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Scope and Objective of Plan

This plan identifies the potential emergency situation that could occur in UNLV Health and School of Medicine operations.  The intent of this Emergency Action Plan (hereinafter referred to as EAP) is to prepare for such emergency situations and provide for effective emergency response.

This plan is only designed to address emergencies associated within our operations and it is envisioned that this plan will be used in conjunction with the Building Owners EAP. Examples of emergencies that would require the use of the Building Owners EAP include, but not limited to, fires, severe weather events (high winds, flooding, etc.), civil disturbances, bomb threats, etc.

This plan assumes that structures in which UNLV Health is operating are designed and constructed in accordance with basic international fire safety standards and that common incipient fire controls, such as fire extinguishers, sprinkler systems, smoke/ heat detectors, and central alarm systems are in place and functioning.

The intent of this plan is to prepare for emergency situations and provide for effective emergency response and includes emergency response procedures to be followed during any emergency situations that are within our scope of services or within our control. It is anticipated that Managers/ Administrators and Supervisors are familiar with UNLV Health and School of Medicine EAP and are aware of the requirements to be followed during an emergency.

General Guidelines and Priorities

During an emergency at this facility the following priorities, in order, should be followed:

1. Life Safety

2. Property protection

3. Prevention of business interruption

At no time should anyone’s safety be compromised in an effort to save property or to prevent business interruption.

As stated above, life safety is always the top priority in a fire or any other emergency and the following guidelines should be followed:

Fire prevention and emergency response procedures shall be included in the safety orientation of all employees.

Safe paths shall be maintained inside facilities from all UNLV occupied locations to safe refuge areas outside the building for use in case of an emergency that requires evacuation.

Clear and unobstructed access to fire detection, alarms, and fire suppression shall be maintained inside UNLV controlled areas of the facilities.

Clear and unobstructed access for Emergency Response Personnel shall be maintained. All fire/ emergency lanes will be clearly marked.

The Emergency Action Plan will be made available to all interested parties upon request.

Applicability

This plan applies to all UNLV personnel and those visitors and contractors under the direct responsibility of UNLV at this site. The intent of the plan is to have one common plan with common procedures that personnel will be familiar with for emergency preparations and during emergencies.

UNLV Medicine Management/ Administrators shall implement this plan and maintain a copy of the written program and all required documentation. Business hours are generally 5 Days a week and operating from 8:00 AM to 5:00 PM PST.

Responsibilities

Department Manager/Administrator

Review of this EAP and becoming familiar with all applicable emergency procedures.

• Implementation of emergency procedures that apply to their areas/ scope of services at this facility.

• Accounting for all UNLV employees under his or her control at the designated gathering point.

• Following the proper notification procedures to Building Security, UNLV team and others, as required in the event of an emergency.

• Coordinating with and participating in required drill events planned by Building Security/ Owner and UNLV Facilities/ Safety team.

• Conducting safety observations and correcting identified hazards within UNLV control that could create emergencies.

• Reviewing and understanding the contents of the EAP prepared by the Building Owner as well as UNLV.

• Ensure that facility personnel, contractors, and visitors have reviewed, and are familiar with their responsibilities as presented in this plan.

Employees

• All employees are responsible for complying with each provision of this program and the site’s emergency procedures.

• All employees are required to promptly report any conditions that could adversely affect life safety in an emergency to the appropriate Manager/ Administrator.

• All employees are required to follow safe work practices in their day to day operations.

Terms

In the event of an emergency building closure, your emergency action plan should address and delegate responsibility to building personnel for any special accommodations you would like implemented, such as; posting building closure notices, escorting staff, monitoring building entrances, etc.

Emergency Codes and Definitions

In the event Lockdown/ Shelter-in-Place is indicated, the facility will:

• Close the building: close and lock all windows, exterior doors, and any other openings to the outside.

• If there are patients or visitors in the building, provide for their safety by asking them to stay - not leave. When authorities provide directions to shelter-in-place, they)expect everyone to take those steps immediately, where they are, and not drive or walk outdoors.

• Unless there is an imminent threat, ask employees, customers, clients, and visitors to call their emergency contact to let them know where they are and that they are safe.

• Turn on call-forwarding or alternative telephone answering systems or services. If the business has voice mail or an automated attendant, change the recording to indicate that the company is closed and that staff and visitors are remaining in the building until authorities advise that it is safe to leave.

• If you are told there is a danger of explosion, close the window shades, blinds, or curtains. If possible, turn off all fans, heating and air conditioning systems.

• Gather essential disaster supplies such as nonperishable food, bottled water, battery powered radios, first aid supplies, flashlights, batteries, and plastic garbage bags.

• Select interior room(s) above the ground floor with the fewest windows or vents. The room(s) should have adequate space for everyone to be able to sit in.

• It is ideal to have a hard-wired telephone in the room(s) you select. Call emergency contacts and have the phone available if you need to report a life-threatening condition.

• Bring everyone into the room(s). Shut and lock the door(s). Barricade if there are no locks.

• Write down everyone’s names in the room, call your business; designated emergency contact to report who is in the room with you, and their affiliation with your company (employee, visitor, client).

• Keep listening to the radio or television until you are told all is safe or instructed to evacuate. Local officials may communicate the need for evacuation in specific areas at greatest risk in your community

TELEPHONE BOMB THREAT 

Upon receiving a telephone bomb threat: Be calm. Be courteous.

ASK: WHY ARE YOU DOING THIS?  

Listen and DO NOT interrupt the caller. Keep the caller on the line and complete one of the blank worksheets. 
NOTE THE FOLLOWING FACTS: 

• Is the caller male or female? Young or old? Is the caller's voice calm? Angry?

• Do you hear a stutter? An accent?  What do the background noises sound like? What is the time of the call?

QUESTIONS TO ASK CALLER CHECKLIST:

• When is the bomb going to explode?

• Where is the bomb right now?

• What kind of bomb is it?

• What will cause the bomb to explode?

• Did you place the bomb? 

CALLER'S VOICE 

Quickly determine the most reasonable way to protect your own life. Patients and visitors are likely to follow the lead of employees and managers. 

What to expect when Law Enforcement Arrives:

• Remain calm and follow the officer's instructions. Immediately raise hands and spread fingers. Keep hands visible at all times.

• Avoid pointing, yelling, or screaming. 

What to tell 911 Operator: 

• Address of building

• Location and number of shooters

• Physical description of shooter(s)

• Types of weapons held

• Number of potential victims at the location 

In the event Hide/Shelter-in-Place is indicated, the clinic should:

Close the clinic. Close and lock all windows, exterior doors, and any other openings to the outside.

If there are patients or visitors in the building, provide for their safety by asking them to stay - not leave. When authorities provide directions to shelter-in-place, they want everyone to take those steps now, where they are, and not drive or walk outdoors.

Unless there is an imminent threat, ask employees, customers, clients, and visitors to call their emergency contact to let them know where they are and that they are safe.

Turn on call-forwarding or alternative telephone answering systems or services. If the business has voice mail or an automated attendant, change the recording to indicate that the company is closed and that staff and visitors are remaining in the building until authorities advise that it is safe to leave.

If you are told there is a danger of explosion, close the window shades, blinds, or curtains. If possible, turn off all fans, heating and air conditioning systems.

Gather essential disaster supplies such as nonperishable food, bottled water, battery-powered radios, first aid supplies, flashlights, batteries, and plastic garbage bags.

Select interior room(s) above the ground floor with the fewest windows or vents. The room(s) should have adequate space for everyone to be able to sit in.

It is ideal to have a hard-wired telephone in the room(s) you select. Call emergency contacts and have the phone available if you need to report a life-threatening condition. (Cellular telephone equipment may be overwhelmed or damaged during an emergency.)

Bring everyone into the room(s). Shut and lock the door(s).

Write down everyone's names in the room, call your business' designated emergency contact to report who is in the room with you, and their affiliation with your company (employee, visitor, client).

Keep listening to the radio or television until you are told all is safe or instructed to evacuate.  Local officials may communicate the need for evacuation in specific areas at greatest risk in your community. 

Workplace violence has emerged as an important safety and health issue in today's workplace. Its most extreme form, homicide, is the third leading cause of fatal occupational injury in the United States. 

SAFETY TIPS 

Watch for signals that may be associated with impending violence: 

• Verbally expressed anger and frustration.

• Body language, such as threatening gestures.

• Signs of drug or alcohol use.

• Presence of a weapon. 

Maintain behavior that helps diffuse anger: 

• Present a calm, caring attitude.

• Don't match the threats.

• Don't give orders.

• Acknowledge the person's feelings (for example, "I know you are frustrated").

• Avoid any behavior that may be interpreted as aggressive (for example, moving quickly, getting too close, touching, or speaking loudly). 

BE ALERT

• Evaluate each situation for potential violence when you enter a room or begin to relate to a patient or visitor.

• Be vigilant throughout the encounter.

• Don't isolate yourself with a potentially violent person.

• Always keep an open path for exiting. Don't let the potentially violent person stand between you and the door.

• Remove from your desk any item that may be used as a weapon by others.

Take these steps to diffuse the situation quickly: 

• Remove yourself from the situation.

• Call building security, announce CODE GRAY, or dial 9-1-1 for help.

• Report any violent incidents to your leadership. 

Clinics are responsible for purchasing spill kits, responding to incidental spills, safely storing, using, and disposing of chemicals they use. Manufacturers or producers of hazardous substances are required by law to prepare a Safety Data Sheet (SDS), accessible to all employees. Our SDS are located in Google Drive and on the Intranet.

Upon discovering an uncontrolled hazardous material spill: 

• Put safety first.

• Isolate the scene and deny entry.

• Notify your supervisor and call 9-1-1.

• Alert people to keep away from the immediate spill area, and not touch the material or walk into it.

• Confine the spill to minimize its spread as long as this can be done safely.

• Determine if available staff can safely clean up the spill, or if emergency personnel should be notified.

In the event of a major spill: 

• Isolate the area. Deny entry to others.

• Read the Safety Data Sheet to identify special precautions; work with a partner, and use a spill kit to clean the area.

• Follow procedures outlined on the Safety Data Sheet or product label.

• Attend to injured or contaminated persons and remove them from exposure, only if personal exposure is unlikely.

• Obtain the Safety Data Sheet to assist with remedial actions.

• If the person is contaminated with toxic materials, follow first aid and decontamination instructions on the Safety Data Sheet. If life-threatening injuries or symptoms, dial 911.

• Contact the facilities helpdesk for additional direction and HAZMAT clean-up contractor information.

• Complete an incident report and document all actions. 

If someone in the clinic needs advanced medical care or is injured, apply the emergency action steps: CHECK – CALL – CARE

• CHECK the scene to make sure it is safe for you to approach. Then check the victim for unconsciousness and life-threatening conditions, such as not breathing or severe bleeding.

• CALL out for help and call 911 immediately.

• CARE for the victim until EMS arrives. 

PROTECTIVE MEASURES 

Follow Standard Precautions. The risk of getting a disease while giving first aid is extremely rare.

To reduce the risk even further: 

• Avoid direct contact with blood and other bodily fluids.

• Use protective equipment, such as disposable gloves and breathing barriers.

• Wash your hands with soap and water immediately after giving care. 

CARE STEPS 

• Check breathing: If the victim is not breathing, begin CPR (use AED if available and trained).

• Call for help and dial 9-1-1.

• Control bleeding: Cover the wound with a dressing and apply direct pressure. Elevate the injured area above the level of the heart (if broken bones are not suspected).

• Care for a shock: Keep the victim from getting chilled or overheated. Elevate the legs about 12 inches (if broken bones are not suspected). Do not give food or drink to the victim.

• Tend to burn: Stop the burning by cooling the burn with large amounts of water. Cover the burn with dry, clean dressings or cloth.

• Care for injuries to muscles, bones, and joints: Rest the injured part. Apply ice or a cold pack to control swelling and reduce pain. Avoid any movement or activity that causes pain. If you must move the victim because the scene is becoming unsafe, try to immobilize the injured area to keep it from moving.

• Send someone to direct the ambulance crew to your location from the building entrance.

SELF-PROTECTIVE MEASURES: 

• If your clothes catch on fire—STOP, DROP, and ROLL.

• If you are caught in smoke, drop to your hands and knees and crawl.

• If you are trapped in a room, place cloth and material under the door to prevent smoke from entering.

• Retreat and close as many doors as possible between you and the fire. Be prepared to signal for help.

PREVENTIVE MEASURES: 

• Learn at least two escape routes and emergency exits from your area.

• Never use an elevator as part of your escape route.

• Learn to recognize alarm sounds.

• If you discover a fire: R.A.C.E.

  • Rescue anyone in immediate danger.

  • Alarm by announcing CODE RED (location) or call 911

  • Confine the fire by closing the door.

  • Evacuate the suite.

If you hear a fire alarm: 

• Evacuate the area. Close windows and close doors as you leave.

• Leave the building; move away from exits and out of the way of emergency operations.

• Assemble in the designated area.

• Report to the Role Taker so s/he can determine that all personnel have evacuated your area.

• Remain outside until competent authority (Building Management, Fire Department, or your supervisor) states that it is safe to re-enter. 

Fight the fire ONLY if: 

• The fire department has been notified of the fire, AND

• You have a way out and can fight the fire with your back to the exit, AND

• You have the proper extinguisher, in good working order, AND know how to use it.

• If you are not sure of your ability or the fire extinguisher's capacity to contain the fire, leave the area.

Stay calm – do not rush – do not panic. Gather your personal belongings if it is safe to do so.  

Jobs: 

• Floor Monitor: Take the initial group of evacuees to the outdoor Assembly Area

• Sweeper(s): Check to make sure all areas have been evacuated. Help mobility-impaired persons to Area of Refuge. Report results of sweep to Floor Monitor. 

Suggestions:  

• Front Desk Staff: Evacuate patients and visitors from the reception area. Grab the sign-in sheet.

• Medical Assistants: Evacuate patients and visitors from exam rooms and restrooms.

• Lab: Evacuate patients from the lab.

• Administrative Staff: Evacuate offices and work areas.  

All Staff: 

• Assist mobility-impaired persons to the Area of Refuge.

• Secure cash drawers/computers.

• If safe, close interior doors and windows, but do not lock them.

• Use the nearest safe stairs and proceed to the nearest exit.

• Proceed to the designated outside Assembly Area (see map) and report to your designated roll taker.

• Wait for instructions from emergency responders.

• Do not re-enter the building or work area until you have been instructed to do so by emergency responders. Emergency Assembly Area (EAA) Location (minimum 150' from the building).

A distinct signal or message provided by public safety officials that indicates the threat or dangerous situation has ended. Resume normal operations.

Emergency Situations  

• Bloodborne Pathogen Exposure

• Explosions

• Utility Failure

• Flood

• Earthquake

Bloodborne Pathogen Exposure

All exposure incidents should be reported to the department director, manager, or supervisor who, in turn, would report the incident to the UNLV Medicine Risk Management Department. The UNLV Medicine Risk Management Department provides information on locations that offer post-exposure evaluation and treatment. Wounds and skin sites that have been in contact with blood and body fluids should be washed with soap and water; mucous membranes should be flushed with water.

Explosions

All types of explosions are hazardous and should be taken seriously. 

• Immediately take cover under tables, desks, or other furniture that will protect from flying glass and debris.

• After the effects of the explosion have subsided, call 911 or UNLV Police Services at (702) 895- 3669.

• If necessary, activate the building fire alarm system.

• Evacuate the immediate area of the explosion.

• Seek and assist injured and disabled people in evacuating the building if needed. Exit via the stairway. Do not use elevators.

• Once outside, move to the designated Emergency Assembly Area or an open area 150 feet away from the affected building. Avoid inner courtyards.

• Keep fire lanes and walkways clear for emergency vehicles and personnel.

• If contaminated, remove affected clothing and try to minimize contamination to others. Report it to your manager/supervisor or the emergency personnel that responds.

• Be cautious of second explosions. Remember, if you see something, say something.

Utility Failure

If the power goes out, remain calm. Most buildings have emergency lights or back-up power generators. However, we recommend having a PLAN B. It is a good idea to have an extra flashlight near-by. Here are some other simple guidelines to remember:

• If your building is experiencing a power outage or utility failure, call UNLV School of Medicine Facilities Help Desk (702)-895-0451 or UNLV Police Services at (702) 895-3669 if after business hours (8 am-5 pm).

• In the event that building evacuation is required, exit via the nearest exit. DO NOT use elevators.  Seek out any disabled persons and assist.

• When mechanical ventilation is interrupted, chemical vapors may reach hazardous concentrations. To avoid this, use natural ventilation, clean up chemicals, and close containers. 

Flood

Any member who discovers a plumbing failure/flood problem or potential flood problem should follow these guidelines: 

• Cease using all electrical equipment. Avoid the area and call UNLV School of Medicine Facilities (702) 895-0451 or UNLV Police Services at (702) 895-3669 if after business hours (8 am-5 pm).

• If a building begins to flood, move to a safe area if possible or evacuate the building.

• Avoid contact with any electrical devices that may have come in contact with water.

• If the building has been evacuated, do not return to the building until instructed to do so. Be sure to take your personal belongings if it is safe to do so. 

It is best practice to assess your workspace before any flood and look at what electronic devices (i.e., desktop tower) you can lift off the floor when possible. 

Earthquake  

During an earthquake: 

• Stay in the building. DO NOT evacuate.

• Remain calm. If indoors, drop to the floor under a sturdy desk or table, cover your head and face with your arms.

• Stay away from overhead fixtures, windows, filing cabinets, bookcases, and heavy equipment.

• Assist any disabled persons to reach a safe place.

• If you are outside, stay outside. Move to an open area away from the buildings, trees, power lines, and roadways.                                           

After an earthquake:

• Be prepared for aftershocks. Aftershocks are usually less intense than the main quake but can cause further structural damage and injury.  

• Protect yourself at all times. 

• Do not use elevators.

• If outdoors, move quickly away from buildings, utility poles, overhead wires, parking garages, and other structures. CAUTION: Avoid downed power or utility lines as they may be energized.  Do not attempt to enter buildings until you are told you can by emergency personnel.

• Evaluate the situation and call 911 for emergency assistance, if necessary.

• Do not use flares, torches, cigarettes, candles, matches, and (or) any open flames, since gas leaks could be present. If a fire is caused or present by the earthquake, evacuate the building carefully.

• Do not operate electrical switches or appliances.

• If the structural integrity appears to be deteriorating rapidly, evacuate the building. Do not use the elevators. Always use the stairs.

• Should you become trapped in a building, stay calm! If a window is available, place an article of clothing (shirt, coat, etc.) outside the window as a marker for rescue crews. If there is no window, tap on the wall at regular intervals to alert emergency crews of your location.

• If you or someone is injured, call 911 for help if possible and give or seek first-aid treatment if able.

• Do not use telephones or roadways unless necessary. Keep them available for emergency use.

• Remember to remain calm. Use a portable radio or your cell phone to stay informed. 

If an evacuation is ordered: 

• Seek any disabled or injured person in the area and assist. Exit via the stairway. Do not use elevators.

• Beware of falling debris or electrical wires as you exit.

• Go to an open area away from buildings, trees, power lines, and roadways.

• Wait for further instructions from emergency personnel. 

Employee Training

All employees shall receive instruction on this Emergency Action Plan as part of New Employee Orientation upon hire.

Additional training shall be provided:

• When there are any changes to the plan or facility;

• When an employee’s responsibilities change; and

• Annually as refresher training.