Chapter 36: Emergency Preparedness and Protective Practices

What is a man-made disaster?

A man-made disaster is an event that causes serious damage through intentional or negligent human actions or the failure of a man-made system.

According to OSHA, what three components must be included in an emergency evacuation plan?

According to OSHA, an emergency evacuation plan must include an emergency evacuation procedure (step-by-step procedures for the rapid, efficient, and safe removal of individuals from the building during an emergency), type of evacuation, and exit routes (an evacuation floor plan is necessary).

What information should be included on an evacuation floor plan?

An evacuation floor plan should include locations including the employee's current location, primary and secondary exit routes, manual fire alarm boxes, portable fire extinguishers, emergency exit doors, wheelchair accessible exits, shelter-in-place areas, and assembly areas.

What is anxiety?

Anxiety is a feeling of worry or uneasiness, often triggered by an event that is perceived as having an uncertain outcome.

What are some examples of fire extinguishing agents?

Common examples of fire extinguishing agents include dry chemicals, foam, carbon dioxide, and water.

What is the difference between a fire drill and a disaster drill?

Disaster drills are usually more comprehensive than fire drills. Disaster drills often involve several community agencies.

What occurs during the alarm phase of the GAS?

During the alarm phase of the GAS, (general adaptation syndrome), the body senses a stressor and releases epinephrine triggering the "fight or flight" response.

What are some examples of man-made disasters?

Examples of man-made disasters include fire, power outages, bomb explosions, terrorism, structural collapse, radiation accidents, chemical spills, and bioterrorism.

Where are fire extinguishers usually located?

Fire extinguishers are usually located along normal paths of travel and near building exits.

How should the medical assistant respond to a patient exhibiting severe anxiety?

If a patient is exhibiting severe anxiety, the medical assistant should try to minimize their reaction by giving the patient directions in a calm and reassuring voice. It may be necessary to touch the patient to gain his or her attention, and then directions should be given in short sentences, speaking a little more slowly than usual and helping them breathe deeply. If a dangerous area must be evacuated, give the patient directions on where to go.

What should the medical assistant do if an emergency occurs at his or her workplace?

If an emergency occurs in the workplace, the medical assistant should immediately focus on responding to the immediate situation, implementing established procedures, and helping others.

What three elements must exist in order for a fire to occur?

In order for a fire to occur it needs a fuel source, ignition source, and oxygen.

What information should be included in the training of employees on the emergency action plan as required by OSHA?

OSHA requires that employees be provided with education and training on the emergency action plan that includes: 1. Individual roles and responsibilities. 2. Threats, hazards, and protective actions. 3. Locations and operation of manually activated pull stations and communication equipment. 4. Emergency response procedures. 5. Evacuation, shelter, and accountability procedures. 6. Location and use of common emergency equipment. 7. Emergency shutdown procedures.

What methods are typically used in the medical office to report emergency situations and/or alert employees to the presence of an emergency situation?

One or two methods that are typically used to report the emergency and /or alert employees to the presence of an emergency situation are dialing 911, dialing an internal emergency phone number, or activation of a manual alarm system.

What effect will oxygen released from an oxygen tank have on a fire?

Oxygen greatly increases the combustion rate of a fire, if something catches fire, oxygen will make the flame hotter and cause it to burn faster and more vigorously.

How might severe anxiety be a problem in an emergency situation?

Severe anxiety can be problematic in an emergency situation because it tends to immobilize the individual and stimulate anxiety in others.

List examples of common ignition sources.

Some common ignition sources are open flames, faulty electrical equipment, hot surfaces, and sparks.

Explain how sprinklers are activated.

Sprinklers are activated by the buildup of heat in the fire area, which causes a glass component in the sprinkler head to melt or break, releasing water from the sprinkler.

When must the emergency action plan be reviewed with each employee?

The emergency action plan should be reviewed by each employee when the initial plan is developed, when new employees are hired, when the employee's responsibilities or designated actions under the plan change, and whenever the plan is changed.

What occurs during the recovery phase of the GAS?

During the recovery phase of the GAS, the stress is removed, and the body returns to a normal state of function.

What is the purpose of a fire door?

The purpose of a fire door is to prevent the spread of fire from one area of a building to another.

What is the purpose of a fire prevention plan?

The purpose of a fire prevention plan is to reduce the probability that a workplace fire will ignite or spread, which helps prevent injury or death, keeps the workplace safe, and helps prevent financial losses to the medical office.

What causes a natural disaster?

A natural disaster is a catastrophic event caused by nature or the natural processes of earth.

What does a positive reaction to a disaster involve?

A positive reaction to a disaster involves the triggering of resources, both internal and external, to meet the challenges.

According to OSHA, when is it acceptable to use direct voice communication to alert employees of an emergency situation?

According to OSHA, it is acceptable to use direct voice communication to alert employees of an emergency situation in an office with 10 or fewer employees, provided that all employees can hear the voice alarm.

What is an evacuation warden?

An evacuation warden is an employee or employees that is in charge of various rescue and medical duties. Each employee evacuation warden must be thoroughly trained in the duty he or she can perform.

What occurs during the exhaustion phase of GAS?

During the exhaustion phase of the GAS, the stress continues and the body's resources to combat it are depleted. The immune system is compromised, and stress-related illnesses may occur.

Who determines whether or not fire drills must be held at a facility?

Fire drills may be required at specific intervals depending on the municipal or state laws for the type of building and insurance requirements.

Why is it important to properly maintain a fire extinguisher?

It is important to properly maintain a fire extinguisher to ensure that they are safe to use and will operate properly when needed.

What is the purpose of an emergency practice drill?

The purpose of an emergency practice drill is to provide employees with the opportunity to practice their assigned duties in a simulated emergency situation.

What occurs when a fire alarm is activated?

When a fire alarm is activated a loud noise and flashing lights are broadcasted to alert building occupants of the fire and to provide them with enough time to evacuate the building. The alarm also notifies the fire department so that firefighters can quickly respond to the fire.

Explain the difference between a flammable and a combustible material and list examples of each. a. Flammable material: b. Combustible material:

a. Flammable material: Catches on fire easily. Examples: Propane and gasoline b. Combustible material: Any material that will burn. Examples: Paper and wood.

What type of evacuation is typically required for the following? a. Large fire: b. Small waste basket fire: c. Tornado:

a. Large fire: An immediate and complete evacuation of a building to a safe area is typically required in the event of a large fire. b. Small waste basket fire: May require only a partial evacuation of employees from the immediate area. c. Tornado: Employees are typically required to evacuate to a safe part of the building such as a designated shelter area (known as a shelter-in-place evacuation).

Why is it important for medical offices to plan ahead for a disaster or serious emergency?

It is important for medical offices to plan ahead for a disaster or serious emergency to minimize the damage and facilitate recovery so that services can be restored as efficiently as possible.

Why is it important to account for all building occupants following an emergency evacuation?

It is important to account for all building occupants following an emergency evacuation to determine of anyone is still in the building in need of rescue.

Why is it important to conduct fire drills?

It is important to conduct fire drills to provide employees with the opportunity to become familiar with exit routes under nonthreatening conditions. This increases the probability of an organized and smooth evacuation during an actual emergency.

Why is it important to learn and practice emergency procedures?

It is important to learn and practice emergency procedures to keep the anxiety level from rising because it will help feel more confident when there is a structured plan to respond to in an emergency situation.

List five examples of fuel sources that may be found in the medical office.

Some examples of fuel sources that may be found in the medical office are patient chairs, furniture, drapes and rugs, office equipment, chemicals used for sterilization and disinfection, laboratory testing chemicals, and trash.

List examples of how a fire may start in the medical office.

Some examples of ways that a fire may start in the medical office are overloaded electrical office, heat producing equipment that is too close to combustible materials, improper use of appliances, improper handling and storage of chemicals, cleaning supplies, and other combustible materials, and arson.

What are some examples of stress-related symptoms that may occur during the resistance phase?

Some stress-related symptoms that may occur during the resistance phase are fatigue, irritability, lethargy, and lapses in concentration.

What role does the medical assistant serve in developing and implementing an emergency action plan?

The medical assistants role in developing and implementing an emergency action plan includes making recommendations to supplement emergency equipment, serving on a committee to review or revise the emergency plan, participating in all fire drills and disaster drills, participating in the review of the effectiveness of the drill, providing emergency first aid or CPR.

What are the two primary functions of a fire extinguisher?

The primary functions of a fire extinguisher are to control or extinguish a small fire that has just started and to protect an evacuation route that a fire might block with smoke or burning materials.

22. What is the purpose of an emergency action plan?

The purpose of an emergency action plan is to prevent fatalities, injuries, and property damage during an emergency situation.

What is the responsibility of an emergency evacuation coordinator?

The responsibility of an emergency evacuation coordinator is to take charge of and manage the evacuation procedures during an emergency.

What are the symptoms of severe anxiety?

The symptoms of severe anxiety include hyperventilation, rapid pulse rate, excessive perspiration, and confused speech.

What is the difference between a primary and secondary exit route? a. Primary exit route: b. Secondary exit route:

a. Primary exit route: The quickest and easiest way to exit a building during an evacuation and is usually represented on the floor plan by a continuous solid red line with a directional arrow. b. Secondary exit route: Secondary means of escape in the event that the primary route becomes blocked by smoke or fire. It is often represented by a continuous dashed blue line with a directional arrow on the evacuation floor plan.

List the fuel sources included in the following fire classifications: 1. Class A: 2. Class B: 3. Class C: 4. Class D: 5. Class K:

1. Class A: Ordinary combustibles such as paper, wood, cloth, rubber, and many plastics. 2. Class B: Flammable liquids such as gasoline, oil, grease, tar, oil-based paints, solvents, lacquers, alcohols, and flammable gasses. 3. Class C: Electrical equipment such as equipment and appliances that are plugged into an outlet, wiring, circuit breakers, and electrical outlets. 4. Class D: Combustible metals such as magnesium, titanium, zirconium, sodium, lithium, and potassium. 5. Class K: Cooking media such as vegetable oil, animal oil, fats in cooking appliances involving these substances.

List five guidelines (as stipulated by OSHA) that must be followed with respect to exit routes?

OSHA requires that guidelines be followed in respect to exit route, including exits should be clearly marked and well lit, exit routes must be at least 28 inches wide at all points, exit routes should be unobstructed and free of clutter at all times, exit signs should be posted indicating the nearest emergency exit, exit doors must be free of decorations or signs that obscure visibility to the exit, route door, doors that cannot be used to leave the facility should be clearly labeled "not an exit" or identified by a sign indicating the doors actual use, an exit door must be unlocked from the inside, and an exit door must be opened outward.

What is the purpose of the tag attached to a fire extinguisher?

The tag attached to a fire extinguisher to document each service check, including the date of the service and the signature of the individual performing the service.

What changes occur in the body when epinephrine stimulates the sympathetic nervous system?

When epinephrine stimulates the sympathetic nervous system, the body experiences dilation of the pupils, increase of heart rate, increase of respiration and perspiration, and increase in the blood pressure.

List methods of fire prevention in the medical office for each of the following categories: a. Flammable and combustible materials: b. Electrical equipment and appliances: c. Inspection and maintenance:

a. Flammable and combustible materials: 1. Keep the medical office free of clutter. 2. Keep flammable and combustible materials away from ignition sources. 3. Read the label and safety data sheet (SDS) accompanying medical office supplies to determine how to properly handle, store, and use these items. 4. Do not allow trash to accumulate. 5. Store trash awaiting removal in a safe location away from heat-producing equipment. 6. Safely dispose of flammable and combustible waste. 7. Clean up any spill of flammable liquids immediately. 8. Do not allow the use of open flames in the medical office. 9. Ensure that smoking bans are enforced in the workplace. 10. Designate an area outside the building for smoking with fire resistant containers. b. Electrical equipment and appliances: 1. Make sure equipment and appliances are properly plugged into wall outlets. 2. Use only grounded appliances plugged into grounded outlets. 3. Do not overload electrical outlets. 4. Promptly disconnect and replace cracked, frayed, or broken electrical cords. 5. Keep heat-producing equipment away from flammable or combustible materials. 6. Turn off all heat producing equipment and appliances at the end of each workday. 7. Shut down electrical equipment that malfunctions or gives off a strange odor. 8. Avoid the use of extension cords. 9. Avoid the use of space heaters. c. Inspection and maintenance: 1. Store oxygen in a clean, dry, well ventilated room. 2. Keep compressed oxygen cylinders and liquid oxygen tanks upright at all times. 3. Ensure that fire alarms and fire extinguishers are clearly visible and not blocked by equipment, decorations, coats, or other objects. 4. Ensure that fire extinguishers are properly stored in their designated locations. 5. Ensure that authorized personnel perform yearly inspections and maintenance of medical equipment. 6. Test smoke detectors every month and replace batteries every 6 months. 7. Have authorized personnel perform regular inspections, maintenance, and testing of fire alarms, sprinkler systems, and fire extinguishers. 8. Report fire hazards you cannot correct yourself.

Identify the steps that should be taken in operating a fire extinguisher following the PASS format.

1. P: Pull out the pin. 2. A: Aim the nozzle at the base of the fire. 3. S: Squeeze the handle. 4. S: Sweep the nozzle from side to side at the base of the fire.

Describe the steps that should be taken in responding to a fire following the RACE format.

1. R: Rescue anyone in immediate danger of the fire. 2. A: Activate the alarm. 3. C: Confine the fire by closing doors and windows. 4. E: Extinguish the fire or evacuate the area. If the fire is small, use a fire extinguisher to put the fire out. If the fire cannot be extinguished, evacuate the area.

What type of testing and maintenance should be performed on battery-operated smoke detectors?

A battery-operated smoke detector should be tested monthly by pressing the test button. Batteries should be changed every 6 months, and the date should be noted on the detector.

What characteristics of a disaster tend to cause the most serious psychological effects?

Disasters tend to cause the mist serious psychological effects when they occur without warning, pose a serious threat to personal safety or have unknown health effects, have an uncertain duration (such as serious floods of major rivers), results from malicious intent or human error, or have symbolic significance (such as the 9/11 attacks).

What occurs during the resistance phase of the GAS?

During the resistance phase of the GAS, the stress remains, and the body adapts but remains "on-guard". Stress related symptoms may be present.

What are some examples of natural disasters?

Examples of natural disasters include floods, tornadoes, hurricanes, earthquakes, tsunamis, blizzards, volcanic eruptions, and epidemics.

When do individuals usually react negatively to a disaster?

Individuals usually react negatively to a disaster when physical and emotional resources are depleted.

What is the purpose of fire protection?

The purpose of fire protection is to prevent the spread of fire from one area of a building to another, allow for the safe exit of building occupants, and prevent or reduce the amount of property damage.

How long does the resistance phase last?

The resistance phase may last hours, days, or even months depending on the circumstances.