Your emergency plan may not include some little’ things

While no one wants to experience a fire, it is an opportunity to evaluate how well the emergency plan works and what small changes might improve it. Overall, the emergency plan worked well during a May 2002 fire at Fayetteville (NC) Ambulatory Surgery Center, says Teresa Craven, RN, nurse administrator. All patients, family members, and staff members were evacuated safely. However, there were several small items that Craven and her staff identified after the event that will improve the plan even more:

Evaluate number and type of portable equipment. "We had several patients in different stages of recovery in the post anesthesia unit [PACU] and one surgical patient who went straight from the operating room to the parking lot," says Craven. PACU staff took portable oxygen tanks, blood pressure machines, crash carts, a battery-operated O2 saturation monitor, and a suction unit with them, she says. "Afterward, we all agreed that we’d be more comfortable having two suction units rather than one," she adds.

Plan for communications. In addition to identifying walkie-talkies as a necessity for staff members checking hallways and rooms after evacuation and helping the fire department, Craven also realized that plans need to include identifying certain employees to pick up cell phones to carry outside. "Most of our staff members have cell phones, but the phones were in their purses in their lockers," she explains. Craven picked up her backpack from her office as she left the building, so staff members were able to call cabs to take family members and patients home, as well as order pizza and drinks for the evacuated people.

Mark biohazard areas on evacuation floor plan. "One of the first questions the fire department asked of me was to identify all biohazard areas," says Craven. "We have one place where all of our biohazard waste is placed, so it was easy to tell the fire personnel where it was, but we’ve now marked it on the evacuation floor plans posted around the center," she says. This is a simple step to make sure the fire department personnel are protected against exposure to biohazardous waste, she adds.

Plan for media coverage. Obviously, there was a lot of media coverage, and Craven did not want inaccurate information given. "I just told all staff members to have members of the media find and talk to me," she says. Designating one person to give up-to-date, accurate information is important, she adds. Because events are occurring quickly, not every staff member has the latest information, she explains. By directing media inquiries to one person who has the information, you can make sure that the different media representatives don’t portray the situation as worse than it is, she adds.

Label electrical closets and hose connections. Whenever you have electrical fuses or control panels, label the doors clearly, suggests Craven. Even when a control panel is located in an open area just inside a door that opens to the outside, label the outside doors so the fire department can locate them quickly, she says. Another item to label is the fire-hose connection valve on or in your building, she adds.

Document everything during the cleanup. One of the most frustrating aspects of cleaning up the surgery center following the fire, in addition to dozens of unsolicited calls from vendors offering to help, was the fact that not too many people were sure who had to inspect what, Craven says. "I was working with my insurance company, the fire marshal, Medicare and Medicaid representatives, county building inspectors, and city building inspectors," she says. Because there is no specific guideline as to what a surgery center must do before re-opening, Craven talked with everyone to get information and their approval to move forward. "I made notes of every conversation, including names, dates, and times," she points out. "I made sure that if any questions came up after we re-opened, I knew who had given me the OK," she adds.