History has shown us that we can
never be sure where or how the
next hurricane, earthquake, viral
outbreak or accident will occur. This is
why, in the event of a natural or
manmade disaster, businesses that
serve the public must be ready today
with contingency plans that can be
put into action in the event of a
natural or manmade disaster. And
nowhere is that readiness more crucial
than in the healthcare industry.
Fortunately, the Centers for Disease
Control has established a Strategic
National Stockpile of pharmaceuticals,
medical devices and other essential supplies that stands ready
for deployment in the case of a major disaster. In addition,
hospital systems across the country have put together strategies
for handling the large increases in acute care patient population
that will likely result from such a disaster.
What role will you as a respiratory DME provider play in
such a scenario? Hospitals and other healthcare facilities may
be overrun with acutely ill patients during and for some time
after an emergency. This may make them inaccessible to homecare
patients. The patients you normally service at home will
likely need to remain at home or else move to an alternate site
like a community center, a school or a church. And they will
need to be cared for without reliable power, running water or
delivery of consumables.Your organization will play a vital role
in the lives of the patients you care for at home.
Helping Families Prepare
What role can you as a respiratory DME provider play in the
preparation for such a scenario? As the recent insurance
company ad says, “Ready feels good.” One of the most important
vital steps roles you can take play is to help the families you service to ready themselves for an emergency situation by
walking them through the preparation process. Help the families
you care for at home break up the preparation process into small,
attainable steps.
Emergency kit. Caregivers should have an emergency kit on
hand and ready to go at all times. Some essential contents are:
first aid kit, airway care supplies, blankets, several days worth
of food and water, radio, flashlights, batteries for the flashlights,
batteries for portable ventilator and other power-dependent
medical devices, a wrench for shutting off natural gas supplies
and other provisions. This kit may need to go with the family if
they evacuate their home so all supplies should be stored in
containers that can be carried by the adults and adolescents
who live in the home.
Power backup. Caregivers should make certain that they are
equipped with the power needed to maintain life-sustaining
medical device operation and supplemental oxygen delivery for
several days in case of power outage. In many cases this means
using a combination of emergency generator and external
batteries. (See Sidebar, Power Backup Sources, for details.)
Power Backup Sources
In an emergency, power backup sources are essential. Here are some considerations
with regard to these sources:
- Emergency generators produce exhaust. They must be situated in a way that does
not allow the exhaust to enter the living area. - Emergency generators that are powered by natural gas may be rendered useless if
the natural gas is shut off due to earthquake or other natural disaster. - Emergency generators that run on gasoline require stores of gasoline. Rough estimates
predict that a 40-gallon supply of gas will provide approximately 60 hours
of power. Gasoline must be stored in approved containers that are manageable by
the residents of the home. It must be used and replenished regularly and it must
be stored in accordance with all safety regulations. - It is best to choose a portable ventilator with low power consumption and the
ability to run (and recharge its internal battery) on non-proprietary batteries. This
will enable the use of car and other batteries to run the ventilator in case of
power outages. Car batteries may be more available than stores of gasoline during
a disaster situation. - Patients who use portable ventilators and other life-sustaining medical devices
must keep an adequate amount of batteries on hand. The batteries should be
charged properly and tested a few times a year to ensure that operational time is
adequate. Batteries are consumable items. Proper battery maintenance that is
specific to the type of battery used is essential to battery longevity. (For more
information on battery maintenance, go to www.universalbattery.com.)
Note the following list of equipment that technology-dependent patients should own. In
some cases it may be prudent for them to own multiple quantities of an item.
- Assistive technology / medical device manufacturer’s external battery system and
charger - Assistive technology / medical device manufacturer’s DC power cord
- Battery system terminal DC adapter accessory outlet (order this online from an
electronics supplier) - Automobile battery(s) and charger(s)
- Natural gas powered generator
- Gasoline powered generator
Facility evacuation. The most important action in a facility evacuation
is getting technology-dependent patients moved to a safe
location with the supplies, power and oxygen they need for
survival. Encourage home caregivers to post facility sketches with
clearly marked exit routes, keep portable disaster kits readily
available, agree upon a safe meeting place outside the home and
practice evacuation drills. These are all essential ingredients to
successful evacuations.
If family members must evacuate their home, they will need
a safe place to go where the technology dependent patient’s
needs can be met. Arrangements for such a place must be made
in advance. Should a patient’s home become unsafe, a prearranged
place such as friend’s home or local
church/school/community center becomes a lifeline. There
should also be a backup plan for a second site should the first site become unavailable or unsuitable.
The fire department is an excellent resource for fire response
and evacuation instructions.
Life threatening emergencies. The 911 system may or may not be
available during a natural or manmade disaster. If a life threatening
emergency occurs at home, it may be best for patients and
their family caregivers may to try to use the 911 system to call
for help. Remind them that it is important when calling to use a
land line if at all possible. This will ensure a quicker response
because the 911 emergency responders will have an easier time
locating the caller.
Encourage your patients and their families to write down the
information that an emergency responder will likely ask them,
such as their home phone number, their home address, the
nearest major cross street and directions to the home from the
cross street.
Your Own Preparations
Just as you make sure that your patients and their families are
ready for any eventuality, as a provider you must make sure that
your own house is in order. As busy as you are, you must still
make the time to meet with your staff to go over the “worst case
scenarios” that you might encounter during a disaster situation.
Develop plans that address the challenges that these scenarios
might impose.
Hopefully, you will never have occasion to implement your
disaster preparedness plans. However, you will sleep better
knowing that you have thought through the options and are
ready to take the proper steps if necessary.
Emergency Planning Sources
- Disaster Resources for People with Disabilities and Emergency Managers
- Emergency Power Planning for People Who Use Electricity and Battery
Dependent Assistive Technology and Medical Devices - Emergency Preparedness: Taking Responsibility for Your Safety – Tips for People
with Activity Limitations and Disabilities - Food and Drug Administration
- “Ventilator Backup: Are You Prepared?” (International Ventilator Users Network)