Case Study – Developing Response Protocols for Emergencies

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					Case Study – Developing Response Protocols for Emergencies Abroad
June 2011

Case Study: This case study is listed in four parts. The parts are chronological and simulate the
actual progression of an emergency situation. Record your answers in the emergency planning
guide below.

Part 1. You receive a call from a parent who says that her daughter is sick. Her daughter lives
in a residence hall in London, England. The parent says that her daughter went to the emergency
room with headaches and double vision, but was released from the hospital shortly after being
seen. She knew her daughter was heading back to the residence hall from the hospital. She has
tried for several hours to reach her daughter via phone and email, but has been unable to do so.

Part 2. You are able to have a staff member (or contact) check on the student. During the next
24 hours, the student becomes worse, returns to the hospital, and is immediately admitted.
Medical staff suspect meningitis, and begin testing. Parent wants to fly over to be with daughter.
One student who is visiting the hospital overhears the possible meningitis diagnosis and alerts
other students in the residence hall. Many of the students call their parents. Parents begin
phoning your institution/organization.

Part 3. A diagnosis of meningitis is confirmed. Hospitalized student is gravely ill. Parent
arrives in London and rushes to the hospital. You are part of a team that is managing
communications with students in the same residence hall, other students on the program, and
contacts from parents and concerned individuals.

Part 4. The student dies. You are notified by the staff member who is at the hospital with the
parent. You are in the process of contacting the appropriate individuals, when you receive a call
from a parent of one of the other students on the program. Notification is spreading on
Facebook, and the parent wants the facts.

Plan considerations                               Your plan
Part 1. How will you gather information about
the situation? How will you be able to find out
what is going on with the student?


Part 1. What basic steps should guide you in
assessing the situation and the needs of the
various individuals involved?


Part 2. What types of simultaneous
communications do you need to be thinking
about and/or doing?


Part 2. Who triggers the flow of
communications in your crisis management
plan? What circumstances are communicated
with whom in what sequence?
Plan considerations                                Your plan
Part 3. What are your responsibilities for
communications and in what order?



 Part 3. How will you communicate
expectations in terms of what you are able to
do and are not able to do?


Part 4. How do you manage communication in
a logical sequence around those immediately
affected while supporting the family of the
deceased student?



Part 4. What are the steps you will need to
take over the coming days and weeks to
continue to support all affected by the tragedy?
                          Crisis Management Communications
    Self-Assessment Questions for Reviewing your Institution’s or Organization’s Plans


                    Questions                                Review/Notes
Who is in charge of the flow of emergency or
crisis communications in your plan? Is it
someone from your office or someone in media
relations/university relations? How is the
overall response coordinated?

What triggers the flow of communication, and
how is communication maintained? What
happens if communication stops?

What if there are multiple individuals involved
collecting information? How is it channeled
back to the crisis management team? Who has
the responsibility for originating and managing
the flow of communications?

How do home and on-site staff know what to
do and who to report to? Do they know their
expectations and responsibilities?

Who trains your staff in the steps of the plan
and in crisis communication and procedures?

Do you discuss or debrief actual scenarios or
applications where you used the plan? If so,
what have you learned? If not, do you think
you should do so?

What other contingencies do you need to plan
for? What if your first source of
communication fails? What backups exist?

How do you engage with students in
communications? What are they instructed to
do and when? How do you follow-up?
How do you manage the communication so
that those immediately affected are contacted
first, and there is a sequence for the rest of the
communications? What happens if the
sequence is disrupted?

Where do all of the other communications not
driven by your plan fit? What happens with
news reports, rumors, social media, etc.?
Developing Response Protocols for
Emergencies Abroad




Carol Foley, HTH Worldwide
Julie Friend, JD, Michigan State University
Arlene Snyder, Arcadia University


June 2, 2011
Vancouver, BC




                                              1
                      Agenda

Introduction

Part 1: Medical Emergency Preparedness

Part 2: During the Life Threatening Crisis

Part 3: Evacuation or Repatriation

Full-group Case Study/Scenario

Small group Case Study/Scenario

Pairs Case Study Scenario

Questions and Answers


                                             2
Medical Emergency Preparedness




                                 3
                        Emergency



Can be perceived or real

May provoke panic or anxiety

Illness or injury requiring medical attention

Victim of crime or accident

Can impact an individual or entire group




                                                4
                           Crisis

Death or life-threatening conditions involving Illness, injury or
victim of crime or accident.

Effects last several days or weeks

Can impact an individual or multiple groups




                                                  United Kingdom


                                                                    5
                          Disaster

Hundreds or thousands of deaths and/injuries

Effects last weeks, months or even years




                                           Japan



                                                   6
            Create Pre-departure Health
            Review/Disclosure Process
Identify pre-existing medical conditions

Collaborate with family physician and campus-based health
professionals

Identify local conditions that may impact participation

Confirm availability of specialist care in host location

Determine availability and reliability of medication(s)

Evaluate appropriateness of program housing
options

Assess ability to participate in program activities


                                                            7
            Develop Emergency Response
                     Checklist

Key Elements
• Obtain important facts – who, what when, where, why, how
• Follow campus crisis management protocols3
• Communicate information as appropriate

Source: Michigan State University Office of Study Abroad




                                           Himalayas
                                                             8
     Pre-Departure Communication Plan
            with Home Campus

Formalized communication plan for program staff and local
partners to report emergencies.

Determine under what situations require family notification –
serious accidents requiring outpatient care, or inpatient care
only.

Clear understanding of roles – confirm who at the institution
notifies and maintains regular communication with the family

 Clear and transparent student understanding of how
communication will flow during the emergency




                                                                 9
    International Insurance Coverage

Direct billing – outpatient and inpatient

Mental health coverage

Bedside visit benefit

Accidental Death Benefit

Political/Security Evacuation

Natural Disaster Evacuation

Medical Evacuation



                                            South Africa
                                                           10
    Research Quality of Medical Care
           in Host Location

Health training for faculty leaders, local partners, and
study abroad staff:
• Nearest Emergency Room
• English-speaking physicians, mental health providers
  and dentists
• 24 hour pharmacy
• International Assistance Provider




                                                       India

                                                               11
         Student Emergency Contact
                Information
Pre-departure
• Family home and mobile phones
• Signed release to discuss medical condition with family
  representative
• Family representative with U.S. passport and ability to travel

Post-departure
• Updated mobile phone number
• Develop a communication plan for use during independent travel




                                                                   12
                          Alcohol

Educate students on cultural expectations relating to
alcohol
Harmful interactions – mixing alcohol with medications
Risks of over-consumption – injury, sexual assault, crime
Center for Global Education -
http://www.youtube.com/watch?v=hFYz2cYHBLQ




                                          Ireland

                                                            13
During the life threatening crisis




                                     14
             Life-Threatening Crisis


•   Planning for the crisis before it happens
•   Obtain all information (who, what, when, where and how)
•   Have staff/contacts help student first
•   Seek appropriate medical care




                                                              15
                  Crisis Action Plan




In seeking medical assistance
• share what you know about pre-existing conditions/medications
• if student is conscious, have him/her contact family
• if student is not conscious, decide who will call emergency
 contact




                                                                16
Who Shares Information with Whom?


Who are the stakeholders and in what order do they
need to receive information?
• Inform host school and home school of student
• Inform local embassy or consulate
• Inform other students on the program




                                              Nicaragua


                                                          17
   Informing Relevant Constituencies

• What information can be shared with whom?
• Where do you have contact information/how is information
  shared
• Importance of refreshing info on regular basis
• Talking with staff and other students




                                                   The Amazon
                                                                18
Helping Parents/Family to Travel

• Who has a passport?
• What do they need help with?
• What are the types of questions or concerns which
 are likely to come up?
• What type of support will they need?
• Expect the unexpected




                                                      19
               Total Support
• Notifying local officials and contacts
• Transport of body and funeral home arrangements
 (can insurance company help?)
• Grief counseling (family, students. Staff)
• What type of support will they need?
• Self-care




                                           United Kingdom



                                                            20
Evacuation or Repatriation




                             21
                    Theory/Practice
                     of Trauma
  Plan for “freezing” not panic             Argentina


 Amanda Ripley, author of “The
Unthinkable: Who Survives When
   Disaster Strikes and Why”




                                  Everyone needs basic first
                                  responder training, not just
                                        supervisors
            Australia

                                                           22
        Insurance Plan/Responsibilities
                 of Trauma
    Evacuation                    Repatriation (Remains)
•   Patient passport           • Death certification/ travel docs
•   Patient escort               from U.S. Embassy
•   Patient readiness/travel   • Autopsy
•   Release to family or       • Religious considerations
    U.S. hospital admit        • Cremate or embalm
                               • Receiving party (U.S. airport)
                               • Death benefit
                               • Make no scholarship promises




          Pakistan
                                                               23
               Follow-up Back Home
                    of Trauma
Recovering
• Prepare for media inquiries
• Send get well card from
  office, encourage others
  units to do the same
• Assist with the sorting of
  academics and/or finances
• Visit student (with other
  students)                     France
• Help with any medical
  reimbursement paperwork
• Check in after 4-6 weeks




                                         24
                         Case Study
               Follow-up Back Home                    2
Death

•   Prepare for media inquiries
•   Send sympathy card from office, encourage other units to do the
    same
•   Obtain visitation and funeral information, share with relevant
    units
•   Send flowers to funeral home
•   Arrange staff/students to attend visitation or funeral
•   Investigate posthumous degree possibilities
•   Make no scholarship promises




                                                                25
                           Case Study
                Practice: Major Medical                 2
• You receive a call at 2:00 AM on a
  Saturday morning from your resident
  director in New Delhi, India.
• Sally traveled to Goa for the
  weekend, but was hit by a car as she
  tried to cross a busy street.
• She is alive, but her condition is
  critical. Medical decisions need to be
  made on her behalf.                                   India

• Delhi is 1200 miles from Goa. Flying
  time is 2.5 hours.                     • What are your first steps?
                                         • Sally’s companion, Nancy, is
                                         at the hospital with Sally, and
                                         is very upset. How do you
                                         handle Nancy?
                                         • Sally’s parents are divorced


                                                                  26
Case Studies/Scenarios




                         27
                     Practice: Death
                           Case Study 3
• It is 4:00 pm on Good Friday.
  You are at cabin in a rural
  area. You receive a call from
  the faculty leader of a short-
  term program in Santiago,
  Chile.
• One of the students drown at
  a nearby beach.
• You know the student is
  Muslim, because she                          Nicaragua
  requested special meal
  arrangements in accordance       • What are your first steps?
  with her religious practices.




                                                             28
                               References

National Institutes for Health – Harmful Interactions : Mixing Alcohol with Medicines
     http://pubs.niaaa.nih.gov/publications/medicine/harmful_interactions.pdf

U.S. Department of Education – Higher Education Center
   http://www.higheredcenter.org

Center for Global Education - http://www.youtube.com/watch?v=hFYz2cYHBLQ




                                                                                  29
Contact Information

Carol Foley, HTH Worldwide

cfoley@hthworldwide.com


Julie Friend, JD, Michigan State University

friendju@msu.edu


Arlene Snyder, Arcadia University

Snydera@arcadia.edu




                                              30

				
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