Multicultural Community Services of the Pioneer Valley, Inc.

Mock Scenario - Heatwave

A record-breaking heatwave is bearing down on the Northeastern United States and Canada. Over the next 9 days, we expect triple-digit temperatures and high humidity will persist over the region with the temperature reaching between 102°F -104 °F.  This is the third heat wave this summer so there has been a high demand on air conditioning/electricity.   It is expected that due to damaged heat transformers there will be sporadic electrical power blackouts across the region. Some wildfires, greater thunderstorm intensity, buckling asphalt, and water line breaks will also be associated with the heat wave. There have been four straight days of unhealthy air quality, increasing demand on health care services.

Hospital admissions due to conditions such as dehydration,  heat stroke, and heat exhaustion, particularly among people with underlying medical conditions, will increase the inpatient admission rate by about 15% over normal. Public shelters will be opened to provide temporary relief from the heat and in response to the power outages. Heat-related deaths are projected to rise by 20% during the period. Warnings are provided to the public to stay home and help elderly neighbors.

The heat wave has widespread impacts on electricity, food, water, and travel.

Residents need to stock up on:

    • water
    • food that does not need to be cooked
    • be careful of heat exhaustion even on beaches

Over 40% of households lose electrical power, with 25% of households without power for 72 hours or more. Ten percent of households are still without power on day 5. As a result of these extended power outages, systems that depend on electrical power, including refrigeration, heating, well water, most telecommunications, and medical devices are impacted. Perishable foods and medicines are lost by families and businesses throughout the region. Many patients/families need assistance through emergency medical services, emergency departments, and emergency shelters.

What do WE need to do to lessen the severity on our patients, staff, and families?

Preparation:

The Clinical Supervisor contacts all staff to prepare in advance for the upcoming heatwave. Be sure staff continue to teach patients/families about how to prep, s/s, and seeking shelter if needed.

Staff Items: the reminder is provided to staff to charge any electronic devices.  Staff is aware if a state of emergency is called staff should not be on the road, but they must be sure their patients are safe. Staff needs to stay hydrated, so carry water with you while seeing patients. Utilize coolers with ice to keep water and drinks cold as long as possible.

Patient Care Items: Patient Priority rating is reviewed by each clinician and patients with a priority 1 are contacted to have an evacuation plan should there be no air conditioning or relief from the heat. Local authorities should be aware of any patient on oxygen that may require transport to an inpatient facility. A visit would be made the day before the predicted date of the heat wave will reach our area for Priority Two patients to discuss preparation for keeping cool and what to do if medication needs refrigeration and there is no electricity. Priority Three patients would follow their contingency plan and the agency would contact the patient and provide teaching over the telephone and check in with the patient about provisions.

As part of the admission process, an emergency contingency plan is developed for all patients. Patients are informed of how to prepare in an emergency and assemble a disaster supplies kit: such as keeping flashlights, extra batteries, first aid supplies, and extra food/clothing/liquids available for emergency use. When the nurses are contacting patients, staff reminds patients to review the Emergency Planning Information that is part of the admission packet.

Staff also advise patients to call 911 for an urgent or emergency if they are unable to get a hold of the nurse or the office. Patients may also call 211 to locate an open shelter during the declared emergency. If there is no electricity listen to battery-operated radios for the location of cooling shelters.

Office Items: The Emergency Tree is available to the on-call staff administrative when the Clinical Nurse Administrator declares the office is closed. Once a state of emergency is called or the office is closed, the on-call staff will begin calling all staff. If the office has no electrical power, essential staff will work remotely.

1. Ideas for planning ahead

  • Staff would review the priority status of the patient to be sure it was current and reflected the patient. This would be updated in the EHR.
  • Since this is the third heatwave, prepare patients by suggesting the purchase of battery-operated fans, cooling towels, prepare ice packs, ice in coolers, or Yeti.
  • Instruct patients to avoid strenuous activity, wear light clothing
  • Patients need to have plenty of liquids on hand – drink plenty of fluids
  • Suggest people (staff/patients if appropriate) fill up gas tanks in cars for some air conditioning relief.
  • Ice Packs – use on the forehead to cool down.
  • During the summer season, remind patients to prepare ahead with their provisions and understand how and when to seek a cooling shelter
  • Have patients & families read https://www.ready.gov/heat

2. What else would need to be done for patient to be safe?

  • Teach a patient how to keep their home cool: cover windows & drapes; weather strip doors & windows; add insulation to keep heat out
  • Go to location that has free Wi-Fi to log into patient chart
  • Staff log into EHR through cell phone
  • Become familiar with the evacuation zone, the evacuation route, and shelter
  • Gather needed supplies for at least 3-7 Keep in mind each person’s specific needs, including medication. Don’t forget the needs of pets.
  • Make sure you have non-perishable food Have a manual can opener.

3. If the emergency continues for several days, what happens to priority 2 and 3 patients?

  • Clinicians will call Priority 2 & 3 patients to be sure they have adequate shelter and provisions including Visits would be triaged.
  • Patients will be provided with shelter information if needed
  • Patients will be instructed to remain safely at home