Lesa Breault-Gulbicki, RN, MSN, CPEN Nurse Leader Lowell Public Schools July 15, 2015 } Define Emergency versus Disaster } Identify key stakeholders in emergency preparedness/crisis planning } Identify the role of the School Nurse } Identify options to crisis planning 1
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} An emergency is a situation that poses an immediate risk to Health, life, property, or environment } A disaster is a natural or manmade (or technological) hazard resulting in an event of substantial extent causing significant physical damage or destruction, loss of life, or drastic change to the environment } Disasters have two things in common: Disasters occur without warning and usually beyond the realm of possibility The degree of disaster preparedness directly affects the outcome of the disaster 3
} Mother Nature is the Greatest Terrorist Hurricane Tornadoes Earthquakes Flooding Snow / Extreme Heat Fires Bioterrorism Threats/Events Infectious Disease Outbreaks Chemical Spills, Etc } Fire } Bomb Threat } Assault } Medical Emergencies } Gas leak } Hazardous material problem } Blizzard/Weather } Armed Intruder 4
} 9/11 changed a lot, including funding priorities on national, state, and local levels } While encouraging and assisting groups to prepare for terrorism, also improving disaster and basic emergency preparedness } Governor Patrick signs legislation to require schools to develop efficient medical emergency response plans Michael s Law signed 5/17/12 An act relative to medical emergency response plans for schools Schools have a legal and moral obligation to make schools as safe as possible for children and to minimize potential harm in the event of emergencies and disasters, planning and preparation should be done on purpose, not by accident CEMPS (Comprehensive Emergency Management Planning for Schools, New Hampshire) 5
} More likely to have to deal with fire, blizzard, bomb threat, large fight with injuries, gas leak, hazardous material problem, and even a school shooting } Need a comprehensive plan that deals with all contingencies } Identifying and gathering resources and creating a plan prior to a disaster will facilitate fewer injuries and a coordinated response } Surveillance and pattern recognition } Ability to assess potential emergency risks } Ability to assess the adequacy of emergency training and practice activities } On the front line when an emergency occurs } Detailed knowledge of CSHCN and the ability to plan ahead for these needs } Ability to assist in the short-term and longterm recovery phase after an event } Access to more potential patients each day then almost any other health care provider 6
www.neushi.org } Become a School Team Member } Assist in developing emergency plans } Educate staff, students and families on emergencies } Have sufficient supplies } Participate in exercises/drills (community and school } Surveillance (prior to, during and into recovery phase) of a disaster } Determine future needs } Volunteer 7
} FEMA Incident Command Training (IS-100a and IS 700a) } CPR/AED Certification } Basic First Aid } Education/Training on Disaster Topics } Participation in Local/State-wide emergency planning CERT and MRC Teams } Exercise Emergency Dispensing Site Plans Local Clinics (Flu, Hep A and others) } Emergency Response Team Members: School Administration EMS Law Enforcement (SRO included) Fire Department Emergency Management Consider representatives from the Health Dept., DCF, Mental Health, School Board, Community College, and parents School Nurse 8
} Develop plans for different types of emergencies: Bomb threat, school shooting, fire, Hazardous Materials, Environmental Disasters, Communicable Disease Etc. Create a communication plan (predetermined intercom announcements): How will staff know to prepare for a possible school shooter? How will staff be alerted to a tornado warning? } Gather disaster preparedness supplies Work with community colleges, hospitals, and EMS for any donations School kits Classroom Kits- Go Kits Helpful Resources: www.redcross.org/disaster/masters/supplies.html www.ready.gov/ 9
} Facilitate the creation/modification of security plans Control access to school through as few unlocked entrances as possible ONE PUBLIC ACCESS Recording every person that comes or goes Consider the use of ID tags for every staff member and students } Work with maintenance personnel to assure that landmarks are labeled for emergency responders Exterior doors Buildings Hallways 10
} Inventory the staff for important skills: First Aid/CPR certified Emergency Medical Technician Certification Bilingual Radio Operation experience Other experience in disaster settings } Identify Children with Special Health Care Needs (CSHCN) What information does EMS need to know if this child becomes sick or injured? In the event of a disaster, what would you and other staff need to know to manage child? If child s mobility is limited, how does evacuation plan need to be modified for him/her? Like an IEP for health care needs 11
} Identify a Command Post and place for a Critical Incident Response Kit containing: Floor Plans Maps Aerial Photos Evacuation Plan with Rally Points Utility/fire alarm deactivation instructions Master Keys } Should also contain: Master School Schedule Attendance Roster for that day for both students and staff Bus Roster and routes Emergency contact numbers phone numbers for school administration, media contact, PTA Student Release Forms 12
} Make Incident Command Assignments Who is going to do what when a critical situation is announced Assignments made BEFORE and incident Should have a back-up for each position Fancy Incident Command Terms, but simple and clear duties Positions should be assigned not people! } Whatever emergency plans you and the ERT implement, they have to be practiced Will help identify problems with the plan and clarify realistic expectations of staff and students Will assure that staff know what to do when a critical situation really occurs Will identify areas of improvement that need to be addressed 13
} Self care is an essential component of disaster planning for all responders. } There is a direct relationship between how well responders take care of themselves, each other and the quality of care they provide to people affected by the emergency event. } Is this plan comprehensive enough? } Does it go into enough detail to be implemented at each of your schools? } Does it cover all of the possible scenarios? } Is it realistic? } Is it clear? } Does it make use of existing resources in schools? } Does it make unrealistic assumptions? 14
} Are defined as those where an individual is actively engaged in killing or attempting to kill people in a confined and populated area. Unfortunately, schools face active shooter situations as well http://www.cdc.gov/violenceprevention/youthviolence/schoolviolence/savd.html 15
} How do you plan? The planning process is not complete until the school EOP is shared with first responders Must include preparing and making available to first responders an up-to-date and well-documented site assessment as well as any other information that would assist them Schools should train their staff, students and families, as appropriate, in what to expect and how to react } Warning signs No profile exists for an active shooter; however, research indicates there may be signs or indicators. Schools should learn the signs of a potentially volatile situation that may develop into an active shooter situation and proactively seek ways to prevent an incident with internal resources, or additional external assistance 16
} Responding to an Active Shooter Situation School EOPs should include courses of action that will describe how students and staff can most effectively responds to an active shooter situation to minimize the loss of life, and teach and train on these practices, as deemed appropriate by the school. Train staff to overcome denial and to respond immediately, including fulfilling their responsibilities for individuals in their charge } Run If it is safe to do so for yourself and those in your care, the first course of action that should be taken is to run out of the building and far away until you are in a safe location } Hide If running is not a safe option, hide in as safe a place as possible Students and staff should be trained to hide in a location where the walls might be thicker or have fewer windows } Fight If neither running nor hiding is a safe option, as a last resort when confronted by the shooter, adults in immediate danger should consider trying to disrupt or incapacitate the shooter by using aggressive force and items in their environment, such as fire extinguisher, and chairs 17
} Interacting With First Responders Staff should be trained to understand and expect that a law enforcement officers first priority must be to locate and stop the person(s) believed to be the shooter(s); all other actions are secondary } After an Active Shooter Incident Once the scene is secured, first responders will work with school officials and victims on a variety of matters. This will include transporting the injured, interviewing witnesses, and initiating the investigation. } Rally A predetermined safe haven location where all students and staff can be evacuated to in case of a crisis } Reunification Point A predetermined location where parents/guardians can pick up children following a school crisis with easy access for buses to transport students and staff. } (Both locations can be used for any major emergency at a school including fire, gas leak, natural disaster, etc.) 18
} A.l.i.C.E. http://www.schoolsecurity.org/trends/ students_fight_gunmen.html } FEMA http://training.fema.gov www.cdc.gov www.ready.gov } Michael s Law http://www.mass.gov/governor/pressoffice/pressreleases/ 2012/2012517 Questions? 19