The Power of Preparedness: Prepare Your Health

Group of people kneeling around a CPR dummy.

The devastating hurricanes of 2017 reminded us how important it is to prepare for disasters. These potentially life-threatening situations have real impacts on personal and public health. During Hurricane Irma, existing medical conditions and power outages increased the likelihood of death. Being prepared with supplies and an Emergency Action Plan can help you protect the health of your family until help arrives.

September is National Preparedness Month (#NatlPrep), and the perfect time of year to remind people of The Power of Preparedness. This year’s call-to-action of Prepare Your Health (#PrepYourHealth) and four weekly themes highlight the roles that individuals, state and local public health, and CDC play in creating community health resilience. It takes everyone “pulling in the same direction” to create families, communities, and a nation that can withstand, adapt to, and recover from personal and public health emergencies.

The first week focuses on personal preparedness, and the importance of nonperishable food, safe water, basic supplies, and the personal items you need to protect your health until help arrives.

Personal needs

A large-scale disaster or unexpected emergency can limit your access to food, safe water, and medical supplies for days or weeks. However, nearly half of adults in the U.S. do not have an emergency kit for their home; they don’t have the provisions, supplies, and equipment necessary to protect the health of their families in a disaster. This list will get you started:

  • Special foods—such as nutrition drinks—for people with dietary restrictions, food sensitivities and allergies, and medical conditions such as diabetes.
  • Prescription eyeglasses, contacts and lens solution
  • Medical alert identification bracelet or necklace
  • Change of clothes
  • Emergency tools (e.g., manual can opener; multi-use tool; plastic sheeting; etc.)
  • Durable medical equipment (e.g., walkers; nebulizers; glucose meters; etc.)
  • Medical supplies, including first aid kit
  • Pet supplies
  • Baby and childcare supplies

Prescriptions

The hands of an elderly man holding a pill organizer

Many people need daily medications and medical equipment. Nearly half of Americans take at least one prescription drug, and a quarter of Americans take three or more medications. A large-scale natural disaster, like a hurricane, could make it difficult to get prescription and over-the-counter medicines.  You and your family may need to rely on a prepared emergency supply. There are some basics to include:

  • A 7 to 10 day supply of prescription medications stored in a waterproof container.
  • An up-to-date list of all prescription medications, including dosage and the names of their generic equivalents, medical supply needs, and known allergies.
  • Over-the-counter medications, including pain and fever relievers, diuretics, antihistamines, and antidiarrheal medications stored in labeled, childproof containers.
  • A cooler and chemical ice packs for storing and keeping medicines cold in a power outage.

Paperwork

Over half of Americans do not have copies of important personal paperwork. Collect and protect documents such as insurance forms, and medical, vital, and immunization records. Here are some of the basics:

  • Health insurance and prescription cards
  • Shot records
  • Living wills and power of attorney forms
  • Vital records (e.g., birth and death certificates; adoption records)
  • User manuals, model and serial numbers, and contact information for the manufacturer of medical devices (e.g., blood glucose meters; nebulizers)
  • Hardcopies of your Emergency Action Plan

Power sources

A portable generator sitting outside in the snow.

A power outage can close pharmacies, disrupt medical services, and can be life threatening for over 2.5 million people who rely on electricity-dependent medical equipment. Be ready for a lengthy blackout with an emergency power plan and back up. You will need alternative power sources for your cellphone, refrigerator , and medical equipment. Here’s a checklist:

  • Extra batteries, including those for hearing aids, in standards sizes (e.g., AA and AAA)
  • Fully-charged rechargeable batteries for motorized scooters
  • Hand-crank radio with USB ports
  • Car chargers for electronic devices, including cell phones and breast pumps
  • A generator

Practical skills

Finally, it’s important to know some basic do-it-yourself skills to stay healthy and safe until help arrives. Here are the basics to get you started:

  • Call 911 in a life-threatening emergency
  • Get trained in cardiopulmonary resuscitation (CPR). If you do not know CPR, you can give hands-only CPR—uninterrupted chest compressions of 100 to 120 a minute—until help arrives.
  • Learn how to use an automated external defibrillator (AED).
  • Learn Handwashing is one of the best ways to protect yourself, your family, and others from getting sick.

The good news is that it is never too late to prepare for a public health emergency. You can take actions, make healthy choices, and download free resources to help you prepare for, adapt to, and cope with adversity.

The Power of Us

Evacuteer checking someone in during 2017 full-scale city assisted evacuation exercise.

“I am a Katrina survivor.” These were the first words out of Joan Ellen’s mouth when I spoke with her. And she was one of the lucky ones. She made it out of New Orleans before Hurricane Katrina made landfall on August 29, 2005. But not everyone was so fortunate. One of Joan Ellen’s neighbors did not evacuate because she could not bring her old dog with her to a shelter and would not leave him behind. Her neighbor died in the flooding. Joan Ellen recalls, “If I had known I would have taken her with me.”

Evacuations are more common than you might think. Every year people across the United States are asked to evacuate their homes due to fires, floods, and hurricanes. However, there are many reasons people may not be able to evacuate– including issues that New Orleans’ residents face, like lack of transportation, financial need, homelessness, and medical or mobility issues.

No one left behindJoan Ellen returned to her home in New Orleans 48 days after Hurricane Katrina. She likes to tell people, “I only had a foot of water – but it was a foot over my roof.” The thing she remembers most vividly about going home was not the destruction, but the smell. When Joan Ellen heard a radio announcement that they were recruiting volunteers to help in a mandatory evacuation she signed up. She has been training other Evacuteers since she joined the organization in 2009. She loves the casual definition of family that keeps people together in the event of an evacuation. “Family is anybody we say is family, and we will keep everybody together. In New Orleans we are only two degrees of separation.”

According to FEMA’s Preparedness in America report, people in highly populated areas were more likely to rely on public transportation to evacuate in the event of a disaster. In the event of a mandatory evacuation, approximately 40,000 people living in New Orleans will need assistance to evacuate because they don’t have a safe or alternative option.

After learning from Hurricane Katrina, the City of New Orleans will now call a mandatory evacuation nearly three days in advance of a dangerous or severe storm making landfall on the Louisiana coast. Everyone must leave during a mandatory evacuation until officials declare the city safe for re-entry.

Mobilizing the Evacuteers

The City also started City Assisted Evacuation (CAE) to help people who are unable to evacuate on their own. Through this program, the city provides free transportation for residents, along with their pets, to a safe shelter. CAE counts on volunteers from Evacuteer.org, a local non-profit organization that recruits, trains, and manages 500 evacuation volunteers called “Evacuteers” in New Orleans. As the Executive Director of this organization I tell people, “We are a year-round public health preparedness agency that promotes outreach to members of the community that aren’t always easy to reach, nor trusting of government, about their options and the evacuation process. The goal is to make sure that everyone using CAE is treated with dignity throughout the entire process.”

Lit evacuspot in Arthur Center
Evacuspot outside of Arthur Monday Multipurpose Center

Evacuteers receive a text message if the City of New Orleans calls for a mandatory evacuation. Teams are assigned to seventeen pickup points, called Evacuspots, placed in neighborhoods around the city. The Evacuteers help register people and provide information about the evacuation process. When residents go to an Evacuspot, Evacuteers will give every person a ticket, a wristband, and a luggage tag to help track their information and ensure that families stay together. After the paperwork is filled out, evacuees are transported to the downtown Union Passenger Terminal bus station where they will board a bus, and for a smaller percentage, a plane, to a state or regional shelter. When the city is re-opened after the storm passes, the process will bring residents back home to New Orleans.

An artistic approach to save lives

Each Evacuspot is marked by a statue of a stick figure with his arm in the air, and looks as though he is hailing a safe ride out of the city. Erected by international public artist, Douglas Kornfeld, the statues are a public art initiative led, and fundraised, by Evacuteer.org. Installed at each of the pick-up points in 2013, the stainless steel statues measure 14-feet tall, and stand as a reminder to residents year-round that there is a process to ensure everyone has the opportunity to safely evacuate.

Do you know what to do?

  1. Have a plan. Know where your family will meet, both within and outside of your neighborhood, before a disaster.
  2. Fill ‘er up. Make sure you have a half a tank of gas at all times in case of an unexpected evacuation. If an evacuation seems likely, make sure your tank is full.
  3. Keep your options open. Have alternative routes and other means of transportation out of your area. Choose several destinations in different directions you can go to evacuate.
  4. Leave early. Plan to take one car per family to reduce congestion and delay.
  5. Stay alert. Do NOT drive into flooded areas. Roads and bridges may be washed out and be careful of downed power lines.

Learn more

Read our other National Preparedness Month blogs:

Preparing for the Worst-case Scenario

"ROTTERDAM, HOLLAND - SEPTEMBER 5, 2010: Demonstration of handling of car crash victim by medics at the annual World Harbor Days in Rotterdam, Holland on September 5"
New York City completed a functional exercise to help the city’s hospital system prepare for emergency medical personnel to treat and transport children, like this young girl, after a catastrophic event.

Setting the Stage

Celia Quinn
Celia Quinn, MD, MPH CDC Career Epidemiology Field Officer assigned to NYC Department of Health and Mental Hygiene

Imagine this: Explosions across New York City target elementary schools. Hundreds of severely injured and traumatized children, teachers, and parents flood hospital emergency departments in the five boroughs. Municipal emergency medical services (EMS) are rushing to respond.

Fortunately this scenario wasn’t really happening – it was part of an exercise conducted on May 25, 2017. The exercise was designed to test the ability of the New York City (NYC) Healthcare System to respond to a massive surge of pediatric trauma patients, exceeding the usual resources of this large and complex healthcare system.

Identifying the Players

As a CDC Career Epidemiology Field Officer assigned to NYC, I worked with the experts in the Pediatric Disaster Coalition and the Fire Department of New York (FDNY). We designed an exercise that reflected the number of injured children who would need to go to the hospital and the type of injuries they might experience if a similar event really happened.

NYC has 62 acute care hospitals that participate in the 911 system. Of these, 16 are level 1 trauma centers designated by the NYC Department of Health  (this includes three pediatric level 1 trauma centers and 4 burn centers). A total of 28 hospitals care for pediatric patients and have, during the past seven years with the assistance of the NYC Pediatric Disaster Coalition, developed pediatric-specific components of their overall disaster plans to prepare them to receive pediatric patients from an incident like the one invented for this exercise. All 28 hospitals participated in the exercise.

Coordinating Resources

Hospitals who participated in the exercise were challenged to rapidly respond to more than 60 simulated patients with a range of injuries and conditions:

  • a 7-year-old boy unresponsive after a traumatic injury to his head

    Hospital nursing leadership reports on the status of nursing staff, while the hospital’s Public Information Officer looks on.
    Hospital nursing leadership reports on the status of nursing staff, while the hospital’s Public Information Officer looks on.
  • A toddler with burns to the face, chest, and abdomen
  • A 12-year-old distraught after witnessing another child lose arms in an explosion

Hospitals had to assess the resources that were available to care for the patients, including

  • What nursing and specialty staff could be made immediately available?
  • What medications and equipment, including imaging equipment and burn supplies, were needed to care for the children?
  • What communications and incident command processes would each hospital use to mobilize staff and other resources in the situation described in the exercise?
  • Which patients needed to be transferred to specialty hospitals to receive care for their injuries?

Coordination between FDNY and hospitals was critical to the success of this exercise – it supported interfacility transfers for patients who required specialty care or to better match hospital resources with patient needs. During the exercise, I met with FDNY leadership from EMS and Office of Medical Affairs physicians, and leaders from NYC Emergency Management and the Health Department at the Fire Department’s Operations Center. There, we tested the communications between hospitals, FDNY, and a volunteer pediatric intensive care physician who was trained to assist FDNY’s Office of Medical Affairs to prioritize patients for urgent interfacility transfers.

Measuring Success

Hospital Incident Command leadership discusses the availability of resources to make more pediatric beds available.
Hospital Incident Command leadership discusses the availability of resources to make more pediatric beds available.

This exercise revealed that 28 NYC hospitals were able to rapidly and dramatically increase their pediatric critical care capacity. It was the largest exercise NYC has done that was focused primarily on caring for injured children. During the exercise, these hospitals:

  • More than doubled the number of beds in pediatric intensive care units (PICUs) and added 1,105 pediatric inpatient beds, so children could stay in the hospital for an extended period of time
  • Opened 203 operating rooms that could treat children who needed surgery

During the exercise, we also identified some challenges, including

  • More than half of the hospitals did not have enough supplies that could be used to treat critically injured children
  • A limited number of pediatric specialists, including doctors who could perform brain surgery on children as well as ear, nose, and throat specialists
  • Hospital resources (beds, supplies, and staff) would have been further strained if the disaster scenario had also included large numbers of adults

We were able to identify ways to improve each hospital’s process and further develop our citywide plans to respond to any emergency that strains our healthcare system. As a pediatrician and a parent of two young New Yorkers, I’m grateful that so many dedicated people are working together to make sure that city and hospital plans account for the unique needs of children in disasters.

The NYC Department of Health and Mental Hygiene receives federal funds used to support state and local public health and healthcare system preparedness through the aligned Hospital Preparedness Program (HPP) – Public Health Emergency Preparedness (PHEP) cooperative agreement. NYC used HPP funds to fund the NYC Pediatric Disaster Coalition to design and conduct the exercise, and coordinate participation of hospitals in the exercise.

Read our other National Preparedness Month blogs:

Preparing for the Worst-case Scenario

"ROTTERDAM, HOLLAND - SEPTEMBER 5, 2010: Demonstration of handling of car crash victim by medics at the annual World Harbor Days in Rotterdam, Holland on September 5"
New York City completed a functional exercise to help the city’s hospital system prepare for emergency medical personnel to treat and transport children, like this young girl, after a catastrophic event.

Setting the Stage

Celia Quinn
Celia Quinn, MD, MPH CDC Career Epidemiology Field Officer assigned to NYC Department of Health and Mental Hygiene

Imagine this: Explosions across New York City target elementary schools. Hundreds of severely injured and traumatized children, teachers, and parents flood hospital emergency departments in the five boroughs. Municipal emergency medical services (EMS) are rushing to respond.

Fortunately this scenario wasn’t really happening – it was part of an exercise conducted on May 25, 2017. The exercise was designed to test the ability of the New York City (NYC) Healthcare System to respond to a massive surge of pediatric trauma patients, exceeding the usual resources of this large and complex healthcare system.

Identifying the Players

As a CDC Career Epidemiology Field Officer assigned to NYC, I worked with the experts in the Pediatric Disaster Coalition and the Fire Department of New York (FDNY). We designed an exercise that reflected the number of injured children who would need to go to the hospital and the type of injuries they might experience if a similar event really happened.

NYC has 62 acute care hospitals that participate in the 911 system. Of these, 16 are level 1 trauma centers designated by the NYC Department of Health  (this includes three pediatric level 1 trauma centers and 4 burn centers). A total of 28 hospitals care for pediatric patients and have, during the past seven years with the assistance of the NYC Pediatric Disaster Coalition, developed pediatric-specific components of their overall disaster plans to prepare them to receive pediatric patients from an incident like the one invented for this exercise. All 28 hospitals participated in the exercise.

Coordinating Resources

Hospitals who participated in the exercise were challenged to rapidly respond to more than 60 simulated patients with a range of injuries and conditions:

  • a 7-year-old boy unresponsive after a traumatic injury to his head

    Hospital nursing leadership reports on the status of nursing staff, while the hospital’s Public Information Officer looks on.
    Hospital nursing leadership reports on the status of nursing staff, while the hospital’s Public Information Officer looks on.
  • A toddler with burns to the face, chest, and abdomen
  • A 12-year-old distraught after witnessing another child lose arms in an explosion

Hospitals had to assess the resources that were available to care for the patients, including

  • What nursing and specialty staff could be made immediately available?
  • What medications and equipment, including imaging equipment and burn supplies, were needed to care for the children?
  • What communications and incident command processes would each hospital use to mobilize staff and other resources in the situation described in the exercise?
  • Which patients needed to be transferred to specialty hospitals to receive care for their injuries?

Coordination between FDNY and hospitals was critical to the success of this exercise – it supported interfacility transfers for patients who required specialty care or to better match hospital resources with patient needs. During the exercise, I met with FDNY leadership from EMS and Office of Medical Affairs physicians, and leaders from NYC Emergency Management and the Health Department at the Fire Department’s Operations Center. There, we tested the communications between hospitals, FDNY, and a volunteer pediatric intensive care physician who was trained to assist FDNY’s Office of Medical Affairs to prioritize patients for urgent interfacility transfers.

Measuring Success

Hospital Incident Command leadership discusses the availability of resources to make more pediatric beds available.
Hospital Incident Command leadership discusses the availability of resources to make more pediatric beds available.

This exercise revealed that 28 NYC hospitals were able to rapidly and dramatically increase their pediatric critical care capacity. It was the largest exercise NYC has done that was focused primarily on caring for injured children. During the exercise, these hospitals:

  • More than doubled the number of beds in pediatric intensive care units (PICUs) and added 1,105 pediatric inpatient beds, so children could stay in the hospital for an extended period of time
  • Opened 203 operating rooms that could treat children who needed surgery

During the exercise, we also identified some challenges, including

  • More than half of the hospitals did not have enough supplies that could be used to treat critically injured children
  • A limited number of pediatric specialists, including doctors who could perform brain surgery on children as well as ear, nose, and throat specialists
  • Hospital resources (beds, supplies, and staff) would have been further strained if the disaster scenario had also included large numbers of adults

We were able to identify ways to improve each hospital’s process and further develop our citywide plans to respond to any emergency that strains our healthcare system. As a pediatrician and a parent of two young New Yorkers, I’m grateful that so many dedicated people are working together to make sure that city and hospital plans account for the unique needs of children in disasters.

The NYC Department of Health and Mental Hygiene receives federal funds used to support state and local public health and healthcare system preparedness through the aligned Hospital Preparedness Program (HPP) – Public Health Emergency Preparedness (PHEP) cooperative agreement. NYC used HPP funds to fund the NYC Pediatric Disaster Coalition to design and conduct the exercise, and coordinate participation of hospitals in the exercise.

Read our other National Preparedness Month blogs:

Empowering Kids to Make Their Families Safer

American-Red-Cross-volunteer-with-pillowcase-in-Alaska_BLUR

After graduating from college I moved to Anchorage, Alaska for a year of post-graduate service through the Jesuit Volunteer Corps NW and AmeriCorps. I served as the Preparedness and Casework Specialist for the American Red Cross of Alaska. Though often overlooked, Alaska is the largest state in the country (more than twice as big as Texas!) and has more coastline than the rest of the United States combined. While a large portion of the population lives in Anchorage, dozens of Native Alaskan villages are scattered all across the state, often hundreds of miles apart.

Education in action If I learned one thing about disaster preparedness education, it’s that you never know when your students will need to put what you taught them into action. I specifically remember one Friday afternoon teaching a group of students on the military base about what to do during an earthquake. We discussed various scenarios such as what to do if you are sleeping or playing at recess when an earthquake occurs. Two days later, a 7.1 magnitude hit the Anchorage area in the middle of the night, one of the larger earthquakes the area had experienced in a few years. The next morning, the teacher contacted me to tell me about how the students were able to use what I had taught them just days before to stay safe during the earthquake. This reaffirmed my belief of the value and effectiveness of The Pillowcase Project and educating students about disaster preparedness.While in Alaska, I spent a good portion of my time managing The Pillowcase Project, a Red Cross youth preparedness program for students between the ages of 8 and 11. The program educates children about how to prepare for emergencies they might experience in their communities. Since the program started in Alaska, The Pillowcase Project has reached youth all over the state and has even crossed the Arctic Circle!

Pillowcases are not just for pillows

During Hurricane Katrina, a Red Crosser noticed college students were carrying their belongings in pillowcases as they evacuated to emergency shelters. Their actions inspired The Pillowcase Project, which uses an everyday household item to hold the necessary items for an emergency kit. Putting all of these supplies in one place makes it easier to grab and go in the event of an emergency.

The Pillowcase Project has reached over 800,000 children both nationally and globally. Trained instructors, mostly volunteers like me, share the curriculum with children in schools, after-school programs, summer camps, scout groups, and various venues.

Beyond the standard preparedness education curriculum, students decorate a pillowcase with symbols that are personal reminders of things that make them feel safe and brave. They are instructed to fill it with emergency essentials such as a first aid kit, flashlight, batteries, spare clothes, and a toothbrush. We also encourage students to include a comfort item such as a favorite stuffed animal or photographs of their friends and family to provide additional support during a stressful time. We also teach coping skills such as breathing exercises and positive visualization techniques, so our students know how to stay calm in stressful situations.

Learn. Practice. Share.Pillowcase Project education session in Los Angeles, CA

Research from FEMA shows that one of the best ways to promote family preparedness is by educating children, who then feel empowered to share what they learned with their families. It is often difficult to convince adults of the negative impact a disaster could have on their family and how important it is to be prepared. This is why The Pillowcase Project seeks to educate students; 8-11 year-olds who are able to accurately relay information and comprehend the curriculum to share it with others. The curriculum centers around three pillars:

  • LEARN. Kids learn about the types of natural disasters that are most likely to happen in their community or neighborhood. In the case of Alaska, we focused on earthquakes and home fires.
  • PRACTICE. We talked through different scenarios that were tailored to the children in the group, because one child might live in a trailer, one on the 7th floor of an apartment building, and one in a two story house.
  • SHARE. We always encouraged the kids to go home and share the information and skills they have learned with their family and friends. The kids I worked with were always so enthusiastic and excited to tell people about what they had learned, which makes this a very proactive preparedness education program.

Sounding the Alarm

7 people are killed in a home fire, and another 36 people are injured every day in the United States.No matter where or what kind of home you live in, you are at risk of experiencing a home fire. That is why every child educated through The Pillowcase Project learns home fire safety and prevention, not limited to how to properly maintain a smoke alarm to how to safely get out of a burning home.

Red Cross volunteers and partners all across the country install free smoke alarms, replace batteries in existing alarms, and help families create escape plans. This year, this Sound the Alarm effort will install its one-millionth smoke alarm. An impossible feat without the dedication and passion of those who believe in the value of disaster preparedness education and prevention.

Learn More

Read our other National Preparedness Month blogs: