EVACUATION PLANS OF FULL
TIME WHEELCHAIR USERS
WITH SPINAL CORD INJURIES
NAT HAN HOG AB OOM
D E PA RT M E N T O F R E H A B IL ITATI O N
SCIENCE AND TECHNOLOGY
UNIVERSITY OF PITTSBURGH
HUMAN ENGINEERING RESEARCH
L A B O R ATO R IE S
VA P I T T S B U RG H H E A LT H C A R E SY ST E M
CO-AUTHORS
Michelle Oyster
 HERL
 University of Pittsburgh PM&R
Melissa Riggins
 University of Arkansas for Medical Sciences
Michael Boninger
 HERL
 University of Pittsburgh PM&R
Natural disasters are becoming more common1
 Hurricane Katrina
 Haitian Earthquake
Recent efforts to improve preparedness2
People with disabilities
 Large percentage with locomotive and/or functional
impairments3
 Problematic during evacuation4
~273,000 people with SCI5
Mobility limitations that could make it difficult to
evacuate effectively
McClure, et al.6
 487 full-time wheelchair users (WCUs) with SCI
 Whether or not they felt they could safely evacuate
 64% had plans from home, 31% from towns/cities
PURPOSE & HYPOTHESIS
How effective were their plans?
What was missing from their plans?
 Identifying missing elements will provide information on how
preparedness in this population can be improved
Hypothesis:
 Evacuation plans would be missing critical elements
 Indicates previous study6 overestimated preparedness of
people with SCI
Participated in McClure, et al.6
 University of Pittsburgh Model Center on SCI
 Wheelchair users at least 1 year post SCI
Phone interview and transcription
 No warning – simulate emergency situation
 Open- and closed-ended questions about evacuation plans
 Open: detailed evacuation plans from each location
 Closed: frequency of practice, human/technology assistance, levels/stories in
building
10 criteria for optimal plans derived from preparedness
checklists
 Scoring system applied to transcriptions
 Each plan given a score 0 – 10
DERIVED FROM FEDERAL EMERGENCY MANAGEMENT AGENCY (FEMA)7, AMERICAN RED
CROSS (ARC)8, CENTER FOR DISABILITY ISSUES AND THE HEALTH PROFESSIONS (CDIHP)9
EMERGENCY PREPAREDNESS PUBLICATIONS
Critical Elements derived from Emergency Preparedness Publications7-9
Escape routes (exits, building stories, distance to travel)
Personal Support Network communication – Before
Personal Support Network communication – After
Supplies/supply kit
Transportation
Assistance needed (human or technology)
Meeting place/temporary shelter
Vital records and documents
Ability to give clear, concise, and detailed directions to emergency personnel
Practice plan
47 participants selected
 Data from 20 used
 No difference in groups
20 with plans from home, 10 from towns/cities
 All who reported a town plan had a home plan
Those with high scores in one had high scores in the
other
 r = .882, p = .001
MEDIAN OF 3 CRITERIA MENTIONED IN BOTH LOCATIONS
Black: home plans
Grey: town/city plans
LIFTING DEVICES WERE THE MOST COMMONLY USED AT
Black: home plans
Grey: town/city plans
Evacuation plans missing critical elements
From homes:
 Most participants mapped escape route, defined assistance, and gave clear and
concise directions
 Fewer mentioned personal support network communication, supplies, or vital
records/documents
From towns/cities:
 Similar to home plans
 Most mentioned accessible transportation
 Few able to give clear and concise directions or had practiced plans
Forethought being put into evacuation preparedness
Critical elements are being omitted
WHAT NEXT?
Consult evacuation preparedness literature:
 FEMA7, ARC8, CDIHP9
 Report of the Online Forum on Disabled and other Vulnerable People in Natural
Disasters – World Bank Disability & Development Team10
Importance of personal support network communication




Network of friends, family, neighbors, co-workers, etc.
People who will plan before and help during an evacuation
One of the first steps in creating a plan
Recommended one for every location where a lot of time is spent
 School, work, home, etc.
 At least 3 members7-9
WHAT NEXT?
Assistive Technology
 Necessary in the planning process
 Lifting devices needed if individual cannot lift him or herself
independently
 Accessible vehicles or transportation
 Able to give directions on AT use to emergency personnel
Educational efforts targeting people with disabilities, their
personal support networks, and emergency personnel
 Fill gaps in evacuation plans
 Proper use of vital AT
MORE INFORMATION
Evacuation preparedness in full-time wheelchair users with
spinal cord injury. Journal of Spinal Cord Medicine
2013;36(4):290-295.
NSH15@pitt.edu
REFERENCES
1.
Guha-Sapir D, Vos F, Below R, Ponserre S. Annual Disaster Statistical Review 2010: The Numbers and Trends. Brussels:CRED; 2011. p. 123.
2.
Nelson C, Lurie N, Wasserman J, Zakowsi S. Conceptualizing and defining public health emergency preparedness. Am J Public Health
2007;97(S1):S29-S11.
3.
StatsRRTC. Annual disability statistics compendium: 2010 [document on the Internet]. 2010 [updated 2010; cited 2013 Oct 14]. Available
from http://disabilitycompendium.org/pdf/Compendium2010.pdf
4.
Bethel JW, Foreman AN, Burke SC. Disaster preparedness among medically vulnerable populations. Am J Prev Med 2011;40(2):139-43.
5.
National Spinal Cord Injury Statistical Center. Spinal cord injury facts and figures at a glance. J Spinal Cord Med 2013;36(2):170-171.
6.
McClure LA, Boninger ML, Oyster ML, Roach MJ, Nagy J, Nemunaitis G. Emergency evacuation readiness of full-time wheelchair users with
spinal cord injury. Arch Phys Med Rehabil;92(3):491-498.
7.
FEMA. Preparing for disaster for people with disabilities and other special needs [document on the Internet]. 2004 [updated 2004; cited
2013 Oct 14]. Available from http://www.fema.gov/library/viewRecord.do?id=1442.
8.
American Red Cross. Disaster preparedness for people with disabilities [document on the Internet]. 2006 [updated 2006; cited 2013 Oct
14]. Available from http://www.redcross.org/museum/prepare_org/disabilities/disability.pdf
9.
Center for Disability Issues and the Health Professions. Emergency evacuation preparedness: Taking responsibility for your safety, a guide
for people with disabilities and other activity limitations [document on the Internet]. 2002 [updated 2002; cited 2013 Oct 14]. Available
from: http://www.cdihp.org/evacuation/emergency_evacuation.pdf.
10.
World Bank Disability & Development Team. Report of the online forum on disabled and other vulnerable people in natural disasters. 2006
May 22-June 9; online discussion. Published December 2006 [document on the Internet]. Available from
http://web.worldbank.org/WBSITE/EXTERNAL/TOPICS/EXTSOCIALPROTECTION/EXTDISABILITY/0,,contentMDK:20922979~pagePK:21005
8~piPK:210062~theSitePK:282699,00.html.