Those who've been there offer advice on preparing for natural disasters

Long outages can be frustrating

Pharmacists residing in Florida, Louisiana, and Texas are well aware of the disaster drill.

After all they've had first-hand experience in coping with disasters about every couple of years in recent memory.

So Drug Formulary Review asked a couple of pharmacists who've survived hurricanes to talk about how they and their areas prepare for natural disasters.

St. Luke's Episcopal Hospital in Houston, TX, had to put its disaster plans into action this past September when hurricane Ike hit.

"With hurricane Ike they had landfall predictions, and you watch that and as they zeroed in on our location, most hospitals had increased their emergency preparedness stance," says Craig P. Frost, RPh, MBA, pharmacy manager at St. Luke's Episcopal Hospital.

Electricity at Frost's own home still was out a week and a half after the hurricane hit, but he says the hospital never lost commercial power because of the emergency planning hospital officials did after tropical storm Allison devastated Southeast Texas in June, 2001, Frost notes.

"All of the hospitals flooded in Texas, and the event caused major flooding problems," he says. "This spurred an incredible awareness of emergency preparedness, so we did very well during Ike."

The most memorable time Erin Mullen, RPh, PhD, assistant vice president for Rx Response in Washington, DC, personally experienced a natural disaster when she was living in Miami during category 5 hurricane Andrew's attack in August, 1992.

Mullen was a new pharmacist who had not yet received her license and didn't have a job, so she evacuated inland to her sister's house as Andrew drew closer.

"We lost our house's roof, and there was significant flooding and damage," Mullen recalls. "So we ended up selling the property at a loss."

Mullen learned a great deal from that experience, including the tip that pharmacists should protect both their personal and professional items with Ziplock bags, she says.

"Any documents, photographs, prescription copies should be put in Ziplock bags," she says. "I implemented that strategy for all hurricanes that came through Orlando in 2004 while I lived there."

"We didn't have significant damage in the pharmacy where I worked in 2004, but we had a lot of wind that went the wrong way down the vent, so everything in the store was filthy and covered from the rain that went through," she recalls.

"But we didn't have to worry about those hard copy prescriptions because those were in Ziplock bags," Mullen adds. "The computer system wasn't safe, but they had backed up its data as part of the normal disaster preparation and recovery."

When Ike struck Texas, hospitals and pharmacy staff were well prepared in a variety of ways, and the hurricane's impact struck them more because of its impact around the hospitals than inside the hospitals, Frost notes.

"We had some wind damage in the hospital, but it was more about how the community was impacted than how we were," he says.

For instance, hospital pharmacists had learned from hurricanes Katrina and Rita that Houston's traffic would be difficult to navigate after a disaster. So they were prepared by having additional medication inventory on hand and planning ways for vendors to reach them with supplies, Frost explains.

"We were ready with people and supplies, who were prepared to act on anything that would come up," Frost says. "You have to have a good preparation plan by looking at utilization patterns and planning for a 4-5 day supply of medications, assuming you won't be resupplied in that period of time."

The medications that need to be stocked for a disaster include tetanus vaccines to treat people injured with cuts and scrapes during the clean-up period after a disaster, he notes.

"We also have plenty of emergency room type of drugs for people with allergic reactions, breathing problems," Frost adds.

It's common procedure for hospitals to assign employees in one of two disaster teams: a ride-out team and a preparation and recovery team, he says.

"That helps us maintain our staffing levels throughout the emergency, and that's pretty common for the hospitals," Frost says. "If you're in the ride-out team you are here during the storm."

Ride-out teams are called to work right before a hurricane, and the team goes into extended shifts by spending the night at the hospital with half working and half resting, he says.

"We hunker down for the storm, discharging as many patients as we can," Frost says.

The remaining patients are moved away from windows.

"Once the event passes enough to where people can get to and from the hospital, then the recovery team comes in, and the ride-out team is relieved," Frost adds.

Frost, who served on the ride-out team during hurricane Ike, says his role was to maintain operations, interface with the command center, give status reports on operations and supplies, and to make sure there were enough employees to perform tasks.

"We have back-up generators, so if we lose power we have an emergency power supply, and the refrigerators are plugged into emergency outlets," Frost says. "We have regular inspections to make certain critical equipment is plugged into emergency outlets."