The behavior of children may signal abuse or neglect long before any
change in physical appearance. Some of the signs may include:








Nervousness around adults
Aggression toward adults or other children
Inability to stay awake or to concentrate for extended periods
Sudden, dramatic changes in personality or activities
Unnatural interest in sex
Frequent or unexplained bruises or injuries
Low self-esteem
Poor hygiene
Child abuse and neglect occur in all segments of our society, but the
risk factors are greater in families where parents:






Appear uninterested in the care or safety of their children
Seem to be having economic, housing or personal problems
Are isolated from their family or community
Have difficulty controlling anger or stress
Are dealing with physical or mental health issues
Abuse alcohol or drugs
If you suspect abuse or neglect may be occurring, report it. To find out how,
call information or contact your department of social services listed under
government agencies in the phone book. If you think a child is in immediate
danger, call the police.
Childhelp USA
APSAC
National Child Abuse Hotline
15757 N. 78th St.
Scottsdale, AZ 85260
(800) 4-A-CHILD
407 S. Dearborn St., Suite 1300
Chicago, IL 60605
(312) 554-0166
The hotline offers crisis intervention,
information, literature and referrals.
A multidisciplinary membership society
promoting support among professionals
who work with victims of child abuse.
Physical Abuse
A non-accidental act which results in
physical pain or injury, it includes physical
coercion and physical restraint.
Abusive Physical Behavior
Includes hitting, slapping, burning,
pushing, punching, pinching, biting, arm
twisting, cutting, hair pulling, forced
confinement in room, chair or bed.
Signs of physical abuse
Abrasions, Bruises, Burn blisters,
Contusions, Rashes, Swelling, Lacerations
Lack of awareness, Weight loss, Agitation,
Broken bones. Etc.
Sexual Abuse
Non-consensual sexual contact, language or
exploitative behavior.
Abusive Sexual behaviors
Includes rape, indecent assault, sexual
harassment, sexual interference.
Signs of sexual abuse
- Unexplained sexually transmitted disease or
infections
- Bruising in genital areas or inner thighs
- Bleeding from the genital area
- Difficulty in walking or sitting not associated
with a medical condition
- Fear
- Agitation
- Disturbed sleep
- Withdrawal
Financial abuse
The illegal, improper use and/or
mismanagement of a person's money,
property or resources.
Abusive financial behavior
Fraud, Stealing, Forgery,
Embezzlement, Reluctance to pay for
accounts or debts, Forced changes to
a Will, etc.
Signs of Financial abuse
Loss of jewelry or personal
belongings, Expression of fear and
anxiety when discussing finances,
Unexplained amounts of money
missing from bank accounts, Unpaid
accounts, Loss of trust, Confusion
over ownership of assets, property
etc.
Psychological/ Emotional Abuse
Psychological abuse is language or actions
designed to intimidate another person and is
usually characterized by a pattern of behavior
repeated over time, intended to maintain a
'hold of fear' over the older person.
Abusive psychological/emotional behavior
Humiliation, Blaming, Name calling, Insults,
Silence, Shouting, Coercing, Intimidation,
Withdrawal of affection, etc.
Signs of psychological abuse
Fearfulness, Hopelessness, Withdrawal, Low
self esteem, Confusion, Sleep deprivation,
Anger, Depression, Anxiety, etc.
Social abuse
Restricting or stopping social
contact with others and stopping
or restricting activities.
Abusive social behavior
Includes being discouraged or
stopped from seeing other people.
Signs of social abuse
Loss of interaction with others,
Sadness and grief of people not
visiting, Worried or anxious after a
particular visit, Appears shamed,
Low self esteem, Withdrawn, etc.
Neglect
Neglect is the failure of a care giver in a relationship of
trust to provide necessities or blocking the provision of
basic needs being provided. Neglect can be deliberate or
unintended.
Abusive neglectful behavior
- Not providing adequate clothing, and personal items
- Unwillingness to allow adequate medical, dental care
or personal care
- Inappropriate use of medication
- Refusal to permit other people to provide adequate care
Signs of neglectful behavior
- Poor hygiene or personal care
- Absence of health aids (dentures, hearing aids,
glasses)
- Unkempt appearance, inappropriate, or lack of, clothing
- Weight loss
- Lack of personal items (photos, ornaments)
Rights of Older Persons
International Federation of Ageing
In December 1991, the United Nations adopted a set of United Nations Principles for Older
Persons, recommending that all member governments incorporate them into their programs for
older people.
Independence
Participation
Care
Self – fulfillment
Dignity
As the number and percentage of individuals 65 and over has increased in this country, so has
the incidence of elder abuse. Unfortunately, the prevalence and nature of this growing problem
has generally remained hidden from public view. It is imperative that healthcare professionals
become more aware of the scope and many issues surrounding this sensitive topic.
Reporting an abusive situation
Care staff should report a situation of abuse to their supervisor in any of the previous
circumstances
Initial response to an abusive situation
All staff, once they are aware of an abusive situation, will need to take steps to respond to it.
 Urgent / Emergency
 Non-urgent
 Listen to the older person
 Reaffirm they have rights
 Help is available
Report Elder Abuse
IDOA hotline at 800-252-8966 or 800-279-0400
Cultural Competence
It's not just political correctness. It's good medicine.
Culture influences the way patients respond to medical services and preventive interventions.
What is Cultural Competence?
A set of congruent behaviors, attitudes and policies that come together as a system, agency or
among professionals and enable that system, agency or those professionals to work effectively
in cross-cultural situations.
Culture shapes individuals' experiences, perceptions, decisions and how they relate to others.
It influences the way patients respond to medical services and preventive interventions and
impacts the way physicians deliver those services. In a society as culturally diverse as the
United States, physicians and others in healthcare delivery need to increase their awareness of
and sensitivity toward diverse patient populations and work to understand culturally influenced
health behaviors.
AREAS OF DISSONANCE
1. Historical Distrust
Past injustices may cause minority patients to distrust their providers. Taking time to establish
a rapport and explain why the forms are needed and who sees the forms may alleviate these
fears.
2. Interpretations of Disability
Physicians feel that treatment should include intervention and that biological anomalies should
be corrected. However, some cultures believe that the "disability" is spiritual rather than
physical or that the "disability" itself is a blessing or reward for ancestral tribulations.
Cultural Competence
It's not just political correctness. It's good medicine.
Culture influences the way patients respond to medical services and preventive interventions.
3. Concepts of Family Structure and Family Identity
Patient decision-making may include members of the extended family and the community.
Providers should consider familial influence on treatment decisions.
4. Incompatibility of Explanatory Models
If patients' and providers' ideas differ about the structure and function of the body, for
example, causes of diseases being bacteria, virus or the environment versus the "evil eye,"
"loss of soul" or "curses," it will be difficult to get patients to comply with treatment.
5. Disease Without Illness
Physicians are well indoctrinated about the dangers of "invisible" diseases like hypertension,
high cholesterol and HIV infection, but people in other cultures are not as willing to intervene
when there are no symptoms.
Cultural Competence
It's not just political correctness. It's good medicine.
Culture influences the way patients respond to medical services and preventive interventions.
6. Illness without Disease
Physicians need to be aware of common folk illnesses that may affect members of a cultural
community. "Some may see a medical doctor for relief of symptoms while also going to a folk
doctor or traditional healer to be rid of the cause of the illness." In addition, although a few
practices may be harmful (or misinterpreted as abuse), most folk medical beliefs and practices
are not harmful and do not interfere with biomedical therapy. Providers should not try to change
patients' benign beliefs but should educate them on the importance of biomedicine as
complementary. A combination of the two forms of therapy may increase patient compliance
because this is within the ethno cultural ideals of the patient.
7. Misunderstandings of terminology, language or body language
Monolingual providers who encounter patients who do not speak their language cite this as a
barrier to healthcare. Body language can be misinterpreted between cultures.
How do I become culturally competent?
Listen with sympathy and understanding to the patient's perception of the problem.
Explain your perceptions of the problem and your strategy for treatment.
Acknowledge and discuss the differences and similarities between these perceptions.
Recommend treatment while remembering the patient's cultural parameters.
Negotiate agreement. It is important to understand the patient's explanatory model so that
medical treatment fits in their cultural framework.
Advanced Healthcare Directive
What is an advance directive?
It tells your doctor what kind of care you would like to have if you become unable to make medical
decisions (if you are in a coma, for example). If you are admitted to the hospital, the hospital staff
will probably talk to you about advance directives. A good advance directive describes the kind of
treatment you would want depending on how sick you are.
How can I write an advance directive?
You can write an advance directive in several ways:
 Use a form provided by your doctor.
 Write your wishes down by yourself.
 Call your state senator or state representative to get a form.
 Call a lawyer.
 Use a computer software package for legal documents.
Advance directives and living wills do not have to be complicated legal documents. They can be
short, simple statements about what you want done or not done if you can't speak for yourself.
Remember, anything you write by yourself or with a computer software package should follow
your state laws. You may also want to have what you have written reviewed by your doctor or a
lawyer to make sure your directives are understood exactly as you intended. When you are
satisfied with your directives, the orders should be notarized if possible, and copies should be
given to your family and your doctor.
Advanced Healthcare Directive
Why are advance directives important to medical care?
It allows an individual to participate indirectly in future medical care decisions even if they become
unable to make informed decisions. Instructive directives may extend individual autonomy and
help ensure that future care is consistent with previous desires. The living will was created to help
prevent unwanted and ultimately futile invasive medical care at the
end-of-life.
When should I refer to a patient's advance directive?
It is best to ask a patient early on in his care if he has a living will, or other form of advance
directives. Not only does this information get included in the patient's chart, but by raising the
issue, the patient has an opportunity to clarify his wishes with the care providers and his family.
However, advance directives take effect only in situations where a patient is unable to participate
directly in medical decision making.
Are advance directives legally binding?
Advance directives are recognized in one form or another by legislative action in all 50 states (in
Washington, see RCW 11.94). If the directive is constructed according to the outlines provided by
pertinent state legislation, they can be considered legally binding. In questionable cases, the
medical center's attorney or ethics advisory committee can provide guidance on how to proceed.
The Patient's Bill of Rights
Patient rights were developed with the expectation that hospitals
and healthcare institutions would support these rights in the
interest of delivering effective patient care. According to the
American Hospital Association, a patient's rights can be exercised
on his or her behalf by a designated surrogate or proxy decisionmaker if the patient lacks decision-making capacity, is legally
incompetent, or is a minor.
EACH PATIENT HAS A RIGHT, AT A MINIMUM TO THE FOLLOWING:
1. To be informed of these rights and facility’s rules and regulations;
2. To be informed of services available in the facility, of the names and professional status of
personnel providing and/or responsible for his/her care;
3. To be assured of medical care and to be informed of his/her current medical condition, unless
medically contraindicated;
4. To participate in the planning of his/her care and treatment; to have the right to refuse
medication and treatment; to be informed of available treatment options, including the option
of no treatment, and possible benefits and risks of each option;
The Patient's Bill of Rights
5. To express grievances to the staff and governing authority and
to recommend changes in policies and services;
6. To consent to or decline to participate in proposed research
studies or human experimentation;
7. To be free from; mental and physical abuse, exploitation, and chemical, physical or other
types of restraints unless they are authorized by a physician for a limited period of time to
protect the patient or others from injury. Drugs or other medications shall not be used for
discipline of patients or for the convenience of facility personnel;
8. To be assured confidential treatment of his or her medical/health record, and to approve or
refuse the release of the record to any individual outside the facility, except as required law
or third-party payment contract;
9. To be treated with consideration, respect and full recognition of his/her dignity, individuality,
and right to privacy;
10. To be free from being asked to perform any work for the facility, unless the work is part of
patient treatment and is performed voluntarily by the patient. Such work shall be in
accordance with Local, State, and Federal regulations;
The Patient's Bill of Rights
11. To join with other patients or individuals to work for
improvements in patient care;
12. To be assured of exercising civil and religious liberties,
including the right to impendent personal decisions;
13. To not be the subject of discrimination because of age, race, religion, sex, sexual
preference, nationality, handicap, diagnosis, ability to pay, or source of payment; and
14. To not be deprived of any constitutional, civil and/or legal rights solely because of
receiving service from the facility;
Patients may call NJ Department of Health Hotline at 800-792-9770, or by mail:
NJ State Department of Health, Healthcare Systems Analysis, Inspections Compliance &
Enforcement, P.O. Box 360, Trenton, NJ 08625
This list of Patient Rights is an abbreviated summary of the current NJ Law and Regulations
governing the rights of patients.
U.S. Department of Health and Human Services
Health Insurance Portability and Accountability Act (HIPAA)
HIPAA is a way that you and your family can have a continuity of health insurance even
through job changes and perhaps even unemployment. Just as employees are portable, so
should be health insurance, thanks to HIPAA.
A few decades ago, people stayed in one or two jobs throughout a whole career. In those days
people had no need for HIPAA, because their jobs were stable. But today, in a time when jobs
and even careers are constantly changing, HIPAA can make a big difference in your personal
welfare, or even the welfare of your family.
HIPAA makes it easier for individuals and small businesses to
get and keep health insurance. To reduce the cost of health
insurance, HIPAA also includes an administrative simplification
section to encourage electronic transactions. Due to the
electronic transactions, HIPAA also has a host of new
regulations to assure the security and privacy of electronically
stored medical data. The regulations set standards for electronic
transactions, the privacy of all medical records and all
identifiable health information and the security of electronically
stored information.
U.S. Department of Health and Human Services
HIPAA is not a guarantee that you will have health insurance, or that you will keep
health insurance after a job change. But HIPAA provisions may help you keep
insurance during transitions, and they may help you get other insurance if you
lose the insurance coverage that was provided by a previous employer.
What is the Privacy Rule in HIPAA?
 The Privacy Rule regulates who can see an individual’s Protected Health Information (PHI).
 Under HIPAA, anyone can choose to allow or not allow others to collect and/or use their PHI.
Why is this Privacy Rule of benefit to individuals?
 Insurance companies and some physicians have sold the
health information they had for profit.
 Pharmaceuticals can utilize such health information to
rationalize benefits from medicines.
 A person who may be likely to getting AIDS.
U.S. Department of Health and Human Services
What is Protected Health Information (PHI)?
PHI stands for any identifiable health information that could be used against a
person. For example, one’s heart rate and blood pressure, demographics,
(not height or weight). Individually Identifiable Health Information is information
that could be used against a person, including demographic information
collected from an individual, and:
1. Is created or received by a healthcare provider, health plan, employer, or healthcare
clearinghouse; and
2. Relates to the past, present, or future physical or mental health or condition of an individual;
the provision of healthcare to an individual; or the past, present, or future payment for the
provision of healthcare to an individual; and
a. That identifies the individual; or
b. With respect to which there is a reasonable basis to believe the information can be
used to identify the individual.
Physicians have always been bound to protect
information revealed by patients or discovered
during the course of medical treatment.
Researchers also have an obligation to keep this
informational confidential!
Be Safe!
Tony Soares, Safety Director
Compensation Solutions, Inc.
tsoares@compsolutionsinc.com
Tel: 1-888-201-5680 Ext. 192
Are you READY?

to prepare
BENEFITS – Reducing fear, anxiety and minimizing the impact of disasters.
BEFORE – Know the risks and danger signs, purchase appropriate insurance (keep copy of it & vital
documents elsewhere), develop a plan, assemble a disaster kit (Blankets, First Aid Kit, Battery operated
radio, Fresh batteries, Whistle, sanitation, and 3-Day supply of Food and Water). Develop safety skills (First
Aid, CPR, Fire Extinguisher). Develop an emergency communication plan (Ask an out-of-state relative or
friend to serve as the "family contact" After a disaster). Have a plan for getting back together.

DURING – Plan into action / Follow written procedures, Follow guidance of officials.
EVACUATION: Full tank of gas, $$$, e-Kit in car, Gather family (Who to contact), Notify others of plan. Know
evacuation routes. SHELTER IN PLACE: Lock doors & windows. Shut-off gas? Leave freezer & refrigerator
plugged in?


AFTER – Repair property, Take steps to prevent future loss.
National Next Of Kin Registry…
http://nokr.org/nok/restricted/home.htm
http://www.ready.gov/index.html
http://www.fema.gov/hazards/
http://www.weather.gov/nwr
NOAA Weather Radio (MHz): 162.4 162.5
http://www.fema.gov/areyouready/assemble_disaster_supplies_kit.shtm
Power Failure

Preparation


The facility is equipped with an automatic emergency electrical system (back-up generator). In
the event of a power failure, the system will automatically start and provide electricity to all
necessary support systems.
During a power failure






If the back-up generator does not automatically start, the nurse manager, or designee, shall
start the system manually.
Ensure that critical medical/electrical equipment is on emergency power (RED outlets).
Notify the power company immediately.
Any case not already in progress will be delayed or canceled until NORMAL power is restored.
You must complete any case that is already in progress, as expeditiously as possible, and no
further case started.
Cases will only be re-started when it is certain that NORMAL power has been returned and the
Medical director, or designee, has given the approval to resume operations.
1906 – San Francisco, CA: 500 city blocks, from 500 to 3,000 deaths
Fires

Each Year: 4,000 Americans die and more than 25,000 are injured in fires (most of which could be
prevented). 500,000 residential fires. Direct property loss over $ 9 billion.

Speed: A fire can double in size every 30 seconds. A wastebasket fire can consume a room in less than
five minutes, and an entire house in less than 15 minutes.

Danger: Heat and smoke can be more dangerous than the flames. Asphyxiation is the leading cause of
fire deaths, exceeding burns by a three-to-one ratio.

Smoke Alarms: It decreases your chances of dying in a fire by half. Place them in every level of your
residence, in bedrooms (on the ceiling or on the walls – 4 to 12 inches from ceiling), at the top of stairways
and near the kitchen. Test and clean them once/Mo. Replace batteries once/Yr. Replace them once/10 yrs.

Prevent: Clean out storage areas. Never use flammables indoors. Store flammable liquids in approved
containers. Keep heat sources away from flammables & combustibles. Screened fireplace. Heating units
inspected yearly by a certified specialist. Have electrical wiring inspected by an electrician. Sleep with door
closed. Install fire extinguishers. Ask FD to inspect your house.

Escaping: Review escape routes with family. Practice escaping from each room. Keep halls, stairwells
and doorways CLEAR to facilitate evacuation.
Fires

If You Discover A Fire Or Smoke: Warn others - Fire Alarm.

If You Hear A Fire Alarm: Immediately leave the building using the nearest safe exit.

Leave The Building Immediately: Do not stop for personal belongings




Crawl low in smoke  Use wet cloth to cover your nose and mouth
Don’t use elevators  If you catch fire, DON’T RUN! – Stop, Drop and Roll
Don’t open a hot door (feel it with the back of your hand) - Close doors as you go.
Call Fire Department: (9-1-1) from a safe location and give ALL relevant information.

If fire is small and controllable, you have received fire extinguisher training; You may
(voluntarily) try to stop the fire (if it is not blocking your exit route). Remember “PASS”.

Stop the source of the fire by using a fire extinguisher, water (do NOT use water on grease or
oil), salt, or by covering the container. Once out, assemble in a pre-determined area.
1889 – Johnstown, PA: 2,200 deaths
1887 – China: 900,000 deaths
1931 – China: 3,700,000 deaths
Floods

Before: Buy Flood Insurance (take photos or videos of all of your important possessions. If your home is
damaged in a flood, these documents will help you file a full flood insurance claim. Store important
documents and irreplaceable personal objects (such as photographs) where they won't get damaged. If major
flooding is expected, consider putting them in a storage facility.






Buy and install sump pumps with back-up power.
Have a licensed electrician raise electric components (switches, sockets, circuit breakers and
wiring) at least 12" above your home's projected flood elevation.
For drains, toilets, and other sewer connections, install backflow valves or plugs to prevent
floodwaters from entering.
Anchor fuel tanks. An unanchored tank in your basement can be torn free by flood waters,
and the broken supply line can contaminate your basement. An unanchored tank outside can
be swept downstream, where it can damage other houses.
If your washer and dryer are in the basement, elevate them on masonry or pressure-treated
lumber at least 12" above the projected flood elevation.
Place the furnace and water heater on masonry blocks or concrete at least 12" above the
projected flood elevation.
Floods

During: When a flood warning has been announced.










Fill bathtubs, sinks, and jugs with clean water in case water becomes contaminated.
Listen to a battery-operated radio for the latest storm information.
Turn off all utilities at the main power switch and close the main gas valve.
If told to evacuate your home, do so immediately.
If the waters start to rise inside your house before you have evacuated, retreat to the second
floor, the attic, and if necessary, the roof.
Floodwaters may carry raw sewage, chemical waste and other disease-spreading
substances. If you've come in contact with floodwaters, wash your hands with soap and
disinfected water.
Avoid walking in floodwaters. Six inches of moving water can knock you off your feet.
Don't drive through a flooded area. If you come upon a flooded road, turn around and go
another way. A car can be carried away by just 2 feet of flood water.
Electric current passes easily through water, so stay away from downed power lines and
electrical wires.
Look out for animals -- especially snakes. Animals lose their homes in floods, too.
Floods

After The Flood: Call the agent who handles your flood insurance to file a claim.








Check for structural damage before re-entering your home. Don't go in if there is a chance of
the building collapsing.
Upon re-entering your property, do not use matches, cigarette lighters or other open flames
since gas may be trapped inside. If you smell gas or hear hissing, open a window, leave
quickly, and call the gas company from a neighbor's home.
Keep power off until an electrician has inspected your system for safety.
Check for sewage and water line damage. If you suspect damage, avoid using the toilets and
the tap and call a plumber.
Throw away any food -- including canned goods -- that has come in contact with floodwaters.
Until authorities declare your water supply to be safe, boil water for drinking and food
preparation.
To make filing your claim easier, take photos of any water in the house and save damaged
personal property. An insurance adjuster will need to see what's been damaged in order to
process your claim.
Salvage water-damaged books, heirlooms and photographs with restoration tips from:
http://www.fema.gov/hazards/floods/coping.shtm
1970 – Peru: 18,000 deaths
Landslides and Debris Flow (Mudslide)


It strikes without warning. The force of rocks, soil, or other debris moving down a slope can
devastate anything in its path.
Before…




Get a ground assessment of your property.
Plant ground cover on slopes and build retaining walls.
Build channels or deflection walls to direct the flow around buildings.
Warning Signs…









Doors or windows stick or jam for the first time.
New cracks appear in plaster, tile, brick, or foundations.
Outside walls, walks, or stairs begin pulling away from the building.
Cracks appear on the ground or on paved areas such as streets or driveways.
Underground utility lines break.
Bulging ground appears at the base of a slope.
Water breaks through the ground surface
Fences, retaining walls, utility poles, or trees tilt or move.
You hear a faint rumbling sound that increases in volume as the landslide nears.
Landslides and Debris Flow (Mudslide)

During…



After…






If indoors: Stay inside, take cover under a desk, table, or other piece of sturdy furniture.
If outdoors: Try and get out of the path of the landslide or mudflow. Run to the nearest high
ground in a direction away from the path. If rocks and other debris are approaching, run for
the nearest shelter such as a group of trees or a building. If escape is not possible, curl into a
tight ball and protect your head. Plant ground take on slopes and build retaining walls.
Stay away from the slide area. There may be danger of additional slides.
Check for injured and trapped persons near the slide area. Give first aid if trained.
Listen to a battery-operated radio or television for the latest emergency information.
Flooding may occur after a mudflow or a landslide.
Check the building foundation, chimney, and surrounding land for damage.
Sinkholes…

A sinkhole occurs when groundwater dissolves a vulnerable land surface such as limestone,
causing the land surface to collapse from a lack of support.
1993 – E. Coast USA: 500 deaths
Winter Storms
They are accompanied by strong winds creating blizzard conditions with blinding wind-driven snow,
severe drifting, and dangerous wind chill. Strong winds can knock down trees, utility poles, and power lines.
Storms near the coast can cause coastal flooding and beach erosion as well as sink ships at sea.


Before…










Be familiar with winter storm warning messages.
Service snow removal equipment and have rock salt on hand to melt ice on walkways and
kitty litter to generate temporary traction.
Make sure you have sufficient heating fuel; regular fuel sources may be cut off.
Winterize your home: Insulate walls and attic. Caulk and weather-strip doors and windows.
Install storm windows or cover windows with plastic from the inside.
Have safe emergency heating equipment available. Fireplace with ample supply of wood.
Small, well-vented, wood, coal, or camp stove with fuel. Portable space heaters.
Install and check smoke detectors.
Keep pipes from freezing.
Have disaster supplies on hand, in case the power goes out.
Winter Storms

During…
If indoors: Stay indoors and dress warmly. Conserve fuel (lower the thermostat and close off
unused rooms). Food provides the body with energy for producing its own heat.

If outdoors: Dress warmly (wear loose-fitting, layered, light-weight clothing). Outer garments should
be tightly woven and water repellant. Mittens are warmer than gloves because fingers generate
warmth when they touch each other.








Stretch before you go out. If you go out to shovel snow, do a few stretching exercises
to warm up your body. Also take frequent breaks.
Cover your mouth. Protect your lungs from extremely cold air by covering your mouth
when outdoors. Try not to speak unless absolutely necessary.
Avoid overexertion. Cold weather puts an added strain on the heart. Be aware of
symptoms of dehydration.
Watch for signs of frostbite and hypothermia.
Keep dry. Change wet clothing frequently to prevent a loss of body heat.
Help your neighbors who may require special assistance.
If no shelter: Prepare a wind-break, or snow cave for protection from the wind. Build a
fire for heat and to attract attention. Place rocks around the fire to absorb and reflect
heat. Do not eat snow: It will lower your body temperature. Melt it first.
Winter Storms

During…
In a car: Stay in your car. Disorientation occurs quickly in wind-driven snow and cold. Run the motor
about ten minutes each hour for heat. Open the window a little for fresh air to avoid carbon monoxide
poisoning. Make sure the exhaust pipe is not blocked. Make yourself visible to rescuers (turn on the
dome light at night when running engine, tie a colored cloth (preferably red) to your antenna or door,
raise the hood indicating trouble after snow stops falling). Exercise from time to time by vigorously
moving arms, legs, fingers, and toes to keep blood circulating and to keep warm.

Frostbite: It can permanently damage its victims. A loss of feeling and a white or pale appearance in
fingers, toes, or nose and ear lobes are symptoms of frostbite.

Hypothermia: When the body temperature drops to less than 95 °F. Symptoms: uncontrollable shivering,
slow speech, memory lapses, frequent stumbling, drowsiness, and exhaustion.

Help: begin warming the person slowly and seek immediate medical assistance. Warm the person's trunk
first. Use your own body heat to help. Arms and legs should be warmed last because stimulation of the limbs
can drive cold blood toward the heart and lead to heart failure. Put person in dry clothing and wrap their
entire body in a blanket. Never give a frostbite or hypothermia victim something with caffeine in it (like coffee
or tea) or alcohol.

Lightning: Avg. 67 deaths per year in USA
Thunderstorms & Lightning

Precautions…








Get inside a home, building or car (not convertible).
Rubber-sole shoes and rubber tires provide NO protection from lightning. You are protected
if you are not touching metal.
Secure outdoor objects. Shutter windows and unplug appliances.
Avoid showering – Plumbing fixtures can conduct electricity.
Use a corded telephone only for emergencies – Cellular phones are safe.
30/30 RULE: Go indoors (if you hear no thunder within 30 secs from lightning). Stay indoor
for 30 min (after the thunderstorm appears to have passed).
Lightning often strikes as far as 10 miles away from any rainfall. It can travel sideways and
strike under blue skies.
If you are…




In a forest – Seek shelter in a low area under a thick growth of small trees.
In an open area – Go to a low place (ravine or valley). Be alert for flash floods.
On open water – Get to land and find shelter immediately.
Anywhere you feel your hair stand on end – Squat low to the ground on the balls of your feet.
Place your hands over your ears and your head between your knees. DO NOT lie flat on the
ground.
1906 – San Francisco, CA: 500 deaths
1556 – China: 830,000 deaths
Earthquakes
An earthquake is a sudden movement of the earth, caused by the abrupt release of strain that has
accumulated over a long time. For hundreds of millions of years, the forces of plate tectonics have shaped
the earth, as the huge plates that form the earth’s surface slowly move over, under, and past each other.
Sometimes, the movement is gradual. At other times, the plates are locked together, unable to release the
accumulating energy. When the accumulated energy grows strong enough, the plates break free.


Before: Repair defective electrical wiring, leaky gas lines, and inflexible utility connections. Get
appropriate professional help. Do not work with gas or electrical lines yourself.








Bolt down and secure to the wall studs your water heater, refrigerator, furnace, and gas
appliances. Install an automatic gas shut-off valve that is triggered by strong vibrations.
Place large or heavy objects on lower shelves. Fasten shelves, mirrors, and large picture
frames to walls. Brace high and top-heavy objects.
Store glass, china, and other breakables on low shelves or in cabinets that fasten shut.
Anchor overhead lighting fixtures.
Be sure the residence is firmly anchored to its foundation.
Install flexible pipe fittings to avoid gas or water leaks.
Locate safe spots in each room, under a sturdy table or against an inside wall.
Hold earthquake drills with your family members: Drop, cover, and hold on!
Earthquakes

During: Minimize your movements during an earthquake to a few steps to a nearby safe place. Stay
indoors until the shaking has stopped and you are sure exiting is safe.

Indoors: Take cover under a sturdy desk, table, or bench or against an inside wall, and hold on. If
there isn’t a table or desk near you, cover your face and head with your arms and crouch in an inside
corner of the building.






Stay away from glass, windows, outside doors and walls, and anything that could fall, such
as lighting fixtures or furniture.
Stay in bed - if you are there when the earthquake strikes - hold on and protect your head
with a pillow, unless you are under a heavy light fixture that could fall. In that case, move to
the nearest safe place.
Use a doorway for shelter only if it is in close proximity to you and if you know it is a
strongly supported, load-bearing doorway.
Stay inside until shaking stops and it is safe to go outside. Most injuries during occur when
people are hit by falling objects when entering into or exiting from buildings.
Be aware that the electricity may go out or the sprinkler systems or fire alarms may turn on.
DO NOT use the elevators.
Earthquakes

Outdoors: Stay there. Move away from buildings, streetlights, and utility wires.

In a moving vehicle: Stop as quickly as safety permits and stay in the vehicle. Avoid stopping near or
under buildings, trees, overpasses, and utility wires. Proceed cautiously once the earthquake has stopped,
watching for road and bridge damage.

Trapped under debris: Do not light a match.· Do not move about or kick up dust. Cover your mouth
with a handkerchief or clothing. Tap on a pipe or wall so rescuers can locate you. Use a whistle if one is
available. Shout only as a last resort - shouting can cause you to inhale dangerous amounts of dust.

After: Be prepared for aftershocks. These secondary shockwaves are usually less violent, but
can be strong enough to do additional damage to weakened structures.
 Open cabinets cautiously. Beware of objects that can fall off shelves.
 Stay away from damaged areas unless your assistance has been specifically requested.
 Be aware of possible tsunamis if you live in coastal areas. These are also known as seismic
sea waves (mistakenly called “tidal waves”). When local authorities issue a tsunami warning,
assume that a series of dangerous waves is on the way. Stay away from the beach.
1900 – Gavelston, TX: Hurricane results in 6,000 to 12,000 deaths
Tornados / Hurricanes

Signs: Dark (often greenish sky), large hail, dark low-lying cloud (particularly if rotating), loud
roar (similar to a freight train).

If A Tornado / Hurricane Warning Is Issued…

SECURE FILES, and lock up confidential documents.

TURN OFF ELECTRICAL EQUIPMENT – And all other utilities (propane).

SECURE HAZARDOUS MATERIALS

PROTECT EQUIPMENT, in order to minimize damage.

SECURE MATERIALS, which must be left outside.


PROTECT WINDOWS – Permanent storm shutters or board up windows with 5/8” marine
plywood (cut to fit and ready to install).
SECURE ROOFS – Install straps or additional clips to securely fasten the roof to the main structure.
Number of Category 4 and 5 Hurricanes Has Doubled Over the Past 35 Years to 10 per year
Hurricanes

Atlantic Hurricane Season: June to November, peaking from August to October.

Beware: Widespread torrential rains (deadly floods), landslides, storm surges (a dome of water pushed
onshore that can reach 25 feet high and be 50-100 miles wide, and storm tides (that can reach 20 feet high).

CAT 1: 74-95 mph winds, storm surge from 4 to 5 feet, minimal damage.

CAT 2: 96-110 mph winds, storm surge from 6 to 8 feet, moderate damage.

CAT 3: 111-130 mph winds, storm surge from 9 to 12 feet, extensive damage.

CAT 4: 131-155 mph winds, storm surge from 13 to 18 feet, extreme damage.

CAT 5: More than 155 mph winds, storm surge greater than 18 feet, catastrophic damage.
1925 – IN, IL, MO: Tornado results in 695 deaths,
Tornados

Spawned From Powerful Thunderstorms: Rotating, funnel-shaped cloud that extends from a
thunderstorm to the ground with whirling winds that can reach 300 mph causing fatalities and devastating
neighborhoods in seconds.

Facts…






They generally occur near the trailing edge of the thunderstorm
They may strike quickly, with little or no warning
The average forward speed is 30 mph, varying from stationary to 70 mph.
Waterspouts are tornadoes that form over water
Peak tornado season is March through May
They are more likely to occur between 3 p.m. and 9 p.m.
Tornados: Avg. 800 deaths per year in USA (1,500 injuries)
Tornados / Hurricanes

During The Tornado / Hurricane…

If You Are Inside: Stay indoors, away from windows and glass doors. Go to lowest floor (winds
are stronger at higher elevations. Get under a heavy desk, table or proceed to the corner of the room
and lie flat and put your arms over your head. If possible cover your body with a blanket or rug.

If You Are On The Road: Take shelter in a nearby steel-framed or concrete building, if
possible. If no building is available, park your car and seek shelter away from the car in a nearby
ditch or ravine. Protect your body and head with anything available (from flying debris). Don't go into
a grove of trees or under a vehicle.
Tornados / Hurricanes

After The Tornado / Hurricane…

DON'T RE-ENTER THE BUILDING, until instructed.

STAY AWAY FROM DOWNED ELECTRICAL WIRES AND UTILITY SERVICES.

LISTEN TO THE RADIO FOR WEATHER UPDATES.

DON'T USE THE TELEPHONE, unless necessary to report an injury or fire.
WHEN RE-ENTERING BUILDING, be alert to gas and water leaks, broken electrical wiring and
ruptured sewer lines. Do not use a match or candle to check for leaking gas pipes - check for leaks
on a gas line.

1815 – Indonesia: 92,000 deaths,
Volcano

Eruptions: Quite or explosive. There may be lava flows, flattened landscapes, poisonous, and flying
rock and ash. It can be followed by earthquakes, mudflows, flash floods, rock falls and landslides, acid
rain, fire and (under special conditions) tsunamis.

EVACUATE – Avoid flying debris, hot gases, lateral blast, and lava flow.

BE AWARE OF MUDFLOWS – It can move faster than you can run.

AVOID – River valleys and low-lying areas.

ASH: Pulverized rock that can be abrasive, acidic, etc. If wet, it’s weight can collapse roofs.
 Wear long sleeve shirts and long pants.
 Use goggles and wear eyeglasses instead of contact lenses.
 Use a dust mask or dump cloth to help with breathing.
 Stay away from downwind from the volcano.
 Stay indoors until the ash has settled (unless danger of roof collapsing).
 Seal room/house to prevent ash from getting inside.
 Avoid running car or truck engines (ash can damage moving parts and stall vehicles)
2004 – South East Asia: 300,000 deaths,
Tsunamis

Cause: the most prevalent is earthquakes. In addition, landslides, volcanic eruptions, explosions, and
even the impact of cosmic bodies, such as meteorites, can generate tsunamis.

Strengths: It can move at speeds of hundreds of mph in open ocean and smash into land with waves
as high as 100 feet or more.

Beware: If noticeable recession in water away from the shoreline, move inland or higher ground
immediately.

After A Tsunami: Stay away from flooded and damaged areas until officially safe, beware of debris
in the water.
Terrorism
Acts of terrorism include: assassinations; kidnappings; hijackings; bomb scares and bombings; cyber
attacks (computer-based); and the use of chemical, biological, nuclear and radiological weapons.

High-risk targets: military and civilian government facilities, international airports, large cities, and
high-profile landmarks. Terrorists might also target large public gatherings, water and food supplies,
utilities, and corporate centers. Further, terrorists are capable of spreading fear by sending
explosives or chemical and biological agents through the mail.


Guidelines:





Be aware of your surroundings.
Move or leave if you feel uncomfortable or if something does not seem right.
Take precautions when traveling. Be aware of conspicuous or unusual behavior. Do not
accept packages from strangers. Don’t leave luggage unattended. Promptly report unusual
behavior, suspicious or unattended packages/devices to the police or security personnel.
Learn where emergency exits are located in buildings you frequent. Plan how to get out in
the event of an emergency.
Be prepared to do without services you normally depend on: electricity, telephone, natural
gas, gasoline pumps, cash registers, ATMs, and Internet transactions.
Explosions
Terrorists have the information readily available to them in books and other information sources on how to
make explosive devices. The materials needed can be found in many places , such as hardware, and auto
supply stores. Explosive devices are highly portable using vehicles and humans as a means of transport.
They are easily detonated from remote locations or by suicide bombers.


Parcels that should make you suspicious…













Are unexpected or from someone unfamiliar to you.
Have no return address, or have on that can’t be verified as legitimate.
Are marked with endorsements such as “Personal,” “Confidential,” or “Do not X-ray.”
Have protruding wires or aluminum foil, strange odors, or stains.
Show a city or state in the postmark that doesn’t match the return address.
Are of unusual weight given their size, or are lopsided or oddly shaped.
Are marked with threatening language.
Have inappropriate or unusual labeling.
Have excessive postage or packaging material, such as masking tape and string.
Have misspellings of common words.
Are addressed to someone no longer with your organization or are otherwise outdated.
Have incorrect titles or titles without a name.
Are not addressed to a specific person.
Explosions

During: Get under a sturdy table or desk if things are falling around you. When they stop falling, leave
quickly, watching for obviously weakened floors and stairways. As you exit from the building, be especially
watchful of falling debris.
 Leave the building as quickly as possible. Do not stop to retrieve personal possessions or
make phone calls.
 Do not use elevators.

IF YOU ARE TRAPPED IN DEBRIS… use a flashlight to signal your location
 Avoid unnecessary movement, so that you don’t kick up dust.
 Cover your nose and mouth with cotton material on hand.
 Tap on a pipe or wall so that rescuers can hear where you are

SHOUT ONLY AS A LAST RESORT
 Shouting can cause you to inhale dangerous amounts of dust.

ONCE YOU ARE OUT:
 Do not stand in front of windows, glass doors, or other potentially hazardous areas.
 Move away from sidewalks or streets to be used by emergency officials or others still exiting
the building.
Chemical Threat
Chemical agents are poisonous vapors, aerosols, liquids, and solids that have toxic effects on people,
animals, or plants (Sarin, Mustard Gas, Cyanide Gas, Phosgene, etc.). They can be released by bombs or
sprayed from aircraft, boats, and vehicles. They can have an immediate effect (a few seconds to a few
minutes) or a delayed effect (2 to 48 hours). A chemical attack could come without warning. Signs of a
chemical release include people having difficulty breathing; experiencing eye irritation; losing coordination;
becoming nauseated; or having a burning sensation in the nose, throat, and lungs. Also, the presence of
many dead insects or birds may indicate a chemical agent release.


Watch For Signs: People having difficulty breathing; experiencing eye irritation; losing
coordination; becoming nauseated; or having a burning sensation in the nose, throat, and lungs.
Also, the presence of many dead insects or birds may indicate a chemical agent release.

ESCAPE THE AREA (where is the chemical coming from?), Leave the building or shelter-in-place?

IF SHELTER-IN-PLACE, Internal room (preferably with no windows and on the highest floor). Seal
room with duct tape and plastic sheeting (pre-cut it). Listen to radio for instructions from
authorities.
Chemical Threat

Decontamination Guidelines…







Use extreme caution when helping others who have been exposed to chemical agents.
Remove all clothing and other items in contact with the body. Contaminated clothing normally
removed over the head should be cut off to avoid contact with the eyes, nose, and mouth. Put
contaminated clothing and items into a plastic bag and seal it. Decontaminate hands using
soap and water. Remove eyeglasses or contact lenses. Put glasses in a pan of household
bleach to decontaminate them, and then rinse and dry.
Flush eyes with water.
Gently wash face and hair with soap and water before thoroughly rinsing with water.
Decontaminate other body areas likely to have been contaminated. Blot (do not swab or
scrape) with a cloth soaked in soapy water and rinse with clear water.
Change into uncontaminated clothes. Clothing stored in drawers or closets is likely to be
uncontaminated.
MEDICAL ATTENTION: Proceed to a medical facility for screening and professional treatment.
1918 – H5N1 killed 50 million people. (world population: 1.8 billion) -
http://www.survivetheflu.com/
1347 – Bubonic Plague killed 25 million people just in Europe . (world population: 440 million)
Biological Threat
Biological agents are organisms or toxins that can kill or incapacitate people, livestock, and crops. The
three basic groups of biological agents that would likely be used as weapons are bacteria, viruses, and
toxins (Anthrax, Botulism, Plague, Smallpox, Ebola, Ricin, etc.). Delivery methods include: Aerosols
(dispersed into the air), Insects and Animals, Food and Water, and by Person-to-person contamination.


Before: Ensure all required or suggested immunizations are up to date. Children and older
adults are particularly vulnerable to biological agents.
 A High Efficiency Particulate Air (HEPA) filter removes particles in the 0.3 to 10 micron
range and will filter out most biological agents that may enter your house.

During: If you become aware of an unusual and suspicious substance nearby:






Move away quickly.
Wash with soap and water.
Contact authorities.
Listen to the media for official instructions.
Seek medical attention if you become sick.
If you are exposed to a biological agent::



Remove/bag your clothes and personal items (contaminated).
Wash yourself with soap and water and put on clean clothes.
Seek medical assistance. You may be quarantined.
2006
"The H5N1 virus could kill Up to one
billion people around the whole
world in six months....
We are half a step away from
a worldwide pandemic catastrophe."
Dmitry K. Lvov, Director, D.I.
Ivanovsky Institute of Virology,
Russian Academy of Medical Sciences
Radiological Accident
It can occur wherever radioactive materials are used, stored or transported. In addition to nuclear power
plants, hospitals, universities, research laboratories, industries, major highways, railroads or shipping
yards.

Radioactive materials are composed of atoms that are unstable. An unstable atom gives off its excess
energy until it becomes stable. The energy emitted is radiation.

People receive some radiation exposure each day from the sun, radioactive elements in the soil and
rocks, household appliances like television sets and microwave ovens, and medical and dental x-rays.
Radiation cannot be detected by sight, smell, or any other sense. There are three factors that minimize
radiation exposure to your body:


Shielding: The thicker and harder material between yourself and the radioactive material,
the less exposed you are (thick walls, concrete, bricks, books and earth). Fall-out shelter or
Basement will protect you from the immediate effects of the blast and the pressure wave.

Distance: The further away you are from the radiation source, the lower your exposure.

Time: Minimizing the time spent exposed will also reduce your risk.
Radiological Accident

Before: Be prepared to evacuate or shelter in your home. Develop an emergency communication plan.
have a plan for getting back together. Ask an out-of-state relative or friend to serve as the "family contact."
After a disaster.

During: Go to a basement or other underground area, if possible. Seal room with duct tape and plastic
sheeting (pre-cut it). Listen to radio for instructions from authorities. DECONTAMINATE YOURSELF, by
washing with soap and water and getting rid of all contaminated clothing (Put items worn outdoors in a
plastic bag and seal it).

After: When the immediate danger has passed, avoid using foods from your garden or milk from your
cows or goats until these can be inspected by a local emergency official. Contamination could affect areas
as far as 50 miles from accident site. Stay inside until authorities say it is safe.

Note: A nuclear power plant accident would not cause the same widespread destruction as a nuclear
weapon. Although radioactive materials could be released in a cloud or plume, no fallout is produced to
endanger people.
Radiological Dispersion Device
Terrorist use of an RDD - often called “dirty nuke” or “dirty bomb” - is considered far more likely than use
of a nuclear explosive device. An RDD combines a conventional explosive device with radioactive material.
It is designed to scatter dangerous and sub-lethal amounts of radioactive material over a general area.
They require limited technical knowledge to build and deploy compared to a nuclear device. Radioactive
materials in RDDs are widely used in medicine, agriculture, industry, and research, easier to obtain than
weapons grade uranium or plutonium.


Purpose: To cause psychological fear and economic disruption. the number of deaths and injuries
from an RDD might not be substantially greater than from a conventional bomb explosion.

Affected Area: The size of the affected area and the level of destruction caused by an RDD would
depend on the sophistication and size of the conventional bomb, the type of radioactive material used, the
quality and quantity of the radioactive material, and the local meteorological conditions - primarily wind and
precipitation. The area affected could be placed off-limits to the public for several months during cleanup
efforts.
Nuclear Blast
A nuclear blast is an explosion with intense light and heat, a damaging pressure wave, and widespread
radioactive material that can contaminate the air, water, and ground surfaces for miles around. A nuclear
device can range from a weapon carried by an intercontinental missile launched by a hostile nation or
terrorist organization, to a small portable nuclear devise transported by an individual. All nuclear devices
cause deadly effects when exploded, including blinding light, intense heat (thermal radiation), initial nuclear
radiation, blast, fires started by the heat pulse, and secondary fires caused by the destruction.


Hazards:




Size of the device: A more powerful bomb will produce more distant effects.
Height above the ground the device was detonated: Extent of blast effects.
Nature of the surface beneath the explosion: Some materials are more likely to become
radioactive and airborne than others. Flat areas are more susceptible to blast effects.
Existing meteorological conditions: Wind speed and direction will affect arrival time of
fallout; precipitation may wash fallout from the atmosphere.
Nuclear Blast

Radioactive Fallout: Any nuclear blast results in some fallout. Blasts that occur near the earth’s
surface create much greater amounts of fallout than blasts that occur at higher altitudes. This is because the
tremendous heat produced from a nuclear blast causes an up-draft of air that forms the familiar mushroom
cloud. As the heat diminishes, radioactive materials that have vaporized condense on the particles and fall
back to Earth. The phenomenon is called radioactive fallout. Radioactive fallout poses the greatest threat to
people during the first two weeks, by which time it has declined to about 1 percent of its initial radiation level.

Electro Magnetic Pulse (EMP): A nuclear weapon detonated in or above the earth’s atmosphere can
create an electro magnetic pulse (EMP), a high-density electrical field. An EMP can seriously damage
electronic devices connected to power sources or antennas. This includes communication systems,
computers, electrical appliances, and automobile or aircraft ignition systems. The damage could range from a
minor interruption to actual burnout of components. Most electronic equipment within 1,000 miles of a highaltitude nuclear detonation could be affected. Battery-powered radios with short antennas generally would not
be affected. Although an EMP is unlikely to harm most people, it could harm those with pacemakers or other
implanted electronic devices.
Nuclear Blast

Before: Make a list of potential shelters near your home, workplace, and school.


During: Take cover, below ground if possible, and stay there until instructed to do otherwise.





During periods of increased threat increase your disaster supplies to be adequate for up to two
weeks.
Do not look at the flash or fireball - it can blind you.
Take cover behind anything that might offer protection.
Lie flat on the ground and cover your head. If the explosion is some distance away, it could take
30 seconds or more for the blast wave to hit.
Take shelter as soon as you can, even if you are many miles from ground zero where the attack
occurred - radioactive fallout can be carried by the winds for hundreds of miles.
After: Decay rates of the radioactive fallout are the same for any size nuclear device. However, the
amount of fallout will vary based on the size of the device and its proximity to the ground. It might be
necessary for those in the areas with highest radiation levels to shelter for up to a month.
 People in most of the areas that would be affected could be allowed to come out of shelter
within a few days and, if necessary, evacuate to unaffected areas.
Recovering from Disaster

Health: Exhaustion, Drink plenty of water, eat well, wash hands often.

Safety: Watch for gas leak, broken glass, electrical hazards and slippery floors.

Emotional Stress: IF: difficulty sleeping, communicating, concentrating; frustration, depression,
guilty, fear, headaches, tunnel vision, muffled hearing, etc. DO: seek help from professional counselors
and religious institutions, talk to others about your feeling, maintain a normal routine, spend time with
family and friend, promote your own physical health.

Help Others: Volunteer! Helping others deal with their problems will improve you emotionally,
psychologically and physically.

Get Ready! Accepting the fact that disasters do happen. Opportunity to identify and collect
resources needed during and after a disaster. When people feel prepared, they cope better and so do
children.
Workplace Violence







1.7 million cases reported annually.
Homicide is now second only to motor vehicles as a cause of work-related deaths.
Over 5,000+ homicides at work over the past five years. (See high risk jobs)
Corporate America spends about U$ 6.5 billion per year in the aftermath of workplace violence.
Homicides and suicides continue to be one of the leading causes of occupational fatalities.
UNDER REACTION TO VIOLENCE – “Violence is random and unpredictable”
Warning Signs: Substance abuse, Severe Stress, Violent history, Decreased productivity, Social
isolation and poor peer relationships, Poor personal hygiene, Drastic changes in personality.
STAGE 1: Objectifying and dehumanizing others, Challenging authority, Regularly becoming
augmentative, Alienating customers or clients, Originating and spreading lies about others, Swearing
excessively (using sexually explicit language), Abusing others verbally, sexually harassing others.
 STAGE 2: Arguing frequently and intensely, Blatantly disregarding organizational policies and
procedures, Setting traps for others, Stealing from the company or from co-workers, Making verbal
threats, Conveying unwanted sexual or violent intensions (by letter, voice mail or e-mail), Blaming
others for problems or difficulties.
 STAGE 3: Getting involved in physical confrontations, Displaying weapons (guns, knives, pepper
spray, etc.), Attempting to or committing assault, sexual assault, homicide, arson or suicide.

Workplace Violence

Employers:











Boost security with guards, locks, cameras, silent alarms, etc.
Restrict entry with coded cards, name tags, and sign-in procedures
Improve lighting, especially in hallways and parking areas
Screen potential employees for violent criminal histories
Ban weapons, harassment, assaults, and threats on the premises
Prevent former employees from returning to the workplace
Set up an employee hotline to report threats or bizarre behaviors
Respond quick and firmly to workplace fights and threats
Train employees to resolve conflicts peacefully
Offer counseling to employees in distress
Employees:



Follow your company’s security procedures
Take extra care in stairways or elevators (if attacked on an elevator, punch all floor buttons
and yell for help when the door opens)
Avoid working late (have someone walk with you to your car, park in well-lit areas, check
your car before unlocking it)
Violent Acts – Dangerous Intruder


Employees:
PERSONAL THREATS, HARASSING PHONE CALLS, FIGHTING, ROBBERY, MURDER…
YOUR GOAL = Prevent anyone from being injured or killed. Calmness is contagious.

COOPERATE: Assailant will not harm anyone as long as he/she perceives that his/her objectives are
being met. Remain calm and courteous (show respect for the person).

SHOOTING: Do NOT run! He/she believes you will call the police and jeopardize his/her objectives.

BE A GOOD WITNESS: Remember, write notes immediately. Who does he/she look like?
Traits:
General built, Skin color, Eye color, Hair color/style, Mustache color/style, Glasses color/style,
Clothes, Smell, Shoes, Speech type.
Vehicle:
Make, color, 2/4door, hatchback, truck, wheels, plate number.

CALL 9-1-1 and provide name of company, site's address and telephone number.
Civil Unrests

Employees:

ALL EMPLOYEES MUST USE ONE ENTRANCE: Designated by the Facility Coordinator.

EACH EMPLOYEE MUST DISPLAY A VALID PHOTO ID: To gain access to the facility.

ALL VISITORS MUST BE CLEARED: 24 hours prior to their arrival. The employee who the visitor is
seeing will be responsible for obtaining the appropriate clearances.

ANY INDIVIDUAL WHO RECEIVES A THREAT: Or harassing behavior from demonstrators must
immediately report it to the Facility Coordinator, through their supervisor.

EMPLOYEES SHOULD NOT ENGAGE IN DISPUTES WITH DEMONSTRATORS: The Facility
Coordinator shall arrange protected parking lots, which will allow personnel to park and enter the
building without walking through demonstrators.

ALL EXTERIOR DOORS MUST BE KEPT CLOSED: Exiting should be through the designated
entrance point of the facility.
Riots

Employees:

CALL 9-1-1

NOTIFY YOUR SUPERVISOR.

IF RIOTING IS OUTSIDE THE FACILITY: lock entrances and stay indoors until Facility Coordinator
or Police gives an all clear.

IF LOOTING AND RIOTING IS OCCURRING WITHIN THE BUILDING: the supervisors or Facility
Coordinator shall evacuate personnel to an outside secure area, away from the building.
Bomb Threats

Employees:

DOCUMENT ALL THE INFORMATION THE CALLER GAVE: As precisely as possible.

NOTIFY THE FACILITY COORDINATOR: Manager or Supervisor.

EVACUATE: Once informed to do so.

NOTIFY SUPERVISORS OF UNUSUAL PACKAGES: Objects that do not belong in the work area.

NOTIFY SUPERVISORS OF ANY INDIVIDUALS: Vehicles in the area of the building, which
appear to be suspicious in nature.

IF AN EXPLOSION OCCURS: Follow the fire emergency procedure.
Communication With The Media

Employer:

DESIGNATE A MEDIA EMERGENCY SPOKESPERSON. No one should speak with the media other
than the designated individual.

INITIALLY, THE MEDIA REPRESENTATIVE MUST DECLINE PROVIDING SPECIFIC COMMENTS
TO THE PRESS UNTIL THE SITUATION HAS BEEN VERIFIED WITH ACCURATE INFORMATION.
It is preferable to decline comments to the press until the situation is controlled. If no comments are
provided, the media will still provide a news story. Providing information is a delicate issue and providing
some type of information is less damaging than providing NO information.

THE DESIGNATED EMERGENCY SPOKESPERSON SHOULD BE TRAINED TO:

Release only information that is verified.

To respond honestly and briefly to media questions.

To provide information as quickly possible to meet press deadlines.
Healthcare and Risk Management

What is Risk management? It is a detailed process used to identify and assess risk, identify and
accept mitigation for risk. It incorporates understanding the potential for risk, as well as the consequence.
The goal of risk management is not to eliminate risk, but balance it responsibly.

Significant Legal Liabilities! Failure to anticipate potential issues, such as equipment malfunction,
medical malpractice, injury to personnel or patient, inadvertent release or loss of patients’ healthcare
information, theft of tools/equipment/supplies, theft of cash or drugs, theft or unauthorized access to patient
records, etc.
The Benefits of Risk Management

Reduction in Material and Property Damage.

Effective Mission Accomplishment.

Reduction in Serious Injuries and Fatalities.
Healthcare and Risk Management
Hazard - A condition with the potential or causing injury, damage, or mission degradation.
Risk - An expression of possible loss in terms of severity and probability.
Risk Assessment - Using sound concepts to detect hazards and estimate the risk they pose.
Operational Risk Management: The process of dealing with risk associated with healthcare
operations, which includes:
 Risk assessment
 Risk decision-making
 Implementation of risk controls
Risk Management Process
1.
2.
3.
4.
5.
Identify Hazards
Assess Hazards
Make Risk Decisions
Implement Controls
Supervise
Healthcare and Risk Management
1.
2.
Identify Hazards
3.
Make Risk Decisions
a.
List Hazards
a.
Consider Risk Control Options
b.
List Possible Causes of

Start with Most Serious Risk First
Hazards Risk decision-making

Refer to preliminary Hazard
Analysis Causes
Assess Hazards
b.
Does Benefit Outweigh Risk
a.
c.
Communicate with Higher Authority if
Required
b.
Prioritize Identified Hazards

Severity of Possible Loss

Probability of Possible Loss
4.
Use available Tools

Risk Assessment Matrix
5.
Implement Controls
a.
Administrative Controls
b.
Engineering Controls
c.
Personal Protective Equipment
Supervise
a.
Monitor for Effectiveness of Controls
Engineering Controls
b.
Watch for Changes
Healthcare and Risk Management
Operational Risk Management: Levels of Application:



Hasty- On the Run Consideration
Deliberate- Application of the Complete 5-Step Process
In-Depth- Complete 5-Step Process with detailed analysis
Risk Management Rules
1.
2.
3.
4.
Integrate into planning
Accept NO unnecessary risks
Make Risk Decisions at the proper level
Accept Risk IF benefits outweigh the cost
Summary


Risk Management is a systematic way of thinking
The Risk Management Process increases awareness of hazards and risks
involved in an operation
Be Safe!
Tony Soares, Safety Director
Compensation Solutions, Inc.
tsoares@compsolutionsinc.com
Tel: 1-888-201-5680 Ext. 192
Fire Facts
US has one of the highest fire death rates in the world.
2004
 U.S.fire departments responded to an estimated 1,550,500
fires. Resulting in:
 3,900 civilian fire fatalities
 17,785 civilian fire injuries
 $9,794,000,000 in direct property loss
 There was a civilian fire death every 135 min and a civilian fire injury
every 30 min
 Home fires caused 3,190, or 82%, of the civilian fire deaths
 Fires accounted for seven percent of the 22,616,500 total calls.
Fire is the third leading cause of accidental death in the home
Evacuation - Recognize a Fire Condition
Do you see or smell smoke?
Does equipment or electrical cords feel hot to the touch?
Do you see flames?
Fire Fighting Dangers
1/4

Flame

Heat

Smoke

Toxic vapors

Suffocation

Explosions
Evacuation - Activate the Fire Alarm
Pull the lever of the nearest Fire Alarm Pull station to start the evacuation of the
building.
2/4
Evacuation - Leave the building
Help the ones in need.
3/4
Evacuation - Dial 9-1-1
Call 9-1-1 to make sure help is on the way
Be specific with information
4/4
What is Fire?
It is the active principle of burning, characterized by the heat and light of combustion
Fire is a vital part of our lives:
•
Heating
•
Cooking
Fire is a “living” thing that feeds itself once created:
•
Needs Fuel
•
Needs Oxygen
If you had to fight a fire that involves flammable liquids (like gasoline), what fire
Extinguishers would you use?
Water
Carbon Dioxide
K Fire Extinguisher
ABC Fire Extinguisher
ABCD Fire Extinguisher
How Does a Fire Work?
Three components
• Oxygen
• Heat
• Fuel
All three components are needed to start a fire
Fire extinguishers remove one or more of the components
Types of Fires
Class A - Wood, paper,cloth, trash
•
Water (heat out)
Class B - Flammable liquids, oil, paint, gas, grease
•
Carbon Dioxide (oxygen out)
Class C – Electrical (motors, computers, etc.)
•
Carbon Dioxide, Halotron I, FE-36
Class D - Combustible metals like beryllium, magnesium, etc.
•
Potassium and sodium
Class K - Kitchen fires
•
Low PH Wet Chemical Agent with fine mist discharge that
helps prevent grease splash and fire re-flash
Pressurized Water Extinguishers
Rated ONLY for Class A fires
It will stop a fire that involves wood, paper or trash
If used on electrical equipment, it will cause an electrical shock - water &
electricity don’t mix (electrical chock injuries can be worse than fire injuries)
If used on a fire that involves metals (beryllium, magnesium, Titanium, etc.),
it will increase the fire
If used in a kitchen fire, it will spread the grease
ABC (Multi-purpose)
Are best all-around choice
Help prevent re-ignition
Make a mess
Class BC contains sodium bicarbonate
Class ABC contains ammonium phosphate
Carbon Dioxide (CO2) Extinguishers
Are Class BC-rated
Are not effective on Class A fires (does not displace enough O2 to putout fire)
Should NOT be used on Class D—metal fires
Do not leave any residue
Are a good choice for computers or electronics (non-conductive)
Must be used 3 to 8 feet from the fire (No pressure gauge)
Metal/Sand Extinguishers
Class D rated
Powdered copper
Sodium chloride
Forms an airtight crust over the fire
Halon Extinguishers
Are Class BC-rated (Gas interrupts fire’s chemical reaction)
Protect valuable electrical equipment
Leaves no residue
Is non-conducting
Have a range of 4 to 6 feet
Halon production is now banned – Environmental Hazard (destroys ozone)
Halotron I Extinguishers
Replaces Halon 1211
Discharges as a liquid
Leaves no residue
Is non-conducting
Is ideal for computers and electronics
Is Class BC-rated
Halotron I is an ozone-friendlier than Halon
Halotron I production is slated to cease in 2015
FE-36
TM
Extinguishers
Halon 1211 replacement
Less toxic
No ozone depletion
Class BC-rated
The FE-36 agent is less toxic than both Halon 1211 and Halotron I. In addition, FE-36 has
zero ozone-depleting potential; FE-36 is not scheduled for phase-out
Water Mist Extinguishers
Class AC-rated
Safety from electrical shock
Less scattering of burning materials
Hospital environments and clean rooms
Unlike an ordinary water extinguisher, the misting nozzle provides safety from electric shock and reduces
scattering of burning materials. This is one of the best choices for protection of hospital environments, books,
documents and clean room facilities. In non-magnetic versions, water mist extinguishers are the preferred choice
for MRI or NMR facilities or for deployment on mine sweepers.
Fire Extinguisher Operation
Remember PASS
P = Pull the pin
A = Aim the nozzle at the base of the fire
S = Squeeze the handle
S = Sweep from side to side

The PASS Method will work on all types of extinguishers
P.A.S.S. Method
Pull the pin
This will allow you to squeeze the handle in order to discharge the extinguisher
P.A.S.S. Method
Aim at the base of the fire
Aiming at the middle will do no good, the agent will just go through the flames
P.A.S.S. Method
Squeeze the handle
This will release the pressurized extinguishing agent
P.A.S.S. Method
Sweep side to side
Spray it at the base of the fire
Cover the entire area that is on fire
Continue until fire is extinguished
Keep an eye on the area for re-lighting
Safety Precautions when fighting a fire
Stay upwind of the fire
Aim low
Safety Precautions when fighting a fire
NEVER allow the fire to get between you and a route to escape
Safety Precautions when fighting a fire
NEVER go into a unknown area to fight a fire
Fight-or-Flight Decision
Alarm has been pulled
Fire Dept. has been called
Fire is small and contained
You can avoid the smoke
Exit is clear
Extinguisher is nearby
You have been trained to use the extinguisher

Use it if you feel comfortable (voluntary basis) and have been trained.

Remember you are NOT a trained fire fighter.

You should NEVER put your life in danger.
Fire Evacuation Procedure
Stop work immediately when alarm sounds
End all calls
Do not take personal items with you
Move quickly to nearest exit without running
Do not use elevators
Meet at you assigned Assembly Area and await further instructions
Return to work only after an “All Clear” is given
Fire Extinguisher Inspections
Make sure your extinguisher can be used in an emergency
It is mounted on the wall
It is not blocked
Pressure is acceptable
Monthly inspected
Pin and seal intact
No dents or damage
Locations and Signs
Readily accessible
75 feet—Class A
50 feet—Class B
50–75 feet—Class C
75 feet—Class D
Highly visible sign
Fire Prevention Principles
Keep unnecessary heat sources out of the workplace:

Candles

Matches

Lit Cigarettes
Smoke only in designated areas
Eliminate the use of extension cords
Use heaters with automatic temperature control limit switches
Store flammable materials in an approved cabinet
Make sure all electronics carry UL approval ratings
Power down all electrical equipment at the end of the day
Keep equipment clean to prevent residue build-up (mainly driers)
Keep exits clear on both sides of the door (know where all exits are located)
Do not block fire extinguishers or other fire protection devices
Report smoke or flames immediately
Empty trash receptacles daily

Good Housekeeping – # 1 fire prevention tip (clean, neat & organized)
Fire Prevention Principles
Use Hot Work Permits when welding or performing other operations that generate sparks
Do not pour flammable solvents in your waste baskets
Check electrical cords and tools for damages
Use ONLY approved safety containers for storing flammables (flame arrestor)
When pouring flammable from one container to another, remember bonding and grounding
to reduce the potential for explosion due to static electricity
Soiled, oily rags (spontaneous combustion if not stored appropriately) use Safety Waste
Cans (metal cans with metal lids)
Keep aisles and passageways clear
Do not attempt to fight a fire unless you are properly trained
Follow all rules regarding fire protection and emergency evacuation
Be Safe!
Tony Soares, Safety Director
Compensation Solutions, Inc.
tsoares@compsolutionsinc.com
Tel: 1-888-201-5680 Ext. 192