Emergency Preparedness - preparing hospitals for disasters



Preparing and Drilling: Earthquake

Know the Terms

Familiarize yourself with these terms to help identify an earthquake hazard:

Earthquake

A sudden slipping or movement of a portion of the earth’s crust, accompanied and followed by a series of vibrations.

Aftershock

An earthquake of similar or lesser intensity that follows the main earthquake.

Fault

The fracture across which displacement has occurred during an earthquake. The slippage may range from less than an inch to more than 10 yards in a severe earthquake.

Epicenter

The place on the earth’s surface directly above the point on the fault where the earthquake rupture began. Once fault slippage begins, it expands along the fault during the earthquake and can extend hundreds of miles before stopping.

Seismic Waves

Vibrations that travel outward from the earthquake fault at speeds of several miles per second. Although fault slippage directly under a structure can cause considerable damage, the vibrations of seismic waves cause most of the destruction during earthquakes.

Magnitude

The amount of energy released during an earthquake, which is computed from the amplitude of the seismic waves. A magnitude of 7.0 on the Richter Scale indicates an extremely strong earthquake. Each whole number on the scale represents an increase of about 30 times more energy released than the previous whole number represents. Therefore, an earthquake measuring 6.0 is about 30 times more powerful than one measuring 5.0.

Take Protective Measures

Before an Earthquake

The following are things you can do to protect yourself, your family, and your property in the event of an earthquake:

• Repair defective electrical wiring, leaky gas lines, and inflexible utility connections. Get appropriate professional help. Do not work with gas or electrical lines yourself.

• Bolt down and secure to the wall studs your water heater, refrigerator, furnace, and gas appliances. If recommended by your gas company, have an automatic gas shut-off valve installed that is triggered by strong vibrations.

• Place large or heavy objects on lower shelves. Fasten shelves, mirrors, and large picture frames to walls. Brace high and top-heavy objects.

• Store bottled foods, glass, china, and other breakables on low shelves or in cabinets that fasten shut.

• Anchor overhead lighting fixtures.

• Be sure the residence is firmly anchored to its foundation.

• Install flexible pipe fittings to avoid gas or water leaks. Flexible fittings are more resistant to breakage.

• Locate safe spots in each room under a sturdy table or against an inside wall. Reinforce this information by moving to these places during each drill.

• Hold earthquake drills with your family members: Drop, cover, and hold on!

During an Earthquake

Minimize your movements during an earthquake to a few steps to a nearby safe place. Stay indoors until the shaking has stopped and you are sure exiting is safe.

|If you are |Then: |

|Indoors | |

| |If an earthquake strikes, you may be able to take cover under a heavy desk or table.  It can provide you with air space if the building |

| |collapses.  If you get under a table and it moves, try to move with it. |

| |Inner walls or door frames are the least likely to collapse and might also shield against falling objects.  If other cover is not |

| |available, go to an inner corner or doorway, away from windows or glass panels. |

| |Stay away from glass and hanging objects, bookcases, china cabinets or other large furniture that could fall.  Watch for falling |

| |objects, such as bricks from fireplaces and chimneys, light fixtures, wall hanging, high shelves and cabinets with doors that could |

| |swing open. |

| |Use a blanket or pillow to shield your head and face from falling debris and broken glass. |

| |If the lights go out, use a battery-operated flashlight.  Don’t use candles, matches or lighters during or after an earthquake.  If |

| |there is a gas leak, these could cause an explosion. |

| |If you are in the kitchen, quickly turn off the stove and take cover at the first sign of shaking. |

| |Stay in bed - if you are there when the earthquake strikes - hold on and protect your head with a pillow, unless you are under a heavy |

| |light fixture that could fall. In that case, move to the nearest safe place. |

| |Use a doorway for shelter only if it is in close proximity to you and if you know it is a strongly supported, loadbearing doorway. |

| |Stay inside until shaking stops and it is safe to go outside. Most injuries during earthquakes occur when people are hit by falling |

| |objects when entering into or exiting from buildings. |

| |Be aware that the electricity may go out or the sprinkler systems or fire alarms may turn on |

| | |

| |DO NOT use the elevators. |

| |High-Rise Buildings |

| |Get under a desk and stay away from windows and outside walls.  Stay in the building.  The electricity may go out and the sprinkler |

| |system may come on.  DO NOT use the elevators. |

| | Crowded Indoor Public Places |

| |If you are in a crowded public place, do not rush for doorways.  Others will have the same idea.  Move away from display shelves |

| |containing objects that may fall.  If you can, take cover and use a jacket or other material to shield your head and face from falling |

| |debris and glass. |

|Outdoors |Stay there. |

| | |

| |Move away from buildings, streetlights, and utility wires. |

|In a moving |Stop as quickly as safety permits and stay in the vehicle. Avoid stopping near or under buildings, trees, overpasses, and utility wires.|

|vehicle | |

| |Proceed cautiously once the earthquake has stopped, watching for road and bridge damage. |

|Trapped under |Do not light a match.· Do not move about or kick up dust. |

|debris | |

| |Cover your mouth with a handkerchief or clothing. |

| | |

| |Tap on a pipe or wall so rescuers can locate you. Use a whistle if one is available. Shout only as a last resort - shouting can cause |

| |you to inhale dangerous amounts of dust. |

Other Considerations when planning: Special Needs

Persons with Disabilities

Before an Earthquake

• Write down any specific needs, limitations and capabilities that you have, and any medications you take.  Make a copy of the list and put it in your purse or wallet.

• Find someone (a spouse, roommate, friend, neighbor, relative or co-worker) to help you in case of an emergency.  Give them the list.  You may wish to provide a spare key to your home, or let them know where they can find one in an emergency.

During an Earthquake

• If you are confined to a wheelchair, try to get under a doorway or into an inside corner, lock the wheels and cover your head with your arms.  Remove any items that are not securely attached to the wheelchair.

• If you are able, seek shelter under a sturdy table or desk.  Stay away from outer walls, windows, fireplaces and hanging objects.

• If you are unable to move from a bed or chair, protect yourself from falling objects by covering up with blankets and pillows.

• If you are outside, go to an open area away from trees, telephone poles and buildings and stay there.

After an Earthquake

• If you are trapped, try to attract attention to your location.

• Turn on your battery-operated TV or radio to receive emergency information and instructions.

• If you can, help others in need.

 

Children’s Special Needs

Fear is a normal reaction to danger.  A child may be afraid of the event happening again, injury or death after an earthquake.  They may fear being separated from their family or being left alone.  Children may even interpret disasters as punishment for real or imagined bad behavior.  Children will be less likely to experience long periods of fear or anxiety if they know what to expect before, during and after an earthquake.  Talking to children openly will also help them overcome fears.

Here are some suggestions:

• Explain that an earthquake is a natural event and not anyone’s fault.

• Talk about your own experiences with natural disasters or read aloud books about earthquakes.

• Encourage your child to express feelings of fear.  Listen carefully and show understanding.

• Your child may need both verbal and physical reassurance that everything will be okay.  Tell your child that the situation is not permanent.

• Include your child in clean-up activities.  It will be comforting to the child to watch the household begin to return to normal and to have a job to do.

PETS: During and after

• Don't try to hold your pet during a quake. Animals instinctively want to hide when their safety is threatened. If you get in their way, even the nicest pets may hurt you.

• Watch animals closely. Leash dogs and place them in a fenced yard.

• Pets may not be allowed into shelters for health and space reasons. Prepare an emergency pen for pets in the home that includes a 3-day supply of dry food and a large container of water.

• If you can't find your pet or must leave it at home after a quake, leave fresh water in nonspill containers such as bathtubs and sinks. Leave plenty of low-fat dry food, which deteriorates more slowly and is less tasty so pets won't try to eat it all at once. Leave a note indicating that you have a pet, where you will be and the date.

After an Earthquake

• Be prepared for aftershocks. These secondary shockwaves are usually less violent than the main quake but can be strong enough to do additional damage to weakened structures.

• Open cabinets cautiously. Beware of objects that can fall off shelves.

• Stay away from damaged areas unless your assistance has been specifically requested by police, fire, or relief organizations.

• Be aware of possible tsunamis if you live in coastal areas. These are also known as seismic sea waves (mistakenly called “tidal waves”). When local authorities issue a tsunami warning, assume that a series of dangerous waves is on the way. Stay away from the beach.

[pic]

|1. Check for injuries. Do not move a seriously injured person |  |4. Tsunami hazard. If you live along the coast, be alert for |

|unless they are in immediate danger of further injuries. | |news of tsunami warnings issued by the Alaska Tsunami Warning |

|2. Safety check. Check for the following hazards: | |Center. If you experience a strong earthquake, there may not be |

|Fire or fire hazards. | |time to issue a warning. Move to higher ground as soon as you |

|Gas leaks: Shut off the main gas valve only if a leak is | |are able, and stay there until the authorities issue an "all |

|suspected or identified by the odor of natural gas. Wait for the | |clear." |

|gas company to turn it back on once the damage is repaired. | |5. Expect aftershocks. Most of these are smaller than the main |

|Damaged electrical wiring: Shut off power at the control box. | |earthquake. Some may be large enough to do additional damage to |

|Downed or damaged utility lines: Stay away from downed lines even| |weakened structures. |

|if power appears to be off. | |Use flashlights or battery-powered lanterns. Do not use |

|Fallen objects in closets and cupboards: Displaced objects may | |lighters, matches, candles, or lanterns until you are sure there|

|fall when you open the door. | |are no gas leaks. |

|Downed or damaged chimneys: Approach chimneys with caution. They | |Use your telephone only in the event of life-threatening |

|may be weakened and could topple during an aftershock. | |emergencies. |

|Check your telephone: Make sure each phone is on its receiver. | |Turn on a battery-powered radio for information, damage reports,|

|Telephones that are off the hook tie up the telephone network | |and for information on volunteering your assistance. |

|unnecessarily. | |Keep streets clear for emergency vehicles. Cooperate with public|

|3. Clean up. Clean up potentially harmful materials and/or | |safety officials. |

|medicines which may have spilled. | | |

Evacuating Your Home or Office

If you must evacuate at home or work:

• Post a message in a location known only to family members, letting them know where you have gone.

• Confine pets to the safest location possible and make sure they have plenty of food and water.  Pets may not be allowed in designated public shelters.

• Take vital documents (wills, insurance policies, etc.), emergency supplies and extra medications with you.

Knowledge Check

Check your knowledge about what to do during an earthquake. For each question, choose answer A or B and circle the correct response. When you have finished, check your responses using the answer key.

What action should you take during an earthquake? The answer varies by where you are when an earthquake strikes. For each situation, pick the best course of action from the choices given.

1. At home or in office:

A. Stay inside

B. Go out to the street

2. In bed:

A. Stand by a window to see what is happening

B. Stay in bed and protect your head with a pillow

3. In any building:

A. Stand in a doorway

B. Crouch in an inside corner away from the exterior wall

4. On the upper floor of an apartment building:

A. Take the elevator to the ground floor as quickly as possible

B. Stay in an interior room under a desk or table

5. Outdoors:

A. Run into the nearest building

B. Stay outside away from buildings

6. Driving a car:

A. Stop the car in an open area

B. Stop the car under an overpass

Earthquake Drill

• Review emergency procedures with your family and co-workers every 3 months.

• Encourage your family and co-workers to participate in earthquake drills.

 

Practice Drop, Cover, and Hold

• Practice taking cover as if an earthquake were taking place. This will make people aware of the safest places in their immediate environment.

Practice Exiting

• Practice exiting your home and work place. Walk through the possible escape routes, and periodically inspect those routes to make certain they are not cluttered, and if they could become blocked by falling debris.

Practice Shutoff

• Practice turning off electricity, gas and water at your home and office. Be sure everyone can do this quickly and safely. Know how to turn off gas, but do not practice this step. Once gas is turned off for any reason, only trained utility personnel should turn it back on.

Practice First Aid

• Review and practice first aid techniques. All members of the household should receive periodic first aid training.

Review Earthquake Plans/ Emergency Operation Plan

• Check and refresh the supply of emergency food and water in your survival kit/cache.

• Check medication and first aid materials at the clinic and also for members of your household including the children, handicapped and elderly.

• Replenish expired supplies of food, water, medicine, fire extinguishers and batteries at least every 6 months.

• Review the responsibility of each staff/family member after an earthquake.

• Call the designated contact person outside the area to remind them of their role.

• Review plans to pick up children and check with schools and daycare centers to ensure the family plan is still appropriate.

• Contact your neighbors, partner organizations, and neighborhood association frequently to review earthquake plans.

• Contact your local Emergency Management Office for an update on the local emergency plan.

If Planning a Tabletop Drill:

Possible: Discussion topics

• Who is part of your Incident Command team and do they know their roles?

• What gaps were there during the drill?

• What worked well?

• What can be worked on for next time? Lessons learned?

• Were supplies appropriate? If not what can be done for next time? Any MOU’s/Mutual Aid for supplies and services?

• Is staff prepared and trained on how to respond?

• What will be done to ease patient and staff fears?

• Do staff know of any communication plans? Are there any?

• How is your Emergency Operations plan being utilized? Is it effective? Do changes need to be made?

• What are the plans for re/training for the future?

• How and who else will you be communicating with during the emergency? After? Do you know how?

• What will you do with a surge of patients? How will you handle flow?

• What will you do if your workforce is limited?

• What are your plans for recovery?

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