EMERGENCY PREPAREDNESS FOR DIALYSIS FACILITIES A …

1 EMERGENCY PREPAREDNESS FOR DIALYSIS FACILITIES A Guide for Chronic DIALYSIS FACILITIES TABLE OF CONTENTS The Format of This Mitigation and Program Program Some Relevant Requirements of ESRD Regulations Of Planning for an EMERGENCY Where to Begin?..6 Mitigation and PREPAREDNESS (Before the EMERGENCY Occurs)..8 Hazard "IBM Hazard Site Assessment Tool"..9 Building Insurance Hazard Fire Mitigation Tornado Mitigation Hurricane Mitigation Flood Mitigation Severe Winter Weather Mitigation Earthquake Mitigation Effective Communication Planning Before an Develop a Communication Helpful Communication No Dial Tone?

2 21 Sample Letter to a County Office of EMERGENCY Sample Public Service Announcement (PSA)..23 EMERGENCY Phone EMERGENCY Should You Purchase Or Rent A Generator or Do You Even Need One?..26 Determine How Much Power You Know Where to Obtain Generators and Related Develop a Generator Generators How to Determine the Size You Generator Rentals ..29 Glossary of Electrical and Generator Terms ..30 Record Management The EMERGENCY Box ..31 Employee and Patient EMERGENCY Employee Drills and Clamp and Cut or Clamp and Cap i Hand DIALYSIS Patient Survival Instructions (Disaster + 72 hours).

3 41 EMERGENCY Drinking Water Disinfection and EMERGENCY Succession for Decisions Management Decision EMERGENCY Response Checklist ..47 Patient Evacuation Priority ..50 Staff Evacuation Special Needs of Pediatric Communication Post EMERGENCY ..57 Recommendations for Management During Utility Internal Management of the DIALYSIS External Maintaining a Water Supply ..59 How to Calculate Water Loss of Water or Power Potential Problems and Rationing of Treatments and Alternate Adult EMERGENCY DIALYSIS Patient Damage Damage Assessment Damage Assessment Physical Site Damage Assessment Equipment Damage Assessment Post-Earthquake Damage Evaluation Earthquake Damage Assessment Post Flooding Evaluation Immediate First Aid for Immediate First Aid for Sustained Operations Logistical Facility Staff Administrative Reference Web Sites.

4 92 Hazard Structural Non-Structural Hazardous Materials ..96 Supply Checklist for DIALYSIS Home EMERGENCY Equipment and EMERGENCY Evacuation Kit for DIALYSIS iiFood and Water ..100 Mutual Aid and Affiliation Planning is the Key to Suggested Guidelines for an Affiliation EMERGENCY Equipment/Supply Temporary Disaster Staff Record ..104 EMERGENCY DIALYSIS Patient Volunteer Volunteer Management Financial Supply and Service Fire Safety ..111 Use of Extinguishers ..111 Fire Basic Fire Safety Occupant Housekeeping/Maintenance ..114 Fire/Life Safety How to Handle Anthrax And Other Biological Agent Threats.

5 115 Letter and Parcel Bomb Recognition Post-Traumatic Reactions to Coping With Post-Disaster Sample EMERGENCY Response Procedure The EMERGENCY Response Administrator or the Nurse-in-Charge Life Safety Responsibilities ..122 EMERGENCY Response Team EMERGENCY Response Team EMERGENCY Evacuation ..123 Medical Bomb Bomb Threat Hazardous Civil Power Violence In The DIALYSIS Flash Care of Disabled Persons in an How to Carry an Injured or Disabled iiiiv The Format of This Manual This manual has been prepared and organized using the principles of EMERGENCY management: Mitigation, PREPAREDNESS , Response and Recovery.

6 This guideline provides a brief overview of each section and how to use the manual most effectively. Even though this book focuses on infrastructure the DIALYSIS facility staff needs to remember that the patient is the main concern. Mitigation and PREPAREDNESS Before you can plan you must know what the hazards are for your area and facility. The three basic assessments you should perform are hazard site assessment, building and insurance review. Once these are completed, you can mitigate and prepare for the known hazards. You will find specific mitigation strategies for all types of emergencies such as fire, earthquake, flooding, tornado, hurricane and severe winter weather.

7 This chapter also gives you communication strategies, training guidelines, record management and tips on EMERGENCY generators. Response This section deals with how to handle an EMERGENCY as it unfolds. EMERGENCY succession must be planned for and documented. The EMERGENCY response checklist gives the person-in-charge a detailed list of issues to consider. Finally, patient evacuation, care of the pediatric patient and communication complete the section. Recovery Once the first hours of an EMERGENCY have subsided, the response phase begins. Decisions on serious issues such as treatment rationing, patient transportation and EMERGENCY DIALYSIS orders must be made in advance.

8 How to conduct a thorough damage assessment of the facility and the first aid care of documents and equipment are reviewed. If the EMERGENCY becomes a sustained event, facility, staff and administrative concerns are addressed. Appendix The final section, which could be used as a stand alone , includes forms and guidelines that are helpful through the entire planning process. 1 Introduction An EMERGENCY is defined as a situation requiring help or relief, usually created by an unexpected event. Thinking about the unthinkable is the driving force behind the development of this manual.

9 Our ability to recognize, assess and respond to an EMERGENCY situation involving a DIALYSIS clinic is critical to continuity of care for our vulnerable patient population. We cannot always predict when conditions or events will require that we implement our EMERGENCY procedures. However, no matter the source and magnitude of the EMERGENCY , the principles and models you will find in this manual will apply. Emergencies do not announce themselves to us, but our reasoned response will determine the extent to which damage can be mitigated and operations resumed. Engage staff and patients in the process through education.

10 PREPAREDNESS is the most effective way to prevent panic. An EMERGENCY stops being one when you are prepared for it. Program Goals It is important to have clear and concise goals for an effective EMERGENCY management program. Goals direct your planning efforts and resources expenditures. Elements of a DIALYSIS facility EMERGENCY management manual should include provisions to: Ensure safety of employees, patients, and visitors. Assure availability of DIALYSIS care. Protect electronic and hard copy clinical and business records (data and paper critical records). Mitigate damage to property and contents.