CHAPTER 11 Emergency and Disaster Preparedness
For the purpose of this chapter, emergency is defined as a threatening event that can be generally managed by local resources. This might include bomb threats, incidents with hazardous materials, gas leaks, student unrest, and intruder or hostage situations. A disaster is defined as an event that overwhelms local management capacity, causes considerable loss of human life and economic resources, and necessitates a request for state and national support (Doyle and Loyacono, 2007). Disasters can include earthquake, weather-related events, radiological and chemical exposures, and a pandemic. The National Association of School Nurses has published a resource, Disaster Preparedness Guidelines for School Nurses (Doyle and Loyacono, 2007), which is helpful in disaster planning.
Given the large population of students and the many hours spent in school, the potential physical and psychosocial fallout of an emergency or disaster must be addressed. By virtue of education and experience, the school nurse is a valuable resource for disaster prevention, response, and recovery. Should a disastrous event occur, the physical safety, emotional well being, and moral integrity of the school population are at risk. As a member of the emergency preparedness team and crisis response team at the school, the school nurse is prepared to work collaboratively with community agencies. A central focus of this service includes crisis management for physical injuries and psychosocial trauma resulting from the critical incident. Every county and district school office has been called upon to organize system-wide responses to emergencies and disasters. The school nurse can be involved as a policy maker and health care practitioner in this organized endeavor. This chapter provides the school nurse with suggestions, guidelines, and resources to use.
PREPARATION FOR EMERGENCIES AND DISASTERS
EMERGENCY SAFETY AND SECURITY MEASURES
The School Emergency Planning Team has a number of areas to develop and include in the emergency preparedness plan. Box 11-1 provides suggestions of key points to address.
Box 11-1 Preparedness Plan For Schools
• Identify and involve community stakeholders, including parents and community emergency responders.
• Establish what crises the plan will cover by considering local hazards, such as earthquakes or tornadoes.
• Identify and define immediate response measures (e.g., evacuation, lockdown).
• Assign appropriate duties to personnel and assign backups.
• Train personnel for specific tasks, including triage, first aid, and search and rescue.
• Obtain adequate supplies and equipment and identify appropriate storage space.
• Make plans for students with physical, sensory, motor, developmental, or mental challenges; include provisions for those with limited English.
• Develop accountability and student release procedures and forms.
• Convey details of the plan with families, especially procedures for reuniting.
• Create a plan to overcome communication difficulties with staff, students, and families both during and after the incident.
• Conduct emergency drills and crisis exercises on a routine basis with students, staff, and emergency responders.
• Prepare the school to be used as an emergency shelter for others in the community.
• Address policies to deal with terror threats and hoaxes.
• Prepare for recovery issues related to ongoing physical and psychosocial well being of students, staff, and parents.
Modified from US Dept of Ed, Office of Safe and Drug-Free Schools: Practical information on crisis planning: a guide for schools and communities, Washington, DC, 2007 (available online): www.ed.gov/admins/lead/safety/emergencyplan/crisisplanning.pdf. Accessed April 20, 2008.
Duck, Cover, and Hold
Special education students in wheelchairs need to stay in place, lock the chair, and hold on. Leaning forward to protect the head and neck is not always possible because the individual may not be able to bend down to the knees. The wheelchair back does not provide sufficient protection (Doyle and Loyacona, 2007). Students with impaired mobility who are not in a wheelchair also need guidelines. Children with special needs should have practice prior to the drill.
Lockdown
During a lockdown, all students must be inside a building and sitting against an inside wall or flat on the floor. All doors are locked and windows are covered. Lockdown is used for an intruder or sniper. Remain until the all-clear signal is given. A code word or phrase should routinely be used with the all-clear signal indicating to all staff that the danger really is over (Arizona Department of Education, 2006). During a real event or drill, if the word or phrase is not used, it could indicate the all-clear signal is being given under duress (e.g., at gunpoint).
EMERGENCY PLANNING
Preparedness plans for schools include five phases: prevention, preparedness, response, recovery and mitigation. Prevention strategies are used to avoid an incident, and preparedness activities reduce the secondary consequences of an incident. The outcome of the disaster directly reflects the comprehensiveness and execution of the plan (Doyle and Loyacono, 2007). Frequent emergency drills and updates keep the plan current and workable.
NOTE: During emergency drills, check expiration dates of supplies.
ORGANIZATIONAL PERSONNEL
I. Incident Commander (IC): Head Administrator on Site
II. Public Information Officer (PIO): Usually Assistant Principal or Administrator
III. Student Management Team: Usually Teachers
IV. First-Aid and Health Team: School Nurse and Trained Staff Members
V. Security Team: Can Be Custodians
VI. Search and Rescue Teams: Can Be Teachers or as Assigned
VII. Reunion Team: Can Be Clerical Staff
NOTE: Prepare grab-and-go box that can easily be taken to incident command site. See Box 11-2 for contents.
Box 11-2 Grab-and-Go Box
1. List of current students and staff
2. Photographs of students and staff (recent yearbook)
4. List of health problems (students and staff)
6. Medication lists (students and staff)
7. Critical medications (3-day supply)
9. Local and district phone directories
11. Blueprint plans of school and yard areas
12. Flashlight with extra batteries
13. Walkie-talkie, megaphones, mobile phones
During emergency drills, check expiration dates of supplies. Modified from Fitzpatrick B: Emergency management, crisis response, and the school nurse’s role. In Selekman J, editor: School nursing: a comprehensive text, Philadelphia, 2006, FA Davis.
