: Hazards Vulnerability Analysis Conduct a Hazard Vulnerability Analysis (HVA) Required by JCAHO (JCAHO 2002) Lists possible hazards (tornados to terrorism) Impact on hospital operations Actions to minimize likelihood, or mitigate the impact Rank vulnerability to hazard and prioritize efforts to reduce vulnerability That hospitals consider their anticipated roles and coordinate activities with other emergency response agencies and hospitals within the community.
American College of Healthcare Executives (ACHE)
Hospital Disaster Response Plans Components of a Hospital Emergency Disaster Plan: Objectives of the Emergency Plan/Disaster Plan Definitions of Roles and Responsibilities Central operations Center Community Contacts Guidelines to Emergency/Disaster Preparedness Pre-Disaster Planning Procedures during an emergency event Recovery plan to resume normal operations Disaster – Specific Scenarios Appendix Table
Hospital Disaster Response Plan Appendices: Listing of Approved Shelters Emergency Preparedness Letter of Understanding Generic Checklist Personal Items to bring to work in the event of an emergency Communications postings and scripting Local Contact Information Materials Management Supplier Disaster Phone List Pay Pone Listing/Alternate Phone Locations
Hospital Disaster Response Plan Appendices: Emergency Staffing Pay Dependent Care Childcare Plan Enrollment Staffing During Emergency/Disaster Event Policy Labor Pool Process Disaster Preparedness Status Briefing Red Cross Chapters Staff Notice/Briefing Procurement Summary Report
Hospital Disaster Response Plan Appendices: Team briefing Format Identification of Personnel Employee Contact Information Visitor Policy Local Radio Station Listing Emergency Plan Staff organization chart Incident Command Checklist Emergency Disaster Exemption Form Communications
Hospital Disaster Response Plan Appendices: Directors Emergency/Disaster Checklist Employee Emergency/Disaster Checklist Post-Impact Assessment Form Sleep Assignment Form Employee Emergency/Disaster Preparedness Handbook (for all employees to have and review)
Initial Operations IC Announces disaster declaration IC notifies Mahogany Row IC give readiness briefing Departments start preparation of their specific areas Internal Communication plans in operation Ensure computer/electronic equipment protection measures Activate labor pool Activate child care plan Prepare and send staffing plans to HR Dismiss Team B for 24 hours if possible
Emergency Department Initial procedures to get ED ready to accept patients: Surge Capacity Decontamination Procedures set up and in place The solution to the pollution is dilution
Summary When natural disasters happen, the chance of hazardous materials releases can hamper a hospitals response Emergency Disaster Plans need to be rehearsed and updated at all levels of the organization Failing to plan for your organization will ensure your plan will fail when you need it most.
Resources Sengul, H., Santella, N., Steinberg, L. J. and Cruz, A. M. (2012), Analysis of hazardous material releases due to natural hazards in the United States. Disasters, 36: 723– 743. doi: 10.1111/j.1467-7717.2012.01272.x Federal Emergency Management Agency. (2008). Fema Information. Retrieved from http://www.fema.gov.http://www.fema.gov Centers for Disease Control and Prevention. (2010). Retrieved from http://www.cdc.gov/http://www.cdc.gov/ Centers for Hazards Research and Policy Development, University of Lousiville Schneid, Thomas D., and Larry Collins. Disaster Management and Preparedness. Boca Raton, FL: Lewis, 2001. Print
Resources Managing Hazardous Materials Incidents. [Atlanta, Ga.]: U.S. Department of Health & Human Services, Public Health Service, Agency for Toxic Substances and Disease Registry, 1994. Print. Briggs, Susan M., and Michael Cronin, eds. The ABC's of Disaster Medical Response. N.p.: International Trauma and Disaster Institute, 2005. Print American College of Healthcare Executives. Healthcare Executives' Role in Emergency Preparedness. N.p.: ACHE, 2009. Print