Department of Health Photo: There is a high risk of malnutrition during emergencies like typhoons. Immediately following mock emergencies, staff members meet to debrief and discuss problems in how the team responded. Agencies across all levels of governance apply the same practices to their emergency plans. In my state of Florida, emergency management is handled by the Florida Division of Emergency Management (FDEM). What should we take away from this is that the state’s Division of Emergency Management plans for and responds to both natural and man-made disasters. That division is the state’s liaison with federal and local agencies on emergencies of all kinds.
No matter the type of emergency, the goal of every agency is be able to assist the community affected and save as many lives as possible. This overview explores how both local and state governments provide their citizens with emergencies plans under the umbrella of crisis management. As a result, we revised our system of monitoring medications used for emergencies and assigned a staff member to this task.An additional obstacle to running mock emergencies in a busy practice is pushback from staff who say it interrupts patient flow and disrupts those working in the clinic. In addition, because we have many volunteer staff who have retired from previous careers, are more than 60 years of age, and have medical issues, we felt it prudent to have measures in place to care for those who help us care for patients.We recognize that our model may require adaptation for use in other offices depending on the number of staff (including physicians, other providers, and nursing staff), role assignment, proximity to an emergency department (ED), response times of local emergency medical services (EMS), the level of care providers are capable of administering (basic versus advanced life support), and state laws regarding who may provide emergency services.
The program begins with a review of all available emergency equipment in the office utilizing an engaging scavenger hunt format. Because our office is staffed mostly by volunteers and not all items can be stored within a crash cart or emergency box, the scavenger hunt helps ensure that all staff members are able to access these items in an expedient manner and that the practice is fully equipped. Additionally, Condition C cards with common emergency situations and the appropriate interventions are located in each exam room and stored with the emergency equipment.
We try to perform these mock emergencies at least two times per year.Our emergency preparedness program involves five key steps, depicted here.
Additionally, we orient all new staff members to our emergency procedures upon hire, and we review staff members' CPR certification regularly. An alternative would be to incorporate all of these steps into a half-day session and to offer CPR certificationCHECKLIST: EMERGENCY SUPPLIES FOR FAMILY MEDICINE OFFICESThe following checklist of recommended emergency supplies includes many expected items, such as oxygen and nitroglycerin, as well as several items not commonly found in family medicine offices, such as an automated external defibrillator In deciding whether to include a particular item in your practice, consider your staff members' ability to use the item appropriately and your office's access and proximity to emergency services. Committed to providing you and your family with the best survival knowledge, skills and equipment.

Useful information about emergency preparedness suggests that a family secure a food checklist. At the local level, cities and counties operate their emergency plans following the guidelines of the federal and state governments.
According to their website, after a disaster, the division conducts damage assessment surveys and advises the governor on whether to declare an emergency and seek federal relief funds.
The Genesee County Health Department wants you to have a plan to protect your employees, lessen the impact of the emergency on your business and remain open or re-open quickly. Division staff members provide technical assistance to local governments as they prepare emergency plans and procedures. Attitudes changed, however, after a true medical emergency transpired, and our staff witnessed that things went smoothly. The emergency physician subsequently called to compliment our clinic for the pre-hospital care.
Both nursing and medical staff participate in finding and reviewing the medications and equipment that might be needed in an emergency situation (see the checklist of recommended emergency supplies). The goal is to have someone call a Condition C in a timely manner, followed by a rapid response by staff with the appropriate emergency equipment. Please check on the picture above to find out the necessary goods to stock at home in preparation for emergency situation. For example, Miami-Dade County’s emergency management system consists of four different phases: mitigation, preparedness, response and recovery.
Mitigation refers to measures that prevent an emergency, reduce the chance of an emergency happening, or reduce the damaging effects of unavoidable emergencies. While the family discussed about this in passing, we don’t have a solid plan yet on what to prepare or do when earthquake happens.
The division prepares and implements a statewide comprehensive emergency management plan and routinely conducts extensive exercises to test state and county emergency response capabilities. Given this patient volume, we felt that everyone on our staff needed to be prepared to deal with medical emergencies.
While local governments have emergency management plans in place to support agencies at federal and state levels, these plans also serve as a direct point of contact for citizens in every municipality.
Medications are not priced here as quantities will vary based on needs assessment, office size, and proximity to an emergency department.Obstacles addressedOne of the main obstacles to effective emergency care that we identified through our mock code situations was a lack of awareness by front office staff of patients in the waiting area.

CERT members also are encouraged to support emergency response agencies by taking a more active role in emergency preparedness projects in their community. The 72-hour emergency kit includes non-perishable goods, medicine, among others, but the food checklist includes a variety of non-perishable and nutritious goods enough to sustain a family for a few days. Implementing an office emergency preparedness program removes the anxiety of dealing with unusual issues, keeps necessary medications and equipment current and in working condition, and identifies problems prior to an actual emergency so that they can be resolved. However, emergency situations in medical offices do not engender the same type of Pavlovian reaction.
While infrequent, emergency situations do occur in office settings, and this program equips us to provide the best possible care for our patients. The EOC serves as the communications and command center for reporting emergencies and coordinating state response activities.
Emergency preparedness should be at the forefront of most public agencies in the event of a crisis. Although the article is good information for the general public, I think most emergency managers have a solid understanding of the topic. Although state and local governments depend on federal money, they have built self-reliant agencies that work in partnership with the federal emergency response units. Although most medical training, including family medicine training, involves learning how to deal with emergency situations, that education has a tendency to wane after graduation. During a recent mock emergency, we discovered that multiple medications in our emergency box were expired.
Though perfection is impossible, all clinicians and staff members must practice their response to medical emergencies in the outpatient setting so they are prepared should an actual emergency arise.
The division also operates the State Warning Point, a state emergency communications center staffed 24 hours each day.
Once physicians are in private practice, with the demands of seeing patients, maintaining emergency certification becomes a lower priority than dealing with day-to-day issues.

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