Welcome to Jefferson Regional Medical Center

EARTHQUAKE DISASTER PLAN

The probability of the occurrence of an earthquake resulting in damage to Jefferson Regional Medical Center is very real.  The following information is intended to serve as a general guideline governing your actions in the event of such a catastrophe.  An earthquake may cause external and internal damage to our facility while causing damage to the community.  Therefore, it is important to remember that other safety plans automatically become part of our earthquake plan.  All employees should be familiar with our Fire Plan, Internal Disaster Plan, External Disaster Plan, and Contingency Plans, located in the Facility Safety Manual as well as their Departmental Manual.

WHAT TO EXPECT IN AN EARTHQUAKE
Most likely there will be no warning preceding an earthquake.  Sometimes, there is a rumbling noise similar to a train approaching, but we are generally, initially aware when the shaking starts.  Historically, the shaking will last from five seconds to four minutes, and the severity will be determined by the intensity of the earthquake at our location.  You may expect such things as a loss of electricity, water breaks, falling objects, window breakage; objects moving such as beds, chairs, ice boxes, food carts, medicine carts, cleaning carts; and other normally harmless conveyances will move with speeds that can cause severe damage, collapsing walls, falling plaster ceilings, and drastic human actions resulting from FEAR.

WHAT YOU CAN DO
There are many actions that you can take to reduce the dangers from earthquakes to yourself and your patients.

Before an Earthquake Occurs
Personal Preparedness Actions:  Know your area and your safety plans.  Know where and how to shut off electricity, gas, and water in your area in the event maintenance personnel are not available.  Be sure you have an adequate supply of flashlights with fresh batteries in your area.  Place large and heavy objects on lower shelves.  Bottled goods, glass, china, and other breakables should likewise not be stored in high places.  Check your area for bookcases, file cabinets, and other items that might fall and block exits.  Also check for items stored on top of these items that might fall off and injure someone.  Remember, in a large earthquake the items can fly across the room instead of just falling off.

You will be concerned with family and loved ones outside of the workplace.  Make provisions that include training, ways to make contact, prearranged agreements and understanding as to what actions family members will take in the event of a disaster in case you are at work.  Examples of these provisions include agreements and understandings of what your school district will do in the event kids are in school; agreements with other residents of your neighborhood or family to check on family and other important items; prepare survival kits for home and car, and, surveys of your home with needed corrections made to allow you and your family to be prepared in the event of a disaster.

During an Earthquake
In earthquakes, most injuries occur as people are entering or leaving buildings.  Should an earthquake strike, try to take cover under a heavy desk, a table, a bench, in a doorway, in the halls, or against inside walls.  Stay away from glass if possible and watch for swaying doors.  Remember -- DROP, COVER, and HANG ON.  Inside walls provide more safety.  In a severe earthquake, you will not be able to move around during the tremor.  Know your area ahead of time because your actions during the first few seconds may make the difference.  You will not have time, nor should you attempt to move patients from beds.  Safety for the staff is critical to allow for patient care afterwards.  Try to stay as calm as possible and ride out the tremor.  Many deaths and injuries are the result of panic.  How we prepare before an earthquake, such as keeping bed siderails in place and bed wheels locked will have a direct impact on our patients and our own safety during a severe earthquake.

After an Earthquake
In conjunction with your Departmental Plans and other Facility Safety Plans, remember, DO NOT PANIC!  Be prepared for “aftershocks” or additional earthquakes.  Evaluate your immediate situation in patient care areas, and do not attempt to exit the building unless you are directed to do so.  Monitor patients and other staff in the immediate area for injuries.  Call for assistance, but do not attempt to move seriously injured patients unless they are in immediate danger of further injury.  If communications are out (telephone, nurse call), try to establish a runner system using non-nursing personnel and including able patients to establish contact with supervision.  Supervision will need area status reports to provide an overall picture for the Safety Director and Administration for allocation of resources including assignment of work pool and building evaluations.  Be alert for damaged electrical wiring.  Mark these areas and keep others away.  Do not shut off main oxygen valves unless the lines are broken.  Be extremely alert for patients who are on oxygen and require this for life support.  If you move patients who can walk, make sure they have shoes and provide them with blankets.  Escort them to the designated areas.  Do not be concerned about personal items such as pictures, flowers, etc.  However, water in covered patient containers present possible sources for immediate drinking water.  If your area has experienced severe structural damage, you may find it necessary to try to group your patients in the most secure appearing areas.  Use your runners to notify command where you are.  In rooms that you are able to leave the patients, make sure all window drapes are closed even if the glass is gone.  Window glass is usually one of the first items to break.  Know and follow your safety plans for your area.  Stay as calm as possible and try to stabilize the situation and injuries, be prepared for aftershock and let command know where you are and your situation.  Remember help will be on the way.

In the office or non-patient care areas where there has been structural damage, exit may be required.  If you leave your area, attempt to leave a note confirming your exit.  This will allow resources to account for missing people.  If you exit the facility, remain on the parking lot by the switchboard, Emergency Room, or on other areas as directed.  Do not leave the staging area without letting someone know.  You are an important part of our emergency work pool.  If you are unable to leave a structurally damaged area, secure yourself as best as possible against “aftershock”.  Try to establish a “personal secure area” under a desk or other support, try to shore it up and remain there.  Establish a signal system to allow rescuers to be able to locate you.  You are assured that help will be coming, the hard part is to try to stay calm until they can get there.  Make sure you know where potential exits are and the best potential direction for arrival of help.  Rescuers will be listening for you and will be searching areas with highest potential populations first, but the entire building will be checked.

The Maintenance Department has various duties assigned in accordance with their Departmental Policies. These include checking the building for structural damage; maintaining electricity, gas, medical gas, water and sewer systems if possible; and providing assistance to the daycare (if needed). This will also include the shutting down of systems as required and other duties as assigned by Administration or the Safety Director.

Security will assist with outside communications, building security and evaluation, crowd control, and other duties as assigned by Administration or the Safety Director.

Administration will assume overall command. A central command post will be established utilizing work pool members for runners or assignment to selected designated areas. Administration will be responsible to authorize evacuation if required and to resolve any conflict or decision requiring their input. As part of their duties, they will establish and distribute work pools; receive and maintain status reports including structural, missing persons, and areas needing assistance; and give and receive critical reports from the outside. The Safety Director will oversee the activities of the Maintenance and Security Departments and will receive structural and missing persons reports from Maintenance and other areas presenting these to Administration with recommendations. The Safety Director will also act on behalf of Administration as directed by Administration and will supervise the building inspection plans and evacuation plan (if needed).

Materials Management will secure in-house supplies and implement a distribution system requiring the signature of Administration for the distribution of supplies. Contingency plans for water, food, or supplies will be placed in effect with Administration approval.

Housekeeping will start area cleanup as directed. Linen (soiled and clean) will be secured. Clean linen will only be issued with Administration approval. There will not be a mass distribution without need as clean linen may become very hard to secure. Housekeeping will have contingency plans to secure and provide clean linen and housekeeping supplies. (Note: An extended disaster recovery period may require linen only to be changed when heavily soiled or with patient changes; also, a large number of patients or surgeries without adequate supply of water will require additional housekeeping chemicals.)

Dietary will immediately secure and inventory all food supply. In the event of a major earthquake, normal cooking procedures may be impossible so attention must be given to which foods should be used first, etc. Dietary will supply the Safety Director with an inventory and an estimation of days the food would last and recommendation of food needed to support the facility for at least six days. All liquids such as canned juice, soda, soups, and liquids from canned vegetables should be secured since potable water supplies may be extremely limited and these sources may have to help replace the shortage of potable waters.

Pharmacy will secure and inventory the drug and medicine supply. Administration and/or the Safety Director should be provided with status reports on drug availability especially DT, antibiotics, and other critical drugs.

Respiratory Therapy will secure and inventory availability of medical gases. Also, they will be responsible to attend persons on life support oxygen with portable tanks.

The Medical Director and Director of Patient Care Services or designee will be responsible to survey in-house patients to prepare to release less critical patients to enable beds to become available for more seriously injured incoming or new patients. This information will be provided to Administration for approval.

The Emergency Room Charge Nurse and the Nursing Shift Supervisor will be responsible to establish a triage area and to advise Administration of the location. Administration will advise the Safety Director and Security of this location. Control of outgoing supplies to ambulances and other emergency units will be limited and must be approved by Administration. This includes medicines and linens.

All other departments will be required to organize in accordance with their Departmental Safety Plans and other Facility Safety Plans.

PERSONAL CONDUCT IN AN EARTHQUAKE DISASTER:

REMAIN CALM: Think through the consequence of any action you take.  Cooperate fully with hospital officials.  If an earthquake occurs, we must be prepared to remain isolated with little or no outside assistance for possibly a week.  Major utilities will probably be disabled.  It is likely that many fires will occur in the immediate areas.  Major thoroughfares and highways will in all probability be closed due to structural damage and collapse of overpasses, exit ramps, etc.

AGAIN, REMAIN CALM:      If you survive the initial shock wave and conduct yourself as this plan suggests, your chances and the chances of our patients of escaping severe injury are very good.

REMEMBER.....

YOU ARE A PROFESSIONAL.  The patients committed to your care also depend on you for survival.  Each department will maintain appropriate Emergency Safety Plans to be as best possible prepared for disasters including earthquakes.

US Patent Numbers 7,720,998 B2, 7,836,207