Disaster/Pandemic preparedness

[LMonty911]

I was looking the the other Disaster/Pandemic thread that Florida1 started. She mentioned that after the hurricanes, that they had problems getting basic supplies and food stores were often closed for weeks after the storm.

That concerns me. I wonder in case of disasters like hurricanes, earthquakes and pandemics if the nurses who work in the area have problems like that. I'd be worried about leaving my family if there was no heat or electric. After loosing electric in the ice storms in the Carolinas a few years back, my husband bought us a generator. I try to keep enough gas stored so that I could run that and maybe have an extra tank of gas for getting back and forth to work, if things were shut down. I never want to wait in the cold on those gas lines again; or have to risk driving around to find necessities!

What disasters have you been through? What lessons did you learn about what things would make life easier if it happens again to you? What can we learn from your experience, and how can we prepare for so we dont have to go through th esame problems you did?

Where there any sepcial tricks or issues that came up that helped you at work? Any special problems that nurses in disasters face?

I have a confession- my home first aid kit is pretty anemic right now :) DH burned his hand prety badly at work last week. I hadnt checked my kit in awhile, and was shocked to see how low I was on some stuff. I only had one roll banfage and had to make a run to WallyWorld the next day! If the stores were shut or the roads iced in or otherwise impassible that would have been an issue. Maybe not life threatening- but its a small example of how not being well prepared can be a problem.

I'd have been so embarrased to admit to hubby I couldnt take care of it, or come thru when he needed me to.

What do you do to prepare? I'm going to restock my kit, and get some more OTC stuff to keep on hand too. What else should I be thinking about?

Laura

[Laidback Al]

Thanks to LMonty911 and other colleagues for putting this list together.

---------------------------------------------------------------------

30 Day Comprehensive Disaster/Pandemic Preparation List

Disclaimer: This list has been created as an aid for individuals in the creation of a personal stockpile in the event of a natural disaster. Please take the time to stockpile all things you deem necessary if such an event were to occur. This list may or may not satisfy all of your needs.

WATER

1 Gallon Per Person Per Day minimum. This amount allows for drinking and food prep. Allow extra 2+ gallons for personal hygiene, washing dishes and clothes.

FOOD

Canned Food Items: 20 cans assorted per small family (4 people); double for large family

o Soup

o Chili

o Pasta

Canned Vegetables: 30 cans assorted per small family (4 people); double for large family

o Corn

o Green Beans

o Tomatoes

o Mixed Vegetables

Dried / Canned Fruit/Peanuts/Nuts; 5 lbs dried or 6 – 12 cans small family, 12-16 large family

Canned Meat: 20 cans per small family 4 persons

Dry Milk: large box or several small cans if no small children or frequent milk drinkers and used for cooking only, increase if family needs require.

Pasta: 5 pounds dry weight

Salt, spices, condiments as preferred

Sugar or alternative sweetner, 5 lbs. or equivalent per small family, increase in large family or if frequently used

Coffee Tea, chocolate, drink mixes, etc. as preferred

Canned or single serve puddings and similar desert items, hard candy, or similar comfort foods and “treats” if funds allow or Cancel

Oatmeal, other hot or cold cereals per preference

Flour; 5 lb bag, increase if used frequently in cooking/baking; yeast if bread baking

Peanut Butter/ Jelly: Large jar each small family, double or triple depending on family size and preference

Crackers, Plain (for sandwiches and snacks) 1 large

box per person

Spaghetti or pasta sauce; 4-8 jars or cans

Baby formula and food, if needed

PERSONAL HEALTHCARE

Thermometer (one per person if possible)

Usual Prescription medicines: 1 month minimum supply (3+ months preferred-contact physican immediately, if needed)

Cough Medicine: 1 bottle per person containing suppressant and expectorant (combined or separate):

o Cough Syrup DM or low dose of opioid cough syrup

Cold/Flu Symptom relief medicine of personal preference, 1 course per person

Anti-diarrhea (Pepto-Bismol or Imodium): 1 Large Bottle or box

Benadryl (Diphenhydramine): 100 Tablet bottle (especially important if any family member has history of allergies)

Acetaminophen 500 mg.tablets: 100 tab Bottle (Note: can alternate with ibuprofen every 3 hours to control fever &/or pain)

Ibuprofen 200mg tablets/capsules: 500 count bottle

Baking Soda: 1 Box

Alternative treatments/supplements as desired

Vitamin Supplement (1-a-Day Multi Containing the following): 1 Medium/Large Bottle:

o Zinc,

o Vitamin A

o Vitamin C

o Selenium

o Magnesium

o Calcium.

o Vitamin B-12

o GLA

Children/Infant: All above in formulas specific for children Suggestions: Dose based upon weight of child, not age; Weigh child and write down dosing requirements (how much & how often) in advance to prevent mistakes under stressful situations.

70% alcohol: 1/4 liter (1 pint)

Hydrogen peroxide (dark bottle): 2 small or 1 pint bottles

Petroleum jelly (Vaseline): 1 large jar or tube

Antibiotic cream or ointment: 1 tube

Aloe (aloevera) gel: good for burns, minor wounds, cooling, moisturizing

sterile gauze pads: 1 package

Gauze bandage rolls: 2 each

Cotton (clean): 1 small package

Adhesive tape (adhesive plaster): 1-inch wide; 2 rolls

Adhesive bandages (Bandaids): 2 boxes asorted sizes

Ace bandage(s) - one roll

Scissors (clean/not rusty): 1 pair blunt and 1 pair sharp tip

Tweezers

PERSONAL SUPPLIES

Personal Hygiene

Soap Bars: 2 bars per person

Shampoo: 1 Large Bottle

Razor blades or disposable razors: per family usage

Toothpaste: 1 large tube

Hand sanitizer: small carry bottle per person, extra to replace; large bottle for refills, several medium bottles for use in bathrooms and kitchen

Antibacterial Hand Soap; dispenser at each sink in home, extra to replace

Baby wipes (not just for babies, reduces water usage): 1 case (6 packages)

Diapers and baby care items as needed

Deodorant

Sanitary Items -2 months supply for first month for each adult female,then 1 month supply for each additonal month preparation

Masks, gloves and goggles

HOME CLEANING/HOUSEHOLD SUPPLIES

Bleach: 2 Large Gallon Bottles

Vinegar: 2 Large Gallon Bottles

Plastic Gloves

Plastic Bags

Garbage Bags: 30+gallon 1 box

Clean cloths

Toilet Paper: 15 Rolls per small family, up to 30 for large family > 4 people

Paper Towels; 6-12 rolls

Paper Supplies:

o plates

o cups

o plastic

o disposable silverware

Flashlights: One per person minimum, consider LED lights to reduce battery usage. Additional LED headlamps extremely useful.

Batteries: 3-4 sets per battery powered item

Battery powered Radio:

o Radio/TV Combo

o Weather Warning

o Short Wave

Can Opener (Manual): Two

Matches: 1 large box 100 packs or 6 boxes wooden matches

MISCELLANEOUS

Stove:

o Dual Fuel Cooking Stove

o Propane Cooking Stove

Fuel for stove

Air Pump (manual)

Water Filter

Alternative heating method for cold climates

[LMonty911]

Al-thanks for posting that.I hope its helpful to others here. Would definitely appreciate feedback and suggestions.

[sanctuary, BSN, MSN, RN]

Add a can or bottle of "OFF" to the above excellent list, just in case the event happens in the bug-time of the year. Remember that if it is the pandemic, respiratory PPE, as well as gloves and a paper gown if you can get them. I have several pkgs of jerky, as the First Nation People knew a thing or two about survival. Put in a small sewing kit, and a big container of dental floss, remembering it can be used as twine, sewing thread, shoe lace (hey, extra shoe laces) and of course, flossing teeth. It is always good to have a small garden going, as possible. This is a great thread.

[indigo girl]

That is a good point about influenza striking in the warmer months. Seasonal flu hits in cold weather, but if we look back at 1918, part of that pandemic occurred in warm weather. We can not assume that this will not happen again. Also, I don't think that it is cold in southeast Asia, an area that has potential for the start of a pandemic as H5N1 is endemic there.

I would think about what kind of things would not be available that I use all of the time. What everyday items will not be available because they come from outside this country? There are many emergency preparedness manuals that can help you to consider what you might need. "Making the Best of Basics" by James Talmage Stevens is a very comprehensive one, but google will give you some others.

The point is, many of us never had to be self sufficient. What if you lost your job temporarily due to illness or accident? Could your family make it for three months without having to buy food? What if your town was hit by hurricane, flood, or some other natural disaster? Would your family be warm, safe, and fed? I do not belong to the Church of Christ of Later Day Saints, but I really admire them for teaching people to store one year's worth of food for their families. What a comfort it would be if all of us had that kind of safety net.

[General E. Speaking, RN, RN]

Last year, after Katrina, Rita was swirling around in the Gulf- at one point heading our way. When they evacuated SE Houston a lot of the traffic came thru our area. I'm about 70 miles inland. I can tell you it was a nightmare. The stores were out of everything, no gas and people were acting crazy. One example: people were stealing gas from employees' tanks in our hospital parking lot. We had to chain the doors of the side entrances because scores of people were trying to come in to the hospital for shelter- we couldn't take everyone that was trying to come in. It was scary to see "We are not a shelter" signs posted on the entrances.

I had prepared ahead of time and had enough food for us but some unexpected relatives showed up after being on the road for 8+hrs (they only got about 40 miles) I scrambled to figure out what to feed everyone. It was an eye opener to go to the store and see there was hardly anything on the shelves.

It was surreal to get the contact names and phone numbers of your neighbors' relatives in case something terrible happened.

My brother is a police officer about 100 miles inland and he sent us a chilling account of the evacuees that were trying to pass thru his small town. People defecating in the street, fights, break-ins, people carrying their dead animals in their arms- horrible!

Rita did not make landfall here. I decided to turn my hurricane kit into a pandemic kit. I am now trying to sort thru some of the dried goods that are expiring. I am not near as prepared as some of the lists posted, but I have a good start. When I shop, I always look for things on sale to buy that have a long expiration date.

I guess a pandemic would be more of a "stay where you are" type emergency as opposed to a "run for the hills" one. I imagine people would panic and try to leave tho.

I used to work for an Immunization program. We frequently had conferences with the CDC. One of my favorite courses was about future pandemics. Keep in mind, it is not a matter of IF but WHEN. This was about 10 yrs ago. Scary then, scarier now.

[Laidback Al]

. . . .I guess a pandemic would be more of a "stay where you are" type emergency as opposed to a "run for the hills" one. I imagine people would panic and try to leave tho. . . .

Sheltering in place (SIP) is your best option during a pandemic. You can prepare now by stocking up and evaluating how you can best use the resources you have in house if a pandemic strikes. If you "run for the hills" what will you be running TO? You will need all the food, water, supplies, PPE, etc. that are mentioned in thread, no matter where you go. So unless you have a cabin the woods, a farm on the prairie, etc. there is no need to run from where you are.

A pandemic is very different than a hurricane. There is tremendous physical damage caused by a hurricane that can directly hurt or kill you: you need to get out its way. A pandemic will not directly cause physical damage to your home or property. The human health impact will occur when people are infected. The best bet is to avoid potential infectious sources. You will have the most control over this if you shelter in place in your own home.

[General E. Speaking, RN, RN]

Sheltering in place (SIP) is your best option during a pandemic. You can prepare now by stocking up and evaluating how you can best use the resources you have in house if a pandemic strikes. If you "run for the hills" what will you be running TO? You will need all the food, water, supplies, PPE, etc. that are mentioned in thread, no matter where you go. So unless you have a cabin the woods, a farm on the prairie, etc. there is no need to run from where you are.

A pandemic is very different than a hurricane. There is tremendous physical damage caused by a hurricane that can directly hurt or kill you: you need to get out its way. A pandemic will not directly cause physical damage to your home or property. The human health impact will occur when people are infected. The best bet is to avoid potential infectious sources. You will have the most control over this if you shelter in place in your own home.

No argument here. I was merely speculating how people may act irrationally during a pandemic...

[Scrubbs]

Hi everyone. I'm new to this site, but thought I would try to add a bit.

I work with developing disaster preparedness plans for ER's as well as for communities in remote areas.

In addition to these great ideas already mentioned, check with your local regional Town, City, State for their disaster protocol. Do they have a POD system for pandemic situations? They might also have medical logistic trailers which mobilize as area clinics. Sort of like a little field hospital.

In a couple of hospitals we have worked through, they have allowed the ED staff to use a limited amount of supplies (dressings, and related items) from their PAR levels to stock personal kits. This enabled the nurses from that facility to not only be for their families, they could also help small groups (i.e. neighbors). You would be surprised how this may help in keeping surge numbers down during an event. Speaking of which, do your areas have back up surge facility plans?

I also had a question for anyone that works with the Hospital Incident Command Structure (HICS). Can anyone tell me what their particular areas require as far as training in ICS? I am looking for references that I can give to one of my disaster planners who needs umm... redirection in his planning, but would like to give them some direct reference from others besides myself.

Thanks

[indigo girl]

Irrational behavior is a big concern, Kris. I worry about my neighbors, and what they will do if their kids are hungry. What will people do? This is a hugh concern. They may do stupid, dangerous things. The behavior of people after those hurricanes is very predictive of what we will be seeing only on a national and international scale. This is unimaginable to us now.

Thank you for reminding of us of this.

I think that not being prepared is also a form of irrational behavior. What are we as nurses going to do about protecting ourselves? I understand the denial, but it is my biggest hope that nurses will snap out of it. Management did not protect nurses during the SARS epidemic. Everyone should understand that those nurses were not protected, and learn from their experience. Unless we start talking to management, and telling them our very realistic concerns, they are not going to protect us in any future epidemic. They are not ready, and may not be willing to spend the money that will be necessary. Surgical masks are inadequate for protection against panflu. The CDC website makes this very clear. We have to make them hear us. No protection, no work.

I have heard that more public service announcements will be offered to educate people. I remember when the former Surgeon General Koop did that mass mailing regarding HIV (I still have my copy), and how courageous he was to do that. It was astonishing that this man put aside any judgement and belief about the victims, and did the right thing for the common good. It was not politically correct. Koop took his role seriously when the president of that time would not speak even a word about AIDS. Sometimes you have to step out of your comfort zone, and do something that might not make you poplular. Would you rather be popular or dead?

People, and that includes nurses are going to panic. We can see some of this in England now as they do some sad things like abandoning their pet chickens in the roadways. Governments do not always tell the truth. Sometimes they tell partial truths to protect economic interests. Again, look at the Brits and what they have been telling people. We are going to be seeing alot of irrational behavior by individuals, businesses, and unfortunately, even govt. Watch these other countries as their stories keep changing, and they are forced to admit the truth.

[indigo girl]

Hi everyone. I'm new to this site, but thought I would try to add a bit.

I work with developing disaster preparedness plans for ER's as well as for communities in remote areas.

In addition to these great ideas already mentioned, check with your local regional Town, City, State for their disaster protocol. Do they have a POD system for pandemic situations? They might also have medical logistic trailers which mobilize as area clinics. Sort of like a little field hospital.

In a couple of hospitals we have worked through, they have allowed the ED staff to use a limited amount of supplies (dressings, and related items) from their PAR levels to stock personal kits. This enabled the nurses from that facility to not only be for their families, they could also help small groups (i.e. neighbors). You would be surprised how this may help in keeping surge numbers down during an event. Speaking of which, do your areas have back up surge facility plans?

I also had a question for anyone that works with the Hospital Incident Command Structure (HICS). Can anyone tell me what their particular areas require as far as training in ICS? I am looking for references that I can give to one of my disaster planners who needs umm... redirection in his planning, but would like to give them some direct reference from others besides myself.

Thanks

Hello Scrubbs,

I am afraid that I am not familiar with your information. I hope others are, and can help us out here.

[indigo girl]

Here it is, a Pandemic Flu PSA:

Thanks, FlaMedic!

http://afludiary.blogspot.com/2007/02/pandemic-flu-psa.html

[Ayrman]

I had the opportunity to talk to the IC nurse the other day - a rare occurance since I work nocs. She almost laughed, after first giving me the look when I asked about bird flu plans. Her reply, in all seriousness, was that the staff would resign or fail to report to a very large extent. Not unforeseeable when you consider the inordinate number of travelers and contract nurses we employ, especially during the prime flu season. There wasn't much else I could say except to quip "I guess that's why they are called travelers."

Surge capacity? I sincerely doubt it has been thought of, nevermind addressed. The County has plans that they published and distributed widely last year earlier, but the hospital has no plan whatsoever aside from saying they'll cross that bridge when they come to it.

Ayrman