NFPA Journal - January/February 2013 - (Page 55)

Following Hurricane Katrina in 2005, 4 airboats were used to evacuate patients and staff from Memorial Medical Center in New Orleans. A component of the EOP is providing the proper “resources and assets,” including vehicles to transport staff, patients, and equipment during an evacuation. Training staff on the EOP and testing the plan through functional or full-scale exercises at least twice annually are additional provisions aimed at keeping an emphasis on emergency planning. “We also require annual updates to the HVA and EOP, which will play a huge role at health care facilities in New York and elsewhere,” says Jonathan Hart, NFPA staff liaison for NFPA 99. “They may have thought Sandy was a 100-year storm. Now that they know it’s a possibility, proper planning could help them prepare for the next one.” Responding to an influx of new arrivals during a disaster—which occurred in New York City when 14 hospitals received patients from evacuated hospitals—is also covered in the code. The section on “surge capacity of victims” provides guidance on assessing victims and the risks they might pose to others. The Joint Commission also saw a need to expand its guidance on emergency preparedness. The Comprehensive Accreditation Manual for Hospitals has beefed up provisions on emergency management that were modeled after Chapter 12 in NFPA 99. Prior to 2009, the requirements were a small subset of another chapter, says George Mills, director for the Commission’s Department of Engineering. “Everyone has been aggressive in getting [an EOP] built,” he says of the manual’s directive for facilities to organize a plan. “Our surveyors are finding that organizations have done a good job with preparation. There’s been a high level of compliance as far as developing these plans.” Exercising the EOP is another Commission requirement that was invaluable when an EF5 tornado, one of the most powerful ever recorded, destroyed St. John’s Regional Medical Center in Joplin, Missouri, Lessons From Katrina The following excerpts are from the supplement “Health Care Emergency Management Response and Recovery: New Orleans,” which can be found in the 2012 edition of the NFPA 99 Handbook, available for purchase at nfpa.org. The supplement outlines the emergency response to Hurricane Katrina in health care settings and the lessons learned from an operational standpoint. Hurricane Katrina struck the Louisiana and Mississippi Gulf Coast on August 29, 2005, as a strong Category 3 hurricane. The hurricane was the single most costly hurricane to strike the United States. Prior to Katrina, health care planning stressed staying in place rather than evacuation as a strategy. This proved to be a fatal mistake in some cases, primarily in long-term care facilities. Review of what went wrong Those responsible for implementing a disaster plan in advance of a storm will be criticized for either evacuating or not evacuating. An evacuation of the magnitude faced during Katrina had never been exercised or completely planned. Moving patients away from a catastrophe is possible given time, planning, and resources. Housing, food, clothing, employment, schooling, and health care needs for displaced patients of a major metropolitan area are beyond the scope of most current plans. Evacuating patients is one of the most hazardous undertakings that a facility can face. The physical trauma and mental stress of moving [can be] sufficient to justify the rejection of an evacuation. However, as the organizations learned the consequences of staying, a point arrived at which the patients were at greater risk by remaining in place. Recommendations: Health care evacuation The largest improvement that can be made is identifying the exact point at which evacuation of health care facilities is mandated. Evacuating is extremely costly and dangerous, as is the decision to stay and weather the storm. At some point, the balance tips, and evacuation must be implemented. A pre-approved checklist of balance points for staying or evacuating is currently not part of disaster planning. Experience is the only reliable guide [to help determine whether to stay or to evacuate]. Those who are on life support, are violently aggressive, or are prematurely born may die if removed from the health care environment for evacuation. Those same patients may die if they are not evacuated and support services fail. Both of these actions were taken during Katrina. The relative comfort of the patient, however, can be dramatically improved when full service is available. Therefore, evacuation must be completed early enough to provide critical care patients the time to be transported with proper support to ensure their survival, and, at the end of their journey, their comfort and care. The element of evacuation in disaster response should be drilled and practiced to provide the administrator and physicians with an understanding of when a balance has been reached or exceeded. Photograph: AP/Wide World JANUARY/FEBRUARY 2013 NFPA JOURNAL 55 http://www.nfpa.org

Table of Contents for the Digital Edition of NFPA Journal - January/February 2013

NFPA Journal - January/february 2013
Contents
First Word
In a Flash
Perspectives
Firewatch
Research
Heads Up
Structural Ops
In Compliance
Buzzwords
Outreach
Electrical Safety
Wildfire Watch
Rebuilding a Hospital
Prepping for the Worst
Chicago View: A Preview of the 2013 NFPA Conference & Expo
Long Time Coming
Section Spotlight
What’s Hot
Looking Back

NFPA Journal - January/February 2013