Emergency Medical Services: More Than a Ride to the Hospital

ambulance

This post was written in collaboration with the National Highway Traffic Safety Administration’s Office of EMS in observance of National Emergency Medical Services Week, May 15-22.

For many of us, the image we have of first responders comes mostly from television and movies.

We picture ambulances with sirens wailing and lights flashing en route to the scene of an emergency. We imagine emergency medical service (EMS) clinicians tending to seriously ill and injured patients, administering emergency medical care, and whisking them away to a hospital.

EMS clinicians are first responders, emergency medical technicians, paramedics, and others whose titles may not always suggest their EMS duties. For example, firefighters and nurses may provide pre-hospital emergency medical care as part of their routine job duties. They are all vital to emergency response.

There are several coordinated efforts underway by federal agencies to help create resilient, stable, and capable EMS systems. They include initiatives to share EMS data, develop the workforce, and enhance public health readiness.

Public Health & EMS Collaborationmap of public health responders

EMS systems provide an essential service in response to emergencies. The last few years have reminded us how important EMS clinicians are to our healthcare, public health, emergency management, and public safety systems, especially in times of crisis.

During the COVID-19 pandemic, EMS clinicians helped keep people out of the hospital by evaluating them in their homes and nursing facilities. They administered vaccines and treatments for COVID-19. They staffed emergency operations centers, hospitals, and other medical facilities around the country. All the while putting themselves at risk for injuries and illnesses, including mental harm caused by the inherent stressors of the job.

The National Highway Traffic Safety Administration (NHTSA) has partnered with the National Institute for Occupational Safety and Health (NIOSH). Together they are developing risk mitigation strategies and interventions to protect and improve the health and resilience of our EMS workforce.

It’s important that local, regional, and state EMS leaders work closely with public health, 911 emergency communications systems, and emergency management to prepare for future public health emergencies.

NHTSA’s Office of EMS (OEMS) is part of a national focus on integrating EMS into planning and preparedness initiatives. It is co-funding a project to research and publish best practices for engagement and collaboration between EMS, 911, public health, and emergency management. It will serve as a valuable tool that can help reduce morbidity and mortality during public health emergencies and promote population health and illness/injury prevention.

During the COVID-19 response, the FEMA/HHS Healthcare Resilience Working Group’s Prehospital EMS/911 team was led by the OEMS. It brought together 27 SMEs from the EMS and 911 industries, generating over 36 cleared documents to help EMS and 911 function throughout the pandemic by collaborating with federal, state, and local partners. Additionally, the use of information exchange between the community and OEMS allowed for shared learning and best practices on how to best manage triage and transport throughout the pandemic.

The Value of Data

NHTSA’s OEMS supports efforts to improve EMS and 911 systems, using evidence based on data, to improve the response to and treatment of patients suffering from traffic crashes, severe injuries, acute illness, or other medical emergencies.

Every encounter between an EMS clinician and a patient is documented following the National EMS Information System (NEMSIS) data standard. Portions of the collected patient care data are submitted to the National EMS Database.

EMS data has proven valuable to researchers, policymakers, and public health officials on topics ranging from COVID-19, drug overdose, stroke care, and traffic crashes. It is used at the local, state, and national levels to improve care and develop evidence-based guidelines.

NEMSIS data were used to develop Prehospital Evidence Based Guidelines on naloxone administration and pain management. It’s also used by the National EMS Quality Alliance to develop performance measures for the National Guideline for the Field Triage of Injured Patients.

NEMSIS is providing the CDC with data on EMS activations that it use to conduct syndromic surveillance, monitor health-related trends, and inform and assess public health interventions. In coordination with state and local partners, federal agencies are exploring ways to link NEMSIS data with other data to monitor and improve outcomes, while protecting patient confidentiality.

Workforce Resilience

Many EMS systems across the country face challenges to providing essential services. They include funding, recruitment, and retention.

With an understanding of the unique challenges faced by rural and tribal communities, the OEMS is working with them to improve communications and access to available resources. The OEMS collaborates with national partners to enhance interstate recognition and reciprocity of EMS personnel.

The theme of this year’s National EMS Week is “Rising to the Challenge.” Meeting current and future challenges requires the people of the EMS system to work together to meet the emergency medical needs of people in every kind of emergency.

Resources

Protecting Children Where They Learn, Play During Disaster Recovery

building inspector

Emergencies, including natural disasters like earthquakes and hurricanes, can happen at any time. They can have lasting impacts on communities.recovery supplement Places that were once safe might become unsafe. Homes, businesses, childcare facilities, schools, and other buildings can be damaged or destroyed.

After the initial response, communities begin a long recovery process. Buildings are rebuilt, infrastructure is repaired, and there is the appearance of recovery. What often goes overlooked is the need for recovery guidance that promotes environmental safety and prevents exposure to hazards.

A major concern in the aftermath of natural disasters is the safety of children. Children are at higher risk from environmental hazards because of their physical, developmental, and behavioral differences from adults. Environmental exposures, such as drinking contaminated water, can cause diseases and disrupt children’s development, learning, and behavior.

What is the Agency for Toxic Substances and Disease Registry doing to help with disaster recovery?

The Agency for Toxic Substances and Disease Registry (ATSDR) recognizes the importance of preparing to protect children from harmful exposures during disaster recovery. We also know that planning for these efforts can be a challenge.

ATSDR’s Choose Safe Places for Early Care and Education (CSPECE) Disaster Recovery Supplement helps public and environmental health professionals reduce children’s environmental exposures where they learn and play. With this tool, professionals are better prepared to

  • identify potential hazards.
  • compile resources needed to address environmental hazards, such as flooding, that can affect locations where children spend time.
  • establish ways to reduce risk and help community members, particularly children, feel secure as they recover and return to pre-disaster routines.

Disaster Recovery Supplement in Action: Puerto Rico

From December 2019 through early 2020, the southwestern region of Puerto Rico experienced an earthquake swarm. It included 11 quakes that were magnitude five or greater.

Before this disaster, the staff members of Head Start, a federal government-sponsored early child care program, attended a training hosted by the Puerto Rico Department of Health (PR DOH) on the new Post-Disaster Self-Assessment Form (PDSAF).

The PDSAF provides resources for childcare facilities in case hazards are discovered. It also provides suggestions on how childcare staff can protect children from environmental hazards during the recovery process.

In response to the earthquakes, Head Start asked that PR DOH use the PDSAF to assess major health hazards that might prevent them from safely reopening facilities. PR DOH visited several Head Start program sites to conduct assessments using the PDSAF tool. They found that many Head Start facilities had cracks in the walls. Some facilities also had cracks in the supporting structures.

Through the PDSAF, it was clear that professional engineers should inspect the Head Start buildings before allowing children back inside. Officials conducted daily site evaluations to determine if they were fit to open while earthquakes and aftershocks continued to occur.

After a disaster, such as an earthquake, the environment and surrounding communities can change drastically. Some of these changes can lead to the migration of harmful substances, such as lead-contaminated debris from damaged buildings, which can cause environmental hazards that were not present previously. Changes like these can complicate decisions about whether it is safe to reopen an early care and education facility after a disaster.

The PDSAF is a useful tool in environmental recovery efforts. It helped Head Start and PR DOH determine whether it was safe to reopen facilities and programs after the disaster.

Returning to pre-disaster routines, such as attending school or childcare, is important to a community’s sense of well-being and disaster resiliency. With proper recovery guidance, we can prepare our communities for environmentally safe recovery.

Learn more about the CSPECE Disaster Recovery Supplement.

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

Self-Serve Food Pantries Help Feed Local Communities

Five teenagers stand beside a freestanding wooden container filled with food. A label on the box says "TLC little free pantry"
High school students (from left) Eva Gottesfeld, Rebecca Levy, Yair Gritzman, Jonathan Hus, and Noah Rubin stand in front of a “TLC Little Free Pantry” with a quick response (QR) code and instructions posted on the front. (Photo credit: Yair Gritzman)

This student-authored post is published by CPR in partnership with Medill News Service and the Northwestern University Medill School of Journalism, Media, Integrated Marketing Communications. The views and opinions expressed in this article are the author’s own and do not necessarily reflect the views, policies, or positions of CPR or CDC.

Summer Faerman was on a walk in early 2020 when she saw a small wooden box at the entrance of a neighborhood. She investigated.

The box was a free library, where people could take a book for themselves and leave them for others. The idea inspired Faerman to create something similar—a self-serve food pantry.

Faerman started with one pantry in front of a Salvation Army. It was a strategic choice. The Salvation Army is known in the community as a place to donate goods. It’s also a block away from a local elementary school and a public housing development.callout

Over the past year, one pantry has turned into 52 TLC Little Free Pantries (LFP) located around South Florida. The newest opened last Veteran’s Day in Boca Raton at a mental health center that treats veterans.

LFPs are open 24 hours. There are no questions asked, no judgments passed, and no forms to fill out, explained Faerman.

The pantries are based on the honor system. The words “If you have, give. If you need, take” are posted in multiple languages, including Creole, Portuguese, and Spanish, on the boxes.

People who take from the self-serve food pantries also give, Faerman said. She’s seen people, including members of the local synagogue and passersby, put food in the boxes.

With the pantries being always open, Faerman ran into a problem. When there was just one box, she was able to keep up with demand.

As new pantries opened, it became more difficult for Faerman to keep them stocked. That’s even with the help of volunteers.

In January 2021, Faerman heard from a group of high school students in an engineering club at Donna Klein Jewish Academy with an offer to help. She explained to them her problem of knowing when the pantries were running low. The students suggested creating quick response (QR) codes for the pantries.

QR codes, explains Yair Gritzman, a senior in high school and member of their engineering club, were a simple and inexpensive solution to keeping tabs on the pantries’ inventory.

Gritzman and his schoolmates enlisted the help of their engineering teacher and the Institute for Sensing and Embedded Network Systems Engineering at Florida Atlantic University. Together they launched “Report That Pantry”.

Report That Pantry is a website. QR codes placed on each pantry link to the site, where users of the code can report the level of food inside the pantries to LFP volunteers.

The QR codes, which link to the website, are now being used by self-serve food pantry projects in other states, including Oregon, Louisiana, Oklahoma, and Ohio, to restock their pantries faster.

Faerman said the QR codes make it so that “if there’s one [a pantry] that’s bare, it’s not bare for long.”

People appreciate that they can go at any time and take as much food as they need, said Faerman. Children share how excited, not embarrassed, they are to go to the pantry and pick out food. Thank-you notes are left inside the pantries as well.

Faerman hopes to implement more self-serve pantries soon. For now, she’s focused on keeping the ones they have stocked with food with the help of the website.

Faerman hopes people find inspiration in the TLC LFPs—as she did in the free library—and replicate it in their communities. Building a self-serve pantry is easy and opening an account on “Report That Pantry” is free. People are only limited by their willingness to get involved.

The U.S. Department of Agriculture (USDA) reported in September 2021 that of the 13.8 million food-insecure households in the U.S., 36.5% of them reported using a food pantry in 2020. USDA defines households as food insecure if they have “difficulty providing enough food for all members at some time in the past year because there wasn’t enough money for food.”(2)

Food assistance is available for low-income individuals and communities. Call USDA’s National Hunger Hotline for information on meal sites, food banks, and other services near you. The number is 1-866-3-HUNGRY (1-866-348-6479) or 1-877-8-HAMBRE (1-877-842-6273) for Spanish. The hotline is open Monday through Friday from 7 a.m. to 10 p.m. EST.

Resources

References

  1. https://www.feedingamerica.org/hunger-blog/what-difference-between-food-bank-and-food-pantry
  2. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/key-statistics-graphics.aspx

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

Prep Your Health with Advance Care Planning

writing

April is National Donate Life Month. April 16 is National Healthcare Decisions Day.

Emergencies, including personal injury and illness, are often unpredictable. That unpredictability is both a reason to prepare and something to prepare for.

Plan Ahead for Personal Health Emergencies

Many people face decisions about treatments that a medical emergency might leave them incapable of making.(1)

Advance care planning is an important preparedness step toward making sure you get the medical care you would want if you cannot speak forcallout yourself.(2)

While you might prefer to think that you will never need such a plan, advance care planning is a way to care for others if you get ill or are injured.

Advance care planning is not just for older adults. At any age, a medical emergency could leave you too ill or injured to make your own health care decisions.

Advance care planning can save loved ones from confusion, family infighting, and second-guessing if they made the right decisions on your behalf.(3)

Advance care planning involves several steps:

  1. Learn about the types of healthcare decisions that you might need to make.
  2. Consider those decisions ahead of time.
  3. Make your decisions known to others.

Talk to family and a doctor as part of your advance care planning. They can help you understand the choices you may need to make and think through your decisions before you put them in writing.(4)

Organ Donation

Organ donation is one of many important decisions you can make as part of your advance care planning for medical emergencies. Others include deciding when you want emergency medical professionals to use cardiopulmonary resuscitation (CPR) or an automated external defibrillator (AED) to restart your heart.

Organ donation is the process of taking healthy organs and tissues from one person for transplantation into another. Organs you can donate include:

  • Internal organs: Kidneys, heart, liver, pancreas, intestines, lungs
  • Skin
  • Bone and bone marrow
  • Cornea(5)

Learn more about how donation works and the difference you can make when you become an organ donor.

Become a Donor

Anyone can sign up to be an organ donor regardless of age, race, ethnicity, religion, or health status. It only takes a few minutes. Sign up online through your state registry or in person at your local department of motor vehicles. Your donation can save or improve more than 80 lives.(6)

You can update your information on your state’s online donor registry at any time. Most states let you choose which organs and tissues you want to donate.(7)

Make Your Decisions Known

Preparedness isn’t a prediction of the future. There’s no guarantee that you’ll need advance care planning. You may never need others to make healthcare decisions on your behalf.

Once you’ve come to decisions on things like organ donation, you should talk to your family about your decisions and write them down. There are several ways to do that.

Advanced directives, including living wills, are legal documents that go into effect only if you are incapacitated and unable to speak for yourself.(8) You can use them to organize and communicate your decisions about things like end-of-life care and organ donation.

Another way to make your decisions known is to carry a wallet card that explains that you have an advance directive and where it is kept.

Give copies of advance care planning documents to your healthcare proxy, your healthcare providers, your hospital, and anyone you think should have the information.

Create digital duplicates of hardcopy documents. Save them in a password-protected format to a flash or external hard drive or a secure cloud service.

Like most important paperwork, advance directive documents, wallet cards, and even online profiles for decisions like organ donation require occasional maintenance. Periodic proofreading for errors and outdated information will save yourself and others time, frustration, and added worry in an emergency.

References

  1. https://www.nia.nih.gov/health/advance-care-planning-health-care-directives
  2. https://www.cdc.gov/aging/advancecareplanning/index.htm
  3. https://www.cdc.gov/aging/advancecareplanning/
  4. https://www.nia.nih.gov/health/advance-care-planning-health-care-directives
  5. https://medlineplus.gov/organdonation.html
  6. https://www.organdonor.gov/learn/organ-donation-statistics
  7. https://www.organdonor.gov/sign-up
  8. https://www.nia.nih.gov/health/advance-care-planning-health-care-directives#:~:text=These%20preferences%20are%20often%20put,of%20medical%20care%20you%20want

Resources

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

Good Cents: Prep Your Finances for Emergencies

A middle-aged man and woman discussing finances.

This post was written in collaboration with the Consumer Financial Protection Bureau in observance of National Financial Capability Month.

Emergencies—especially when multiple occur at the same time—can test your ability to financially respond and recover. For example, getting back to “normal” after a flood during a pandemic takes financial resources that many people may not have.(1)

Emergencies big and small often feel like they couldn’t happen at a worse time. There are things you can do to improve your financial preparedness that might make the unexpected a little bit less of a disaster.

Building an Emergency Fund

Developing a habit of putting money aside—even if it is a small amount—is the easiest way to develop an emergency fund and build financial resiliency.

Without savings, the financial shock of an emergency—however minor—could affect you, your family, and your community. Research suggests that people who struggle to recover from a financial shock have less savings to help protect against a future emergency. They may rely on credit cards or loans, which can lead to debt. They may also pull from other savings, like retirement funds, to cover these costs.(2)

The Consumer Financial Protection Bureau (CFPB) offers advice and resources on how to financially prepare for an emergency. Here are five strategies for building and maintaining an emergency fund:

  • Create a savings habit. Set some goals for yourself, create a system for making consistent contributions, monitor your progress, and don’t forget to celebrate your successes!
  • Manage your cash flow. Your cash flow is how your money comes in (your income) and what you spend. If you notice gaps where more money is going out, you can work with the people or organizations you owe money to (i.e., your creditors) to get extra time and avoid falling behind with your payments.
  • Save. Take opportunities to put away money whenever possible: a tax refund, or a holiday or birthday gift. Putting away some money, even small amounts, helps you create an emergency fund.
  • Make your saving automatic. Setting up automatic transfers from your checking account to a savings account is a great way to start saving. And you can always adjust the transfers if your situation changes.
  • Save through work. You might be able to split your paycheck between accounts if you have direct deposit set up. Work with your employer to see if there are options to put money aside without having to remember to do it.(3)

A low or no-cost way to prepare for the financial impact of a disaster is to collect important information related to your property and accounts. Download a copy of the “Your Disaster Checklist” (available in multiple languages) to help you keep track of account numbers, valuables, medical information, and more.

An additional set of challenges often affect individuals and populations with limited English proficiency or who are unfamiliar with the nuances of the U.S. financial system and culture. The American Savings Education Council, a coalition of private and public partners offers resources for communities about all aspects of financial security.

MyMoney.gov has information on how to rebuild your finances after a disaster. Call 1-800-FED-INFO to speak to a specialist in English or Spanish. They can answer your questions about federal agencies, programs, benefits, or services related to financial literacy and education.

Other resources include:

Personal and Community Financial Resiliency

Natural disasters are happening with greater will greater frequency and severity. In 2021, there were 20 separate billion-dollar weather and climate disasters.(5)

Experts say the “whole community” must respond by increasing its preparedness, response, and recovery capacities.(6) Everyone has a role in making our communities and our nation more financially resilient.

Working together to address the causes of people’s and communities’ barriers to financial preparedness is essential to developing a stronger, more resilient, and healthier nation. Work with organizations to promote financial education in your community. Homeowner associations, community organizations, adult learning centers, social clubs, places of worship, and other members of the whole community have the potential to increase our resiliency.

Tailoring Financial Preparedness Strategies

The financial readiness needs of a community are closely related to the conditions where members live, play, work, and study and while some communities focus on mastering FEMA’s Emergency Financial First Aid Kit, others may need to start first on increasing access to education and basic financial literacy.

Ultimately, it’s about individuals and communities owning their financial preparedness and building resilience. When they receive the support of their local authorities, our nation becomes more resilient and better prepared to expedite its financial recovery after disasters.

Resources:

References

  1. https://www.census.gov/content/dam/Census/library/publications/2021/demo/p60-273.pdf
  2. https://www.consumerfinance.gov/start-small-save-up/start-saving/an-essential-guide-to-building-an-emergency-fund/#anchor_how-do-i-build-an-emergency-fund
  3. https://www.consumerfinance.gov/an-essential-guide-to-building-an-emergency-fund/
  4. https://www.ncdc.noaa.gov/billions/events
  5. https://coast.noaa.gov/states/fast-facts/hurricane-costs.html
  6. https://www.fema.gov/sites/default/files/2020-07/whole_community_dec2011__2.pdf

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

 

Callout: What is an emergency fund?

 

An emergency fund is a cash reserve that’s specifically set aside for unplanned expenses or financial emergencies. Some common examples include car repairs, home repairs, medical bills, or a loss of income.

 

In general, emergency savings can be used for large or small unplanned bills or payments that are not part of your routine monthly expenses and spending.

 

Source: https://www.consumerfinance.gov/an-essential-guide-to-building-an-emergency-fund/#anchor_what-is-an-emergency-fund

Creating a Nutritious Emergency Food Supply

Nutrition Facts label

March is National Nutrition Month.

There are several things to think about when picking food to include in your emergency food supplies. They include:

  • Shelf life. Shop for nonperishable items
  • Foods that don’t require cooking, water, or special preparation are best.
  • Does your family have food allergies or other special dietary needs?
  • How much do you need to keep your family fed? Where will you store it?

Often less attention is paid to the nutritional facts of the foods in our emergency kits. But taking care of your body is an important part of self-care during an emergency. One way to do that is to try to eat healthier foods.

Here are a few tips to help you build a nutritious emergency food supply.

Improve Your Food Label Literacy

Knowing how to read food labels is a practical skill that you can use to make decisions about what goes in your emergency food supply.An annotated example of a Nutrition Facts label.

Nutrition Facts labels include information on serving size, calories, and nutrients that can help you make healthier food choices.(1)

Because you can’t know how an emergency will affect your every day, you may want to stock your food supply with more calories than you normally eat. A day spent cleaning up after a disaster expends more calories than one spent sheltering in place.

When using food labels to help make healthier choices consider the serving size, especially how many servings there are in the food package. The number of servings you eat determines the number of calories you’re eating. Eating too many calories per day is linked to overweight and obesity.

Shop Smart

When shopping for food, imagine having to rely on your emergency food supply and emergency water supply. How will you meet your family’s nutritional needs on a limited supply of water and without access to grocery stores and restaurants? Here are some things to think about when buying for your emergency food supply.

Include Fruits and Vegetables

Canned and shelf-stable fruits and vegetables can be a nutritious addition to your emergency food supply. Look for low and no sodium and no-sugar-added options. Also, consider dried fruit and nuts.

Look for Lower Sodium Foods

Sodium (salt) helps to preserve some foods, especially shelf-stable canned items. Salty food can increase your thirst, which could cause you to drink more water than you planned when creating an emergency water supply.

You should store at least 1 gallon of water per person per day for 3 days for drinking and sanitation. Try to store a 2-week supply of water, if possible.

Most of the sodium you eat is added to packaged foods before you purchase them. This makes reading food labels and choosing lower sodium foods even more important.(2)

Different brands of the same foods may have different sodium levels. For example, sodium in chicken noodle soup can vary by as much as 840 mg per serving for different brands. Look for brands that advertise low or reduced sodium. Compare the nutrition facts panels of different brands to choose the lowest sodium option.(2)

Include Protein

Protein is a critical part of our diet. Everyone needs a minimum amount of protein every day, even during an emergency.

Protein also gives you a feeling of fullness. Feeling full can help keep you from eating other foods in your emergency supply and make your emergency food supply last longer.(3)

Protein-rich foods include:

  • canned or pouched fish,
  • canned poultry,
  • beans and legumes,
  • nuts
  • low-fat or non-fat dairy products packaged in shelf-stable packaging. You can usually find these products in the cereal aisle at the grocery store.

Things like canned or packaged tuna, salmon, or chicken; protein bars, nut butters (presuming no one has an allergy), and some non-dairy milk alternatives are good choices for your emergency food supply.

If buying dairy or non-dairy beverages, look for products that are UHT, or Ultra High-Temperature Pasteurization (also referred to as Ultra Pasteurization or UP). These are shelf-stable and do not require refrigeration for safe storage.

If buying canned proteins, look for labels that say canned in water, low sodium, or no salt added.

Avoid Added Sugars

Added sugars include sucrose, dextrose, table sugar, syrups, honey, and sugars from concentrated fruit or vegetable juices.(4)

The leading sources of added sugars in the US diet are sugar-sweetened beverages, such as regular soda (not sugar-free), fruit drinks, and sports drinks, and foods like cookies and cakes.(4)

One way to avoid added sugars in your emergency food supply is to choose foods with little to no added sugar. Examples include fruit canned in its juice or water.

Help Others Create a More Nutritious Food Supply

People get most of their food for an emergency food supply from food retail venues, such as grocery and corner stores, and food pantries. Having healthier food available and making it affordable in places like these empowers people to make healthier food choices every day and when preparing for emergencies.(5)

When nutritious foods are not available, people may settle for foods that are higher in calories and lower in nutritional value.(5)

The whole community can work together to improve access to healthier food in several ways. They include:

  • connecting people to healthier foods by addressing transportation gaps in communities.
  • increasing nutritious food offerings in food service venues
  • bringing partners together to link local food hubs to organizations that sell or serve food in low-income communities.

Learn more ways government, communities, businesses, nonprofit groups, and others can work to improve access to healthier food.

Resources

References

  1. https://www.fda.gov/food/food-labeling-nutrition/changes-nutrition-facts-label
  2. https://www.cdc.gov/salt/index.htm
  3. https://www.health.harvard.edu/blog/extra-protein-is-a-decent-dietary-choice-but-dont-overdo-it-201305016145
  4. https://www.cdc.gov/nutrition/data-statistics/added-sugars.html
  5. https://www.cdc.gov/nutrition/healthy-food-environments/index.html

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

Prep Your Health for Floods

road closed sign

March 14–20 is Flood Safety Awareness Week

Floods are the most widespread of all weather-related natural disasters. They happen in every U.S. state and territory.(1) Floodwater can be dangerous. It can contain different hazards that can harm your health and the health of others.

Here are some ways you can prepare for and respond to flooding.flood warnings

Know Your Risk

Flooding can happen year-round anywhere it rains.(1) If you live in a flood-prone area, you should prepare.

Use FEMA’s Flood Map Service Center to find your official flood map. You can also contact your local emergency management agency.

Use the information you gather to make an informed decision about how best to protect your finances and property.(2) Homeowners’ insurance policies do not cover flooding. A flood insurance policy typically takes up to 30 days to go into effect.

Prepare Yourself or Your Household

Planning for an emergency can give you and your family peace of mind. If the entire process seems too big, you can take small steps throughout the year.

  • Collect emergency supplies, including
    • personal items such as water, medications, and supplies for pets
    • personal protective equipment, including
      • an N-95 respirator
      • long pants or waders
      • rubber boots
      • rubber gloves
      • goggles (i.e., safety glasses)
    • insect repellent
    • cleaning supplies (Unscented household bleach can be used to disinfect surfaces, canned goods, and even water if bottled water is not available.)
  • Collect, check, and protect important paperwork, including homeowners or renters and flood insurance policy documents.
  • Stay informed of weather updates. Follow trusted sources of information on social media like your local National Weather Service Weather Forecast Office.

Along with preparing yourself for a flood, you should also take steps to get your home ready for a flood. This includes learning practical skills like how to turn off the utilities in case you must evacuate.

Protect Your Health

Floodwater can be dangerous. It can contain things that may harm health. We don’t know exactly what is in floodwater at any given point in time. Protect yourself and others from possible contaminants, chemical hazards, and objects.

  • Stay out of floodwater. Exposure to contaminated floodwater can cause wound infections, skin rash, gastrointestinal illness, tetanus, and other health problems. If you must enter floodwater, wear rubber boots, rubber gloves, and goggles.(3)
  • Don’t drive into flooded areas—turn around, don’t drown! Have an evacuation plan that gives you options in case a path is flooded.(3) A few inches of water can sweep a car away.
  • Prevent injuries. If you happen to have an open wound during a flood, make sure to avoid floodwater by keeping wounds clean and covered. (3)

Going home after a flood can present challenges, too. Here are some practical steps to take when you first reenter your home.

  • Throw out any food, including emergency supplies, that may have come into contact with floodwater. Discard canned foods that are bulging open, or damaged. Food in undamaged cans can be saved if properly cleaned.
  • Use Environmental Protection Agency (EPA)-registered insect repellents to protect yourself from mosquito bites. Immediately following a hurricane, flooding occurs. Mosquito eggs laid in the soil by floodwater mosquitoes during previous floods hatch. This results in very large populations of floodwater mosquitoes. Most of these mosquitoes are considered nuisance mosquitoes. In general, nuisance mosquitoes do not spread viruses that make people sick.(4)
  • Dry out your home to prevent mold. When returning to a home that has been flooded, be aware that mold growth may be present. Mold can be a health risk for your family. If possible, air out your house by opening doors and windows. Use fans to dry wet areas. Position fans to blow air out doors or windows. Use proper protective gear such as safety glasses, gloves, and N95 respirator when removing mold.(5)

Visit the CDC website for more information on what to do when reentering a flooded home.

References

  1. https://www.nssl.noaa.gov/education/svrwx101/floods/
  2. https://www.fema.gov/flood-maps
  3. https://www.cdc.gov/disasters/floods/floodsafety.html
  4. https://www.cdc.gov/mosquitoes/mosquito-control/community/mosquitoes-and-hurricanes.html
  5. https://www.cdc.gov/disasters/mold

Resources

 

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

Arizona Creates ASL Glossary of Emergency Management Terms

An American Sign Language interpreter at a press conference.
ERIC team member, Jackie Schodt (left), interprets remarks from Cara Christ, former Director of the Arizona Department of Health Services, in April 2021 at the opening of Arizona’s first state-run indoor drive-thru COVID-19 vaccination site.

This student-authored post is published by CPR in partnership with Medill News Service and the Northwestern University Medill School of Journalism, Media, Integrated Marketing Communications. The views and opinions expressed in this article are the author’s own and do not necessarily reflect the views, policies, or positions of CPR or CDC.

During an emergency, the right message, from the right person, at the right time can save lives. That’s assuming people can find, understand, and use the information.

Many people who are Deaf and hard-of-hearing rely on sign language interpretation and captions to receive information. The inability to provide real-time interpretation and captions during an emergency can endanger lives.

In Arizona, where nearly 17% of people have a hearing loss, the Arizona Department of Emergency and Military Affairs (DEMA) has created an American Sign Language (ASL) glossary of emergency management terms to improve access to information during emergencies.

The ASL glossary website features a series of videos. The videos are a training resource for Emergency Response Interpreter Credentialing (ERIC) program interpreters and a reference for Deaf community members who are unfamiliar with emergency management terms.

Victoria Bond, Community Outreach Coordinator for DEMA, leads the team that created the glossary. The team included Certified Deaf Interpreters (CDI) Beca Bailey and Shelley Herbold.

CDIs are members of the Deaf community who know and understand Deaf culture. Their linguistic expertise helped account for nuances in ASL, which evolve like any other spoken language, Bailey said.

“The language [ASL] is complex,” said Bond, an experienced interpreter in her own right. “The glossary was created to standardize language around emergencies for interpreters and the Deaf community.”

But emergency management is also complex. Interpreters needed to learn about the Incident Command System and the terminology before they could create accurate interpretations. They took online training and spoke to response experts to broaden their understanding and create a list of possible terms for the glossary.

The team drafted signs for the terms. They shared the signs with other trained interpreters and Deaf professionals in emergency response to ensure that they were clear and accurate. Their feedback was used to decide which signs to include in the glossary.

So far, the team has created and recorded over 150 terms for the glossary. Related terms are grouped into the same video.

The glossary was made possible with funding from the Arizona Department of Health Services and is an outgrowth of DEMA’s ERIC. Bond is the program director.

The ERIC program trains American Sign Language (ASL) interpreters and Communication Access Realtime Translation (CART) captioners on the Incident Command System, integrating into an emergency response team, content, and vocabulary for all-hazard incidents. ERIC trained personnel deploy statewide to support state and local emergency response agencies.

Interpreters and captioners attend media briefings, town hall meetings, and livestreamed meetings. They interpret and transcribe emergency information in real-time for people who are Deaf and hard of hearing.

The alternative is to add sign language interpretations and captions to recordings after the event. Bond says that’s too long to wait for emergency information, especially in life-threatening situations.

Bond recalls a deployment to Coconino County, Arizona, in July 2019. She provided interpretation services during a town hall meeting. One community was under an evacuation order. Fifteen others were under an evacuation watch. In situations like that, making time-sensitive information accessible cannot be an afterthought.

“The goal of ERIC is to provide real-time access to emergency information,” said Bond. “If information is being livestreamed or broadcast on television, we want it immediately accessible and understandable to people who are Deaf and hard-of-hearing.”

“The glossary helps advance that goal,” she continued. “If someone watching doesn’t recognize a sign, the glossary is there for their use and understanding.”

Bond thinks of the glossary as a living resource that DEMA will continually edit and update.

“We plan to continue to add terms,” said Bond. “As the community and our team of interpreters use the glossary and become familiar with it, we’ll use their feedback to determine what terms are missing. We may also add longer videos that give more detailed information about a specific topic.”

Visit the Arizona Emergency Information Network website to access the ASL glossary and the DEMA website for more information about the ERIC program.

Resources

 

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

3 Ways to Improve Your Food Label Literacy

A person pushing a shopping cart in a grocery store.

Canned goods are an emergency preparedness staple. And for good reason. They are reasonably affordable, require little to no preparation, and have a long shelf life. These characteristics make them a good choice for your emergency food supply.

As often as people buy and cook with canned goods, they can find food labels confusing.(1, 2) Because labels are required for most packaged foods, it’s good to know how to read and understand them.(3)

Knowing how to read food labels is a practical skill that can help you avoid food allergens, reduce sodium and sugar in your diet, reduce food waste, and better manage your emergency food supply.

Here are three ways you can improve your food label literacy.

Learn to Identify Allergens

Food allergies affect millions of Americans and their families. They occur when the body’s immune system overreacts to certain proteins in food.

Food allergic reactions vary in severity. Mild symptoms can include hives and lip swelling. One severe, life-threatening reaction, often called anaphylaxis, may involve fatal respiratory problems and shock.(4)

The best way to prevent a food allergy reaction is to avoid the foods that cause reactions.

Laws and regulations, such as the Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA), and the Food Allergy Safety, Treatment, Education and Research Act (FASTER) make it easier for people to identify potential food allergies in food products.

FALCPA requires labeling for the eight most common food allergens. They are milk, eggs, fish, crustacean shellfish, wheat, soy, peanuts, and tree nuts.

FASTER identifies sesame as a major food allergen. Food labels must start to identify sesame as an allergen beginning January 1, 2023.

FALCPA says the name of the food source of a major food allergen must appear in one of three ways:

  • Using the allergens common name in the ingredient list (e.g., milk).
  • In the ingredient list in parentheses after the name of a less common form of the allergen (e.g., “lecithin (soy),” “flour (wheat),” and “whey (milk)”).
  • Immediately after or next to the list of ingredients in a “contains” statement. (e.g., “Contains wheat, milk, and soy.”).(5)

Consumers may also see advisory statements such as “may contain [allergen] or “produced in a facility that also uses [allergen].” Statements like these are used to address “cross-contact,” which can occur in different ways:

  • When multiple foods are produced in the same facility using shared equipment.
  • When multiple foods are produced on the same production line.
  • As the result of dust or aerosols containing an allergen.(4)

Make a habit of carefully reading labels even for foods you purchase often because ingredients and manufacturing processes can change. Reading labels each time you shop to avoid food allergens will ensure your emergency food supply is ready when you need it.

Be Informed About Expiration Dates

Americans throw away almost 40 million tons of food every year. Confusion over date labeling accounts for an estimated 20% of consumer food waste, according to FDA.(6)

Many people incorrectly think phrases like “Best By” and “Best if Used By” refer to food safety. Manufacturers use phrases like these to refer to when the food is at peak freshness and flavor.

Shelf-stable foods like canned goods can last for years past their “best by” date if the can is in good condition. That means no rust, dents, or signs of swelling.(7)

Vermont Law School’s Center for Agriculture and Food Systems launched the “Labels Unwrapped” website to help you better understand food labels. The “Labels 101” resource includes examples of common phrases on food packaging and explanations of the terms used to communicate quality.

After an emergency, it’s important that you take steps to prevent illness from unsafe food. Visit CDC’s website for information on what to do with food after an emergency or disaster.

Get the FoodKeeper App

The FoodKeeper app was developed by the USDA’s Food Safety and Inspection Service and others to help you understand how to store food and beverages.

The app allows you to search different foods by category for information about when you should consume them and how to safely store them. For example, the app recommends that you keep low-acid, unopened canned goods like stew, soups, and beans in the pantry.

The app also suggests you eat them within 2 to 5 years of purchase. You should refrigerate and eat low-acid canned goods within 3 to 4 days after opening.

Use your new understanding of food labels and tools like the FoodKeeper app to help you manage your pantry and maintain your emergency food supply. At the same time, you can avoid allergens, reduce waste, and save money on your food bill.

Resources

References

  1. https://www.usatoday.com/story/money/2020/03/02/soup-tuna-top-selling-canned-foods-in-america/111338376/
  2. https://pubmed.ncbi.nlm.nih.gov/30770169/
  3. https://www.fda.gov/food/food-labeling-nutrition
  4. https://www.fda.gov/food/food-labeling-nutrition/food-allergies
  5. https://www.foodallergy.org/resources/how-read-food-label
  6. https://www.fda.gov/food/consumers/how-cut-food-waste-and-maintain-food-safety
  7. https://www.usda.gov/media/blog/2013/06/27/you-toss-food-wait-check-it-out

 

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

Prep Your Health for Earthquakes

A seismograph

February is Earthquake Awareness Month

If people were asked where in the United States do most earthquakes happen, they are likely to answer California. They’d be correct.(1) But earthquakes are a hazard in other parts of the country, too.

The U.S. Geological Survey (USGS) estimates that nearly half of all Americans live in areas with some potential for damaging earthquakes. That includes people living in the central states where there is what USGS calls “strong shaking potential.”(2)

If you live under the threat of earthquakes, there are ways you can prepare. They start with collecting emergency supplies, including personal needs, and planning ahead. Here are three more ways you can prepare.

Know Your Risk

There’s no way to know when or where an earthquake will happen. The best scientists can do is calculate the probability that a significant earthquake will happen in a specific area within a certain number of years.(3)

It is, however, possible to better know the earthquake hazard where you live and the earthquake risk to your community.

An earthquake hazard is anything associated with an earthquake that may affect the normal activities of people. This includes landslide, liquefaction, tsunamis, and seiches.(4)

Use the USGS National Seismic Hazard Map to learn the general earthquake hazard in your area. The map shows how many times earthquakes could cause damaging ground shaking in 10,000 years. That doesn’t mean the earthquakes won’t happen before. They could happen at any time.(5)

Your earthquake risk is the probable building damage and the number of people that are expected to be hurt or killed if an earthquake occurs on a particular fault. Earthquake risk and earthquake hazard are sometimes incorrectly used interchangeably. High earthquake hazard does not mean high risk.(6)

The best way for you to stay informed about both the hazard and risk to your community is to contact your local emergency management or geological survey office. Understanding your risk can help you take steps to protect yourself and your property.

Earthquakes can trigger tsunamis. A tsunami can strike any U.S. coast, but the hazard is greatest in places near subduction zones. For example, Hawaii, Alaska, Washington, Oregon, California, and the U.S. Caribbean islands. If you live along the coast in one of these places, you are at risk from tsunamis.

Practice Your Response

Earthquakes can have immediate and long-term impacts on health and safety. They can cause injuries, anxiety and stress, and death.(7)

Participating in emergency response activities like the Great ShakeOut earthquake drill can teach you practical skills that you can use during an earthquake. Take these steps:

  1. STOP and stay put. Stay inside if you are inside and outside if you are outside. If inside and if possible, move away from glass, hanging objects, bookcases, cabinets, and large furniture that could fall. If you are outside, move away from buildings, utility wires, and fuel and gas lines.
  2. DROP down onto your hands and knees. This position protects you from falling but allows you to still move if necessary.
  3. COVER your head and neck (and your entire body if possible) underneath a table or desk. If there is no shelter nearby, get down near an interior wall or next to low-lying furniture that won’t fall on you, and cover your head and neck with your arms and hands. If you are in bed, hold on and stay there. Protect your head with a pillow.
  4. HOLD ON to your shelter (or to your head and neck) until the shaking stops. Be prepared to move with your shelter if the shaking shifts it around.

Studies of injuries and deaths caused by earthquakes over several decades show that you are much more likely to be injured by falling or flying objects than to die in a collapsed building.(8)

Imagine your home or workplace being picked up and shaken sideways. What would be thrown around and cause injury or damage?

Reduce your risk of injury by taking no-cost steps to secure the space around you:

  • Move or secure furniture, such as bookcases, away from beds, sofas, or other places where people sit, sleep, or spend a lot of time.
  • Move heavy objects to lower shelves.
  • Move heavy or unstable objects away from doors and escape routes.(9)

Learn more about how to protect yourself during an earthquake.

Protect Your Property

Consider buying earthquake insurance if you have the means and live someplace where there’s a high earthquake hazard. Standard homeowners’ and renters’ insurance policies do not cover damage resulting from land movement or landslides.

Earthquake insurance isn’t a realistic option for everyone. Increases in insurance premiums have made it difficult to find coverage in many areas. California experiences 90% of the country’s earthquakes, but only 10% of residents had earthquake insurance in 2014.(10)

There are many things to consider when deciding whether to buy earthquake insurance. They include how often earthquakes happen in your area, how long it’s been since the last earthquake, the value of your home and its contents, and the cost of the insurance and restrictions on coverage (i.e., the deductible).(11)

Learn more about earthquake insurance.

Resources

References

  1. https://www.usgs.gov/faqs/which-state-has-most-earthquakes-cause-damage-which-state-has-most-earthquakes-not-human
  2. https://www.usgs.gov/news/featured-story/nearly-half-americans-exposed-potentially-damaging-earthquakes
  3. https://www.usgs.gov/faqs/can-you-predict-earthquakes
  4. https://earthquake.usgs.gov/learn/glossary/?term=earthquake%20hazard
  5. https://www.usgs.gov/programs/earthquake-hazards/science/introduction-national-seismic-hazard-maps
  6. https://earthquake.usgs.gov/learn/glossary/?term=earthquake%20risk
  7. https://emergency.cdc.gov/cerc/ppt/CERC_Psychology_of_a_Crisis.pdf
  8. https://www.earthquakecountry.org/dropcoverholdon/
  9. https://www.earthquakecountry.org/step1/
  10. https://www.fema.gov/emergency-managers/risk-management/earthquake/insurance
  11. https://www.usgs.gov/faqs/how-do-i-decide-whether-or-not-get-earthquake-insurance

 

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.