Children's Hospital of the King's Daughters
Emergency Response App

General Knowledge

• For Rapid Response dial 1,2 (not 0).

• ***Exception: For suspicious package or bomb threat, dial 8-7162. For an active threat, when safe dial 911 then 8-7162.

• See It-Say It -Report any suspicious activity to safety and security (668-7162).
• Communication Resources to sign up for or access during disasters (not all resources are used for every event):

• RAVE Alert - Receive text and email alerts for life threatening events. Register at  https://www.getrave.com/login/chkd.
• Emergent Event Phone Line (668-7787) - Recorded pertinent event updates for staff.
• KDnet and CHKD.org (for employees).

• During a disaster the emergency operations plan is activated and incident command is established. Incident command identifies select individuals (incident commander, safety officer, public information officer, liaison officer, operations section chief, etc.) who oversee all activities throughout that event.
• Your Role - Remain calm, ensure safety of yourself and others. Follow your departmental emergency plan and await directives. In imminent life-threatening situations supervisors and charge nurses may have to make independent, life-saving decisions, such as evacuating to safer area. This should only be done if the risk of staying, outweighs the risk of moving.
• Script: “For the safety of your children, we are on heightened alert. You are safe. Leadership is addressing the issue and will provide us with information soon. Please remain here until further information is provided.”

Know:

• Location of emergency tool kit.
• System failure phone location.

Facility Alert-Fire (provide description and location)

Physical Environment Policy FS-02

RACE

Rescue from area, move to nearest safety zone which may be the nearest fire doors or stairwell.

Activate the alarm, pull the nearest fire alarm and call 911. Provide exact location of smoke/fire.

Contain, close all doors.

Extinguish the fire if it is safe to do so. PASS or evacuate.

PASS

Pull the pin.

Aim at the base of the fire.

Squeeze the handle.

Sweep from side to side.

Hospital Horizontal, Vertical or Total Evacuation

• Evacuation is a last resort and may occur as an incident evolves. Stay informed.
• Be prepared by ensuring all patients and visitors have ID bands. If time permits, secure patient chart and essential medication and equipment in a bag and transport with patient.
• For imminent life-threatening situations, staff should initiate lifesaving actions by moving to the nearest safe area. Preferred movement is horizontal to the nearest safe area, beyond fire doors, and not vertical to another floor.
• Do not use elevators, exit via stairwells. If unable to use stairs, seek shelter within stairwell and await rescue.
• Fire alarm pull boxes are located by exit routes (stairwells) in central hallways.
• Fire extinguishers are available within 75 feet of your location. Know the location of the closest fire extinguisher.
  Know: location of closest fire extinguisher

Facility Alert-Severe Weather Warning

EOP Annexes EmerMgt-05  

• The National Weather Service issues severe weather warning (or tornado warning) alerts. Upon alert, encourage patients/families/staff to remain safe in the building until the weather alert has expired.
• Monitor conditions closely and follow leadership directives. Pull emergency tool boxes: flashlights, whistles, face masks. Have a current patient census. If possible, keep your cell phone with you.
• During a tornado warning, be prepared to act quickly. Staff should be prepared to:

• Ensure everyone seeks shelter on lower level, away from windows and corridors that are close to outside doors.
• Relocate non-ambulatory patients to center corridors, furthest away from windows if possible. Patients that cannot be moved should have their beds lowered, covered with layers of blankets and pillows.
• Do not use elevators during imminent tornadic activity.
• Hide under desks, behind solid walls. Use arms to protect head and neck and get into a “drop and tuck” position.

• Know: location of our shelter area.

Security Alert-Behavior Event (include description and location)

Physical Environment Policy SEC-12

• When a patient or visitor starts displaying change from “defensive” to “aggressive” behaviors, acting out, loss of control, or elevating voice with/without threats, staff should dial 1,2 and provide your name, department, and exact location of event.
• A designated Crisis Prevention Institute (CPI) trained response team will respond to the area to assist.
• Staff in area should provide for safety needs of staff, patients, and visitors until the team arrives. Show respect to the individual. Do not turn your back, keep your distance, and do not isolate yourself in area with the individual.

Security Event-Active Threat (include description and location)

Physical Environment Policy SEC-10

RUN

• Remain calm. Take charge. Move away from identified threat area. Always have an escape route in mind. Others will mimic your behavior and follow.
• Clearly state “follow me”, leave your belongings.
• Warn individuals from entering area.
• Do not attempt to move wounded.
• If others will not leave, do not delay your exit.
• Keep your hands visible at all times
• Call 911 when you are safe.

HIDE

• When RUN is not an option, your hiding spot should be out of view and provide protection (solid surface).
• Lock the door, turn off lights.
• Hide behind large items.
• Silence cell phones and pagers.
• Remain quiet.
• Do your best to remain calm.
• Pre-identify potential safe areas to hide.

FIGHT

• As a last resort, when your life is in imminent danger:

•  Attempt to injure the shooter with improvised weapons such as

• Fire extinguisher. Spray in their face.
• Hit them in the face or at the base of their skull with a heavy object.
• Yell loudly, act aggressive.

• Act as a group to overpower, or confuse.

Security Alert-Missing Person (provide description, location last seen)                       

Physical Environment Policy SEC-11

• Report a missing person immediately by dialing 1, 2.
• Provide the operator the following information: Your name and location, a description of the missing person (age, skin, hair and eye color, and clothing), Give last known location seen.
• All staff must “adopt an exit” - Stand at all stairwells, corridors, elevators, crosswalks, and external exits. Be on the lookout for the missing person. Inspect large packages, bags, unusually dressed individuals (ie: bulky clothing).
• Do not confront an individual that presents a safety risk. Report concerns to safety and security (8-7162).
• The place where the person was last seen may be a crime scene. Secure the area for the police.
• Know:

• Our “adopt an exit” area(s).

Equipment and Utility Failure

Environment of Care Policy EM-09 and UM-07

Bio Medical - Emergency events contact 668-7355. For routine non-urgent concerns, complete a work request form available on KDnet. Tag item and remove from service.

Engineering - Contact 668-7148. For routine non-urgent concerns, complete a work request form available on KDnet.

Interruption: Power Outage

What to Expect: Emergency generators will start.

What to Do: Only items plugged into “red outlets” will work and egress lighting. Open emergency tool kit and distribute flashlights.

Interruption: Water

What to Expect: Limited to no water from sink fixtures, commodes, and may include the fire suppression system.

What to Do: Utilize bottled water. Restrict usage to what is absolutely necessary. Utilize alcohol based hand sanitizers and moist towelettes for hygiene. Minimize commode usage. Do not flush unless necessary. Institute fire watches.

Interruption: Medical Gas.

What to Expect: Limited to no service.

What to Do: Utilize portable gas cylinders.

Interruption: Medical Vacuum.

What to Expect: Limited to no service.

What to Do: Utilize portable gas cylinders.

Interruption: Telephones.

What to Expect: No service. May interrupt facility monitoring systems.

What to Do: Utilize system failure phones from emergency tool kit. Place list of phone numbers next to phone. Utilize cell phones. Determine need for fire watch.

Interruption: HVAC.

What to Expect: No or limited cooling, heating, or ventilation.

What to Do: Provide for comfort of patients, monitor VS and hydration level. Remove from direct sunlight, close blinds, and obtain portable fans. Evaluate the need to move patients to cooler areas. In cooler weather, distribute blankets and open blinds.

Hazardous Material Spill

Physical Environment Policy HMW-11

• Dial 1,2 when there is a large volume, or highly toxic material spill.
• Staff should remove people from area, apply containment material, shut doors, and obtain safety data sheet (SDS) from MSDS Online (KDnet) and act as a response  team resource.

Suspicious Package or Bomb Threat    

Physical Environment Policy: SEC-9     

• Dial security at 8-7162 and report the event. Do not use handheld radios or cell phones near the package. Use landlines and runners.
• Keep the caller on the phone as long as possible and document conversation on the form below. Give to security/police.
• Do not touch the suspicious package and prevent people from entering the area where the package is located.
• Be observant of the area. Incident command may direct staff to perform an inspection of their respective areas, being conscious of suspicious packages or objects.
• Report any recent suspicious activity or behaviors to safety and security (8-7162).
• If you identify a suspicious package report the location and description to safety and security immediately (8-7162). Do not approach. Attempt to clear immediate area.

Stay calm. Do not interrupt or disrespect caller, notify a coworker to call security (8-7162), keep caller on the line as long as possible. Document exact words of the caller.

Know:

• Phone number/extension call taken on.
• Time call started.
• Time call ended.

If your phone has caller ID, record number of incoming call.

Questions to Ask

Who is this?

Where are you calling from?

Where is the bomb?

What does it look like?

When will it explode?

Do you realize innocent children will be hurt or killed?

What type of bomb is it?

Description of Call/Caller

Know:

• Male/Female.
• Age approximation.
• Was the voice familiar?

Voice:

• Raspy
• High pitched
• Loud
• Soft
• Deep
• Intoxicated
• Distorted

Speech:

• Slang
• Foul
• Stutter
• Lisp/slurred

Accent:

• Local
• Regional-Southern, Midwest
• Ethnicity

Manner:

• Calm
• Serious
• Angry
• Tense
• Blaming
• Irrational
• Nervous

Background:

• Voices
• Music
• Animals
• Trains, planes, cars
• House noises-TV

Connection:

• Clear
• Pay phone
• Static
• Long distance

7/28/20

“Be Prepared” with

Rave Alert

Mass Notification System

Sign up to receive timely alerts of emergent information.

CHKDHS, has partnered with Rave Mobile Safety to provide rapid, mass notification of

urgent/emergent alerts via e-mail, text or voice messaging.

Alerts sent to volunteer recipients are brief and will only address critical need to know information such as severe inclement weather, dangerous travel conditions, or other life safety hazards within the hospital, campus or community.

There is no charge for signing up, however you may be responsible for standard text messaging rates based on your providers contract.

To Activate Your Account:

1. Use the following link to sign up. https://www.getrave.com/login/chkd
2. Click on “Register”
3. Enter your name, CHKD email address (Registration e-mail), select a password, and enter your mobile phone number under Mobile Contacts.
4. Click on “Proceed to Next Step”
5. Rave Mobile Safety will send a “Confirmation” message to your e-mail address. Open the confirmation e-mail and follow directions. You must complete this step in order to receive alerts!
6. After registering you may add other email addresses or phone numbers.
7. Questions please e-mail Walter.Soto@chkd.org
8. Participation in CHKD Rave Alert is voluntary. Text STOP to 67283 to dis-enrol

Health Center, Ambulatory Surgery Center, Urgent Care and Office Building
Safety Reference Chart

Know:

• Address
• Department

Emergency - Call 911

Activate Panic Alarms

Know: Non-Emergency Number

Initial Alert and Information Sharing

1. Ensure safety of building occupants. If life threatening, call 911 then department leadership to report event.
2. Ensure all building occupants are aware of situation. This may be accomplished by “All Call Phone” function, handheld radio, or word of mouth.
3. Contacted leadership will determine the need for mass notification to others within the organization through Rave Alert.

1. Contact Emergency Management (668-6903) or (567-4854), request a “Rave Alert” to be sent to identified individuals or building information (location) list.
   Provide: Event type, initial actions, your name ,and contact number.

4. Identify someone within the building to meet first responders (police, fire).

Communication Resources Within This Building (overhead, handheld radios, etc.)

List Resources:

Location of Emergency Tool Kit

List Location:

Medical Alert and Medical Alert-Adult

1. Dial 911 and assign someone to meet EMS, fire, or police.
2. Call out loudly for help, obtain AED, and begin CPR if trained.

Know: Location of Nearest AED (automatic external defibrillator).

Facility Alert-Fire (report location)

Physical Environment Policy FS-02

RACE

Rescue from area, move to nearest safety zone which may be the nearest fire doors or stairwell.

Activate the alarm, pull the nearest fire alarm and call 911-provide exact location of smoke/fire.

Contain, close all doors.

Extinguish the fire if it is safe to do so (PASS) or evacuate.

PASS

Pull the pin.

Aim at the base of the fire.

Squeeze the handle.

Sweep from side to side

Building Evacuation-Fire

1. Evacuate during fire alarms, and if in immediate danger. Instruct patients/families where to meet (designated meeting place).
2. Staff should bring current patient list and perform roll call of patients and staff at designated meeting place.
3. Do not use elevators, exit down nearest staircase. If unable to use stairs, seek shelter within stairwell and await rescue from responding fire department.
   Fire alarm pull boxes are located by exit routes (stairwells) in central hallways.

Know: our designated meeting place.

Facility  Alert-Severe Weather Warning

EOP Annexes EmerMgt-05 

1. The National Weather Service issues severe weather warning (or tornado warning) alerts. Upon alert, encourage patients/families/staff to remain safe in the building until all clear. Monitor conditions closely.
2. Obtain current patient census and know the location of every patient, visitor, and employee.
3. Open Emergency Tool Box (flashlights, whistles, dust masks). Obtain current patient census. Place cell phone in pocket.
4. During a Tornado Warning be prepared to act quickly:

1. Move to shelter area - Do not use elevators during a tornado. Seek shelter on lower level, away from windows and corridors that are close to outside doors.
2. Move non-ambulatory patients to center corridors, as far from windows as possible. Patients who cannot be moved should have their beds lowered, covered with layers of blankets and pillows.
3. Hide under desks, behind solid walls. Use arms to protect head and neck and get into a “drop and tuck” position.
4. Do not leave shelter until safe to do so. If structure is damaged put on face mask, use cell phone to call 911, text message someone not in area with your location and condition (text messages may go through when calls will not).

5. Blow whistle intermittently to aid first responders trying to locate you.

Know: our shelter area.

Security Alert-Behavior Event

Physical Environment Policy SEC-12

1. When a patient, family member, or visitor starts displaying significant defensive behaviors, loss of control, or elevating voice with or without threats staff should activate panic button (if available) and call 911. Provide your name and exact location.
2. Ensure safety of self and others. Show respect to the individual, do not turn your back or isolate yourself in area with the individual, and keep a reasonable distance.

Security Alert-Missing Person (provide description, location last seen)

Physical Environment Policy SEC-11

1. Report a missing person immediately. Call 911. Provide your name, exact location, description of missing person, and last known location.
2. Share information with building occupants and “adopt an exit.” Staff should search building and stand at all stairwells, corridors, elevators, and external exits. Be on the lookout for the missing person. Inspect large packages, bags, oversized clothing, etc.
3. Do not confront an individual that presents threat. Report information to police. Attempt to obtain license plate, direction of travel.
4. The place the person was last seen will be a crime scene. Secure the area for the police.

Know: our adopt-an-exit area.

Hazardous Material Spill

Physical Environment Policy HMW-11

If a large volume or highly toxic hazardous material spill occurs, call 911 and notify your immediate supervisor.

1. Remove people from area and obtain safety data sheet (SDS) from MSDSonline (KDnet). If you have trouble obtaining SDS from KDnet, call: 1-888-362-7416.
2. Provide SDS sheet to arriving fire, police.

Security Event-Active Threat (provide location)

Physical Environment Policy SEC-10

Run

1. Remain calm, take charge. Move away from threat area. Always have an escape route in mind. Others will copy your behavior and follow.
2. Clearly state “follow me”, leave your belongings.
3. Run in a zig-zag, not straight.
4. Do not attempt to talk to perpetrator.
5. Warn individuals not to enter area.
6. Do not attempt to move wounded.
7. Keep your hands visible at all times.
8. Call 911 when you are safe.
9. If others will not leave, do not delay your exit.

Hide

1. When Run is not an option, Hide out of view, behind a solid surface or large object.
2. Shut doors, turn off lights, go silent - phones, pagers.
3. Make it difficult for perpetrator to enter area. Place heavy objects in front of door, tie a belt/cord to top arm of door.
4. Stay behind door, away from direct access if door is opened.
5. As groups, make a plan of what to do if perpetrator enters area.
6. Do not leave area until directed by police.

Fight

1. As a last resort, when your life is in imminent danger:

1. Attempt to injure the perpetrator with improvised weapons such as:

• Spray a fire extinguisher in their face.
• Hit them in the face or base of skull with a heavy object.

2. Yell loudly, act aggressive.
3. Act as a group. This is your last option to save lives.

Know: potential safe areas to hide.

Equipment Failure

Physical Environment Policy EM-09

Contact biomedical services. Always remove equipment from service and tag.

1. For routine, non-urgent events, remove item from service, tag and complete a “Biomedical Services Work Request Form” available on KDnet.
2. Emergency event contact 668-7355.

Utility Interruptions

Physical Environment Policy UM-07

Utility interruptions for health centers and urgent care, contact engineering (668-7148) and real estate (668-9688). All other sites, contact real estate only.

Interruption: Electrical Power

What to Expect: Emergency generator (if available) will start. Only items plugged into “red outlets” will work. Egress lighting.

What to Do:

1. Ensure all essential equipment is plugged into red outlets at all times.
2. Complete OR cases in progress. Do not start next case.
3. Open emergency tool kit and distribute flashlights.

Interruption: Emergency Power

What to Expect: Failure of all electrical systems. All lights out except battery-powered units.

What to Do: Same as above

Interruption: Elevators

What to Expect: Elevator will not respond to call button.

What to Do:

1. Remove elevator from service, utilize others if available.
2. Reassure individuals stuck in elevator. Contact 911 for elevator rescue.
3. Assist patients and visitors down stairs if safe.
4. If unable to safely exit by stairs, await resumption of service, or contact 911 for evacuation assistance.

Interruption: Fire Alarm System

What to Expect: No fire alarms or sprinkler system.

What to Do:

1. Institute fire watches.
2. Call 911 to report fire/smoke events.
3. Notify safety and security (668-7162).

Interruption: Water

What to Expect: Sinks, commodes, fire suppression system may not be operational.

What to Do:

1. Utilize bottled water.
2. Minimize commode usage to a select few, do not flush unless necessary.
3. Institute fire watches.

Interruption: Medical Gas

What to Expect: Medical gas system alarms. Limited to no service.

What to Do:

1. Utilize portable oxygen cylinders.
2. Complete current OR cases in progress. Do not start next case.

Interruption: Medical Vacuum

What to Expect: Medical vacuum system alarms. Limited to no service.

What to Do:

1. Utilize portable vacuum pumps.
2. Complete current OR cases in progress. Do not start next case.

Interruption: HVAC

What to Expect: No or limited heating, cooling, or ventilation.

What to Do: Provide comfort for patients unable to leave at the time. Obtain portable fans, shut all blinds, and relocate to cooler area of building. Cooler weather open all blinds, provide blanket, move to warmer area.

Interruption: Gas smell

What to Expect: Staff complaining of smell of gas.

What to Do:

1. Leave area, go outside for fresh air. Share with building occupants.
2. Call 911 to report extent of impact, area of noxious odor.
3. Call Virginia Natural Gas leak, odor or emergency number (877-572-3342.)

Interruption: Telephones, computers, programs

What to Expect: No telephone service, interruption to computers. Monitoring agency alerts may be inoperable (fire, access).

What to Do:

1. Utilize cell phones, email, and texting.
2. Use down-time procedures.
3. If available, utilize handheld radios and runners.

Suspicious Package or Bomb Threat

Physical Environment Policy: SEC-9

1. Do not touch the package. Prevent people from entering area.
2. Call 911 (do not use a cell phone) to report. Inform your supervisor and notify security (668-7162).
3. Do not use handheld radios, cell phones, or microwave ovens.
4. Stay calm, keep person on phone as long as possible. Document conversation below and give to police.

Know phone number call received on.

If Caller ID, did a phone number appear on screen?

Questions to ask caller:

• Who are you?
• Where is the bomb?
• When will it explode?
• What does it look like?
• Ask them “Do you know children could be hurt or killed?”
• Describe caller: Voice male or female. Speech slurred, slang, slow, or fast.
  Accent: Local, ethnic.
  Manner: Calm, serious, angry, irrational, nervous, blaming.
  Connection: Clear, static.
  Background: Voices, noises, trains, animals

7/28/20