Emergency Preparedness and Response
Joy Carr
NUR/408
January 10, 2012
Sandi Wheeler, R.N., MSN

Emergency Preparedness and Response Public emergency preparedness and response is the ability of the public health and health care systems, communities, and individuals, to prevent, protect against, quickly respond to, and recover from emergencies, particularly those whose scale, timing, or unpredictability threatens to overwhelm routine capabilities. Preparedness involves a continuous process of planning and implementation that relies on measuring performance and taking corrective action. There are many different public agencies, from local to national, that are dedicated and devoted to this. The Neighborhood is a community that is nestled near Neighborhood River and along the Neighborhood Forest, with a population of 64,200. They are in the presence of a wildfire that is raging just west of the town border. The fire has been burning out of control for five days with the local fire departments battling to contain it. Initially, it was believed to be easily containable but with the early advent of the windy season, the fire continues to burn out of control. Community officials urge citizens that they are not in any immediate danger for evacuation but will issue alerts if they feel the fires may shift course towards the community. Public health officials are urging residents, especially those with chronic heart and lung disease, to remain inside unless absolutely necessary, due to the smoke, haze, and irritants. The local hospital is seeing an influx of patients to the emergency department as well as the units being filled with patients that are having worsening of their respiratory illnesses. The increase in patients is so bad that the staff on the nursing floor is overwhelmed and staff morale is extremely low. The emergency department needs more beds than the floor has available and staff is filling beds as quickly as they are emptied. Administration’s answer is to implement mandatory overtime for all employees with the start of the next pay period. Karen, the nurse at the senior center, has noticed that many of her clients need to increase their oxygen use. She has instructed these clients to remain indoors to avoid the potentially deadly irritants from the smoke. The school nurse, Violet, is also seeing her students with respiratory ailments presenting with worsening symptoms. One particular student, Kelsey, a seven year old second grader, was sent to her office due to increase cough, respiratory rate, and wheezing. The student did not have an inhaler available to her therefore her mother was called and it was recommended she be taken to her pediatrician and an inhaler provided for use at school. One particular household in The Neighborhood is also experiencing difficulties as a result of the smoke and increase irritants in the air, and they are the Bley family. The Bley household consists of Jimmy, age 78, and Cecelia, age 75. The two have been married for 56 years. Jimmy is a retired electronics technician for the Army and Cecelia is a housewife. Cecelia is in relatively good health; her only issue is osteoarthritis, which she considers an annoyance. Jimmy’s health related issues include hearing loss, which he describes as “mild”, and emphysema, which he describes as “not that bad”. Jimmy does have a hearing aid but would rather not wear it; therefore he does not make regular battery maintenance a priority. He has noticed that over the last few years his breathing difficulties have become worse, as a result, Jimmy knows that he must pace himself when completing tasks, otherwise he becomes quite short of breath and it takes him longer to recover from it. Unfortunately, Jimmy continues to smoke despite the knowledge that his smoking is having a negative impact on his emphysema. For Jimmy smoking is something that he enjoys and is not interested in quitting to better his current respiratory illness. The Bley’s are aware of the impact the impure, smoke filled air could have on Jimmy’s respiratory status therefore, despite the fact that the dryer is broken and Jimmy can fix it with the necessary part, Jimmy opts to stay indoors until this increasing threat passes. Thankfully the Bley’s have raised eight children, which all live nearby, and one of their daughters comes by and takes Cecelia to the Laundromat to finish the laundry. The healthcare workers in The Neighborhood have been trying to keep up with the increased need for medical attention as a result of the smoke from the wildfire. The hospital staff members are struggling to keep up with the increased demand and administration is not offering much assistance. In fact, administration has added increased stress and demand upon the staff by instituting mandatory overtime for all staff members, instead of calling in additional staff to assist with the increased demand. Thus further causing staff morale to plummet. The nurses at the school and senior center have been very vigilant in identifying potential people that are at a higher risk for adverse affects from the smoke by being aware of preexisting respiratory illnesses and offering treatment quickly. They have been stressing to the public that unless it is necessary it is best to remain indoors until this threat has passed. In the community in which I live in, there are several various agencies that would respond in the event of a wildfire. First, all the local fire and rescue departments would respond to the fire and establish safe zones or shelters in the event of an evacuation. The local Red Cross chapters from Johnstown and surrounding areas would respond to this area to assist in any way that they could. The Red Cross is an independent, volunteer-led organization, financially supported by voluntary public contributions and cost-reimbursement charges (American Red Cross, 2011). Since its founding in 1881 by visionary leader Clara Barton, the American Red Cross has been the nation's premier emergency response organization. The American Red Cross distinguishes itself by also aiding victims of devastating natural disasters. Over the years, the organization has expanded its services, always with the aim of preventing and relieving suffering. Today, the American Red Cross offers compassionate services in five other areas: community services that help the needy; support and comfort for military members and their families; the collection, processing and distribution of lifesaving blood and blood products; educational programs that promote health and safety; and international relief and development programs (American Red Cross, 2011). Another agency that would respond from the surrounding areas would be the Community Emergency Response Team (CERT). The Community Emergency Response Team (CERT) Program educates people about disaster preparedness for hazards that may impact their area and trains them in basic disaster response skills, such as fire safety, light search and rescue, team organization, and disaster medical operations. Using the training learned in the classroom and during exercises, CERT members can assist others in their neighborhood or workplace following an event or disaster. CERT is about readiness, people helping people, rescuer safety, and doing the greatest good for the greatest number. CERT is a positive and realistic approach to emergency and disaster situations where citizens will be initially on their own and their actions can make a difference. Through training, citizens can manage utilities and put out small fires; treat the three killers by opening airways, controlling bleeding, and treating for shock; provide basic medical aid; search for and rescue victims safely; and organize themselves and spontaneous volunteers to be effective (United States Search And Rescue Task Force, 2011) . Finally, a national agency that is vital in disaster preparedness and response is the CDC’s Office of Public Health Preparedness and Response. This organization works with state and local health departments to save lives and safeguard communities from public health threats. When states are prepared to detect or respond rapidly to threats, communities are better protected. The CDC plays a critical role in preparing states because of its unique expertise in responding to infectious, occupational, or environmental incidents. They also provide funding and technical assistance to states to build and strengthen public health capabilities. By ensuring that states can adequately respond to threats will result in a greater health security (Centers for Disease Control and Prevention, 2011). Emergency preparedness, response and recovery means the provision of funding and staff resources to support and assist local public health departments, other public health and health care partners and state agencies with planning, training, and exercising in order to effectively respond to public health emergencies and assure readiness. Effective emergency response also includes addressing the variety of special-needs populations which include, but are not limited to, people with disabilities such as deafness, blindness, or mobility impairments; frail elders; limited or non-English speaking people; and people with low literacy skills. Wildfires can spread quickly, igniting brush, trees and homes. With the addition of strong winds, dry brush and periods with little or no rainfall and a wildfire can jump from a burning hillside and race through a community within a matter of minutes. Reduce your risk by preparing now. There are many actions that we as citizens can take to make our properties more “fire safe” for example establish a safety zone around the perimeter of your house by clearing all flammable vegetation within a minimum 130 feet radius of your home, sloped areas should be cleared further, keep your grass short and discourage underbrush from growing along the edges of your safety zone, clean up all leaves, fallen needles and other dead vegetation. Once a wildfire has been identified it is key to gather a disaster kit and keep it easily accessible, back vehicles into driveways, always have a flashlight and portable radio available, make plans ahead of time or keep pets in one room for ease of removal upon evacuation, connect a hose to any outside water faucets, and stay tuned to local radio and television stations for any urgent news updates. These are just some of the steps that can be taken to ensure one’s safety in the event of a wildfire or any unforeseen disaster. Evacuation plans must be in place amongst all households and practice drills should be carried out on a regular basis in order to eliminate chaos and confusion in the event a disaster should arise. Education, awareness, and preparedness are all key components in establishing and maintaining an effective disaster plan. Without having met these three components one cannot have an effective disaster plan in place. There are numerous ways that families can receive the knowledge and education necessary to implement and carry out an effective plan. Local health departments and even the schools offer information for families about preparedness. There are websites abound that are dedicated to this subject. It is imperative that every person all over the world establish some type of plan in order to remain prepared in the event of a disaster. A disaster can present at any time and in any form and one must stay one step ahead and remain prepared. Your life and the lives of your loved ones are at stake if you do not become prepared!

References
American Red Cross. (2011). A brief history of the American Red Cross. Retrieved from http://www.redcross.org
Centers for Disease Control and Prevention. (2011, December 30). Office of public health preparedness and response. Retrieved from http://cdc.gov
United States Search And Rescue Task Force. (2011). The FEMA CERT program. Retrieved from http://www.ussartf.org