This PRAXIS Nexus post was adapted from a previously published Lung Health Professional article.
Jane M. Martin, BA, LRT, CRT, Associate Director of Education, COPD Foundation
As busy health care professionals we know how an emergency power outage can get in the way of how we go about our daily lives.
Living without electricity - in the dark with no heat, air conditioning or cold food storage can certainly be an inconvenience for those in the best of health.
But for individuals with COPD, whether it is a large scale disaster such as Hurricane Sandy, or a small scale emergency such as a power outage, an interruption in normal life can be a major emergency – even a matter of life or death.
Are your COPD patients prepared to survive not only an emergency power outage, but a full blown disaster? As a busy health care professional, you don’t have time to educate your patients in the details of disaster preparedness, nor do you have time or resources to take care of all these patients when disaster strikes.
In light of disasters such as super storm Sandy, the COPD Foundation developed the Disaster Preparedness Plan (DPP) available for download here. The COPD DPP is a comprehensive resource providing individuals and families impacted by COPD with not only lists, but information and education on understanding how to evaluate the expected scope of a disaster, potential consequences, and tips on how to decide whether to evacuate or stay put. In short, the COPD DPP include information on how to weather not only the storm outside but the potentially fatal consequences of being caught in a disaster while already ﬁghting daily the ravages of chronic disease.
Important to Know
Here are just some of the many risk factors speciﬁc to those with COPD causing them to be greatly compromised, illustrating the need for a comprehensive disaster preparedness plan for all patients with COPD.
- Cold, damp air especially to those with a predisposition to bronchitis
- Multiple (>= 6) co-morbidities
- Multiple medications required daily or more than once daily
- Need for supplemental oxygen
- Need for non-invasive ventilation
- Overlap Syndrome
With this in mind, consider this: when a disaster or mass casualty event occurs, the belief of the public is that the federal government will provide assistance to the aﬀected areas if state and local governments’ disaster capabilities are overwhelmed. FEMA is one such agency, yet it has no plan for management of oxygen supplies, in or out of the hospital setting. FEMA's main responsibility is to coordinate disaster recovery, usually requiring a few days to organize the eﬀort.
The Strategic National Stockpile (SNS) is designed to respond more quickly. SNS sites are located in various areas around the United States.(1) They can send their “12-hour push pack” of medications, medical supplies, and equipment to disaster areas within 12 hours of notiﬁcation of need, yet, their stockpile does not contain oxygen. Instead they maintain contracts with private vendors to deliver oxygen when needed. Many organizations with the same needs, however, have contracts with companies who would be requiring oxygen deliveries during this time, which may hamper the ability to meet SNS needs quickly.
Hospitals have large supplies of liquid oxygen and a supply of compressed gas oxygen cylinders that allow several days of reserve, but a large inﬂux of patients from a disaster can strain these resources. Contracted vendors may have oxygen to deliver, but delivery is not possible when transportation of these supplies is halted when only “emergency” vehicles are permitted on the roads immediately following a disaster.
The COPDF DPP is an easy-to-read and use booklet including:
Planning for a Disaster:
- Understanding the types of disasters common to a speciﬁc area
It’s important for patients to understand and prepare for the types of disasters common to their area. For example, the increased likelihood of a hurricane or tornado would call for supplies to be placed ahead of time in the basement or the location of the home that is the least likely to collapse or blow away. The potential for ﬂooding, rather, would require that supplies be available in the highest point in the house.
- References, Links and Resources for support
Community resources are often available, but patients need to know ﬁrst that they exist, where they are and how to contact them. An Associated Press survey found that these programs vary state to state and that only a small percentage of patients know that the services exist.(2)
Developing a Communication Plan
- Creating a support network with family, DME suppliers, physicians and utility companies
There may be help available, but the customer must have the ability to access it. If a resource is web-based, a customer without electric power cannot access that help. Resources for support – both online links and phone numbers – should be included.
The DPP encourages your patients to create a support network, talking with family members, neighbors, DME suppliers, health care providers and utility companies before disaster strikes. It will give tips on how to obtain, complete and submit forms for priority service from utility companies for a person who needs oxygen and/or electrically-powered medical equipment.
Building an Emergency Plan with Kits
- Stay put plan
- Evacuation plan
- Basic supply kit
- Food supply kit
- Medical record kit
Evacuating Before a Disaster Hits
- Deciding to stay or evacuate
This includes a list of options and scenarios. “If I do this, such and such may happen - if so, am I prepared for it?” along with what should be considered when deciding to stay or go, with separate plans in place for staying put and evacuating.
- Letters for physicians to notify electric and utility companies of special needs
- Required supplemental Oxygen
- Electrically powered medical equipment
- Service animals and pets
This section provides information and tips for patients with special needs, especially those in rural areas with limited resources experiencing loss of electricity to power their concentrator, non-invasive or conventional ventilator. Also included is an illustrated reminder of the use of pursed-lips breathing to conserve oxygen.
Having a DPP in place – for a massive disaster, a limited location power outage, or anything in between – can go a long way in maintaining peace of mind for your patients and for you, their health care professional. Knowing that they’ve done all they can to plan ahead and be aware of available resources can be of great comfort to them, keeping in mind, of course, that the emergency may never take place.
The COPD Foundation extends special thanks to The Sara Chait Memorial Foundation Inc for their support of the Disaster Preparedness Kit.
1,2 Thomas C Blakeman and Richard D Branson, Respir Care, January 2013 58:173-183 http://www.ncbi.nlm.nih.gov/pubmed/23271827.