1. General Emergency Preparedness for all BIDMC Staff BIDMC Emergency Management January 2010

2. What is Emergency Management (EM)? Emergency Management provides coordination of resources and organization during emergency response. EM moves into play when hospital operations may be disrupted. EM is responsible for preparedness, mitigation, response and recovery.

4. Focus of Emergency Management (EM) Standards Standards are organized to allow hospitals to plan responses to the effects of potential emergencies that fall on a continuum from disruptive to catastrophic Emergency Operations Plan need to have an “all-hazard” approach Plans that are scalable, may escalate in complexity, scope and duration 2009 standards were developed after reviewing over 300 events nationally

5. EM for ALL employees What is your role in emergency response- to support essential services of the hospital Who do you report to?- Your supervisor/manager/resource nurse Where are your evacuation routes?- Posted in the nursing station and in the evacuation plan

6. EM for ALL employees Who do I call to report a power failure?- Service Response Center- refer to Emergency Response Quick Reference Flipchart Where do you find response emergency actions?- Emergency Response Quick Reference Flipchart Does the medical center have an incident command structure?- Yes Know where to find your resources!

7. Resources O

8. Code Triage (Disaster Activation)  A warning or an alert may come by alarm, first observer or call from an external emergency response agency (call Public Safety to alert the AOC). Key staff will be alerted to activate the Emergency Operation Plan via Code Triage pagers by the AOC. All staff may be alerted via ACS, managers or overhead announcement if needed.  All on-duty staff is considered “essential” and should report into your department, do not leave the premises without managerial permission.

9. Provide Immediate First Aid For a splash into eyes, flush eyes with lots of water. For exposure other than the eyes, wash the exposed body part with lots of soap and flush mucous membranes thoroughly with water. Immediately report exposure to your manager, anti-viral therapy may be needed. Remove soiled clothing, wash skin, and change to clean clothing. Complete appropriate incident report form. Report as soon as possible (preferably within 1-2 hours) to: Employee Occ. Health (2-0710) or Emergency Department. Follow-up with any recommended treatment and/or evaluation. Body Fluid Exposure

10. Restricted Access or Lockdown Restricted Access: Notify Public Safety, Safety Officer, and the Administrator on Call to restrict all exits and entrances to all threatened areas of the hospital as needed. All persons wishing to enter the hospital will be questioned as to the purpose of their visit. Anyone who states that they have been exposed to a harmful agent or have a possible harmful agent in their possession will be directed to the decontamination area outside the ambulance entrance of the Emergency Department. Lock Down: If contamination occurs in the Emergency Department, lock down will be initiated so as to allow no one in or out until released by the Safety Officer.

11. Code Red Implement RACE: Rescue – Rescue people in immediate danger if you can do so without endangering yourself. Alarm – Sound the Alarm by pulling pull station and call the emergency line 2-1212 from a safe distance. Employees must be prepared to give the following information: Code Red; Location of emergency (building, floor, room number); caller’s name and callback number. Contain – Contain the fire by closing all doors, windows and other openings. Extinguish-Extinguish only a small fire AND if you have been trained. Prepare to evacuate if instructed by Floor Marshal or Boston Fire Department (BFD). Do not use elevator unless authorized by BFD. Clear the hallways by removing all items or move items to one side of the hall. Re-assure patients and visitors by stating this is an event that we will be verifying. Instruct patients/visitors that we will keep them informed regarding next steps.

12. Code Orange (Hazardous Spill Response) Low Hazard Spill: 1 liter or less of a known chemical that according to its Material Safety Data Sheet (MSDS) does not pose a threat to human health and the environment, and can be easily mitigated at the time of release by employees in the immediate release area. Actions: Contain and absorb spill. Collect and label residue. Arrange pick up by calling the Environmental Health and Safety (EH&S) dept at 7-3088. Notify unit manager or supervisor. Medium to High Hazard Spill: More than 1 liter of hazardous chemical or any volume of a known high hazard chemical/material, unknown chemical/material, radioactive material, elementary mercury, and/or spills involving injured staff needing medical attention. Actions: DO NOT ATTEMPT TO CLEAN UP. Attend to injured staff/prevent further contamination. If necessary, seek medical help by calling 2-9111. If possible, isolate spill area, relocate to a safe area. Activate the CODE ORANGE line by calling 2-1212. CODE ORANGE line will notify EH&S and/ or Radiation Safety on-call personnel. Provide spill information to responders. Responding staff will assess the incident and coordinate clean-up. Notify unit manager/supervisor.

13. System Failure Telecomm Failure, IS Failure, Med Gas/Vacuum Failure, Sewer Failure, Fire Alarm Failure, etc. Call one or more of the following: Service Response (2-0070) IS (4-8080) Public Safety (2-9111) Check all patients, red plugs, vented patients, etc.

14. What’s New in EM? In 2009 all in-patient units and support services have held evacuation trainings, including a short presentation and a hands on portion with Evac u Sleds In 2010 evacuation training will roll out to the ambulatory areas Evac u sleds have been distributed to most in-patient units, caches of sleds are in both East and West distribution centers for deployment

15. Evacuation Trainings

16. New department safety/evacuation plans Currently, we have two Mass Maritime interns formally mapping horizontal and vertical evacuation routes, holding areas and life safety devices to be posted in each unit These plans will be one page plus evacuation routes and posted in nursing stations We would like to designate a specific identifiable area in each unit for all emergency resources

17. REMEMBER….. Code Triage is our term for activating our Emergency Operations Plan Always refer to the Emergency Response Flipcharts for emergency directives-who to call, what to do It is the responsibility of everyone to support the essential functions of the medical center

18. Questions?