Situation Manual
Time Allotted
215 Minutes
Situation Manual – Tabletop Exercise
1
Disaster Resistant Communities Group – www.drc-group.com
Operation Shelter Care – Start Exercise
No Image
During this exercise it will be important to remember and comply with the following statements:
 For the purpose of this exercise the designers have developed information and materials on a simulated shelter
activated due to a region wide flood.
 This exercise is designed to assist nursing students and others to assess the various capabilities of providing
Disaster Health Services in a shelter environment.
 It is important NOT to jump ahead in the exercise scenario. In other words don’t focus on what might happen, focus
on the Common Operating Picture that is presented during the exercise to make informed decisions.
 In any exercise a number of assumptions and artificialities may be necessary to complete play in the time allotted.
During this exercise, the following apply:
1. The scenario is plausible, and events occur as they are presented.
2. There is no “hidden agenda”, nor any trick questions.
 Exercise Basics:
1. This exercise contains a total of 12 scenario and inject pages.
2. The exercise is self-paced and it should take your team appropriately an hour to complete. However, based
on the time your team spends on each scenario and inject your team may complete the exercise in less than
an hour or it may take much longer than an hour for your team to complete the exercise.
3. All videos embedded within this exercise can be enlarged to FULL SCREEN by simply clicking on the full
screen icon in the lower right hand corner of the video.
4. Thoroughly review all scenarios and injects as they are presented during the exercise.
 After the exercise each registered participant that took part in the exercise will need to log into the ONX System to
complete their individual Hotwash to receive their Certificate of Participation.
 If you need assistance anytime during the exercise please call the Help Desk at:
Phone Number - 605-475-4700
Account Number - 1076890 #
Time Allotted
20 Minutes
Situation Manual – Tabletop Exercise
2
Disaster Resistant Communities Group – www.drc-group.com
Operation Shelter Care – Scenario – # 001
Image of Flood Watch
Soil conditions are nearly saturated across the region due to recent rains.
A late season frontal boundary has stalled across the state and a low pressure system has developed just south of the
front. The low is forecast to strengthen and move through the area over the next 72 hours bringing a serious threat for
excessive rainfall across the region.
A Flood Watch has been issued by the local forecast office of the National Weather Service through 5:00PM Saturday.
Flood Watch
Issued Thursday 1:37PM
Expires Saturday 5:00PM
NOAA Weather Radios throughout the area sound their alarm due to the Flood Watch.
CLICK ON POD CAST TO PLAY
NOAA Weather Radio Alert
Persistent bands of heavy rainfall are forecast within the Flood Watch area off and on today through Saturday, with a wide
east-to-west swath of rainfall totals expected to reach 10 to 15 inches.
A High Threat for significant flooding exists, with many drainage basins likely to be overtopped later today or Friday. High
water may accumulate in residential and agricultural areas, as well as cover roadways. Areas near small streams,
drainage canals and poor drainage systems will be the first to flood and will experience the most significant impacts.
Time Allotted
10 Minutes
Situation Manual – Tabletop Exercise
3
Disaster Resistant Communities Group – www.drc-group.com
Operation Shelter Care – Inject – # 002
Image of Hurricane Preparedness Activities
You and your fellow nursing students have been trained and are ready to assist flood
evacuees in a General Population Shelter as an American Red Cross Disaster Health Services
volunteer.
Yes
No
Have you taken the time to prepare yourself, your family and your pets for a flood or other
disaster?
If the above answer is yes. – Identify and describe at least three disaster preparedness activities that you and your fellow
nursing students have personally implemented.
(Example: Family Communications Plan – Because our family members may not be together when disaster strikes we
have completed an Emergency Communications Card for each adult family member that they keep in their wallet or
purse. We have also completed a card for each child and put it in their school backpack. The contact card contains phone
numbers, e-mail addresses, etc. for all family members.)
If the above answer is no. – Briefly explain what is keeping you from preparing yourself, your family and / or your pets for
the next disaster.
Time Allotted
15 Minutes
Situation Manual – Tabletop Exercise
4
Disaster Resistant Communities Group – www.drc-group.com
Operation Shelter Care – Inject – # 003
Image of Notification
As heavy rains begin to cause severe flooding throughout the region would you wait for the
American Red Cross to contact you or would you make contact with your local American Red
Cross chapter offering your assistance?
Wait To Be
Contacted
Contact the
American Red
Cross
(Note: Contact information for your local American Red Cross chapter can be found at www.redcross.org/find-your-localchapter.)
Identify your local American Red Cross chapter and list the chapter’s contact information (phone number, address, etc.).
Time Allotted
15 Minutes
Situation Manual – Tabletop Exercise
5
Disaster Resistant Communities Group – www.drc-group.com
Operation Shelter Care – Scenario – # 004
Shelter Timeline
No Image
Day One
The local chapter of the American Red Cross has just been requested by local emergency management officials to open a
General Population Shelter due to the evacuation order that has been issued for residents living in flood prone areas.
The chapter has activated its agreement with the local school district to use the district’s high school as a shelter.
Within several hours the shelter management team has opened the high school as a shelter and is greeting individuals
and families who have evacuated from their homes due to the flooding.
CLICK ON VIDEO TO PLAY
(Note: This video provides an overview of what a typical American Red Cross shelter looks like.)
Video Library – Video # 39 – Shelter Activation
The high school does not have a generator so if the electricity is lost the only available lighting will be via flashlights and
battery powered lanterns.
The local chapter has delivered a Health Services Supplies Kit to the shelter. This kit contains only the most basic health
care supplies.
Upon arriving at the shelter you are quickly assigned to assisting other volunteers with registering evacuees as they
arrive.
Time Allotted
15 Minutes
Situation Manual – Tabletop Exercise
6
Disaster Resistant Communities Group – www.drc-group.com
Operation Shelter Care – Inject – # 005
Shelter Timeline
Image of Senior Citizen
Day One
Tom Hartwell, the neighbor of Shirley Jones who is an 87 year old widow, has just dropped Mrs Jones off at the shelter
because her home is within a known flood prone area.
During the registration process it is learned that Mrs Jones does not have any relatives who live in the area.
Mrs Jones brought a walker, ten days of multiple types of medications and a single portable tank (24 hours) of oxygen
with her to the shelter.
As Mrs Jones is completing her Shelter Registration Form the Shelter Registration Staff uses the Shelter Registration
Intake Guidelines to conduct an initial health / functional needs assessment. The two observations and questions
contained in the Shelter Registration Intake Guidelines are asked by the Shelter Registration Staff to offer evacuees an
early opportunity to let Shelter Staff know of access and functional needs they may have.
Medical Profile
Individual
Shirley Jones
Age
87
Medical Condition
Transportation
Uses a walker for mobility.
On oxygen 24 hours a day.
Has congestive heart failure and
takes numerous medications.
Relies on public
transportation
Speaks
English
Yes
Upon completing the health / functional needs assessment, will Mrs Jones be admitted to the
shelter?
Yes
No
If the above answer is yes. – Briefly describe the accommodations that will need to be made for her.
If the above answer is no. – What will Mrs Jones be told?
Situation Manual – Tabletop Exercise
7
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Time Allotted
20 Minutes
Situation Manual – Tabletop Exercise
8
Disaster Resistant Communities Group – www.drc-group.com
Operation Shelter Care – Inject – # 006
Image of Shelter Intake Interview
Shelter Registration Drill
The purpose of the “Shelter Registration Drill” is to give exercise participants an opportunity to use their nursing skills as
well as their knowledge of shelter operations to assist an evacuee with identifying access and functional needs after they
have been through the shelter registration process.
Drill Instructions
1. Each exercise participant will need a paper copy of the CMIST Worksheet.
2. Pair up with a fellow exercise participant.
3. One exercise participant will fulfill the role of an evacuee while the other fulfills the role of a Disaster Health
Services volunteer assigned to the shelter.
4. The individual fulfilling the role of an evacuee will need to use their medical knowledge and a little imagination to
simulate that they have several health related conditions / needs.
5. The individual fulfilling the role of the Disaster Health Services volunteer will use the above referenced document to
assist the evacuee with the determining their access and functional needs.
6. Once the drill is completed the two individuals should switch roles and work through the drill again.
Once all the exercise participants have completed the drill conduct a short review on lessons learned.
Time Allotted
25 Minutes
Situation Manual – Tabletop Exercise
9
Disaster Resistant Communities Group – www.drc-group.com
Operation Shelter Care – Scenario – # 007
Shelter Timeline
Image of Shelter Occupants
Day Two
Over the next 15 hours 253 evacuees register to stay at the shelter. However, during the day many of the evacuees will
be leaving the shelter to check on the condition of their homes, go to work, attend school and / or begin the recovery
process.
The shelter has been inspected by local emergency management and the American Red Cross and has been approved to
house 330 individuals based on 20 square feet per person.
Local emergency management has delivered 70 cots and blankets to the shelter.
The age range of shelter residents:
Age
Number
Infants
2
Toddlers
3
School Age
47
Young Adults (18 – 40)
104
Middle Age (41 – 59)
59
Senior Citizens (60 up)
38
The shelter is in operation 24 hours a day and is expected to remain open for at least the next 10 days.
Volunteers assigned to the shelter are working eight hour shifts: 8:00AM – 4:00PM / 4:00PM – 12:00PM / 12:00PM –
8:00AM.
Time Allotted
10 Minutes
Situation Manual – Tabletop Exercise
10
Disaster Resistant Communities Group – www.drc-group.com
Operation Shelter Care – Inject – # 008
Image of Disaster Health Shelter
In addition to screening health and functional needs related issues of individuals as they register to stay at the shelter,
identify and briefly describe three other roles that Disaster Health Services would support as part of shelter operations.
Disaster Health Services Forms
Aggregate Morbidity Report
Client Health Record
Cot-To-Cot Assessment Guidelines
(Example: Referrals – Disaster Health Services volunteers should be able to assist individuals and families residing in the
shelter to identify and access available community resources in order to prevent or resolve health and / or other disaster
related problems or concerns.)
Role # 1:
Role # 2:
Role # 3:
Time Allotted
15 Minutes
Situation Manual – Tabletop Exercise
11
Disaster Resistant Communities Group – www.drc-group.com
Operation Shelter Care – Inject – # 009
Shelter Timeline
Image of Insulin
Day Three
James Hall is 68 years old, never been married, and has very few close friends.
Mr Hall has diabetes and has been insulin dependent for the past 24 years. Due to his diabetes, his right foot was
amputated three years ago and has no prosthetic foot requiring crutches and a wheelchair to move around.
Considering himself very self-sufficient, Mr Hall was trying to protect his home from the flooding when he fell, fracturing
both of his wrists. A neighbor called 911 and Mr Hall was transported to the hospital.
After his discharge from the hospital, he cannot return home due to the flooding, nor can he give himself his insulin
injections, use his crutches or wheelchair, nor perform any of his other activities of daily living. He considers his options
and chooses to stay at the shelter.
A cab has just dropped him off at the shelter.
Medical Profile
Individual
James Hall
Age
68
Medical Condition
Speaks
English
Transportation
Diabetic
Amputee – right foot
Broken wrists
Personal truck (However at
the current time he cannot
drive.)
Yes
CLICK ON VIDEO TO PLAY – OPTIONAL
(Note: The following videos demonstrate support services that can be expected to be performed within a shelter housing
evacuees with functional needs such as James Hall.)
Video Library – Video # 032 – Blood
Glucose Monitoring
Situation Manual – Tabletop Exercise
Video Library – Video # 034 –
Assisting In Feeding
12
Video Library – Video # 028 – Bedpan
Usage
Disaster Resistant Communities Group – www.drc-group.com
Identify then briefly describe how the various needs of Mr Hall will be met during his stay at the shelter.
Time Allotted
20 Minutes
Situation Manual – Tabletop Exercise
13
Disaster Resistant Communities Group – www.drc-group.com
Operation Shelter Care – Inject – # 010
Shelter Timeline
Image of Cough
Day Three
It will be important that you constantly interface with shelter residents to monitor their physical and mental health.
CLICK ON VIDEO TO PLAY
Video Library – Video # 037 – Initiating A Conversation With A Disaster Victim
While talking with several shelter residents it is pointed out that Sam Rogers, another shelter resident is coughing and
spitting into a cup.
You approach Mr Rogers and have a brief discussion with him where you determine that he is indeed spitting up blood.
Upon checking the CMIST Worksheet that was completed on Mr Rogers you notice that he did not state that he had any
medical problems.
Briefly describe the immediate actions that will need to be taken to assist Mr Rogers.
Are there any broader shelter-wide issues that need to be addressed regarding the condition
of Mr Rogers?
Yes
No
If the above answer is yes. – Briefly describe what these broader issues are and how they would be addressed.
Time Allotted
20 Minutes
Situation Manual – Tabletop Exercise
14
Disaster Resistant Communities Group – www.drc-group.com
Operation Shelter Care – Inject – # 011
Shelter Timeline
Image of Stress
Day Four
Several shelter residents have been constantly monitoring local news reports which indicate that homes throughout the
evacuation area have sustained major damage due to the flooding.
Upon hearing this news shelter resident Bob Highsmith begins to worry about the condition of his home. When Mr
Highsmith checked-in to the shelter, he indicated on the Initial Intake / Assessment form that he was on several
psychotropic medications due to severe depression.
June Lockhardt, a fellow shelter resident, has noticed that Mr Highsmith is extremely agitated. He has told Ms Lockhardt
that he is concerned about what he is going to do now because he believes that his home has been destroyed. He does
not have any flood insurance. She has approached the Disaster Health Services team to see if someone could assist Mr
Highsmith.
CLICK ON VIDEO TO PLAY – OPTIONAL
(Note: The following video demonstrates support services that can be expected to be performed within a shelter housing
evacuees with functional needs such as Bob Highsmith.)
Video Library – Video # 040 – Psychological First Aid Basics
Will you as a Disaster Health Services volunteer be able to assist Mr Highsmith?
Yes
No
If the above answer is yes. – Briefly describe what assistance can be provided to Mr Highsmith.
Time Allotted
20 Minutes
Situation Manual – Tabletop Exercise
15
Disaster Resistant Communities Group – www.drc-group.com
Operation Shelter Care – Inject – # 012
Shelter Timeline
Image of Environmental Health
Day Six
You just noticed that the children of several shelter residents who have been playing together outside have been
scratching their arms. You are also aware that a number of adult residents have been asking for anti-itch creams.
When you arrived at the shelter for your assigned shift the nurse that you relieved reported that several shelter residents
have been seeking interventions for an assortment of bug bites, bee stings and outdoor spider bites.
In addition, three shelter residents have presented with s-shaped or linear tracks on their skin, associated with some signs
of weeping blisters and their scratch marks.
Identify the probable cause / causes of the environmental health problems.
Briefly describe how the identified environmental health problems can be mitigated and treated.
Time Allotted
20 Minutes
Situation Manual – Tabletop Exercise
16
Disaster Resistant Communities Group – www.drc-group.com
Operation Shelter Care – Inject – # 013
Image of Public Health
Assisting shelter residents with their health, mental and functional needs will be a large undertaking and involve many
government agencies and departments as well as community and faith based organizations.
Identify and list the following information for three agencies, departments and / or organizations (Community Partners)
which can provide assistance in meeting the health, medical and functional needs of individuals and families residing at
the shelter.



Name of Community Partner.
Phone Number for Community Partner.
Services Provided by Community Partner.
(Example: Low Country Center for Independent Living – 555-555-5555 – Can replace wheelchairs that were lost during
the flooding.)
(Note: You can search the national 2-1-1 Information and Referral database for agencies and organizations within your
area that could assist disaster survivors with functional needs.)
Community Partner # 1:
Community Partner # 2:
Community Partner # 3:
Time Allotted
20 Minutes
Situation Manual – Tabletop Exercise
17
Disaster Resistant Communities Group – www.drc-group.com