Day 1 | CME- Trauma Symposium | Haz mat in natural disasters fryman
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Day 1 | CME- Trauma Symposium | Haz mat in natural disasters fryman
- 1. 2013 Kentucky Trauma and Emergency Medicine Symposium • Jointly Sponsored by;
- 2. Sampson and Goliath Hazardous Materials Releases in Natural Disasters
- 3. We Will NEVER Forget!!!!
- 4. Financial Disclosure • I, Les Fryman, have no relevant financial or nonfinancial relationships in the products or services described, reviewed, evaluated or compared in this presentation.
- 5. Objectives • Brief history of natural disasters in Kentucky. • Most prevalent natural disasters in recent history. • What are the most prevailing chemicals released in natural disasters. • Hospital preparation for these events • Hospital operations for those contaminated patients.
- 6. How About Some Data • Natural Hazards were the cause of approximately 16,600 Hazardous Materials Releases reported by the NRC between 1990 and 2008. • That is 3% of all Hazardous Materials Releases that were reported. • Rain induced were the most at 26% • Hurricanes – 20% • Winds, Storms and other weather related phenomenon account for another 25%
- 7. Disasters • A single natural hazard event may effect a large area and many industries • The response to the natural disaster itself may divert resources that otherwise would be available. • Source of data from the NRC’s Incident Reporting Information System. (IRIS) • Natural Disasters make up 75% of FEMA declared disasters.
- 8. History of Natural Disasters • Where does Kentucky rank in the nation as far as declared natural disasters? • #8 • Since 1953 there have been: • 56 Disaster Declarations • 4 Emergency Declarations • 6 Fire Management Assistance Declarations
- 9. Most Prevalent Disasters in Kentucky • Severe Storms, Straight-Line Winds, Severe Winds, etc… • Since 1957 – 43 Major Disaster Declarations • From 1950-2010 – • 2,071 extreme wind events • 26 Considered Strong Wind Events Zeus
- 11. Kentucky Severe Storm Vulnerability Score
- 12. Kentucky Hail Vulnerability Score
- 13. Most Prevalent Disasters in Kentucky • Floods, Rockslides, and Mudslides • Since 1957 – Mentioned in 39 Natural Disaster Declarations. • From 1950-2010 • 604 Extreme Flooding Events • 0 Extreme Landslides Poseidon
- 14. Flood and Landslide Damage
- 15. Kentucky Flood Vulnerability Score
- 17. Most Prevalent Disasters in Kentucky • Tornadoes: • Since 1957 listed in 20 Major Disaster Declarations • Tornado Index: • Kentucky – 136.89 • U.S - 136.45 Aeolus
- 18. Tornado Damage
- 20. Most Prevalent Disasters in Kentucky • Winter Storms or Snow: • Since 1957, listed in 7 Major Disaster Declarations • 1950-2010 – • 7 Extreme Ice Storms • 25 Extreme Winter Storms • 16 Extreme Heavy Snow Events • 22 Extreme Winter Weather Events Boreas
- 22. Kentucky Winter Storm Vulnerability Table
- 23. Most Prevalent Disasters in Kentucky • Fires: • Since 1957, listed in 6 Fire Management Assistance Declarations. • 1950-2010 – • 1 Extreme Wildfire Event • 24 Extreme heat Events Hephaestus
- 24. Wildfire Damage
- 25. Kentucky Wildfire Vulnerability Table
- 26. Number of Releases Associated with Various Natural Phenomena
- 27. Most Prevalent Hazardous Materials Released In Natural Disasters Chemical Process IDLH % in Spills Nitrogen Oxide Flare Stack Emissions 20ppm 13 Benzene Flare Stack Emissions 500ppm 8 PCB’s Dielectric and coolant fluids 0.5ppb in drinking water 5 Sulfur Dioxide Byproduct or Sulfuric Acid Production 100ppm 5 Hydrogen Sulfide Sewer Gas Breakdown of organic material 10ppm 4 Ammonia, Anhydrous Refrigeration systems at storage tanks 300ppm 4
- 28. Quantity of Materials Released • Range from drops to millions of liters. • Most spills are less than 400 liters spilled • Other spills were well over 40,000 liters. • Total volume from 1990-2008 = 29 million liters spilled
- 29. Volume of petroleum released by Natechs, 1990-2008
- 30. Hospital Preparedness • Golden Rule with Preparedness: • IF YOU FAIL TO PREPARE……THEN PREPARE TO FAIL!!!! • First Receiver Programs for Hospitals • JCAHO Recommendation • It is no longer sufficient to develop disaster plans and dust them off if a threat appears imminent. Rather, a system of preparedness across communities must be in place everyday.
- 31. JCAHO Recommendation • JCAHO requires: • Hazards Vulnerability Analysis • Conduct a Hazard Vulnerability Analysis (HVA) • Required by JCAHO (JCAHO 2002) • Lists possible hazards (tornados to terrorism) • Impact on hospital operations • Actions to minimize likelihood, or mitigate the impact • Rank vulnerability to hazard and prioritize efforts to reduce vulnerability • That hospitals consider their anticipated roles and coordinate activities with other emergency response agencies and hospitals within the community.
- 32. American College of Healthcare Executives (ACHE)
- 33. American College of Healthcare Executives (ACHE)
- 34. American College of Healthcare Executives (ACHE)
- 35. Hospital Disaster Response Plans • Components of a Hospital Emergency Disaster Plan: • Objectives of the Emergency Plan/Disaster Plan • Definitions of Roles and Responsibilities • Central operations Center • Community Contacts • Guidelines to Emergency/Disaster Preparedness • Pre-Disaster Planning • Procedures during an emergency event • Recovery plan to resume normal operations • Disaster – Specific Scenarios • Appendix Table
- 36. Hospital Disaster Response Plan • Appendices: • Listing of Approved Shelters • Emergency Preparedness Letter of Understanding • Generic Checklist • Personal Items to bring to work in the event of an emergency • Communications postings and scripting • Local Contact Information • Materials Management Supplier Disaster Phone List • Pay Pone Listing/Alternate Phone Locations
- 37. Hospital Disaster Response Plan • Appendices: • Emergency Staffing Pay • Dependent Care • Childcare Plan Enrollment • Staffing During Emergency/Disaster Event Policy • Labor Pool Process • Disaster Preparedness Status Briefing • Red Cross Chapters • Staff Notice/Briefing • Procurement Summary Report
- 38. Hospital Disaster Response Plan • Appendices: • Team briefing Format • Identification of Personnel • Employee Contact Information • Visitor Policy • Local Radio Station Listing • Emergency Plan Staff organization chart • Incident Command Checklist • Emergency Disaster Exemption Form • Communications
- 39. Hospital Disaster Response Plan • Appendices: • Director’s Emergency/Disaster Checklist • Employee Emergency/Disaster Checklist • Post-Impact Assessment Form • Sleep Assignment Form • Employee Emergency/Disaster Preparedness Handbook (for all employees to have and review)
- 40. Initial Operations • IC Announces disaster declaration • IC notifies “Mahogany” Row • IC give readiness briefing • Departments start preparation of their specific areas • Internal Communication plans in operation • Ensure computer/electronic equipment protection measures • Activate labor pool • Activate child care plan • Prepare and send staffing plans to HR • Dismiss Team “B” for 24 hours if possible
- 41. Emergency Department • Initial procedures to get ED ready to accept patients: • Surge Capacity • Decontamination Procedures set up and in place “The solution to the pollution is dilution”
- 42. Summary • When natural disasters happen, the chance of hazardous materials releases can hamper a hospitals response • Emergency Disaster Plans need to be rehearsed and updated at all levels of the organization • Failing to plan for your organization will ensure your plan will fail when you need it most.
- 43. Resources • Sengul, H., Santella, N., Steinberg, L. J. and Cruz, A. M. (2012), Analysis of hazardous material releases due to natural hazards in the United States. Disasters, 36: 723– 743. doi: 10.1111/j.1467-7717.2012.01272.x • Federal Emergency Management Agency. (2008). Fema Information. Retrieved from http://www.fema.gov. • Centers for Disease Control and Prevention. (2010). Retrieved from http://www.cdc.gov/ • Centers for Hazards Research and Policy Development, University of Lousiville • Schneid, Thomas D., and Larry Collins. Disaster Management and Preparedness. Boca Raton, FL: Lewis, 2001. Print
- 44. Resources • Managing Hazardous Materials Incidents. [Atlanta, Ga.]: U.S. Department of Health & Human Services, Public Health Service, Agency for Toxic Substances and Disease Registry, 1994. Print. • Briggs, Susan M., and Michael Cronin, eds. The ABC's of Disaster Medical Response. N.p.: International Trauma and Disaster Institute, 2005. Print • American College of Healthcare Executives. Healthcare Executives' Role in Emergency Preparedness. N.p.: ACHE, 2009. Print
Hinweis der Redaktion
- Sometimes either one of these disasters can be bigger then life. How we deal with them can make the difference between success or failure.
- NRC – National Response Center Natechs – term used to describe a natural hazard in association with the hazardous materials release associated with them.
- Paper written by Hatice Sengul, Nicholas Santella, Laura Steinberg, and Ana Cruz Natural Disasters kill about 1 million people around the world each decade, not to mention leaving millions more homeless each decade Natural Disasters leading to what is called technological disasters and Hazardous materials spills are listed as these Technological disasters.
- Greek God of Sky and Thunder, was the God over all Gods in Greek Mythology
- Severe Storms can occur anytime, anywhere with little or no warning. Past severe storms occurrences cannot predict future occurrences or damage. However they can show trends of risk from the past. The Severe Storm Vulnerability Score was determined by first totaling the number of past occurrences from 1960-2006 for each county using SHELDUS data sets. Next, the county data was overlaid onto the census tract file and each census tract was assigned their Hazard Score derived from what county they are within. Each census tracts were ranked 1-5 (1=low, 5=high) based upon the number of occurrences in each census tract producing a Hazard Score. Finally, a Severe Storm Vulnerability Score was calculated for each county by multiplying the Exposure Score by the Hazard Score and ranked 1-5 (1=low, 5=high). An asset hazard vulnerability table (Appendix 10) consisting of all 1132 main and non-campus assets has been created to display and identify each assets vulnerability to each hazard. This table allows the reader to specifically identify each individual asset and that assets vulnerability to each one of the Hazards identified in the plan.
- Hail can occur anytime, anywhere with little or no warning. Past severe storms occurrences cannot predict future occurrences or damage. However they can show trends of risk from the past. The Hail Vulnerability Score was determined by first totaling the number of past occurrences from 1960-2006 for each county using SHELDUS data sets. Next, the county data was overlaid onto the census tract file and each census tract was assigned their Hazard Score derived from what county they are within. Each census tracts were ranked 1-5 (1=low, 5=high) based upon the number of occurrences in each census tract producing a Hazard Score. Finally, a Hail Vulnerability Score was calculated for each county by multiplying the Exposure Score by the Hazard Score and ranked 1-5 (1=low, 5=high). An asset hazard vulnerability table (Appendix 10) consisting of all 1132 main and non-campus assets has been created to display and identify each assets vulnerability to each hazard. This table allows the reader to specifically identify each individual asset and that assets vulnerability to each one of the Hazards identified in the plan.
- Once it is known that a census tract contains a floodplain it must be determined how vulnerable that county is to flooding. First, by using floodplain boundary data from the FEMA Q3 and the new Digital Federal Insurance Rate Maps (DFIRMs) data set which is the digital floodplain boundary used for the GIS process, each census tract’s percent of area within the floodplain was determined. Next, the census tracts were ranked 0-5 (0=N/A, 1=low, 5=high) based upon the percentage of the floodplain located within each census tract producing a Hazard Score. Finally, a Flood Vulnerability Score was calculated for each census tract by multiplying the Exposure Score by the Hazard Score and ranked 0-5 (0=N/A, 1=low, 5=high). An asset hazard vulnerability table (Appendix 10) consisting of all 1132 main and non-campus assets has been created to display and identify each assets vulnerability to each hazard. This table allows the reader to specifically identify each individual asset and that assets vulnerability to each one of the Hazards identified in the plan.
- Landslide vulnerability was determined by first overlaying the census tract with a landslide overview map from the USGS. This determined what percentage of each census tract was covered by risk of landslide. Each census tract’s risk of landslide was defined based on the USGS methodology as explained in the U.S. Geological Survey Professional Paper 1183. Incidences Low = Low Landslide Incidence (less than 1.5% of the area is involved in a landslide) Moderate = Moderate Landslide Incidence (1.5-15% of the area is involved we chose the Mean = 6.0) High = High Landslide Incidence (greater than 15% of the area is involved in landslides) Susceptibility Combo – Hi – areas with a high susceptibility to landslides but moderate incidences was graded at 15% SUS- High - High susceptibility and low incidences as graded a 15% SUS – Mod – Moderate susceptibility and low incidences was graded 6% If a census tract area was covered by two or more attributes the values were summed. (For example a census tract is covered by 2 susceptibility polygons – Sus High covers 10 percent of the area, and SUS MOD covers .3 percent of the county the county is assigned a hazard value of (10*15%) + (.3*6%) =1.518 the value 1.518 represents the percentage of area of the county that is susceptible to land sliding.) The total percent of each census tract susceptible to landslide was calculated and then ranked 1-5 (1=low, 5=high) producing a Hazard Score. Finally, a Landslide Vulnerability Score was calculated for each census tract by multiplying the Exposure Score by the Hazard Score and ranked 1-5 (1=low, 5=high). An asset hazard vulnerability table (Appendix 10) consisting of all 1132 main and non-campus assets has been created to display and identify each assets vulnerability to each hazard. This table allows the reader to specifically identify each individual asset and that assets vulnerability to each one of the Hazards identified in the plan.
- Ruler of the winds in Greek Mythology
- Tornadoes can occur anytime, anywhere with little or no warning. Past tornado occurrences cannot predict future occurrences or damage. However they can show trends of risk from the past. The Tornado Vulnerability Score was determined by identifying location points of where past tornados have occurred using a GIS data file from NOAA. The tornado points were overlaid onto the census tracts and each census tracts tornado occurrences were identified. Next, counties were ranked 1-5 (1=low, 5=high) based upon the number of occurrences in each census tract (See Appendix 30) producing a Hazard Score. Finally, a Tornado Vulnerability Score was calculated for each census tract by multiplying the Exposure Score by the Hazard Score and ranked 1-5 (1=low, 5=high). An asset hazard vulnerability table (Appendix 10) consisting of all 1132 main and non-campus assets has been created to display and identify each assets vulnerability to each hazard. This table allows the reader to specifically identify each individual asset and that assets vulnerability to each one of the Hazards identified in the plan.
- Greek God of the North Wind
- Severe Winter Storms can occur anytime, anywhere with little or no warning. Past severe storms occurrences cannot predict future occurrences or damage. However they can show trends of risk from the past. The Severe Winter Storm Vulnerability Score was determined by first totaling the number of past occurrences from 1960-2006 for each county using SHELDUS data sets. Next, the county data was overlaid onto the census tract file and each census tract was assigned their Hazard Score derived from what county they are within. Each census tracts were ranked 1-5 (1=low, 5=high) based upon the number of occurrences in each census tract producing a Hazard Score. Finally, a Severe Winter Storm Vulnerability Score was calculated for each county by multiplying the Exposure Score by the Hazard Score and ranked 1-5 (1=low, 5=high). An asset hazard vulnerability table (Appendix 10) consisting of all 1132 main and non-campus assets has been created to display and identify each assets vulnerability to each hazard. This table allows the reader to specifically identify each individual asset and that assets vulnerability to each one of the Hazards identified in the plan.
- Greek god of blacksmiths, craftsmen, artisans, sculptors, metals, metallurgy, fire and volcanoes
- The Wildfire Vulnerability Score was determined by identifying location points of where past Wildfire have occurred from 1997-2007 using a GIS data file from the Kentucky Division of Forestry. The wildfire points were overlaid onto the census tracts and each census tracts wildfire occurrences were identified. Next, counties were ranked 0-5 (0=N/A, 1=low, 5=high) based upon the number of occurrences in each census tract (See Appendix 32) producing a Hazard Score. Finally, a Wildfire Vulnerability Score was calculated for each census tract by multiplying the Exposure Score by the Hazard Score and ranked 0-5 (0=N/A, 1=low, 5=high). An asset hazard vulnerability table (Appendix 10) consisting of all 1132 main and non-campus assets has been created to display and identify each assets vulnerability to each hazard. This table allows the reader to specifically identify each individual asset and that assets vulnerability to each one of the Hazards identified in the plan.
- Hurricane Katrina and Rita in August and September 2005 Hurricane Gustav and Ike in August September 2008 1994 & 2000 Severe Winter Storms
- Petroleum products were released in about 60% of natechs whereas various chemical releases made up another 30%, aqueous materials comprise about %5 of releases and natural gases made up about 3% of releases. Crude oil is the most common form of petroleum product released both in frequency at 28% and quantity at 41%. Flare Stack Emissions had such a low reporting RQ initially that is why the percentage was so high. Anhydrous Ammonia – most commonly released material without flare stack emissions being the primary source. Ammonia Nitrate made up almost one-half of all natech releases by weight, principally due to large releases after fertilizer warehouses were washed away by floods. Other Chemicals released at lower levels: Nitrogen Dioxide Ethylene Glycol Asbestos Sodium Hydroxide Copper Sulfate Ammonium Nitrate Sodium Carrbonate 36% of these releases present limited acute health risks but they may cause environmental damage. Releases are from oil contaminated water 16% are releases of sewage The remainder are from other various unspecified chemicals at low levels.
- Go through sample disaster plan and discuss a little about each component.