Management

June is Pet Preparedness Month

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Every time a major disaster strikes our pets are at risk.  We’ve seen it with wildfires, flooding, tornadoes and earthquakes.  Many of us have seen the heartache of pets separated from their families during times of crisis. Often because of a lack of identification either through a collar tag, microchip or even a family photograph, pets end up in shelters or are euthanized. With just a little bit of planning you can protect your family including your pets.

Graphic: What's in Your Pet Prep Kit?
What’s in your Pet Preparedness Kit? For more information, please visit Ready.gov/pets

The month of June is set aside each year to remind us to include our pets in our preparedness planning.  FEMA has a number of suggestions.  One of the most important is making sure your pet can be easily identified.  Microchipping is certainly an option, but a collar and tag can work just as well.  Don’t forget to include a picture of you and your pet in your documents ziplock bag.  You might need it after the crisis to verify that you and your pet belong together.

At a minimum your “go kit” should include:

  • Water – One gallon per day for a minimum of 3 days
  • Food – Enough for 3 days stored in a waterproof container
  • Medicines – Pack your pet’s medicines in a ziplock bag
  • Vaccination records – Include copies of any vaccination records in a waterproof container
  • Photos of your pet
  • Pet first aid kit
  • Collar or harness and leash.
  • Pet carrier
  • Cleaning supplies such as newspapers, paper towels, litter, trash bags and bleach solution

As part of your personal disaster plan you should have an evacuation route mapped out.  Try to find out ahead of time if the hotel/motel or shelter will allow pets.

You know how stressful a disaster can be.  Imagine what it must be like for your pets.  Help them by having a plan and practicing that plan.

More detailed information is available at Ready.gov.

Be petpared!

petprepared

US Hospitals Unprepared for Ebola

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Ebola virus

A survey of nurses in the US reveals a stunning lack of preparedness in our hospitals to handle a major infectious disease outbreak. The survey conducted by National Nurses United (NNU) indicates our front-line health care safety net is not ready.   As reported in Infection Control Today, 85% of RN respondents stated that they had been given no information on Ebola by their hospitals. Could this have been the communication breakdown in Dallas that sent an infectious Ebola patient back into the public? They also report a lack of the basic personal protective gear required to handle Ebola patients.

The recommendations by NNU make sense. Treat this as an emergency.  Communicate and train.  Distribute supplies to those who need them.

One of the concerns in an outbreak like this is who will report for duty.  As has happened in other natural disasters and disease outbreaks, some health care workers choose self preservation over doing their noble work. Despite protective gear and other precautions, fear of something that cannot be seen like Ebola becomes overwhelming. Descriptions of the disease such as “a fire straight from the pit of Hell” do little to reassure.  Health care workers fail to report for work and walk away.  That leaves a reduced number of  true heroes to provide care for patients. The situation turns ugly.

But the impact of an outbreak such as Ebola reaches out in ever expanding circles.  Everyone involved in patient contact must be trained and provided protective gear.  That would include people who do housekeeping in the hospital.  They may be asked to do clean up in the Emergency Room.  Normal universal precautions for blood borne illnesses don’t seem adequate in the face of Ebola.

The City of Houston Emergency Medical Service has eghty-eight patient care vehicles. Less than half of those are staffed and equipped to provide Advanced Life Support (ALS).  As seen in Dallas, an ambulance unit transporting an Ebola patient was taken out of service for extensive decontamination.  It would not take many Ebola infected patients to remove a high percentage of Houston EMS vehicles from service for an indefinite period of time. Those Paramedics and EMT’s who staff those units might also be removed from the streets for monitoring.   All of the expected fires, car wrecks and health emergencies will still happen.  Will there be enough services available to respond?

Our health care system could be quickly overrun despite our advanced infectious disease control procedures. This version of Ebola moves fast. Can those in charge of our health care systems move faster?

Infection Today: First Line of Defense – Nurses Express Concerns Over State of Preparedness for Ebola.

 

On the Bougainvillea and Mitigation

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Bougainvillea bract

Mit-i-gate verb: make less severe, serious or painful.

Removing a dead bougainvillea is a slow deliberate process. It must be done carefully to prevent bloodshed. Vicious thorns found on every twig and branch attack with little provocation. My removal method is to work from the outside in, cutting small pieces of twigs that will fit easily into the large trash can. Then I cut short lengths of the larger branches. I learned that trick the last time I had to remove a bougainvillea. You see, this is not my first rodeo with the bougainvillea plant. This job is so distasteful to me that I even did my taxes first.

The bougainvillea is a beautiful thorny plant native to South America often used in landscaping along the Texas Gulf coast. It doesn’t need a lot of water and blooms without much attention at all. The flowers are really quite small, but the surrounding specialized leaves called “bracts” give the bougainvillea the vibrant shows of color. Thick hedges of bougainvillea are sometimes used as security fences around homes deterring unwanted intruders. The vine versions can easily grow four stories high. And that growth can occur in a short period of time. My bougainvilleas grew over seven feet tall and seven feet around in one year. They normally flourish in this area, but we have had two cold winters in a row. After the freezing weather of 2012 killed one vine, I foolishly replaced it with another. This winter was even colder than last winter. That replacement bougainvillea is the one I am removing now, very carefully one branch at a time.

Bougainvillea thorns

Bougainvillea thorns


If I was out in the country and were the plant not so close to my fence and garage, I would be tempted to take a flame thrower to it. There is no way to grab the plant without getting stuck by a thorn. I’m sure it would be satisfying to burn the thorny thing down. But I have this nagging fear that the thorns will become flame hardened and get me anyway. So here I am clipping one twig and branch at a time and then using the clippers as a claw to manipulate the cutting into the trash can much like Homer Simpson manipulates the radioactive capsules at the reactor. Care must also be taken to remove any cuttings that fall on the ground to prevent thorns from penetrating shoes and feet.

Yes, this is a hazardous assignment. Even after some close calls I am unscathed, although there is still half to go. I’ll keep the band-aids close at hand.

So what does this have to do with mitigation?

I am mitigating this situation by planting something different this spring. Exactly what will be planted hasn’t been decided. I do know that it will be something without thorns. And that new plant will have to form a screen. The bougainvillea was doing a great job of hiding a worn section of fence next to the garage. So in addition to planting something new in that spot, I’ll need to replace a section of fence. That will mitigate a painful letter from the homeowners’ association.

So, mitigation can take many forms. It might be something as complicated and expensive as making sure emergency generators are located in safe locations. Or it might be additional training so employees know what to do in an emergency. Or it might be as simple as planting a non-thorny shrub.

A Lesson for All of Us

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Flooded New Orleans

Flooded New OrleansHurricane Katrina proved to be an epic lesson in preparedness. From the individual level all the way to the highest levels of the federal government, failures to plan and mitigate ended in disaster. We are still learning lessons from that terrible storm in August of 2005. A recent book, Five Days at Memorial by Sherri Fink, is one of the more gut wrenching efforts to document what can happen when disaster strikes. Health care professionals at New Orleans’ Memorial Medical Center faced the ultimate nightmare scenario. They were left to decide those they could help and those they could not help. The last remaining back-up electrical generator had failed. Emergency batteries providing the last hope for life support equipment had nothing left to give. There is no question that everyone involved in those terrible hours were heroes in their attempts to provide for the patients. Building maintenance personnel performed extremely dangerous procedures attempting to keep power going in the building. Doctors and nurses did everything possible to save their sickest patients. But it was not enough.

The word “mitigation” is thrown around a lot. But it is an important word and concept. So many of the problems seen at Memorial Medical Center could have been mitigated either by building design or by more effective management practices. With the number of flooding disasters in recent years, those involved with building design and operation should understand the folly of placing critical infrastructure below grade. Back-up electrical generators will not run underwater. Oh, but it has never flooded at that location. All that can be said is that it has not flooded there yet. Mitigation moves that critical infrastructure above flood levels. It is important to remember that floods are not always related to a storm event.

A different maintenance routine and generators designed for long term use could have delayed some of the problems. Running a generator for a short time once a month is not enough as they found out. Weekly start-ups and then, longer 24 hour runs under load once a month might have revealed problems with the system before it was needed. That is what mitigation is all about. Finding problems and solving them before a procedure or piece of equipment is needed.

Five Days at Memorial is not a light read. In fact it can be painful. But it is full of lessons for all of us who plan for disasters. I am mentioning the book only from the standpoint of emergency preparedness. A lot of the book delves into the ethics of euthanasia and the medical personnel involved in a controversial way.

1,000,000 Gallons of Water Flood Building!

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flooded floor

The headline is stark. But this was not from a rising river. This was from a broken fire sprinkler system within the building. One of the problems with this event is that the break was not discovered until an employee came in early to do some work. By that time the water was eight feet deep in the basement. As is very common in building design, the electrical and elevator systems were located in the basement and were inundated.

Water in a building can be devastating. Water in a basement with critical infrastructure can result in long lasting interruption to business activities in that building. It is also very expensive. Water removal, building dry out, mold removal, damage to equipment, replacement of supplies and loss of business cost money. These costs may or may not be covered with insurance or FEMA assistance. In the case of FEMA, only a portion of losses can be recovered.

Prevention is often impossible. Things happen. Pipes break, sprinkler heads pop off or a valve may malfunction. Maintenance can help some of that, but “IT” happens somewhere everyday.iStock_000010866677Small

Early warning is key. The first question I have in a situation like this is why there was no flow alarm on the sprinkler system? A sensor within the fire sprinkler system should have sounded audible and visual alarms as well as send a signal to a monitoring station. Water flowing in a sprinkler system should trigger the fire alarm automatically. Either those things didn’t happen or there was no one to see and hear the alarms.

Any facility with important infrastructure located below ground should also have water alarms. These simple devices tied into the building alarm system detect water on the floor sounding an alarm to mitigate potential damage. This can provide warning when water from outside the building floods a basement whether from flooding rains or from a water main break next door.

The ultimate mitigation to this sort of damage is careful consideration of locating critical electrical controls, emergency generators and other important infrastructure in basements.

http://www.koco.com/news/oklahomanews/okc/okc-city-building-flooded-with-more-than-1-million-gallons-of-water/-/11777584/24249532/-/15cbu23/-/index.html?showAds=0

Take Time

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Crushed Tiller Cab

I watched a training video yesterday created by the Raleigh Fire Department after a disastrous crash involving one of their ladder trucks.  The crew was responding to a fire and entered an intersection too fast.  The truck overturned injuring the four firefighters on board. The point of the video is that sometimes we get into such a rush to help others that we fail to take care of ourselves.   I shared the video with my nephew, a Lieutenant with a local fire department.  He confirmed the pressure to get out of the station as quickly as possible. But he confirmed the extra emphasis on training and safety that is occurring too.  Everyone has to be strapped in with their seat belts before the truck leaves the station. That is tough to do with all the gear they are wearing. By taking a few more seconds they have a better chance of reaching that fire or EMS call safely.

ladder truck overturned.

Crushed tiller cab.

We can learn those lessons too.  Not only with wearing seat belts, but by taking the time necessary to do our jobs correctly.  Sometimes workplace pressures drive unsafe shortcuts.  As supervisors we have to be mindful of all the steps required to do a job correctly.  Then we have to provide the resources to our employees to make sure they can do their jobs the right way. Those resources include not only the people required, but the training, materials, time and the knowledge that their work is appreciated.

Photo credit – FireNews.net