Global Traumatology

Are you ready?

2007-11-05T01:14:00.000-08:00

Are You Ready?

Fires

Each year, more than 4,000 Americans die and more than 25,000 are injured in fires, many of which could be prevented. Direct property loss due to fires is estimated at $8.6 billion annually.
To protect yourself, it is important to understand the basic characteristics of fire. Fire spreads quickly; there is no time to gather valuables or make a phone call. In just two minutes, a fire can become life-threatening. In five minutes, a residence can be engulfed in flames.
Heat and smoke from fire can be more dangerous than the flames। Inhaling the super-hot air can sear your lungs. Fire produces poisonous gases that make you disoriented and drowsy. Instead of being awakened by a fire, you may fall into a deeper sleep. Asphyxiation is the leading cause of fire deaths, exceeding burns by a three-to-one ratio.

Take Protective measures

Before a FireSmoke Alarms

Install smoke alarms. Properly working smoke alarms decrease your chances of dying in a fire by half.
Place smoke alarms on every level of your residence. Place them outside bedrooms on the ceiling or high on the wall (4 to 12 inches from ceiling), at the top of open stairways, or at the bottom of enclosed stairs and near (but not in) the kitchen.
Test and clean smoke alarms once a month and replace batteries at least once a year. Replace smoke alarms once every 10 years.

Escaping the Fire:
Review escape routes with your family. Practice escaping from each room.
Make sure windows are not nailed or painted shut. Make sure security gratings on windows have a fire safety opening feature so they can be easily opened from the inside.
Consider escape ladders if your residence has more than one level, and ensure that burglar bars and other antitheft mechanisms that block outside window entry are easily opened from the inside.

Teach family members to stay low to the floor (where the air is safer in a fire) when escaping from a fire.
Clean out storage areas. Do not let trash, such as old newspapers and magazines, accumulate.

Flammable Items
Never use gasoline, benzine, naptha, or similar flammable liquids indoors.
Store flammable liquids in approved containers in well-ventilated storage areas.
Never smoke near flammable liquids.
Discard all rags or materials that have been soaked in flammable liquids after you have used them. Safely discard them outdoors in a metal container.
Insulate chimneys and place spark arresters on top. The chimney should be at least three feet higher than the roof. Remove branches hanging above and around the chimney.

Heating Sources
Be careful when using alternative heating sources.
Check with your local fire department on the legality of using kerosene heaters in your community. Be sure to fill kerosene heaters outside, and be sure they have cooled.
Place heaters at least three feet away from flammable materials. Make sure the floor and nearby walls are properly insulated.
Use only the type of fuel designated for your unit and follow manufacturer’s instructions.
Store ashes in a metal container outside and away from your residence.
Keep open flames away from walls, furniture, drapery, and flammable items.
Keep a screen in front of the fireplace.
Have heating units inspected and cleaned annually by a certified specialist.

Matches and Smoking
Keep matches and lighters up high, away from children, and, if possible, in a locked cabinet.
Never smoke in bed or when drowsy or medicated. Provide smokers with deep, sturdy ashtrays. Douse cigarette and cigar butts with water before disposal.

Electrical Wiring
Have the electrical wiring in your residence checked by an electrician.
Inspect extension cords for frayed or exposed wires or loose plugs.
Make sure outlets have cover plates and no exposed wiring.
Make sure wiring does not run under rugs, over nails, or across high-traffic areas.
Do not overload extension cords or outlets. If you need to plug in two or three appliances, get a UL-approved unit with built-in circuit breakers to prevent sparks and short circuits.
Make sure insulation does not touch bare electrical wiring.

Other
Sleep with your door closed.
Install A-B-C-type fire extinguishers in your residence and teach family members how to use them.
Consider installing an automatic fire sprinkler system in your residence.
Ask your local fire department to inspect your residence for fire safety and prevention.
During a FireIf your clothes catch on fire, you should:
Stop, drop, and roll - until the fire is extinguished. Running only makes the fire burn faster.
To escape a fire, you should:
Check closed doors for heat before you open them. If you are escaping through a closed door, use the back of your hand to feel the top of the door, the doorknob, and the crack between the door and door frame before you open it. Never use the palm of your hand or fingers to test for heat - burning those areas could impair your ability to escape a fire (i.e., ladders and crawling).

Hot Door
Cool Door
Do not open. Escape through a window. If you cannot escape, hang a white or light-colored sheet outside the window, alerting fire fighters to your presence.
Open slowly and ensure fire and/or smoke is not blocking your escape route. If your escape route is blocked, shut the door immediately and use an alternate escape route, such as a window. If clear, leave immediately through the door and close it behind you. Be prepared to crawl. Smoke and heat rise. The air is clearer and cooler near the floor.
Crawl low under any smoke to your exit - heavy smoke and poisonous gases collect first along the ceiling.

Close doors behind you as you escape to delay the spread of the fire.
Stay out once you are safely out. Do not reenter. Call 9-1-1.
After a FireThe following are guidelines for different circumstances in the period following a fire:
If you are with burn victims, or are a burn victim yourself, call 9-1-1; cool and cover burns to reduce chance of further injury or infection.

If you detect heat or smoke when entering a damaged building, evacuate immediately.
If you are a tenant, contact the landlord.
If you have a safe or strong box, do not try to open it. It can hold intense heat for several hours. If the door is opened before the box has cooled, the contents could burst into flames.
If you must leave your home because a building inspector says the building is unsafe, ask someone you trust to watch the property during your absence.
Follow the instructions for recovering from a disaster in Part 5.
Knowledge CheckAnswer each question and check your responses using the answer key.
You need to escape a fire through a closed door. What, if anything, should you do before opening the door?
What should you do if your clothes are on fire?
What actions should be taken for burn victims?
To reduce heating costs, you installed a wood-burning stove. What can you do to reduce the risk of fire from this heating source?

To escape in thick smoke, what should you do?

For More Information

If you require more information about any of these topics, the following are resources that may be helpful.
FEMA PublicationsAfter the Fire: Returning to Normal. FA 046. This 16-page booklet provides information about recovering from a fire, including what to do during the first 24 hours, insurance considerations, valuing your property, replacement of valuable documents, salvage hints, fire department operations, and more.
Protecting Your Family From Fire. FA 130. This pamphlet was written to provide the information you need to decide what you must do to protect your family from fire. Topics include children, sleepwear, older adults, smoke detectors, escape plans, and residential sprinklers.
Fire Risks for the Hard of Hearing. FA 202; Fire Risks for the Older Adult. FA 203; Fire Risks for the Mobility Impaired. FA 204; Fire Risks for the Blind or Visually Impaired. FA 205 These reports address preparation for fire risks for populations with special challenges.
Wildland Fires has moved; to be redirected click http://www.fema.gov/areyouready/wildfires.shtm.

2007-09-06T19:28:00.000-07:00

What to do ....

2007-08-12T00:51:00.000-07:00

In the Case of a Biological or Chemical Attack:
In case of a biological or chemical attack, listen to your radio for instructions from authorities on whether to remain inside or evacuate. If instructed to stay inside, turn off all ventilation and seek shelter in an internal room, preferably one without windows. Seal the room with plastic sheeting and duct tape. Remain in protected areas where toxic vapors are reduced or eliminated and take a battery-operated radio with you.

Seek medical attention immediately if you suffer from symptoms of exposure. Pay close attention to all official warnings and instructions on how to proceed. If exposed, remove clothes and seal in plastic bag, wash off with soapy water immediately. For more information, visit the CDC Web site at www.bt.cdc.gov.

If you believe that you have been exposed to a biological or chemical agent, or if you believe an intentional biological threat will occur or is occurring, please contact your local health department and/or your local police or other law enforcement agency.

• For more information on how to respond to an attack, consult FEMA's "Are You Ready? A Guide to Citizen Preparedness"
• For information on state and local health departments: www.cdc.gov/other.htm#states
• Health agency contact directories: www.statepublichealth.org
• For questions about smallpox, visit www.bt.cdc.gov/agent/smallpox/index.asp, or call the CDC public response hotline at (888) 246-2675 (English), (888) 246-2857 (Español), or (866) 874-2646 (TTY).
• Contacts for use by state and local health officials and healthcare providers: CDC Emergency Response Hotline (24 hours) 770-488-7100, program questions: 404-639-0385.

ARE WE READY?

2007-08-12T00:42:00.000-07:00

NEW YORK — Authorities were taking extra counterterrorism precautions Friday in response to what they said was an unsubstantiated radiological threat to the city.

Officials said they had not changed the city's terror alert status in response to online chatter mentioning a truck packed with radioactive material. But police deployed extra radiological sensors on street, water and air patrols, and were stopping vehicles at checkpoints in lower Manhattan and around the city.

Deputy Police Commissioner Paul J. Browne called the measures "strictly precautionary." He said the online posts were made following a video released Sunday that featured an American member of Al Qaeda threatening foreign diplomats and embassies across the Islamic world.

"We are closely monitoring the situation," said Homeland Security Department spokesman Russ Knocke. "There continues to be no credible information telling us that there's a threat to the homeland at this time."

The FBI also said there was no credible threat.

Will anyone listen?

2007-08-04T08:55:00.000-07:00

Dozens Missing as Minneapolis Search Efforts Are Halted

Ben Garvin/Associated Press

The Interstate 35W bridge over the Mississippi River in Minneapolis on Thursday morning.

By JON ELSEN and LIBBY SANDER

Published: August 2, 2007

Rescue workers halted their efforts this afternoon to search the waters of the Mississippi River in Minneapolis for dozens of people still missing in the wreckage of a collapsed highway bridge after strong currents blocked their work.

Skip to next paragraph

Multimedia

Slide Show

Bridge Collapse: Day 2

Photographs

Bridge Collapse: Day 1

Graphic

Highway Catastrophe

Video

Are we ready for the next big one?

2007-08-04T08:47:00.000-07:00

NEW YORK (CNN) -- Americans have failed to learn the most important lesson of 9/11 and Hurricane Katrina: We need to make building resiliency from within our borders as urgent a priority as confronting dangers from without.

There would have been thousands of more victims in New York on September 11 if the city had not made significant new investments in emergency management and if the Port Authority of New York and New Jersey, which owned the World Trade Center, had not conducted regular fire drills, improved the emergency lighting and applied photoluminescent markings on stair treads and handrails in the stairwells of the twin towers. It was New York's investment in resiliency after the 1993 World Trade Center truck bombing that made that tragic day in 2001 far less tragic.

Today, New Orleans would have long ago recovered from Hurricane Katrina had the city's flood control system not been so badly neglected. But throughout the 1990s, the funds that might have been used to repair and strengthen the levees and flood walls were routinely bled off for other projects. In 2004, when the U.S. Army Corps of Engineers asked for $22.5 million to make emergency repairs to the storm protection system in New Orleans, the White House cut that figure to $3.9 million. It was New Orleans' lack of resiliency in the face of a foreseeable natural disaster that produced a catastrophe that has practically destroyed a great American city.

Building resiliency requires three things. First, we must anticipate likely man-made or natural disasters. Second, we must be willing to take prudent actions in advance of these disasters that lower our exposure to their potentially catastrophic consequences. Third, we must be able to mobilize a speedy response and recovery after disasters occur.

An estimated 90 percent of Americans now live along the coast, near flood zones and earthquake fault lines, or in other locations that are at a high or moderate risk of being hit by a major natural disaster. But since 9/11, we have been acting as though the only serious threat we face is terrorism and that the only way to manage that threat is by military efforts abroad. When an aggressive offense against terrorists is our only defense, homeland security and planning for natural disasters end up as lesser priorities.

This is insane. Sure we should be confronting our enemies when we have the intelligence to tell us where they are and what they are up to. But our intelligence apparatus is badly broken and the terrorist threat is a rapidly mutating. We need only look to the 2004 train bombings in Madrid, Spain, and the 2005 attack on the London subways to remind us that the al Qaeda threat is not confined to the Middle East and that all acts of terror cannot be prevented.

More importantly, Americans are far more likely to be caught in the cross hairs of a major natural disaster such as an earthquake, flood, forest fire or a hurricane than an attack by terrorists.

No act of modern warfare, with the possible exception of a nuclear exchange between major world powers, has the potential to threaten as many lives and cause as much disruption to the global economy as the H5N1 avian influenza would if it makes the evolutionary leap that allows it to spread among humans as quickly and as lethally as it has among birds. Of the just over 100 documented human infections between 1997 and 2005, the mortality rate was 54 percent. With a flu outbreak leading to a projected 80 million illnesses in the United States, millions of Americans would be in need of hospital care, but our entire national inventory of staffed hospital beds is just 970,000.

Acts of terror and disasters cannot always be prevented, but they do not have to be catastrophic. The key is being willing to invest in things that are not particularly sexy, such as public health, emergency planning and community preparedness.

It requires that we repair frail levees, pipelines, dams and the electrical grid. And we also need to learn from disasters and near misses. Californians adopted a new construction code after the 1906 San Francisco earthquake. New Yorkers took evacuating skyscrapers seriously after the World Trade Center was attacked in 1993. Adequately preparing for foreseeable events is the only way for the United States to step back from the edge of disaster.

What is your take on this commentary? E-mail us

The opinions expressed in this commentary are those of the writer. This is part of an occasional series of commentaries on CNN.com that offers a broad range of perspectives, thoughts and points of view.

Your responses

CNN.com asked readers for their thoughts on this commentary. We received a lot of excellent responses. Below you will find a small selection of those e-mails, some of which have been edited for length and spelling.

Marc, Los Angeles, California
It's about time for somebody to stand up and make Americans realize that we need to invest in critical infrastructure. We've already seen the consequences and we vow to never let them happen again, yet we keep failing to invest in levees, in emergency responders, and hospital beds. I wonder what it will take to wake us up? Apparently 1,300 people dying in New Orleans was not enough for our country to figure it out

Larry Wilson, Houston, Texas
The only problem is that there is no desire on the part of any U.S. leader to risk losing an election by asking us to make the expensive choice.

Sally Brandon, Winter Haven, Florida
I was born and live in the state of Florida, it blows my mind that people are STILL shelling out millions of dollars for homes on barrier islands. The name alone tells us what the function of that strip of sand is for, yet folks flock by the car loads to throw away money on a gamble.

Terrence Barnhardt, College Station, Texas
Who cares? We can spend a lifetime in fear of something that never (or rarely) happens and spend billions of dollars to protect ourselves from the same. Is it worth it? Obviously not.

Thomas Stiyer, Beltsville, Maryland
The author is right on the money. We could not be in a worse state of preparedness if our enemies were running our country. Money has been spent willy-nilly on who knows what and who knows where. We are told that nobody should have to pay his or her money to the government in taxes; as if all of our infrastructure, care, protection and research, to say nothing of political pay-back pork barrel projects, cost nothing. Yes, it's our money, but the bills are ours, also.

Robert, Nampa, Idaho
I totally agree. In addition I would ask, "Why do local and federal governments allow people to build in flood plains and tidal surge areas?" How many millions of dollars are spent to assist homeowners to repair and rebuild in these areas, only to have their homes damaged or destroyed by the next flood or hurricane?

Tom Iovino, Clearwater, Florida
This commentary is long overdue. I am an emergency management Public Information Officer in a coastal Florida county and -- even though we are pretty well prepared -- so much more can and needs to be done. We all need to realize that preparing ourselves is vital to this effort. I'm stunned when I talk with people who routinely let their gas tanks drain to E, keep less than one day's worth of necessary medication or let their pantries run clean of food. We need to create a culture not of panic but of preparedness!

Curtis Rankin, Paso Robles, California
Your commentary has obvious merit. The national problem is that the current White House is only interested in spending that serves its own narrow political interests, not any broad public interest where there is no immediate payback to the president.

Kurt Heuer, Brighton, Colorado
Most things in life are pretty simple. This is very easy to understand. Nothing complicated. Why can the leaders of this nation (Republicans & Democrats) take a good listen to what he is saying here and just "do it?" Everything has to be such a big deal. The simple fact is that we're not prepared, but does it have to stay that way? Sheessshhhh, I'll help.

Thomas Edwards, Zurich, Switzerland
Intriguing, with a logic no rational person can deny. But it requires Americans do the one thing they loathe most to do - open their pocketbooks and, yes, actually pay taxes for the protection we feel we're due. But if we won't even "pay as you war" in Iraq, how can we ever even begin to think about the issues of national emergency infrastructure mentioned by Flynn?

Gerald Cassin, Oxford, Connecticut
Right on the money with one additional thought. Regardless of which political party has power, or which one you belong to, pork barrel projects are taking money from these needed projects

2007-07-11T08:30:00.000-07:00

Homeland Security Advisory System

Current Threat Level
July 11, 2007 — The United States government's national threat level is Elevated, or Yellow.

The U.S. threat level is High, or Orange, for all domestic and international flights. Only small amounts of liquids, aerosols and gels are allowed in carry-on baggage.
See the Transportation Security Administration (TSA) website for up-to-date information on items permitted and prohibited on airlines.

Recommended Activities
All Americans should continue to be vigilant, take notice of their surroundings, and report suspicious items or activities to local authorities immediately.

Everyone should establish an emergency preparedness kit and emergency plan for themselves and their family, and stay informed about what to do during an emergency.

2007-07-11T08:15:00.000-07:00

30 Tips for Emergency Preparedness

Here are 30 tips to help you and your family become better prepared for an emergency.

Preparedness Tip #1
Take a moment to imagine that there is an emergency, like a fire in your home, and you need to leave quickly. What are the best escape routes from your home? Find at least two ways out of each room. Now, write it down — you’ve got the beginning of a plan.

Preparedness Tip #2
Pick a place to meet after a disaster. Designate two meeting places. Choose one right outside your home, in case of a sudden household emergency, such as a fire. The second place you choose needs to be outside your neighborhood, in the event that it is not safe to stay near or return to your home.

Preparedness Tip #3
Choose an emergency contact person outside your area because it may be easier to call long distance than locally after a local/regional disaster. Take a minute now to call or e-mail an out-of-town friend or family member to ask him or her to be your family’s designated contact in the event of an emergency. Be sure to share the contact's phone number with everyone in the family. During an emergency, you can call your contact who can share with other family members where you are; how you are doing; and how to get in contact with you.

Preparedness Tip #4
Complete an emergency contact card and make copies for each member of your family to carry with them. Be sure to include an out-of-town contact on your contact card. It may be easier to reach someone out of town if local phone lines are out of service or overloaded. You should also have at least one traditionally wired landline phone, as cordless or cellular phones may not work in an emergency. Visit www.redcross.org or www.ready.gov for sample emergency contact cards.

Preparedness Tip #5
Dogs may be man’s best friend, but due to health regulations, most emergency shelters cannot house animals. Find out in advance how to care for your pets and working animals when disaster strikes. Pets should not be left behind, but could be taken to a veterinary office, family member’s home or animal shelter during an emergency. Also be sure to store extra food and water for pets. For more information, visit the Animal Safety section on www.redcross.org or visit the Humane Society Web site at www.hsus.org

Preparedness Tip #6
Go through your calendar now, and put a reminder on it — every six months — to review your plan, update numbers, and check supplies to be sure nothing has expired, spoiled, or changed. Also remember to practice your tornado, fire escape or other disaster plans.

Preparedness Tip #7
Check your child’s school Web site or call the school office to request a copy of the school’s emergency plan. Keep a copy at home and work or other places where you spend a lot of your time and make sure the school’s plan is incorporated into your family’s emergency plan. Also, learn about the disaster plans at your workplace or other places where you and your family spend time.

Preparedness Tip #8
Teach your children how and when to call 9-1-1 or your local Emergency Medical Services number for help. Post these and other emergency telephone numbers by telephones.

Preparedness Tip #9
Practice. Conduct fire drills and practice evacuating your home twice a year. Drive your planned evacuation route and plot alternate routes on a map in case main roads are blocked or gridlocked. Practice earthquake and tornado drills at home, school and work. Commit a weekend to update telephone numbers, emergency supplies and review your plan with everyone.

Preparedness Tip #10
A community working together during an emergency makes sense.
Talk to your neighbors about how you can work together during an emergency.
Find out if anyone has specialized equipment like a power generator, or expertise such as medical knowledge, that might help in a crisis.
Decide who will check on elderly or disabled neighbors.
Make back-up plans for children in case you can't get home in an emergency.
Sharing plans and communicating in advance is a good strategy

Preparedness Tip #11
What if disaster strikes while you’re at work? Do you know the emergency preparedness plan for your workplace? While many companies have been more alert and pro-active in preparing for disasters of all types since the September 11, 2001 attacks, a national survey indicates that many employees still don’t know what their workplace plan is for major or minor disasters. If you don’t know yours, make a point to ask. Know multiple ways to exit your building, participate in workplace evacuation drills, and consider keeping some emergency supplies at the office. Visit www.ready.gov and click on Ready Business for more information about business preparedness.

Preparedness Tip #12
You should keep enough supplies in your home to meet the needs of you and your family for at least three days. Build an emergency supply kit to take with you in an evacuation. The basics to stock in your portable kit include: water, food, battery-powered radio and flashlight with extra batteries, first aid supplies, change of clothing, blanket or sleeping bag, wrench or pliers, whistle, dust mask, plastic sheeting and duct tape, trash bags, map, a manual can opener for canned food and special items for infants, elderly, the sick or people with disabilities. Keep these items in an easy to carry container such as a covered trash container, a large backpack, or a duffle bag.

Preparedness Tip #13
Preparing for emergencies needn’t be expensive if you’re thinking ahead and buying small quantities at a time. Make a list of some foods that:
Have a long shelf-life and will not spoil (non-perishable).
You and your family like.
Do not require cooking.
Can be easily stored.
Have a low salt content as salty foods will make you more thirsty.
Keep the list in your purse or wallet and pick up a few items each time you’re shopping and/or see a sale until you have built up a well-stocked supply that can sustain each member of your family for at least three days following an emergency.

Preparedness Tip #14
Take a minute to check your family’s first aid kit, and note any depleted items — then, add them to your shopping list. Don’t have a first aid kit? Add that to the list or build a kit yourself. Just add the following items to your shopping list and assemble a first aid kit. Consider creating a kit for each vehicle as well:
First Aid Kits - Assemble a first aid kit for your home and one for each car.
(20) adhesive bandages, various sizes
(1) 5" x 9" sterile dressing
(1) conforming roller gauze bandage
(2) triangular bandages
(2) 3 x 3 sterile gauze pads
(2) 4 x 4 sterile gauze pads
(1) roll 3" cohesive bandage
(2) germicidal hand wipes or waterless alcohol-based hand sanitizer
(6) antiseptic wipes
(2) pair large medical grade non-latex gloves
Adhesive tape, 2" width
Anti-bacterial ointment
Cold pack
Scissors (small, personal)
Tweezers
CPR breathing barrier, such as a face shield
First Aid Manual
Non-Prescription and Prescription Drugs
Aspirin or non-aspirin pain reliever
Anti-diarrhea medication
Antacid (for stomach upset)
Syrup of Ipecac (use to induce vomiting if advised by the Poison Control Center)
Laxative
Activated charcoal (use if advised by the Poison Control Center)
Prescription drugs, as recommended by your physician, and copies of the prescriptions in case they need to be replaced
For more information about first aid kits, visit www.redcross.org.

Preparedness Tip #15
Keep at least a three-day supply of water per person. Store a minimum of one gallon of water per person per day (two quarts for drinking, two quarts for food preparation and sanitation). Store water in plastic containers such as soft drink bottles. Avoid using containers that will decompose or break, such as milk cartons or glass bottles. A normally active person needs to drink at least two quarts of water each day. Hot environments and strenuous activity can double that amount. Children, nursing mothers, and people who are sick will also need more.

Preparedness Tip #16
One of the easiest ways you can prepare for emergencies is to keep some supplies readily available. Every kit is unique and can be tailored to meet the specific needs of your family, but below is a general list of supplies you may want to consider:
Tools and Supplies (Essential Items are Marked with an Asterisk *)
Mess kits, or paper cups, plates, and plastic utensils
Emergency preparedness manual and a copy of your disaster plan, including your emergency contacts list
Battery-operated radio and extra batteries*
Flashlight and extra batteries*
Cash or traveler's checks, change*
Non-electric can opener, utility knife*
Fire extinguisher: small ABC type stored near where fires are likely to occur such as a kitchen, or near a fireplace. It should not be kept in the disaster supplies kit.
Tube tent
Duct Tape*
Compass
Matches in a waterproof container
Aluminum foil
Plastic storage containers
Signal flare
Paper, pencil*
Needles, thread
Medicine dropper
Shut-off wrench or pliers, to turn off household gas and water
Whistle*
Plastic sheeting*
Map of the area (for locating shelters and evacuation routes)
(Continued in the next tip)

Preparedness Tip #17
Also include items for sanitation in your emergency supply kit. Consider the following:
Sanitation (Essential Items are Marked with an Asterisk *)
Toilet paper, towelettes*
Soap, liquid detergent*
Feminine supplies*
Personal hygiene items*
Plastic garbage bags, ties (for personal sanitation uses)*
Plastic bucket with tight lid
Disinfectant
Household chlorine bleach
(Continued in the next tip)

Preparedness Tip #18
Include at least one complete change of clothing and footwear per person in your emergency supply kit. We suggest long pants and long sleeves for additional protection after a disaster.
Clothing and Bedding (Essential Items are Marked with an Asterisk *)
Sturdy shoes or work boots*
Rain gear*
Blankets or sleeping bags*
Hat and gloves
Thermal underwear
Sunglasses

Preparedness Tip #19
You should also keep a smaller version of your emergency supply kit in your vehicle, in case you are commuting or traveling when disaster strikes.
Emergency Kit For Your Vehicle
Bottled water and non-perishable high energy foods, such as granola bars, raisins and peanut butter
Flashlight and extra batteries
Blanket
Booster cables
Fire extinguisher (5 lb., A-B-C type)
First aid kit and manual
Maps
Shovel
Tire repair kit and pump
Flares or other emergency marking devices

Preparedness Tip #20
Teach children how to dial 9-1-1 in an emergency. Review emergency action steps with all family members:
Check the scene and the victim
Call 9-1-1 or your local emergency number posted by the telephone
Care for the victim
Help your children learn more about emergencies. Download this preparedness coloring book. or visit Red Cross' "Masters of Disaster."

Preparedness Tip #21
Read the information on your city, county and/or state government Web sites as well as the “Be Prepared” section of www.redcross.org or Ready.gov and print emergency preparedness information. Be sure to keep a copy with your disaster supplies kit. It can provide telephone numbers, addresses and other information you need when electronic connections are not available options for obtaining the information.

Preparedness Tip #22
When water is of questionable purity, it is easiest to use bottled water for drinking and cooking if it is available. When it’s not available, it is important to know how to treat contaminated water. In addition to having a bad odor and taste, water from questionable sources may be contaminated by a variety of microorganisms, including, bacteria and parasites that cause diseases such as dysentery, cholera, typhoid, and hepatitis. All water of uncertain purity should be treated before use. Use one or a combination of these treatments:
Filter: Filter the water using a piece of cloth or coffee filter to remove solid particles.
Boil: Bring it to a rolling boil for about one full minute. Cool it and pour it back and forth between two clean containers to improve its taste before drinking it.
Chlorinate:
Add 16 drops (1/8 teaspoon) of liquid chlorine bleach per gallon of water. Stir to mix. Sodium hypochlorite of the concentration of 5.25% to 6% should be the only active ingredient in the bleach. There should not be any added soap or fragrances. A major bleach manufacturer has also added Sodium Hydroxide as an active ingredient, which they state does not pose a health risk for water treatment.
Let stand 30 minutes.
If it smells of chlorine. You can use it. If it does not smell of chlorine, add 16 more drops (1/8 teaspoon) of chlorine bleach per gallon of water, let stand 30 minutes, and smell it again. If it smells of chlorine, you can use it. If it does not smell of chlorine, discard it and find another source of water.
Flood water can also be contaminated by toxic chemicals. Do NOT try to treat flood water.

Preparedness Tip #23
In some emergencies you may be required to turn off your utilities. To prepare for this type of event:
Locate the electric, gas and water shut-off valves.
Keep necessary tools near gas and water shut-off valves
Teach adult family members how to turn off utilities.
If you turn off the gas, a professional must turn it back on. Do not attempt to do this yourself.

Preparedness Tip #24
Understand that during an emergency you may be asked to “shelter-in-place” or evacuate. Plan for both possibilities and be prepared to listen to instructions from your local emergency management officials. Visit Ready.gov and www.redcross.org/preparedness for more information on sheltering-in-place.

Preparedness Tip #25
A disaster can cause significant financial loss. Your apartment or home may be severely damaged or destroyed. You may be forced to live in temporary housing. Income may be cut off or significantly reduced. Important financial records could be destroyed. Take the time now to assess your situation and ask questions.
To help you, consider using the Emergency Financial First Aid Kit (EFFAK), a tool developed by Operation Hope, FEMA and Citizen Corps or contact your local Red Cross chapter for Disasters and Financial Planning: A Guide for Preparedness.

Preparedness Tip #26
Learn if earthquakes are a risk in your area by contacting your local emergency management office, local American Red Cross chapter, or state geological survey or department of natural resources. Information about earthquake risk is also available from the U.S. Geological Survey National Seismic Hazards project.

Preparedness Tip #27
Floods are among the most frequent and costly natural disasters in terms of human hardship and economic loss. As much as 90 percent of the damage related to all natural disasters (excluding draught) is caused by floods and associated debris flow. Most communities in the United States can experience some kind of flooding. Melting snow can combine with rain in the winter and early spring; severe thunderstorms can bring heavy rain in the spring or summer; or hurricanes can bring intense rainfall to coastal and inland states in the summer and fall. Regardless of how a flood occurs, the rule for being safe is simple: head for higher ground and stay away from floodwater. Even a shallow depth of fast-moving floodwater produces more force than most people imagine. You can protect yourself by being prepared and having time to act. Local radio or television stations or a NOAA Weather Radio are the best sources of information in a flood situation.

Preparedness Tip #28
When there is concern about a potential exposure to a chemical or other airborne hazard, local officials may advise you to "shelter-in-place “ and “seal the room.” This is different from taking shelter on the lowest level of your home in case of a natural disaster like a tornado. If you believe the air may be badly contaminated or if you are instructed by local officials, follow the instructions below to create a temporary barrier between you and the contaminated air outside.
To shelter-in-place and seal-the-room:
Close and lock all windows and exterior doors.
Turn off all fans, heating and air conditioning systems.
Close the fireplace damper.

Get your disaster supplies kit and turn on your battery-powered radio.
Go to an interior room that is above ground level and without windows, if possible. In the case of a chemical threat, an above-ground location is preferable because some chemicals are heavier than air, and may seep into basements even if the windows are closed.
If directed by local authorities on the radio, use duct tape to seal all cracks around the door and any vents into the room. Tape plastic sheeting, such as heavy-duty plastic garbage bags, over any windows.

Listen to your radio or television for further instructions. Local officials will tell you when you can leave the room in which you are sheltering, or they may call for evacuation in specific areas at greatest risk in your community

Preparedness Tip #29
If there is an explosion:
Take shelter against your desk or a sturdy table.
Exit the building immediately.
Do not use elevators.
Check for fire and other hazards.
Take your emergency supply kit if time allows.
If there is a fire:
Exit the building immediately.
If there is smoke, crawl under the smoke to the nearest exit and use a cloth, if possible, to cover your nose and mouth.
Use the back of your hand to feel the upper, lower, and middle parts of closed doors.
If the door is not hot, brace yourself against it and open slowly.
If the door is hot, do not open it. Look for another way out.
Do not use elevators.
If your clothes catch on fire, stop-drop-and-roll to put out the fire. Do not run.
If you are at home, go to your previously designated outside meeting place.
Account for your family members and carefully supervise small children.
GET OUT and STAY OUT. Never go back into a burning building.
Call 9-1-1 or your local emergency number.

Preparedness Tip #30
Unlike an explosion, a biological attack may or may not be immediately obvious. Most likely local health care workers will report a pattern of unusual illness or a wave of sick people seeking medical attention. The best source of information will be radio or television reports.

Understand that some biological agents, such as anthrax, do not cause contagious diseases. Others, like the smallpox virus, can result in diseases you can catch from other people.
In the event of a biological attack, public health officials may not immediately be able to provide information on what you should do. It will take time to determine exactly what the illness is, how it should be treated, and who may have been exposed. You should watch TV, listen to the radio, or check the Internet for official news including the following:

Are you in the group or area authorities believe may have been exposed?
What are the signs and symptoms of the disease?
Are medications or vaccines being distributed?
Where? Who should get them and how?
Where should you seek emergency medical care if you become sick?

During a declared biological emergency:
If a family member becomes sick, it is important to be suspicious.
Do not assume, however, that you should go to a hospital emergency room or that any illness is the result of the biological attack. Symptoms of many common illnesses may overlap.
Use common sense, practice good hygiene and cleanliness to avoid spreading germs, and seek medical advice.

Consider if you are in the group or area authorities believe to be in danger.
If your symptoms match those described and you are in the group considered at risk, immediately seek emergency medical attention.

If you are potentially exposed:
Follow instructions of doctors and other public health officials.
If the disease is contagious expect to receive medical evaluation and treatment. You may be advised to stay away from others or even deliberately quarantined.
For non-contagious diseases, expect to receive medical evaluation and treatment.
If you become aware of an unusual and suspicious substance nearby:
Quickly get away.

Protect yourself. Cover your mouth and nose with layers of fabric that can filter the air but still allow breathing. Examples include two to three layers of cotton such as a t-shirt, handkerchief or towel. Otherwise, several layers of tissue or paper towels may help.
Wash with soap and water.
Contact authorities.

Watch TV, listen to the radio, or check the Internet for official news and information including what the signs and symptoms of the disease are, if medications or vaccinations are being distributed and where you should seek medical attention if you become sick.
If you become sick seek emergency medical attention.

http://www.dhs.gov/xcitizens

2007-07-10T10:41:00.001-07:00

Some Do's and Dont's

Do say:

These are normal reactions to a disaster
It is understandable that you feel this way
You are not going crazy
It wasn't your fault, you did the best you could
Things may never be the same, but they will get better, and you will feel better

Don't say:

It could have been worse
The bible says all things work together for your good
It's best if you just stay busy
I know just how you feel
You need to get on with your life

Our human desire is to try and fix everything. Don't try to fix the survivor's painful situation or make the survivor feel it will work out overnight.

2007-07-10T10:18:00.000-07:00

Global Traumatology Disaster counseling Skills

Disaster counseling involves both listening and guiding. Let the survivors talk about their disaster experiences and assist them with problem solving solutions and referral resources.
Survivors respond to workers who can make eye contact, offer a touch on the should and someone who can listen to their fearful hearts and troubled mind.

Lean how to be an attentive, active listener

Close your mouth - Don't talk to much. Allow survivor to recover from the shock phase and become aware of feelings. Just being close to the survivor will speak volumes.
Eye Contact - Let the survivor know that you are in tune with them.
Let the survivor know that he or she is being heard
Reflect feelings - You may notice that the survivor's tone of voice or nonverbal gestures suggest anger, sadness or fear.
Allow expression of emotions - Expressing intense emotions through tears or angry venting is important of the healing process

2007-07-10T07:44:00.000-07:00

References

National Center for Post-Traumatic Stress Disorder, Department of Veterans Affairs

Center for the Treatment and Study of Anxiety

Department of Psychiatry, University of Pennsylvania

2007-07-10T07:36:00.000-07:00

Burnout

This term has been applied to all helping professions. Burnout often manifests in a gradual wearing down over time.

Symptoms of burnout include:

Discouragement
Depression
Loss of compassion
Cynicism
Boredom

The factors at add to burnout include:

Professional Isolation
Emotional drain from helping others
Long working hours with little results

2007-07-10T07:26:00.000-07:00

Working with Trauma Survivors

Always remember that trauma survivors are in an ongoing process of healing and recovery.

Always approach survivors with Respect
Concern
Answer any questions they may ask
Normalize their distress ( What you are experiencing is normal)
Help them learn effective coping strategies

2007-07-09T11:19:00.000-07:00

It is important to understand that in the next 3-5 years, we will see an increase in global crises. This will come by acts of nature (Katrina in U.S.), and Religiously Motivated Terrorism. Let us not forget the thousands of Americans who experienced 911 and Katrina. The images of television will be imprinted in our minds until we die.

What have we learned from these disasters? Are we a better prepared nation? Those who encounter behavioral and emotional problems, have they received the proper counseling and treatment?

While serving as a Pastor and Chaplain, many shared the post traumatic stress symptoms they encountered. A airline pilot shared his frustration with me in a counseling session. After 911, he daily processed his anger, frustration, fear and for a brief moment, a desire for revenge.

Many people respond to the impact of a disaster in different ways. What are the phases?

Disorganized- This is a natural and expected reaction for individuals. Think about it, your life has been threatened and you or someone you know has encounterd close with death.

This is natural for a human, but what about our Government? What about your local Government? School Board? Any place with a large Gathering of People!

Organize and Rescue- Let us learn from our past with Katrina. Trying to organize after the crisis does not work. Each segment of our Nation, and local government must have a plan for dealing with Traumatology.

Check with your local government, send me your response to your cities plan for disaster.