OPTIONS for Independence Emergency Preparedness Manual Table of Contents
Emergency Preparedness Plan Emergency Preparedness Plan Emergency Preparedness Questionnaire Utah Special Needs Registry Personal Emergency Checklist Ability Self-Assessment Emergency Supplies and 72 Hour Kits Water Food First Aid Kit Tools and Supplies Sanitation Clothing and Bedding Special Items Important Family Documents Important Documents: Collection-Storage-Retention Emergency Documents Storage Emergency Health Information Cards Emergency Contact List Establishing Your Personal Support Network
Disability-Specific Emergency Tip Sheets Development or Cognitive Disabilities Communication Disabilities Environmental Illness Deaf or Hard of Hearing Life-Support Systems Mobility Disabilities Psychiatric Disabilities Service Animals and Pet Owners Visual Disabilities Additional Resources
Personal Preparedness Plan
My Personal Information
Name: Address: City: State: Zip:
Family Emergency Numbers
1. 2. 3.
School Contact Information
Name: Phone:
Emergency Meeting Place
Near Home: Away from Home:
Local Contact Information
Name: Phone:
Out of State Contact Information
Name: Phone:
Doctor Contact Information
Doctors Name: Doctors Name: Doctors Name: Phone: Phone: Phone:
Pharmacy Contact Information
Name: Phone:
Medical Information
Blood Type:
Critical Medical Information
Allergies:
Current Medications: Check if Critical-Continue list on Back if needed
Critical Prescription Dosage
Health Insurance (Include Medicaid/Medicare)
Company Name: Policy Number Company Name: Policy Number Phone: Phone:
Local Emergency Services Contacts
Emergency, Police, Fire, Ambulance: Non-Emergency Police: Gas Company: Electric Company Other:
911
OPTIONS for Independence Emergency Preparedness Questionnaire
_____________________________________________________________________________
Name (Last) Street Address
(First) Apt. # Utah__ State
(MI)
_____________________________________________________________________________
________________________________
_______________
City (435) _________________ Phone
_____________________________
Zip
____________________________
Other Phone
________________________
M
F
Email Emergency Contact Name
Date of Birth (mm/dd/yyyy)
Gender
_____________________________________________________________________________
Phone
Relationship
Who will check on or assist you in an emergency? Name:__________________________ Telephone:____________________ □ Yes □ No
How will they contact you? _____________________________________________ Will you require evacuation assistance?
Who will provide evacuation assistance? _________________________________ Who helps care for you?
□ Self □ Assistance from care giver □ Home Health or Hospice Assistance
Frequency of Care? Full-time Daily
Several Days a Week
Bi-Monthly
Monthly
Do you have pets? □ Yes □ No them? ? □ Yes □ No Service Animal: □ Yes □ No
Have you made arrangements for Type: Sight Hearing Seizure
Other____________ Interpreter Required: □ Yes □ No Language: ASL Foreign:_______
Type of Disability/Limitation (check all that apply) □ Vision ○ Blind □ Hearing ○Deaf □ Physical Disability ○ Paraplegia ○ Quadriplegia □ Cognitive___________________ □ Emotional_______________ □ Cannot Lay Flat □ Non-Verbal □ Speech Impairment □ Mental______________ □ Bariatric___________ Weight________ □ Oxygen_____________ □ Allergies_________________________________________________________________ □ Other____________________________________________________________________ □ Life Sustaining Medication: Cardiac Respiratory Blood Pressure Diabetes Other: _______________________________ □ Location in home you would likely be: ________________________ Assistive Technology Used (check all that apply) □ Power Wheelchair □ Scooter □ Manual Wheelchair □ Insulin Dependent (Refrigeration required) □ Walker/Cane □ Oxygen - □ Liquid or □ Concentrator □ Electrical Needs □ Portable Oxygen – Hours per/day: _______ Liter Flow: _______ □ Porch Lift □ Ventilator Required □ Other: ___________________________________________ There is no substitute for personal preparation. In a disaster, government and other agencies may not be able to meet your needs. It is important for all residents to make individual plans and preparations for their care and safety in an emergency. I understand that I am responsible for the provision of any prescription medications, oxygen supplies, medical equipment, and special dietary items I may require during an emergency. Would you like additional information or training on emergency preparedness? □ Yes □ No
Utah Special Needs Registry I understand my participation in this registry is voluntary and all information will be strictly confidential, and used only for emergency purposes. This registration website allows residents with special needs an opportunity to provide information to emergency response agencies so those agencies can better plan to serve them in a disaster or other emergencies. The information collected here will not be available to the public. It will only be shared with emergency response agencies to improve their ability to serve. Please be as complete as possible in your responses. You will be contacted occasionally to ensure the information is correct and to make any necessary changes. If you have questions, please call 211 or go to: www.specialneedsutah.org By submitting my information, I agree that I voluntarily authorize its release. I PERMIT ___________ DO NOT PERMIT __________ OPTIONS to enter this information on my behalf in the Utah Special Needs Registry. If permission is not granted for OPTIONS to enter this information in the Utah Special Needs Registry, then OPTIONS will retain this information in my consumer service record only and use the data on this form to assess the general needs of people with disabilities in this community without disclosing any of my personal information. Registrant Signature:_______________________________ Date: ___________ Guardian/Power of Attorney:_________________________ Date: __________ Relationship to Registrant: ___________________________Date: __________ Witness: ________________________________ Title:_______________
Date entered on Special Needs Registry:_______________________ By:______________________________
Introduction
This training manual is designed to help OPTIONS consumers prepare and plan for an emergency or disaster. This manual has a cross-disability focus; however, all of the tips and guidelines should be adapted to address your individual specific needs. Tips for specific disabilities are included in the last section of the manual. These tips should be used and integrated into the program when necessary. The following tips for specific disabilities are included: visual, hearing, cognitive, developmental, mobility, psychiatric, multiple chemical sensitivities, speech and respiratory disabilities.
PERSONAL EMERGENCY PREPAREDNESS CHECKLIST FOR PEOPLE WITH DISABILITIES
Activity
Establish a support Network Customize an Emergency Health Information Card Keep Copies in wallet/purse and emergency supply kits Complete an Emergency Contact list (see Tips for Collecting Emergency Documents) Collect Emergency Documents (see Tips For Collecting Emergency Documents). Conduct an Ability Self-Assessment Collect 'Carry-With-You' Supplies to keep with you at all times Collect Disability-Related Supplies for emergency kits. Maintain a seven day supply of Essential Medications. Keep important Equipment and Assistive Devices in consistent, convenient and secured place. Write Out Instructions for items you will need help with in an emergency. If you use a Service Animal (see Tips for Service Animal and Pet Owners).
Date Completed
See Additional Tip Sheets as appropriate (i.e., People with Visual Disabilities, Deaf or Hard of Hearing, Communication and Speech Related Disabilities, Psychiatric Disabilities, Developmental or Cognitive Disabilities, Mobility Disabilities, Multiple Chemical Sensitivities and People Who Use Life Support Systems.
Conduct an “Ability Self-Assessment” Evaluate your capabilities, limitations and needs, as well as your surroundings to determine what type of help you will need in an emergency. 1. Will you be able to independently shut off the necessary utilities (gas, water, electricity)? Do you know where shut-off valves are? Can you get to them? Can you find and use the right wrench to turn those handles? 2. Can you operate a fire extinguisher? Have you practiced? Will extended handles make these items usable for you? 3. Will you be able to carry your evacuation kit? What do you need to do, in order to carry it; how much can you carry regularly; do you have duplicates at other locations? Yes Yes No No Yes Yes No No
Yes
No
4. Have you moved or secured large objects that might block your escape path? _____________________________________________________
5. Write instructions for the following (keep a copy and share a copy with your personal support network): How to turn off utilities; color-code or label these for quick identification. Main gas valve, located next to the meter - blue; Electrical power circuit breaker box red; and Main water valve - green._______________________________________
If you have a reduced or limited sense of smell, alert your personal support network to check gas leaks.____________________________________________
How to operate and safely move your essential equipment. Consider attaching simple to read and understand instructions to your equipment_________________ How to operate and safely move your essential equipment. Consider attaching simple to read and understand instructions to your equipment.________________
5. Continued
How to safely transport you if you need to be carried, and include any areas of vulnerability_________________________________________________________
How to provide personal assistance services._______________________________
Remind anyone who assists you to practice strict cleanliness and keep fingers out of mouth. With limited water and increased health hazards, the possibility of infection increases. Keep a supply of latex gloves in your emergency supply kit and ask people assisting you with personal hygiene to use them.______________________
List all personal care assistance needs (dressing, bathing, etc.) with instructions on how best to assist you._________________________________________________
Make a map of where to find medications, aids and supplies. Share with your personal support network. ___________________________________________
How Will You Evacuate. Be aware of barriers and possible hazards to a clear path of exit. Change what you are able to change (clear obstacles from aisles; secure large, heavy items such as bookcases that may fall to block your path). Plan alternate exit paths._____________________________________________________________
Emergency Supplies
The purpose of the following section is to help you collect adequate supplies to use in the event of an emergency.
Personal Story: “I was in a basement meeting when the earthquake hit. Everyone walked upstairs leaving me in the basement as the elevator won’t function. One brave man came back downstairs and we positioned [ourselves] in as safe an area as we could until the quake emergency team arrived. They eventually carried my chair and me separately upstairs.” – Glendora, CA Had this person not been lucky enough to be rescued quickly, how might they have survived for two or three days?
EMERGENCY SUPPLIES 72 Hour Kits
If a disaster strikes you may not have access to emergency services from your town, city or county for a few hours, a few days and possibly for a few weeks, depending on where you live. It is important to plan and have enough supplies to get you by for at least 72 hours. A 72 hour kit should have basic supplies but it also needs to be personalized to fit your needs. Each member of your family should have a kit that meets their individual needs. It should be stored in a bag that is easy and light enough to carry for some distance. Your kit should be located near an exit in your home, so you can grab it on the way out in an emergency or disaster.
A basic kit should include: Check off item when it is placed in your emergency kit. Bedding Clothing Communication Food First Aid Kit Heat Hygiene/Sanitation Blankets, sleeping bag A complete change of clothing appropriate for the weather conditions in your area Flashlight, radio, (include extra batteries and bulbs), whistle. Non perishable, needing little or no cooking (may include ration bars, Meals Ready to Eat (MRE) Include a manual and other essential supplies Body warmers, candles, fuel and matches Toothpaste, toothbrush, comb, insect repellant, toilet paper, plastic garbage bags, sunscreen, soap, dish soap, towel, washcloth, hand sanitizer, wipes chlorine bleach, etc. Titles, bank and credit card information, emergency contact info. ID Spare set
Documents Keys
Medications
Prescription and non-prescription, a list of medications you currently take – don’t forget to update regularly Books, cards, pencil, paper, sewing kit, eyeglasses, games (something to do if you have to stay in a shelter) Cash in small denominations and change Plastic sheeting, poncho, survival blanket, tent, etc. Gloves, screwdriver, pliers, wrench, etc. One (1) gallon of water per person, per day Tablets, purifier, etc.
Miscellaneous
Money Shelter Tools Water Water Purifying
Other items that may be needed: Infants Diapers, extra clothes, wet-wipes, formula, food, bottle, etc. Children Elderly Pets/Service Animals Extra clothing, Toys, special food, vitamins Extra clothing for warmth, medications Extra water, food, veterinarian contact, identification tags, etc.
People with Disabilities -Write down what your needs are so that you can insure that those needs are met in an emergency. -If you receive regular services (home health, transportation, dialysis), make a plan with each service provider. -If necessary look for evaluation assistive devices. -If you require accessible transportation to evacuate an area, identify resources both public and private. -Plan for different ways of sheltering. Consider what you can do to safely shelter-in-place. Consider how to shelter with friends and family. Finally consider how a shelter for designated for the public would meet your needs. Inspect your kit twice a year; a good time is at daylight savings, spring and fall.
Food and Water in an Emergency If an earthquake, winter storm or other disaster strikes your community, you might not have access to food, water and electricity for days, or even weeks. By taking some time now to store emergency food and water supplies, you can provide for your entire family. This brochure was developed by the Federal Emergency Management Agency in cooperation with the American Red Cross and the U.S. Department of Agriculture. Having an ample supply of clean water is a top priority in an emergency. A normally active person needs to drink at least two quarts of water each day. Hot environments can double that amount. Children, nursing mothers and ill people will need even more. You will also need water for food preparation and hygiene. Store a total of at least one gallon per person, per day. You should store at least a two-week supply of water for each member of your family. If supplies run low, never ration water. Drink the amount you need today, and try to find more for tomorrow. You can minimize the amount of water your body needs by reducing activity and staying cool.
Water
Check off item when it is placed in your emergency kit.
How to Store Water Store water in clean plastic containers such as soft drink bottles. Avoid using containers that will decompose or break, such as milk cartons or glass bottles. You can also purchase food-grade plastic buckets or drums. Never use a container that has held toxic substances. Seal water containers tightly, label them and store in a cool, dark place. Rotate water every six months. Store one gallon of water per person per day. A normally active person needs to drink at least two quarts of water each day. Hot environments and intense physical activity can double that amount. Children, nursing mothers, and ill people will need more Keep at least a three-day supply of water per person (two quarts for drinking, two quarts for each person in your household for food preparation/sanitation).*
Items marked with an asterisk * are considered essential.
Three Ways to Treat Water In addition to having a bad odor and taste, contaminated water can contain bacteria that cause diseases such as dysentery, typhoid and hepatitis. You should treat all water of uncertain purity before using it for drinking, food preparation or hygiene. There are many ways to treat water. None is perfect. Often the best solution is a combination of methods. Two easy treatment methods are outlined below. These measures will kill most bacteria but will not remove other contaminants such as heavy metals, salts and most other chemicals. Before treating, let any suspended particles settle to the bottom, or strain them through layers of paper towel or clean cloth.
1. Boiling: Boiling is the safest method of treating water. Bring water to a rolling boil for 3-5 minutes, keeping in mind that some water will evaporate. Let the water cool before drinking. Boiled water will taste better if you put oxygen back into it by pouring the water back and forth between two clean containers. This will also improve the taste of stored water. 2. Disinfection: You can use household liquid bleach to kill bacteria. Use only regular household liquid bleach that contains 5.25 percent sodium hypochlorite. Do not use scented bleaches, color safe bleaches or bleaches with added cleaners. Add 16 drops of bleach per gallon of water stir and let stand for 30 minutes. If the water does not have a slight bleach odor, repeat the dosage and let stand another 15 minutes. The only agent used to treat water should be household liquid bleach. Other chemicals, such as iodine or water treatment products sold in camping or surplus stores that do not contain 5.25 percent sodium hypochlorite as the only active ingredient, are not recommended and should not be used. While the two methods described above will kill most bacteria in water, distillation will remove bacteria that resist these methods, and heavy metals, salts and most other chemicals. 3. Distillation: Distillation involves boiling water and then collecting the vapor that condenses back to water. The condensed vapor will not include salt and other impurities. To distill, fill a pot halfway with water. Tie a cup to the handle on the pot's lid so that the cup will hang right-side-up when the lid is upside-down (make sure the cup is not dangling into the water) and boil the water for 20 minutes. The water that drips from the lid into the cup is distilled.
Hidden Water Sources in Your Home If a disaster catches you without a stored supply of clean water, you can use the water in your hot-water tank, pipes and ice cubes. As a last resort, you can use water in the reservoir tank of your toilet (not the bowl). Do you know the location of your incoming water valve? Yes No You'll need to shut it off to stop contaminated water from entering your home if you hear reports of broken water or sewage lines. To use the water in your pipes, let air into the plumbing by turning on the faucet in your house at the highest level. A small amount of water will trickle out. Then obtain water from the lowest faucet in the house. To use the water in your hot-water tank, be sure the electricity or gas is off, and open the drain at the bottom of the tank. Start the water flowing by turning off the water intake valve and turning on a hot-water faucet. Do not turn on the gas or electricity when the tank is empty.
Emergency Outdoor Water Sources If you need to find water outside your home, you can use these sources. Be sure to treat the water according drinking it. Rainwater Streams, rivers and other moving bodies of water Ponds and lakes Natural springs
Avoid water with floating material, an odor or dark color. Use saltwater only if you distill it first. You should not drink flood water.
Food for Disaster Supply kit
Store at least a three-day supply of non-perishable food. Select foods that require no refrigeration, preparation or cooking, and little or no water. If you must heat food, pack a can of sterno. Select food items that are compact and lightweight. (Remember to include a can opener) Include a selection of the following foods in your Disaster Supplies Kit: Ready-to-eat canned meats, fruits, and vegetables Canned juices Staples (salt, sugar, pepper, spices, etc.) High energy foods Vitamins Food for infants Comfort/stress foods
Food Supplies
When Food Supplies Are Low
If activity is reduced, healthy people can survive on half their usual food intake for an extended period and without any food for many days. Food, unlike water, may be rationed safely, except for children and pregnant women. If your water supply is limited, try to avoid foods that are high in fat and protein, and don't stock salty foods, since they will make you thirsty. Try to eat salt-free crackers, whole grain cereals and canned foods with high liquid content. You don't need to go out and buy unfamiliar foods to prepare an emergency food supply. You can use the canned foods, dry mixes and other staples on your cupboard shelves. In fact, familiar foods are important. They can lift morale and give a feeling of security in time of stress. Also, canned foods won't require cooking, water or special preparation. Following are recommended short-term food storage plans.
Special Considerations As you stock food, take into account your family’s unique needs and tastes. Try to include foods that they will enjoy and that are also high in calories and nutrition. Foods that require no refrigeration, preparation or cooking are best. Individuals with special diets and allergies will need particular attention, as will babies, toddlers and elderly people. Nursing mothers may need liquid formula, in case they are unable to nurse. Canned dietetic foods, juices and soups may be helpful for ill or elderly people. Make sure you have a manual can opener and disposable utensils. And don't forget nonperishable foods for your pets. Food Storage Tips Keep food in a dry, cool spot - a dark area if possible. Keep food covered at all times. Open food boxes or cans care-fully so that you can close them tightly after each use. Wrap cookies and crackers in plastic bags, and keep them in tight containers. Empty opened packages of sugar, dried fruits and nuts into screw-top jars or air-tight cans to protect them from pests. Inspect all food for signs of spoilage before use. Use foods before they go bad, and replace them with fresh supplies, dated with ink or marker. Place new items at the back of the storage area and older ones in front.
Nutrition Tips During and right after a disaster, it will be vital that you maintain your strength. So remember: Eat at least one well-balanced meal each day. Drink enough liquid to enable your body to function properly (two quarts a day). Take in enough calories to enable you to do any necessary work. Include vitamin, mineral and protein supplements in your stockpile to assure adequate nutrition.
Shelf-life of Foods for Storage Here are some general guidelines for rotating common emergency foods. Use within six months: Powdered milk (boxed) Dried fruit (in metal container) Dry, crisp crackers (in metal container) Potatoes
Use within one year: Canned condensed meat and vegetable soups Canned fruits, fruit juices and vegetables Ready-to-eat cereals and uncooked instant cereals (in metal containers) Peanut butter Jelly Hard candy and canned nuts Vitamin C
May be stored indefinitely (in proper containers and conditions): Wheat Vegetable oils Dried corn Baking powder Soybeans Instant coffee, tea and cocoa Salt Noncarbonated soft drinks White rice Bouillon products Dry pasta Powdered milk (in nitrogen-packed cans)
First Aid Kit
Assemble a first aid kit for your home and one for each car.
Check off item when it is placed in your emergency kit.
(20) Adhesive bandages various sizes. (1) 5" x 9" sterile dressing. (1) Conforming roller gauze bandage. (2) Triangular bandages. (2) 3 x 3 sterile gauze pads. (2) 4 x 4 sterile gauze pads. (1) Roll 3" cohesive bandage. (2) Germicidal hand wipes or waterless alcohol-based hand sanitizer. (6) Antiseptic wipes. (2) Pair large medical grade non-latex gloves. Adhesive tape, 2" width Anti-bacterial ointment. Cold pack. Scissors (small, personal). Tweezers. CPR breathing barrier, such as a face shield. Thermometer
Non-Prescription Drugs
Check of item when it is placed in your emergency kit.
Aspirin or non-aspirin pain reliever Anti-diarrhea medication Antacid (for stomach upset) Syrup of Ipecac (use to induce vomiting if advised by the Poison Control Center) Laxative Activated charcoal (use if advised by the Poison Control Center) Sunscreen Bug repellant Chap stick Burn cream/gel Anti-itch cream Tools and Supplies
Check off item when placed in your emergency kit.
Mess kits, or paper cups, plates, and plastic utensils* Emergency preparedness manual* Battery-operated radio and extra batteries* Flashlight and extra batteries* Cash or traveler's checks, change* Non-electric can opener, utility knife* Fire extinguisher: small canister ABC type Tube tent Pliers
Duct Tape Compass Matches in a waterproof container Aluminum foil Plastic storage containers Signal flare Paper, pencil Needles, thread Medicine dropper Shut-off wrench, to turn off household gas and water Whistle Plastic sheeting Map of the area (for locating shelters) Survival Blanket – usually called Mylar Utility Knife
Sanitation
Items marked with an asterisk * are considered essential.
Check off item when it is placed in emergency kit.
Toilet paper, towelettes* Soap, liquid detergent* Feminine supplies* Personal hygiene items* (shampoo, toothbrush, toothpaste) Plastic garbage bags, ties (for personal sanitation uses) Plastic bucket with tight lid Disinfectant Household chlorine bleach Q-tips, Safety Pins
Clothing and Bedding
*Include at least one complete change of clothing and footwear per person. Check off item when it is placed in your emergency kit.
Sturdy shoes or work boots* Rain gear* Blankets or sleeping bags* Hat and gloves Thermal underwear Sunglasses
Special Items
* Remember family members with special requirements, such as infants and elderly or disabled persons
Check off item when it is placed in your emergency kit.
For Baby*
Formula Diapers Bottles Powdered milk Medications
For Adults*
Heart and high blood pressure medication Insulin Prescription drugs Denture needs Contact lenses and supplies Extra eye glasses
Entertainment (based on the ages of family members)
Games (cards) and book Portable music device
Important Family Documents Keep these records in a waterproof, portable container: o Will, insurance policies, contracts deeds, stocks and bonds o Passports, social security cards, immunization records o Bank account numbers o Credit card account numbers and companies Inventory of valuable household goods, important telephone numbers Family records (birth, marriage, death certificates) Store your kit in a convenient place known to all family members.
Pet Supplies
Check off item when it is placed in your emergency kit.
Water Food Food and water dishes Veterinarian records
Other Things to Consider
Keep items in airtight plastic bags. Change your stored water supply every six months so it stays fresh. Replace your stored food every six months. Re-think your kit and family needs at least once a year. Replace batteries, update clothes, etc. Ask your physician or pharmacist about storing prescription medications.
Additional Items to Have on Hand
Emergency Banners (Red means you need help, green means you are okay) Cotton balls Rubbing alcohol Hydrogen peroxide
Important Documents
The purpose of the following section is to help you identify and collect important documents, as well as properly store these important documents. The recent events surrounding hurricane Katrina have highlighted the necessity of keeping important documents in multiple locations. Health records, medication lists, and social security cards were all swept away and lost by residents who only kept these documents in their homes. The documents included in this section are; an emergency health card, emergency contact list, and the establishment of a personal support network.
Personal Story:
“I have Juvenile Rheumatoid Arthritis and use a wheelchair. We had a bomb threat at work, which was very scary. Everyone evacuated, but I was still left on the 3rd floor by the stairwell for the firefighters to come get me. But, no one came. Finally, I just struggled, and I used pure fear to get myself down the stairs and outside. It was scary just to realize that there are not really any procedures in place to help someone like me in an emergency.” – Los Angeles, CA Had this person established a personal support network including someone from their workplace, how might have this situation been different?
Emergency Documents
(Includes important information typically needed after a disaster).
Store emergency documents in your home emergency supply kits. Copies of life saving information (i.e., specifications for adaptive equipment or medical devices should be in all of your emergency kits and medication lists should be on your health card) should be stored in all of your emergency kits. Other emergency documents should be kept together with your home emergency pack - family records, wills, deeds, social security number, charge and bank accounts, etc., for access in an emergency. These should be stored in sealed freezer bags with copy sent to out-of-state contacts. Additional Tip Sheets are available to cover above topics in more detail.
Emergency Documents
(Includes important information typically needed after a disaster).
Check off item when it is placed in your emergency kit. Copies of Emergency Documents Should Include: Specifications for adaptive equipment (in case it needs to be replaced) Proof of ownership or lease of your residence. (This is important when applying for disaster assistance after an emergency.)* Social security numbers of family members.* Vehicle, boats, etc. make, identification and license numbers.* Charge and bank account numbers.* Insurance policy numbers.* - include Medicare and Medicaid #’s Securities, deeds and loan numbers including company name, address and telephone numbers.* Will/living trust and letter of instructions.* Photos or video of all valuables for documentation of insurance claim. (This inventory should be backed up on disk if it is on computer. Consider documenting your inventory by going through your areas with a video or camera and capture all your possessions on film.)* Important business documents.* Family records (birth, marriage, death certificates).* List style and serial numbers of medical devices such as pacemakers.
*Store these documents only in your home emergency supply kit.
Storage of Emergency Documents
Store Emergency Contact List and Emergency Documents in a tightly sealed freezer bag in emergency supplies. Send a copy to an out of state contact and keep another copy in safety deposit box. Store additional copies of Emergency Contact List and all Emergency Documents (except for those followed by an *): In Emergency Carry With You Supply Kits; In your wallet; With your personal support network. Update Every Six Months Emergency Health Information Card Emergency Contact list An easy way to keep your documents up-to-date is to schedule reviewing and updating your information on the same day clocks are set forward or back for Daylight Savings Time.
Health Card
An emergency health information card communicates to rescuers what they need to know about you if they find you unconscious or incoherent, or if they need to quickly help evacuate you. An emergency health information card should contain information about medications, equipment you use, allergies and sensitivities, communication difficulties you may have, preferred treatment, treatment-medical providers, and important contact people. Make multiple copies of this card to keep in emergency supply kits, car, work, wallet (behind driver's license or primary identification card), wheelchair pack, etc.
TIPS FOR CREATING AN EMERGENCY HEALTH INFORMATION CARD
Example:
FRONT[Side 1] Name: Jane Doe Street Address: 123 willow Lane City, State, Zip: Logan, UT 84321 BACK [Side 2] Physicians: Dr. Adams, Dr. Smith Conditions, Disability: Assistance Needed:
Communication/Equipment/Other Phone (Home, Work): (555) 555-7777, Needs: (555) 555-8888 Fax: (555) 555-8877 Birth date: 3/20/1960 Blood Type: A positive Social Security: 333-33-3333 Health Insurance Carrier and Individual and Group # Immunization Dates: Allergies: Medications:
Emergency Contacts:
ACTIVITIES Complete and/or Customize Health Card Keep up-to-date copies in wallet, purse and all emergency supply kits
DATE COMPLETED
Customize Card
An emergency health information card communicates to rescuers what they need to know about you if they find you unconscious or incoherent, or if they need to quickly help evacuate you. An emergency health information card should contain information about medications, equipment you use, allergies and sensitivities, communication difficulties you may have, preferred treatment and treatment-medical providers, and important contact people.
EMERGENCY HEALTH INFORMATION CARD [SIDE 1 OF 2]
Please Fill out, and use to make your own emergency Health Information card
Name: Street Address: City: Home Phone: Work Telephone: FAX Number: TTY Contact: Birth Date: Blood Type: Soc. Security #: ____ State: Zip: Home Contact: Work Contact: TTY Number:
Health Insurance Carrier: Health Insurance Group No.: Emergency Contacts:
EMERGENCY HEALTH INFORMATION CARD [SIDE 2 OF 2]
Physicians Allergies Immunization Dates Conditions/Disability Medications
Assistance Needed Communication/Equipment/Other Needs
Suggestions for completing emergency health card
As with all items on this card, be sure your name, address, phone, etc. are clear and easy to read. Conditions/Disability List conditions which a rescuer might need to know about, keeping in mind the wide variety of possible disasters, being sure to include any thing that might be helpful for you in an emergency. (If you are not sure, list it): e.g. diabetes, epilepsy, heart condition, high blood pressure, respiratory condition, HIV positive. Example: "I take Lithium and my blood level needs to be checked every _____."
Medications If you take medication make sure this is stated clearly and Include: Prescriptions dosage times taken Other details regarding specifications of administration/regime: Example: insulin, etc. Instructions: Example: take my gamma globulin from the freezer; take my insulin from the refrigerator. Name, address, phone number and fax number of pharmacy where you get your prescriptions filled. Anticipated assistance needed "I need specific help with: walking, eating, standing, dressing, transferring." Walking - best way to assist is to allow me to hang on your arm for balance. Allergies and sensitivities: History of skin or other reaction or sickness following injection or oral administration of: Penicillin or other antibiotics Tetanus, antitoxin or other serums Morphine, Codeine, Demerol or other narcotics Adhesive tape Novocain or other anesthetics Iodine or methiolate Aspirin, emperin or other pain remedies Foods such as eggs, milk, chocolate, or others Sulfa drugs Sun exposure Insect bites, bee stings
Immunization Dates Remember to list all Immunizations (Regularly updating your card will also serve as a reminder for boosters and other recurring medical needs.) Communication/Equipment/other needs Specific communication needs (examples): "I speak using an artificial larynx, if it is not available I can write notes to communicate." "My primary language is ASL (American Sign Language). I am deaf and not fluent in English, I will need an ASL interpreter. I read only very simple English." Equipment used: Motorized wheelchair Suction machine Home dialysis Respirator Instructions: Take my oxygen tank. Take my wheelchair. Sanitary needs: Indwelling catheter. Trach
Copies of Card
Make multiple copies of this card to keep in emergency supply kits, emergency carry-with-you kits, car, work, wallet and purse (behind driver’s license or primary identification card) wheelchair pack, etc.
Emergency Contact list
Ask several relatives or friends who live outside your immediate area (approximately 100 miles away) to act as a clearing house for information about you and your family after an earthquake or other emergency. It is often easier to place an out of state long distance call from a disaster area, than to call within the area. All family members should know to call the contact person to report their location and condition. Once contact is made, have the contact person relay messages to your other friends and relatives outside the disaster area. This will help to reduce calling into and out of the affected area once the phones are working. (See attached worksheet) Besides emergency out-of-town contacts, list should include personal support network, equipment vendors, doctors, utility companies, employers, schools, day care centers, for other family or household members.
Other Important contacts: Personal support network Equipment vendors Utility companies Animal Control Center Veterinarian Out of home contacts for each household member: Employer Children schools, day care centers, etc
EMERGENCY CONTACT LIST
Out-Of- Town Emergency Contacts First person reached needs to call others on this list. Listed in priority order. Contact 1: Contact Name: Home Phone: Work Phone: Pager: Fax: Cellular Phone: E-Mail Address: Contact 2: Contact Name Home Phone Work Phone Pager Fax Cellular E-Mail Address Contact 3: Contact Name Home Phone Work Phone Pager Fax Cellular E-Mail Address
Possible Evacuation/Shelter sites
Outside neighborhood but within local area, listed in priority order. Site 1: Address Telephone Alternate Phone Pager Fax Cellular E-Mail Address Site 2: Address Telephone Alternate Phone Pager Fax Cellular E-Mail Address Site 3: Address Telephone Alternate Phone Pager Fax Cellular E-Mail Address
Establish a Personal Support Network
A personal support network is made up individuals who will check with you in an emergency to ensure you are o.k. and to give assistance if needed. This network can consist of friends, roommates, family members, relatives, personal attendants, co-workers and neighbors. Some people rely on personal assistance services (attendants). This type of assistance may not be available after a major quake. Therefore it is vital that your personal support network consist of different people than those who are your personal attendants. If you employ a personal attendant or use the services of a home health agency or other type of in home service, discuss with these people a plan for what you will do in case of an emergency. How will you get along in an emergency for as long as 7 days? A critical element to consider in your emergency planning is the establishment of a personal support network. Even if you do not use a personal attendant, it is important to consider having a personal support network to assist you in coping with an emergency. Do not depend on anyone person. Work out support relationships with several individuals. Identify a minimum of three people at each location where you regularly spend a significant part of your week: job, home, school, volunteer site, etc. In spite of your best planning, sometimes a personal support network must be created on the spot. For example you may find yourself in a shelter and needing to assemble help for immediate assistance. Think about what you will need, how you want it done and what kind of person you would select.
Seven Important Items for Your Personal Support Network:
Check off when you have completed each step
Make arrangements, prior to an emergency, for your support network to immediately check on you after a quake and, if needed, offer assistance. Exchange important keys. Show where you keep emergency supplies. Share copies of your relevant emergency documents, evacuation plans and emergency health information card. Agree and practice a communications system regarding how to contact each other in an emergency. Do not count on the telephones working. You and your personal support network should always notify each other when you are going out of town and when you will return. The relationship should be mutual. Learn about each other's needs and how to help each other in an emergency. You could be responsible for food supplies and preparation, organizing neighborhood watch meetings, interpreting, etc.
Traveling
When staying in hotels/motels identify yourself to registration desk staff as a person who will need assistance in an emergency and state the type of assistance you may need.
Natural Disaster Preparedness
The purpose of the following section is to help you plan for the occurrence of a natural disaster such as; flood, severe weather (also blackouts), and earthquakes. Personal Story: “My wheelchair ramp washed away in a flood and my house was left with three feet of mud everywhere. It was hard to use my electric wheelchair. I had money to pay for a ramp, but couldn’t hire anyone, as they were busy elsewhere.” – Texas What kinds of precautions could this person have taken to prepare an event such as this one?
Refer to the following PDF files on the CD accompanying this manual: (Note Adobe Acrobat Reader is required to open these files.) blackouts, earthquakes, floods, mudslides, winter storms, natural_hazards_1, natural_hazards_2.
for
Fire and Carbon Monoxide Poisoning Preparedness
The purpose of the following section is to help you plan for, and take preventive measures for, fire and carbon monoxide inhalation. Personal Story: “There was no disaster preparations for the work fire, no evacuation plan, or escape options except to walk down three flights of cement stairs, which is not an option. I was left at a stairwell because no one knew what to do.” – Sacramento, CA How might personal planning give this person control over their situation?
Refer to the following PDF files on the CD accompanying this manual: (Note Adobe Acrobat Reader is required to open these files.) fires, wildfires, carbon monoxide, natural_hazards_2.
WRAP-UP
The purpose of the following section is to make sure that you have completed all of the checklists and practice communication skills in case of an emergency. Any additional information that is specific to consumers or additional questions may also be covered in this section.
Communication: Practice Assertiveness Skills
Take charge and practice how to quickly explain to people how to move your mobility aids or how to move you safely and rapidly. Be prepared to give clear, specific and concise instructions and directions to rescue personnel, i.e., "Take my oxygen tank, take my wheelchair, take my gamma globulin from the freezer, take my insulin from the refrigerator, take my communication device from under the bed. Practice giving these instructions with the least amount of words in the least amount of time. For example: the traditional fire fighters carry may be hazardous for some people with some respiratory weakness. You need to be able to give brief instructions regarding how to move you. Be prepared to request an accommodation from disaster personnel. For example, if you are unable to wait in long lines for extended periods of time, for such items as water, food, and disaster relief applications, practice clearly and concisely explaining why you cannot wait in the line.
Emergency tips for people with development or cognitive disabilities
(Mental retardation, brain injury, stroke and other conditions which may reduce the ability to process information)
ACTIVITIES Practice what to do during and after an earthquake Keep a written Emergency Plan with you. Copies of plan to Personal Support Network buddies Ways to Help Remember. Practice how to tell someone about what you need.
DATE COMPLETED
Before, during and after an earthquake Practice what to do during and after an earthquake. Practice leaving places where you spend time (job, home, school, volunteer assignment, etc.) until you feel comfortable and feel confident that you will know what to do during and after a quake. Emergency Plan Keep a written emergency plan with you and in several locations. Make sure your emergency plan is easy to read and understand. After a quake, information often comes at you quickly. Think through ways to do things you will need to do after a quake. Small tape recorder, calendar with room for notes, to do lists, etc., will help you remember things. Give copies of your written emergency plan to your personal support network buddies.
Communication Think through what a rescuer might need to know about you and be prepared to say it briefly, or keep a written copy with you: I cannot read. I communicate using an augmentative communication device. I can point to simple pictures or key words which you will find in my wallet or emergency supply kit. I may have difficulty understanding what you are telling me, please speak slowly and use simple language. I forget easily. Please write down information for me.
Emergency tips for people with communication and speech related disabilities
ACTIVITIES How Will You Communicate? Store Communication Aids in all Emergency Kits. Complete Emergency Health Information Card with Communication Information Batteries or Chargers for Communication Equipment.
Communication
Determine how you will communicate with emergency personnel, if you do not have your usual communication devices (augmentative communication device, word board, artificial larynx). Communication Aids Store copies of a word or letter board, paper and writing materials, pre-printed messages and key phrases specific to an anticipated emergency, in all your emergency kits, your wallet, purse, etc. Emergency Health Information Card Make sure emergency health information card explains the best method to communicate with you, i.e.: written notes, pointing to letters/words/pictures, finding a quiet place. Alternate Power Source Obtain an alternative power source (i.e., power converter, batteries) if you use a computer or laptop computer as a means of frequent communication.
Emergency tips for people with environmental illness or multiple chemical sensitivities ACTIVITIES Emergency Supplies based on your worst days. “Carry With You" Important Supplies to keep with you at all times (medications, first aid kit, evacuation kit). Special additions to your Emergency Supplies. In case of Evacuation, know where the nearest safe places are from your home. Emergency Supplies Collect emergency supplies based on your worst days. After a major quake an excess of smoke, excessive dust, molds, gas leaks, diesel from idling rescue vehicles, flashing lights, radio waves, electro magnetic fields (from generators, emergency lights, cellular phones and walkie talkies) and airborne toxins may trigger stronger reactions than you normally experience. "Carry With You" Emergency Supplies Emergency Health Information Card should clearly explain your sensitivities and reactions, most helpful treatments, and treatments which are harmful. Be specific, as environmental illness is not commonly understood. Remember that some reactions (disorientation, aphasia, panic) may be diagnosed and treated as something other than chemical sensitivity and you may not be able to describe your needs verbally. Medications including: inhalers, epinephrine shots, anticonvulsant. Prescriptions and Treatment Authorization Request (T.A.R..'s) From your doctor for unusual, orphan or hard-to-find medications. Supplements, herbs, homeopathic remedies. DATE COMPLETED
First Aid Kit: Cotton bandages, gauze, and paper tape. Hydrogen peroxide, zephiran chloride or your tolerated disinfectant. Emergency Supplies Charcoal mask and/or respirator. Well aired-out (outgassed) plastic or steel tubing and ceramic mask or outgassed plastic mask for oxygen. Rolls of aluminum foil for such things as covering chairs, sleeping area, food, etc. Baking soda stored in a waterproof container (for washing). Food that requires no cooking. Water, if storage in glass containers is necessary, consider using one quart bottles, stored inside layers of thick socks to protect the glass and to enable carrying. Note: glass bottles will break if the water freezes and expands. Portable charcoal water filter. Before purchasing a fire extinguisher, check your sensitivity to the contents. Evacuation Plan Know where the nearest safe places are, especially open air places, such as a beach, up wind from traffic, refineries and fires. Avoid hermetically sealed shelters.
Emergency tips for people who are deaf or hard of hearing
ACTIVITIES Store and maintain extra Batteries. Store Hearing Aids. Install both Audible Alarms and Visual Smoke Alarms. Prepare written communication for emergency personnel.
DATE COMPLETED
Batteries Store extra batteries for hearing aids and implants. If available, store an extra hearing aid with emergency supplies Maintain TTY batteries (consult manual). Store extra batteries for your TTY and light phone signaler. Check the manual for proper battery maintenance. Hearing Aids Store hearing aid(s) in a strategic, consistent and secured location so they can be found and used after a quake. For example consider storing in a container by bedside which is attached to night stand or bed post using string or Velcro. Missing or damaged hearing aids will be difficult to replace or fix immediately after a major disaster. Alarms Install both audible alarms and visual smoke alarms. At least one should be battery operated.
Communication
Determine how you will communicate with emergency personnel: if there is no interpreter; if you do not have your hearing aid(s). Store paper and pens. Consider carrying pre-printed copy of key phrase messages with you such as: "I speak American Sign Language (ASL) and need an ASL interpreter," "I do not write or read English." "If you make announcements, I will need to have them written or signed." If possible, obtain a battery operated television that has a decoder chip for access to signed or captioned emergency reports. Determine which broadcasting systems will be accessible in terms of continuous news that will be captioned and\or signed. Advocate so that television stations have a plan to secure emergency interpreters for on camera emergency duty.
Advocacy
Recruit interpreters to be Red Cross emergency volunteers. Maintain pressure on TV stations to broadcast all news and emergency information in open caption format. Ensure hotels have access packets for deaf and hearing impaired persons, including audible alarms, when you travel. Ask for them when you check in.
Emergency tips for people who use life support systems
(dialysis, respirator, oxygen, suction, intravenous pump, infusion therapy)
ACTIVITIES Secure Equipment Maintain current list of Alternate Providers. Obtain Alternate Power source. Obtain a Generator. Oxygen Users. Regularly Test and Back Up power supply. Register with Utility Company. Teach a Personal Support Network how to operate and safely move your equipment. Secure Equipment
DATE COMPLETED
Secure any life support equipment to prevent damage from falling. If you use a chain to secure equipment, make sure it is a welded (not bent) chain. Alternate Providers Determine which facilities/providers would serve you in the event that your home system becomes inoperable or your provider is unable to provide you service. Alternate Power Discuss with your vendor alternative power sources that will provide you with support for up to five to seven days. Could you use a generator? What type? Could you use manually operated equipment? Can your equipment be powered from a vehicle battery? If yes, obtain necessary hardware for the hook-up.
Obtain a Generator Obtain a generator, if appropriate and feasible. To run generators in an emergency, fuel must be safely stored. Generators need to be operated in an open area to ensure good ventilation. A 2,000 to 2,500-watt gas-powered portable generator can power a refrigerator and several lamps. (A refrigerator needs to run only 15 minutes an hour to stay cool if you keep the door closed. So, you could unplug it to operate a microwave or other appliance.)
Emergency tips for people with mobility disabilities
ACTIVITIES Store Needed Aids in consistent, convenient and secured location Emergency Kit Extras. Arrange and Secure Furniture and other items to provide multiple barrier-free passages. Practice using Alternate Methods of Evacuation. Storage Store emergency supplies in a pack or backpack attached to walker, wheelchair, scooter, etc. Store needed mobility aids (canes, crutches, walkers, wheelchairs) close to you in a consistent, convenient and secured location. Keep extra aids in several locations, if available. DATE COMPLETED
Evacuation Plan Arrange and secure furniture and other items to provide multiple paths of travel and barrier-free passages. If you spend time above the first floor of an elevator building, plan and practice using alternate methods of evacuation. If needed, enlist the help of your personal support network. If you cannot use stairs, discuss lifting and carrying techniques that will work for you. There will be instances where wheelchair users will have to leave their chairs behind in order to safely evacuate a structure
Emergency Kit Keep a pair of heavy gloves in your supply kit to use while wheeling or making your way over glass and debris. If you use a motorized wheelchair/scooter consider having an extra battery available. A car battery can be substituted for a wheelchair battery but this type of battery will not last as long as a wheelchair's deep-cycle battery. Check with your vendor to see if you will be able to charge batteries by either connecting jumper cables to a vehicle battery or by connecting batteries to a specific type of converter that plugs into your vehicle's cigarette lighter in the event of loss of electricity. If you do not have puncture proof tires, keep a patch kit or can of "seal-in-air product" to repair flat tires and/or also keep an extra supply of inner tubes. Store a lightweight manual wheelchair, if available.
Sometimes transporting someone downstairs is not a practical solution unless there are at least two or more strong people to control the chair. Therefore it is very important to discuss the safest way to transport you if you need to be carried, and alert them to any areas of vulnerability. For example: the traditional "fire fighter's carry" may be hazardous for some people with some respiratory weakness. You need to be able to give brief instructions regarding how to move you.
Emergency tips for people with psychiatric Disabilities
ACTIVITIES Practice how to Communicate your needs. Anticipate the types of Reactions you may have after a quake and plan strategies for coping with these reactions. Keep with you Instructions for Treatment if you are hospitalized. Communication Think through what a rescuer might need to know about you and be prepared to say it briefly, or keep a written copy with you; for example: I have a psychiatric disability. In an emergency I may become confused. Help me find a quiet corner and I should be fine in approximately 10 minutes. I have a panic disorder. If' panic, give me one green pill (name of medication) located in my (purse, wallet, pocket, etc.). I take Lithium and my blood level needs to be checked every ________. Reactions There are a number of emotional reactions that may occur or become more severe after an emergency. These reactions include: confusion, thought processing and memory difficulties, agitation, paranoia, crying, fear, panic, sleep disturbance, pacing, shouting, depression, withdrawal, irritability, anxiety, shaking, and sleep disturbance. Think through the types of reactions you may anticipate having and plan strategies for coping with these reactions. Consider seeking input from your friends, family, therapist or service provider(s). DATE COMPLETED
Be prepared to have members of your personal support network offer emotional support so you can acknowledge and express feelings about the emergency. Treatment Instructions You may need medical assistance. You even may be hospitalized. Keep with you instructions for your care and treatment, or a copy of a durable power of attorney for health so that someone you have chosen may intervene for you.
Emergency tips for service animal and pet owners
ACTIVITIES I.D. Tags and License are current. Animal Care Plan. Be prepared to Function Without Assistance from service animal -Identify Alternate Mobility Cues. Assemble Service Animal's Emergency Kit. I.D.'s and Licenses Make sure your service animals and pets have /.D. tags with both your home telephone number and that of a your primary out of town contact person. Make sure your animal's license is current. Animal Care Plan how your pets will be cared for if you have to evacuate. Pets, in contrast to service animals, may not be allowed in emergency shelters due to health regulations, so have some animal shelters identified! Contact your local Red Cross chapter or state office of emergency management for guidance. Establish relationships with other animal owners in your neighborhood. In case you are not home, there will be someone to help your animal. Alternate Mobility Cues Pets and service animals may become confused, panicked, frightened or disoriented in and after a disaster: keep them confined or securely leashed or harnessed. A leash/harness is an important item for managing a nervous or upset animal. Be prepared to use alternative ways to negotiate your environment. DATE COMPLETED
Service Animal's Earthquake Kit (for 7 days) Container suggestions: pack supplies in a pack that your animal can carry in case you need to evacuate. This kit should include: Bowl for water and food Food Blanket for bedding Plastic bags and paper towels for disposing of feces. Neosporin ointment for minor wounds. (Animals can easily get cut after an earthquake. Ask your veterinarian if there is anything specific you should include for your animal.) A favorite toy Extra harness
Emergency tips for people with visual disabilities
ACTIVITIES Store extras canes. Alternate Mobility Cues in each room. Label Emergency Supplies with Braille, large print or fluorescent tape. Secure Computers and important information. Canes If you use a cane, keep spares in strategic, consistent and secured locations at job, home, school, volunteer site, etc. to help you maneuver around obstacles and hazards. Keep a spare cane in your emergency kit. DATE COMPLETED
Label Supplies If helpful, mark emergency supplies with large print, fluorescent tape or Braille. Secure Computers Anchor special equipment such as computers. Create a back-up system for important data and store it off site.
Alternate Mobility Cues If you have some vision, place security lights in each room, to light paths of travel. These lights plug into electrical wall outlets and light up automatically if there is a loss of power. They will, depending on type, continue to operate automatically for 1 to 6 hours and can be turned off manually and used as a short-lasting flashlight. Store high-powered flashlights with wide beams and extra batteries. If you wear soft contact lenses, plan to have an alternative because you will not be able to operate the cleaning unit without power. Service animals may become confused, panicked, frightened or disoriented in and after a disaster. Keep them confined or securely leashed or harnessed. A leash/harness is an important item for managing a nervous or upset animal. Be prepared to use alternative ways to negotiate your environment. Plan for losing the auditory clues you usually rely on after a major quake.
Advocacy Issues Advocate that TV news not only post important phone numbers but also announce them slowly and repeat them frequently for people who cannot read the screen.
References:
Independent living Resource Center San Francisco, 649 Mission Street, 3rd Floor, San Francisco, CA 94105 English (415) 543-6222, http://www.ilrcsf.org/Publications/prepared/. The American National Red Cross. (2006) http://www.redcross.org/. Federal Emergency Management Agency. (2005) http://www.fema.gov/. The Research and Training Center on Independent Living, The University of Kansas. (2005, May 15). Report #1: Consumer Survey Quotes: Nobody Left Behind. Lawrence, KS: C. Rooney.