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Staying Healthy During a Crisis
Picture this: it is near the end of a hectic day. You hear a loud screeching of brakes from the nearby highway, and silently breathe a sigh of relief that you are not out in the traffic. As you greet your little ones waking from an afternoon rest, the phone rings. It is a neighbor calling to report that a nearby chemical spill has resulted in an advisory to close all windows and vents and stay inside. The highway is closed, and will stay that way for at least several hours.
Will you be prepared if this happens to your childcare program? When developing a response plan, most authorities recommend preparing for three or more days (72+ hours) either in an evacuation site or sheltering in place (as would probably occur in the above scenario). Thoughtful planning will help the children in your care and staff stay healthy and clean during an emergency and should become part of your overall disaster plan.
Water
A supply of clean water is an absolute necessity. Tap water could be compromised by chemical spills or lack of power for pumps. The usual recommendation is that you should have one gallon of water available per person per day for consumption and sanitation. Additional water may be needed for toilets, food preparation, or cleaning. Store water in plastic containers. Label and date the containers and store in a cool, dark area, replenishing them at least every six months to keep the water fresh.
Drinking water is essential. Do not ration drinking water; drink the bottled water you need today and try to find more for tomorrow. You can use tap water for flushing toilets.
Sanitation
Guarding against the spread of disease, which is always a concern in childcare, is even more crucial during a disaster when there may be more people crowded into less space for an unknown period of time. Hand washing continues to be the single most effective means to prevent disease spread. If there is plenty of water available, insist on the hand washing ideal--use soap and running warm water. If water is not readily available, use waterless cleansers. Stockpile a three-day supply of hand washing materials such as:
- Liquid soap in tightly closed containers.
- Paper towels.
- Waterless cleansers. Select non alcohol formulations to reduce both drying of skin and the risk of flammability; cleansers should be kept accessible and out of children’s reach unless being used with supervision.
- Sealed packages of germicidal hand wipes, pre moistened towelettes, and cleansing wipes. Use wipes for diapering and antiseptic wipes for hand washing, and follow your program’s procedure. Even sealed towelettes and wipes can dry out, so rotate supplies from the disaster kit on a regularly scheduled basis.
Sanitation items such as diapers, paper towels, toilet paper, tissues, sanitary napkins/feminine hygiene items, tooth brushes, tooth paste, and small disposable cups also should be available, preferably a three-day supply if space allows. Include sturdy disposable trash bags for general waste and diapers, and “red bags” for waste contaminated with blood or body fluids.
While planning, rely on your experience. Pay attention to the average number of diapers used in a typical day, the numbers of times hands are washed, the average number of medications given, the life span of a roll of toilet paper and paper towel pack, and other recurring activities that require sanitation materials, and determine an average number of items needed. Think about the minimum amounts you would need to have, with consideration to what you normally have on hand.
Another issue to consider is where to store emergency supplies. Time for evacuation may be short. Will you be able to move emergency supplies as well as children to the safe site if you have to evacuate, or would storing some supplies at the evacuation location be a better option? You will need quick access to these items, so store them in one easily accessible space. Consider storing items in a clean, wheeled trash can with a tight fitting lid or a wheeled cooler, which can later be used for food or medication storage.
Diapering and Toileting
Diaper disposal may be one of the most difficult tasks, during an emergency regardless of whether you are sheltering in place or evacuating. Trash removal may not be available for several days, so identify a place for trash bags where they will not pose a safety hazard. This should be away from the main activity areas or food and cooking locations. Avoid overfilling trash bags, as they may break and will be difficult to maneuver.
Toileting also may be a challenge if there is no running water. Plastic buckets with tight fitting lids can serve as portable toilets; until then, they also serve as a good storage tub for your disaster supplies. You also may want to include a potty chair/seat with the disaster supplies. Children will be more comfortable with something that appears familiar when routines are disrupted, and the potty chair might help a frightened child feel more at ease with toileting. Large childcare programs may want to explore portable toilets designed for disaster use.
If space permits, store extra underwear, pants, and sweaters/shirts, as toileting accidents often accompany disrupted routines.
Cleaning
Be certain to include at least one gallon of sealed household bleach and new empty quart spray containers labeled “Bleach Disinfectant” with your disaster supplies. Diluted common household bleach--1 tablespoon bleach to 1 quart of water (or 1/4 cup to a gallon) is an effective disinfectant. To maintain potency, mix this disinfecting solution daily and store it out of direct sunlight. Store these supplies away from food and children.
First Aid Supplies
A well-stocked first aid kit is mandatory. It is usually cost effective to use the kit that you already keep on hand and use daily. However, if this is the choice made, then careful restocking must occur after each use so that the first aid kit is well equipped for an emergency. Include in your supply container at least two full boxes of non porous gloves in size medium and/or large. These should be non powdered vinyl gloves appropriate for people with latex allergies.
Store extra first aid supplies in an easily accessible, portable and durable container such as a backpack that is clearly marked and not used for any other purpose. Include a small flashlight with extra batteries, a whistle, pen and paper, and a booklet of first aid instructions.
Blankets will be invaluable in the event that utilities are disrupted, especially during winter months. Use a large wheeled trash can to store at least one small blanket per child and one larger blanket for each staff person. Sleeping bags also should be considered, as they are easy to store and use and are warm. Also, a plastic tarp may prove useful, if only for marking a privacy area.
Janie Sailors, RN, NCSN
Health Specialist, Training and Technical Assistance Services (TTAS)
Western Kentucky University
RESOURCES
A checklist for emergency preparations from the Federal Emergency Management Agency (FEMA), C St., SW Washington, D.C. 20472; 202-566-1600; www.fema.gov/rrr/emprep.shtm
INTERNET RESOURCES
A compilation of resources and materials on disasters, bioterrorism and psychological support of children from the American Academy of Pediatrics, www.aap.org/terrorism/index.html
Disaster Planning Self Assessment Guide for Child Care Centers and Family Child Care Homes (California Department of Social Services), ccld.ca.gov/ChildCareS_1941.htm
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