Second National Emergency Management Summit

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Second National Emergency Management Summit
Full Building Evacuation
Presented by Scott Aronson, MS Principal ?
860-793-8600 saronson_at_phillipsllc.com
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Evacuation From a Healthcare Facility Is the
EXCEPTION, Not the Rule
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It Could Be More Dangerous
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However, Just in Case

• 2007 CA Wildfires
• 2006 MA and NY hospitals nursing homes
• 2005 Hurricanes Katrina Rita
• 2004 Florida Hurricanes

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Preplanned Methodology

• Prepare patients within units / departments
• Move to an internal Holding Area
• Transport from the Holding Area to receiving
  facilities, or discharge

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Key Components of the Plan

• Activation of FBE Plan Staff Awareness
• Activation of a Labor Pool
• Establishment of Internal Holding Areas
• Coordination of Transportation (internal
  external)
• Patient Preparation on Units
• Evacuation Path of Travel
• Determination of Receiving Sites
• Patient Tracking (internal and external)

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Decision Making

• Full Building Evacuation or Internal
  Surge/Relocation
• Should staff call-backs go into effect (remember
  staff burnout)?
• Are we transporting directly to EMS transports or
  can internal Holding Areas be utilized to
  stabilize and track?
• Is this a regional incident or are we going to
  have local and state assets supporting us?
• Is the building infrastructure impacted
  (earthquake, flooding, internal explosion, no
  power)
• How does this affect means of travel? Vertical?
• Are area healthcare facilities prepared for a
  surge?

Was this initial thinking just completed without
Incident Command in place?
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Patient Preparation On Unit

• Complete top portion of the Patient Evacuation
  Tracking Form
• Department-specific Plan should include
• Package chart (including MAR, face sheet
  nursing notes) customized for unique records in
  depts. i.e. baby chart
• Package with personal belongings (i.e. glasses,
  dentures, hearing aids, etc.)
• Evacuation Stairs and Elevators specific to the
  unit
• Medications and Supplies that MUST go
• Special Considerations
• Intra-aortic Balloon Pump Patient
• Ventricular Assist Device Patient
• Non-ambulatory Bariatric Patient
• Special Precautions
• Staff to Patient Ratio (suicide risk
  aggressive/violent complex equipment)

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Holding Areas

• Holding Areas cleared prior to evacuation
  initiating

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Green Holding Pick-up
Behavioral Holding Pick-up
Route 8
Yellow Holding Pick-up
Police Roadblock
Bus Staging Blessed Sacrament Church - Roberts
Street
Red Holding Pick-up
Ambulance Staging Opticom Parking Lot - Grand
Ave.
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Priority of Evacuation

• Consider
• Ambulatory
• Non-ambulatory, low to mid acuity (stable)
• Non-ambulatory, high acuity/high intensity
• Non-ambulatory, unstable high acuity/high
  intensity/non-ambulatory bariatric
• Consider (Behavioral Health)
• Low Risk
• High Risk - Suicidal
• High Risk Aggressive
• Consider bypassing the Holding Area with those
  that should not be mixed with the general
  population

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Once a Unit is Evacuated

• Once evacuation of the unit / department is
  completed
• Check unit / department to ensure evacuation is
  complete YELLOW TAGS
• Account for all staff
• Direct all staff to report to the Labor Pool (or
  they may be leaving with patients)
• Report evacuation status to the Command Center
  and the Holding Area
• Deliver Patient Destination form to Command Center