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RISKAlert November, 2014 Updated Incident Planning for Healthcare Facilities

Incorporating Active Shooter Incident Planning into Health Care Facility Emergency Operations Plans

National preparedness efforts, including planning, are based on U.S. Presidential Policy Directive (PPD) 8: Preparedness, which was signed by the President in March 2011.  This updated  directive represents an “evolution” in understanding of national preparedness based on lessons learned from rom natural disasters like Hurricane Sandy, terrorist acts like the Boston Bombing and active shooter and other violent incidents.

Preparedness is centered in five areas: Prevention, Protection, Mitigation, Response, and Recovery. These concepts are applied to Health Care Facility (HCFs) Planning for active shooters and other violent incidents.

Emergency Operations Plans for Health Care Facilities (EOPs) should be living documents that are routinely reviewed and consider all types of hazards, including the possibility of an active shooter or terrorist incident. As law enforcement continues to draw lessons learned from actual emergencies, HCFs should incorporate those lessons learned into existing emergency plans or in newly created EOPs.

It advises a whole community approach that includes staff, patients, and visitors as well as individuals with access and functional needs. Examples of these populations include children, older adults, pregnant women, individuals with disabilities, etc.

The key concepts include not only familiar concepts like “Run-Hide-Fight” but also concepts on addressing a wider range of risks (threats), how to do drills, improvement of situational awareness activities, expanding the definitions of risks, how to do Psychological First Aid (PFA), and how to integrate these with HIPAA guidelines and Rules and the importance and role of Security in Emergency Operations Planning (EOPs).

Lesson  Learned :    Don’t Wait to Respond!

A 2005 investigation by the National Institute of Standards and Technology into the collapse of the World Trade Center towers on September 11, 2001, found that people close to the floors impacted waited longer to start evacuating than those on unaffected floors.   Similarly, during the Virginia Tech shooting, individuals on campus responded to the shooting with varying degrees of urgency. (ref:  Federal Building and Fire Safety Investigation of the World Trade Center Disaster: Occupant Behavior, Egress, and Emergency Communications.)

            Frequent Security Situational Awareness Training, and Active Shooter –
Disaster Drills can prevent this “frozen” phenomena and save lives in
a violent incident , a terrorist attack, or a disaster scenario.


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Got a House near the Coast? The Storm Surge Lessons we’re Learning from the Philippines Disaster and Hurricane Sandy…

You already know that the climate is getting progressively warmer, and sea levels around the world
are rising.

This new climate reality played out last week in the Philippines, an archipelago nation with over 7000 islands, as a giant typhoon smashed into the central Philippines districts and destroyed everything in its path, including housing for millions of people living near areas around the cities of Tacloban and Cebu and other islands.

With thousands already dead and thousands more in  island areas that have not been reached yet,
the ultimate death toll may be weeks in coming, but some experts think it could top over 15,000 people.

If, like me, you live near an ocean coast anywhere, you have to wonder how future storms may affect your region.

The rising sea levels are already invading fresh water wells along Florida’s east coast, polluting the fresh water with salt, and forcing cities to find new fresh water sources.  Saltwater seeping in from the ocean keeps spreading farther west, threatening to ruin the freshwater supplies that provide most of South Florida’s drinking water.

Even though the US doesn’t get typhoons, it does get hurricanes, and what we learned in this typhoon, just like we learned in Hurricane Sandy in October, 2012, was that it’s not the wind, it’s not the rain,
it’s the STORM SURGE that creates the disaster. 

In the recent typhoon, the storm surge, while not technically a tsunami, pushed up an enormous amount of water on shore, that destroys everything it touches and pushes the water inland, dragging along houses, trees, cars, people, animals, giant ships, hotels and anything else it finds on it’s path.

“As a nation we don’t understand storm surge well, nor do coastal communities understand storm surge risk,” said Jamie Rhome, a storm surge specialist at the Hurricane Center. “It’s one of the hardest things to communicate.”

Storm surges can travel inland up to thirty miles and can quickly push up rivers, and bays. “People
don’t understand how far inland storm surge can go,” Rhome said. “It penetrates well inland, goes up rivers, into bays. It goes wherever it can, and people don’t realize they are at threat of flooding.”

Cities and regional planning groups need to re-examine the storm surge threat in their areas, and make plans to deal more effectively with these lethal storm surges that may come from hurricane and typhoons in the future.




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