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Graceland Emergency Preparedness Guide
This document, while written in response to a possible worse-case swine flu pandemic, can be a helpful guide to prepare for any type of severe community emergency that disrupts our normal standard of living. Swine flu: Information, prevention & preparation We have every indication that the swine flu will return in the fall and it will be much stronger than a normal flu season. Swine flu's symptoms are very similar to seasonal flu except that it often includes vomiting and diarrhea too. Normal healthy people are infected by the swine flu versus the seasonal flu affecting weakened folks. It attacks in a very severe way. It is highly contagious. So far, it is not air or water borne. The federal government estimates that 40-50 % of Americans may get the swine flu over the next two years. Prevention is always preferable to treatment of illness. Viral illnesses are often communicated from person to person, and in this case the pathway is the respiratory system. When a virus is picked up by an individual’s hands, the hands usually communicate the virus to the face via nose, eyes, or mouth, with symptoms developing a couple of days later. Frequent hand washing and/or sanitizing is the primary mode of protection. Proper disposal or sanitation of contaminated articles (i.e. tissue, linesn, phone receivers, etc.) is strongly advised, as viruses may remain alive on surfaces for an extended period of time (48-72 hours or more). Viruses can also be transmitted within a three to five foot radius via droplet particles floating in the air, originating from another person’s cough or sneeze. Therefore, care should be taken to cover all coughs and sneezes with tissue. In addition, minimizing close contacts with other people may be advisable. Such a severe illness may affect businesses, schools, and churches. Closures may occur. Quarantines may be enforced. Shortages of goods and interruptions in utilities may happen. When a disaster strikes, people often have difficulty coping due to lack of preparedness. This often results in: denial, over-reaction, fatigue, anger/blaming, headaches, loss of appetite, sleep disturbances, family problems. Prepare early to avoid these issues. Swine Flu: Tends to affect normally healthy people as opposed to regular flu Symptoms: fever, sleepiness, head and body aches, cough, and sore throat. Tell-tale symptoms include: vomiting and diarrhea. Severe symptoms: blue or gray coloring, pneumonia, inability to wake up, and seizures. Treatment: Keep the person warm and comfortable and hydrated. Ensure that the person takes his/her normal medicine and food and drink. Give normal flu medicines unless they interfere with their regular medicine. If tell-tale symptoms occur, go to the doctor immediately. Rush to ER if severe symptoms occur. Early indications are that it is highly contagious. Wear a N-95 mask and gloves if you have them. There are two approved drugs for swine flu: Relenza and Tamiflu. Tamiflu is available in large stockpiles. The government plans to vaccinate every American, however, we do not as yet have adequate supplies. Expect vaccination to begin to occur in mid-October and extend into February 2010. Swine flu vaccination occurs in TWO SHOTS given over several weeks. Emergency Numbers: Write in your numbers if not within the New Albany Area New Albany Ambulance Hospital Fire Police Water Gas
Electricity Sewer Basic Nutritional Requirements Food (2200 calories for men, 2000 calories for women and children) Individuals can go a week without food but are progressively weakened. Federal guidelines = Two weeks of food per person= 42 meals Use perishable foods first, from the refrigerator second, from the freezer third, from canned goods fourth. Food spoils quickly without refrigeration. Use the natural refrigeration of wintertime to extend storage of food. Supplement cheaply with vitamins. Five small meals are better than three to keep from being hungry. Good choices include rice and beans, oatmeal, canned meats, fish, beans, soups, stews. Ramen noodles and soup mixes for seasoning. Add oil to add calories. Buy things your family will eat. Buy some treat foods for comfort. If children won't eat your stockpiled food, add protein powder to canned fruit initially. Hungry children will eventually eat no matter what. Water (1 gallon per person per day= ½ gallon for drinking + ½ gallon for cleaning) 3 days without water = severe weakness and death. Federal guidelines = Two weeks of water (14 gallons) per person A. If water supply is suspect, filter with coffee filters if necessary, add 16 drops of unscented bleach to one gallon. Let sit for 30 minutes. You can pour it back and forth between containers to release the bleach smell. Alternative boil for one minute. Add a dash of salt to improve flavor or pour it several times in a clean container to re-add oxygen. Water is heavy (1 gallon = 8.5 lbs). A hot water tank commonly holds 40 gallons of water. To pull from the tank, 1)shut off the gas or electricity to the tank 2) shut off the incoming water line 3) open the drain spigot into a container. Never store water in used milk jugs (will cause sickness).B. Never drink water from outside water sources without boiling and adding bleach. C. Collect water in all the clean containers you have. Water stored in a bathtub will need to be purified. D. Keep water in insulated areas to keep from freezing. E. Pipes can freeze too. If the house is cold, keep a tiny trickle of water going to prevent freezing. If the water goes off, drain the lines to prevent leaks later. F. A little window washer antifreeze put down toilets, washing machine drain lines, and sinks will assist them from freezing in an unheated home. A Water Bob can be purchased for about $25 and acts as a reservoir of up to 100 gallons www.waterbob.com Cooking If the power or gas fails, use your outside grill. It is easier to cook for the entire day at once on a grill rather than cooking several times. Have adequate charcoal and propane on hand. Medicine Fill prescription medicines now. There are discounts on several months of medications. Make a first aid kit to treat headaches/body aches, fever, cough, sore throat, vomiting, and diarrhea. Dehydration can best be treated with sports drinks or by giving ORS:Oral Rehydration Solution Simple formula: 3 Tablespoons of sugar 1 teaspoon of salt, dissolved in 1 quart of potable water. Superior formula ORAL REHYDRATION SOLUTION FORMULA (ORS) · 1/4 teaspoon Salt (common table salt - sodium chloride) · 1/4 teaspoon Salt Substitute or “Lite Salt” (potassium chloride) · 1/4 teaspoon Baking Soda · 2 ½ tablespoons Sugar · Combine these ingredients and dissolve them in 1 qt. of sterile water. Can be flavored with 1 tsp of instant jello mix (powder) Q. How much solution do I feed?
A. Feed after episode of diarrhea. Adults and large children should drink at least 3 quarts of ORS a day until they are well. Each Feeding: For a child under the age of two=between a quarter and a half of a large cup For older children =between a half and a whole large cup For Severe Dehydration: Drink sips of the ORS (or give the ORS solution to the conscious dehydrated person) every 5 minutes until urination becomes normal. (It's normal to urinate four or five times a day.)
Q. How do I feed the solution?
A· Give it slowly, preferably with a teaspoon.· If the child vomits it, give it again. The drink should be given from a cup (feeding bottles are difficult to clean properly). Remember to feed sips of the liquid slowly.
Q. What if the child vomits?
A. If the child vomits, wait for ten minutes and then begin again. Continue to try to feed the drink to the child slowly, small sips at a time. The body will retain some of the fluids and salts needed even though there is vomiting.
Q. For how long do I feed the liquids?
A. Extra liquids should be given until the diarrhea has stopped. This will usually take between three and five days.
Q. How do I store the ORS solution?
A. Store the liquid in a cool place. Chilling the ORS may help. If the child still needs ORS after 24 hours,
10 Things you should know about Rehydrating a child.
1. Wash your hands with soap and water before preparing solution. 2. Prepare a solution, in a clean pot, (as above) - with one quart of clean drinking or boiled water (after cooled) Stir the mixture till all the contents dissolve. 3. Wash your hands and the baby's hands with soap and water before feeding solution. 4. Give the sick child as much of the solution as it needs, in small amounts frequently. 5. Give child alternately other fluids - such as breast milk and juices. 6. Continue to give solids if child is four months or older. 7. If the child still needs ORS after 24 hours, make a fresh solution. 8. ORS does not stop diarrhea. It prevents the body from drying up. The diarrhea will stop by itself. 9. If child vomits, wait ten minutes and give it ORS again. Usually vomiting will stop. 10. If diarrhea increases and /or vomiting persists, take child over to a health clinic.
Loss of heat Most heaters are electric or gas. Very cold temperatures can occur in the wintertime without heating. Purchase a kerosene heater and extra kerosene as a cheap source of heat. Average kerosene use = two gallons of kerosene per 12 hour period. If you have a southern sunny window, hang black plastic two inches from that window, and tape foil to the plastic to radiate heat into the room. Ensure that your fireplaces have been cleaned of creosote before use otherwise a chimney fire could happen. Never burn wood in a gas fireplace. They are not intended for burning wood.
Heat loss occurs mostly from your head. WEAR A HAT AND GLOVES INDOORS. Wear multiple layers of loose knit clothing. Pitch a tent or pick a small room for everyone to sleep in. Insulate it with blankets, rugs, mattresses, etc. Sleep together to watch small children and conserve heat. Have smoke alarms in that room. Emergency blankets reflect 90% of body heat and are inexpensive. Never burn an open fire without ventilation. Never burn charcoal inside. It builds up deadly fumes. Never leave candles burning. Loss of lighting It gets dark very early in winter. Plan activities accordingly. Have enclosed paraffin oil lamps and plenty of paraffin oil. Doubles as a heat source. A mirror placed behind casts more light. LED flashlights use less batteries and burn brightly. Crank style flashlights are excellent for children. Open candles are very dangerous and should be used as a last resort. Sanitation Dishes - Scrape dishes well, then wash in hot soapy water that has a few drops of bleach added. Surfaces - For general disinfecting (floors, counters, etc.), use 1 tablespoon of liquid bleach in 1 quart of water. Soak small items for 5 minutes. Surfaces such as floors or counters should be wet liberally and kept wet for 2 minutes. Laundry - Keep as clean as possible as it prevents illness. Use hand sanitizer and waterless soap if you have them. Water placed in black bottles that sit in the sun (for two hours) will warm them. Only brush your teeth or clean contacts with clean water. Prepare one sink with a minimum of soapy water, hand wring them, rinse in one sink. Hang to dry. Save your waste water in marked buckets/containers. Toilets will still flush even if the water goes off. Use the waste water to flush toilets. Use proper precautions: contamination happens when you touch something dirty and touch your face. Purchase sanitary products ahead of time. If toilets will not flush, store waste materials in one container, and then place in plastic bags for burial later. Money If power outages occur city-wide, ATMs and credit card machines may not work. Have a reserve of $500 for emergencies. Sheltering in Place (SIP) This is a government medical term for staying at home and self-quarantines. Stay away from large crowds when told to do so. Wear a mask and gloves when the flu hits in our area and you must travel. Do not let your children play with other neighbor children if quarantines are in place. Communication Emergency information will be available on all television and radios. Most cars have a radio, but reserve power and gas in case you must evacuate quickly. Purchase a batter powered radio in case of power outages. Land line phones should work unless there are outages. Have a cell phone handy. Avoid unnecessary phone calls to keep the circuits from becoming overloaded. Avoid rumors which will only exacerbate the situation. Aftermath Once the pandemic concludes, neighbors will need our assistance. Knock on doors and ask if they need help. Teach preparedness to them. Assist children whose parents have fallen ill. Look for elderly victims. Notify authorities of illness and death. If you knock on doors to assist others, always go in twos, and
identify yourselves clearly, maintaining a distance of six feet. Wear a mask and gloves, if in doubt. Expect neighbors to be highly nervous and anxious. Speak slowly and clearly. Helpful Websites: There are a variety of websites which have carefully thought out a response to the pandemic flu. The official government website is http://flu.gov/. If you look under individual preparedness, you'll see that our government is recommending each American (at a very minimum) have enough food and water stored for two weeks. That number was originally three days worth, and has been revised due to the serious nature of the pandemic. One government website from Idaho is:http://getpandemicready.org/. This website details some very specific messages to targeted audiences. It is simple and effective in its ways of inexpensively dealing with the flu. Another excellent website is:http://www.readymoms.org/#anchor1. They have developed many printed materials which we could use or modify for use to our members. One physician has detailed some ways to handle sick family members. His website can be found here:http://www.birdflumanual.com/ He has made freely available a booklet on his website. The direct link is: http://www.birdflumanual.com/resources/Home_Influenza_Treatment/files/Good%20Ho me%20Treatment%20of%20Influenza/ Southern Baptist North American Mission Board: http://www.namb.net/site/c.9qKILUOzEpH/b.1761077/k.6230/Pandemic_Flu_Preparedness.htm Disclaimer: this information is intended to serve as a resource manual for Graceland members and attendees. The information contained herein is considered reliable. It is not intended as medical advice for an individual patient and does not take the place of regular medical advice from your physician.
CLINICAL PRACTICE PROFESSIONAL GUIDELINE Radiopaque Contrast Media DATE OF ISSUE: 13 (Appendix) NUMBER: ISSUED BY: SUPERCEDES: ISSUED BY: Purpose: To provide a guideline to assist Physicians in the management of patients who are scheduled for Radiology tests involving Radiopaque contrast media (RCM) at The Credit Valley Hospital. This guideline focuses on prevention and t
National sheep improvement program in the USA: with emphasis on hair sheep evaluations Paper presented at 3 SINCORTE, Joao Pessoa, Paraiba, Brazil, November 2007 (published with the approval of the Coordination of 3 SINCORTE)2 PhD, President of the NSIP Board of DirectorsAbstract - After 40 years of use in the livestock industry, the major technology for identifying superior performance