Transcript Slide 1
Practical Tips to Emergency Preparedness John Dahlin CHT, CWS-1 Texas ESRD Emergency Coalition Objectives 1. Outline the basic technical information for disaster preparedness. 2. Review preparation & response activities. 3. Discuss lessons learned from previous disaster events. Staff - Personal Preparations • Ensure that your staff have their own family disaster plans. • Update phone & contact information. Physical Plant • Contact landlords • Exercise / test emergency equipment • Boarding of exterior windows Physical Plant - continued • Turn off water main • Turn off city water booster pump • Sandbag entryways Equipment • Move equipment off floor • Cover & tape all equipment with plastic • Disconnect & move computer equipment to a centralized location. Water Treatment – Pre Storm • Prepare the equipment for possible prolonged facility closure. • Discuss with the equipment manufacturers regarding system outage lasting longer than 48 hours. Water & Concentrate Systems • Reverse Osmosis Machines • Distribution Systems • Concentrate Prep Inventory • Place inventory items as high as possible onto pallets & shelving. • Evaluate and ensure that the stockroom & supplies are usable and not damaged. 0 Response • Following the storm and the surrounding areas are deemed safe for re-entry. • 1. SAFETY FIRST !!! 2. Inspect outside walls & roof of building 3. Do not enter building alone 4. Contact local law enforcement if building appears to be broken into. 5. If necessary, contact a contractor for evaluation of systems & structure. 1 Assessments • Verify utilities are operable 1. Electricity 2. Water 3. Sewer • Notify Management of findings • Take pictures of damage identified 2 Re-opening Facility • Utilities Coordinate any needs for generators, water tankers, equipment or supplies. • Water Treatment Turn on water main if previously closed. Flush all pretreatment equipment to drain for 30 minutes. Test chlorine levels before & after carbon tanks Flush the distribution system to drain Disinfect the RO and distribution system & rinse. Replace all cartridge filters 3 Re-opening Facility • Water Treatment - continued Perform full water testing procedures Increase frequency of monitoring Draw water cultures, endotoxin & AAMI analysis as soon as possible. • Obtain approval from Medical Director 4 Re-opening Facility • Dialysis Machines 1. Chemically disinfect dialysis machines & rinse 2. Perform self test & function check • Inventory • Physical Plant 5 City Water Quality • Contact water department to assess status of municipal water. • Outage for how long ? • Under a Boil Water Alert ? • Any increase in chemical additives ? 6 Generators – important points to remember • Secure a primary & secondary electrician • Proper sizing is critical - kW • Voltage & amperage load determined • Contract with fuel vendor – fuel additives • Automatic Transfer switches recommended • Periodic maintenance performed • Test operations under full load periodically • Establish security services 7 Communication with Utility Companies • Have you established contact yet ? • Is there a dedicated Account Manager or Customer Service rep for the facility ? • Does the facility have a restoration priority ? 8 Emergency Water Supply • Water Tanker filled with potable water – verify source • Tanker used for food grade hauling • Ensure water is from a reliable water source • Hose connections after the backflow preventer • Water from tanker may need to be pressurized (transfer pump) • If tanker cannot be left on site, make arrangements for a suitable storage system 9 Water Tanker Hookup 0 Emergency Water Hookup 1 Additional Resources • AAMI - RD52 / RD62 Documents • CDC - Technical Considerations When Bringing Hemodialysis Facilities Water Systems Back on Line After a Disaster • CDC - Guidelines for Dialysis Care Providers on Boil Water Advisories • FDA - Tips about Medical Devices and Hurricane Disasters • CDC - Safe Use of Tanker Water for Dialysis • CMS - Emergency Preparedness for Dialysis Facilities – A Guide for Chronic Dialysis Facilities • OSHA – Fact Sheet • TEEC – Texas ESRD Emergency Coalition • KCER – Kidney Coalition for Early Response 2 Lessons Learned 1. Communication – daily calls ( internal & external ) 2. Contracts established – primary & secondary 3. Take care of relief staffing needs 4. Plan staggered relief schedules 5. Emergency cash 6. Don’t be afraid to ask for help !