Emergency preparedness and community response

Emergency preparedness

Ambulatory care centers and hospitals may be the first to recognize and initiate a response to a community emergency. If an infectious outbreak is suspected, Standard Precautions should be implemented immediately to control the spread of infection. If the problem has the potential to affect a large number of individuals in the community (e.g., suspected food contamination), a communications network should be established to notify local and state health departments and perhaps federal officials. Your employer may participate in an annual community disaster preparedness drill designed to help facilities improve their response to natural disasters and other emergencies.

Community preparation and response to emergencies are managed by several agencies, including the Office of Civil Defense, Local Emergency Management Agency (LEMA), Emergency Services, or Homeland Security. Local governments are responsible for creating a system that coordinates police, fire, emergency medical services, public health, and area healthcare response to community-wide emergencies. These agencies develop an all-hazards response plan that would be appropriate for any community emergency. Local officials can turn to state, regional, or federal officials for assistance as needed.

Every healthcare facility should have a policy that includes specific procedures for the management of emergencies on site. When a new employee starts on the job, part of the orientation process is to review the site’s policies and procedures manual. As a new employee, be sure to get answers to any questions you have about emergency management in that particular facility.

Staff members should discuss emergencies that may occur and should have an emergency action plan for rapid, systematic intervention. For instance, local industries may present unique problems that call for very specialized care. Plan for these, and ask the provider’s advice on the procedures to follow and the supplies to have on hand. If the facility has several employees, each should be assigned specific duties in the event of an emergency. Organization and planning make the difference between systematic care for patients and complete chaos.

Emergency plan for a natural disaster or other emergency in an ambulatory care facility:

• Evacuate the facility as needed.
• Include procedures for the protection of patients’ health records. If the facility uses electronic health records (EHRs), make sure this information is backed up on offsite systems.
• In the case of a community emergency, provide care to the extent possible within the facility.
• Coordinate services between the ambulatory facility and other local healthcare systems, including hospitals and public health departments.
• Provide staff and supplies as needed to help in a community emergency.
• Maintain up-to-date phone trees to notify staff members of an emergency.
• Educate patients in emergency preparedness.

Community resources for emergency preparedness

Most communities have an emergency medical services (EMS) system. This system includes an efficient communications network 290(e.g., the emergency telephone number 911), well-trained rescue personnel, properly equipped ambulances, an emergency facility that is open 24 hours a day to provide advanced life support, and a hospital intensive care unit for victims.

More than 100 poison control centers in the United States are ready to provide emergency information for the treatment of victims of poisoning. Every healthcare facility is required to post a list of local emergency numbers. This list should be kept in plain sight and should be known to all office personnel. A good place to post this vital information is next to all the phones in the facility. Include on the list the numbers for the local EMS system, poison control center, ambulance and rescue squad, fire department, and police department.

Contact information for emergency preparedness

Keep the following telephone numbers readily available in the facility:

• Local hospital numbers, including the emergency department, infection control officer, administration contacts, and public affairs office
• Local and state health department numbers
• Centers for Disease Control and Prevention (CDC) Emergency Response Office
• Telephone: 800-232-4636
• Website: www.cdc.gov/phpr/index.htm

The Centers for Disease Control and Prevention (CDC) recommends that all healthcare facilities be aware of possible agents of bioterrorism, including anthrax, botulism, plague, and smallpox. The provider is responsible for diagnosing and reporting any suspected cases, but the medical assistant may be involved in patient care and certainly will participate in preventing the spread of infection in the facility. As with any suspected infectious disease, Standard Precautions should be used to control disease transmission. These precautions should be implemented with all patients, regardless of their diagnosis or possible infection status.

Infection control procedures for bioterrorism threats include the following:

• Sanitize your hands routinely.
• Wear disposable gloves when contamination with blood and body fluids is possible.
• Use masks/eye protection or face shields if you may be splashed by secretions or blood and body fluids.
• Wear impermeable gowns to protect your skin and clothes as needed; remove them promptly and wash your hands to prevent transmission of infectious material.
• Sanitize, disinfect, and sterilize equipment, supplies, and environmental surfaces.
• Dispose of contaminated waste in appropriate biohazard containers.

Another resource that can aid with community emergency preparedness is the Laboratory Response Network (LRN), which coordinates with the DHHS, the CDC, the Federal Bureau of Investigation (FBI), and the Association of Public Health Laboratories (APHL) to ensure an effective laboratory response to bioterrorism threats. The LRN links state and local public health laboratories, and veterinary, agriculture, military, and water- and food-testing laboratories to protect U.S. citizens from bioterrorism, chemical terrorism, and other public health threats.

Community emergency preparedness plans are required by the federal government so that a coordinated response is in place if a natural disaster occurs. The federal government requires all healthcare facilities, including private providers’ offices, to be prepared to provide medical services and to contribute medical supplies if a natural disaster or other emergency occurs in the area.

Emergency preparedness plans are designed to coordinate the care provided by all healthcare facilities and agencies in the community, including local emergency management agencies, EMS, fire departments, law enforcement agencies, the American Red Cross, and the National Guard. Each of these groups can provide crucial services during a community emergency.

Medical assistants also can contribute to rescue and emergency efforts. Services that might be performed by trained medical assistants include providing emergency first aid at the site of a disaster; conducting patient interviews in an empathetic manner while using therapeutic communication to help calm victims and gather important health-related information; helping with mass vaccination efforts or antibiotic distribution; performing documentation and electronic health record management; ensuring compliance with the procedures required by Standard Precautions; assisting with patient education efforts; and performing phlebotomy and laboratory procedures according to their skill level.