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    Shaken but not rattled – earthquake preparation standard at Naval Hospital Bremerton

    Shaken but not rattled – earthquake preparation standard at Naval Hospital Bremerton

    Photo By Douglas Stutz | Built to last and absorb ... The Nisqually, Wash., quake on Feb. 28, 2001, registered...... read more read more

    BREMERTON, Wash. - Fourteen years, four months and 22 days before the recently published New Yorker article, "The Really Big One," on July 20, 2015, about a massive earthquake impacting the Pacific Northwest, NHB experienced strong seismic activity and has prepared for future tremors.

    The Nisqually, Washington, quake at 10:54 a.m. on Feb. 28, 2001, registered 6.8 on the Richter Scale and was felt throughout the greater Puget Sound region. That quake gave staff members a forewarning of what it was like to experience a sizable seismic shaking, as the epicenter is just 50 miles south of Bremerton.

    Staff members working on upper floors vividly remember the shaking that lasted up to 45 seconds. Books, plants, coffee cups and other office gear were tossed like so much ticker-tape. Patients were alarmed, staff members uncertain, and friends and family concerned.

    Dan Frederick, then officer in charge of Branch Health Clinic, Puget Sound Naval Shipyard, was attending a training class on the sixth floor when the quake hit.

    “I remember it very well. Everything started to shake. I was able to see outside and could notice how much the building was moving in relation to the trees. And the movement kept going. It was scary the amount of movement taking place. I was thinking that this structure can’t take much more because the force will cause it to break apart. Being on one of the top floors and feeling and seeing the motion was quite the ride,” said Frederick.

    Because of that quake and where the command is situated, NHB completed a unique seismic retrofit project in 2007 which vastly improved the structural ability of the facility to withstand a large earthquake.

    NHB became the first Navy medical facility to undergo this type of seismic retrofit project, says Russell Kent, NHB facility manager.

    “Our hospital has to be operational immediately after an earthquake and we retrofitted it to stringent criteria to be better able to withstand a sizable quake in the future,” Kent said. “We did experience damage and inconvenience when the Nisqually quake hit. That event helped to accelerate the need for a much more secure and stable structure. Our hospital building itself is quite strong and flexible. We had no structural damage. But even with the tremor about 50 miles away and deep below the earth’s surface, the ground motions, and intensity of the seismic shaking caused significant nonstructural damage, especially at the upper floors. Rigid materials such as drywall, window panes and piping do not perform well when suddenly required to bend.”

    Then, as now, there are two old adages shared in the greater Puget Sound area regarding earthquakes. One is that it’s not a matter of "if" as much as "when."

    The other states that if there’s a sizable earthquake in the region, there are two structures that need to remain standing and functional. A hospital is one of them. The other is the jail.

    History has shown that the entire area is prone to quakes, with notable seismic events such as a magnitude 6.5 quake widely felt on April 29, 1965 and a measured 7.1 quake on April 13, 1949.

    According to Terry Lerma, NHB Emergency Preparedness Coordinator, the NHB Facilities Management department has done a great job to safeguard the core building with the seismic retrofit - shock absorbing inertia dampeners - to prevent the upper floors from transitioning from the initial shaking to the rolling circular motion experienced in the 2001 Nisqually Quake.

    “We were also the first naval hospital to be wired with sensors throughout the building and have our own seismograph that will tell us immediately after a quake if the hospital building is safe to stay in, or if we should evacuate,” said Lerma.

    Lerma attests that "if" such a sizable quake happens again, NHB’s role in handling such an emergency situation becomes a crucial component for humanitarian assistance and disaster relief efforts.

    “Our duties are three fold. One, our primary mission is to provide health service support to the fleet and active duty forces, and they will be the primary focus for medical support. Second, routine medical appointments will most likely be deferred for rescheduling until the extent of any damage is known at NHB, or the community begins to return to a degree or normalcy in the recovery phase. We would focus on accounting for all our staff and family members, and focus on performing the level of service our infrastructure, provided it hasn’t been compromised, will allow us to do. Our third duty is our role as a healthcare provider in the local Kitsap County community. We have practiced on the scenario that if the right combination of bridges, overpasses and/or streets collapse or are damaged, a good portion of Kitsap County civilians may not be able to access Harrison Medical Center in Bremerton or Silverdale, or go elsewhere. We would then have the additional requirement to not only provide medical care if needed, but additional security, and we would work with local Kitsap County Department of Emergency Management and the American Red Cross to provide assistance after we complete their medical care,” said Lerma.

    As with any emergency, preparedness is the key to prevent it from becoming a disaster.

    After a major earthquake, structure or utility systems may be compromised or inoperable for weeks or longer. Having supplies for up to 10 days, a communications plan, an emergency plan that all family members know and have practiced, and a method by which to contact not only family members but a work center/command will help. Staff should also know how to update, use, and access the Navy Family Accounting and Assessment System (NFAAS) if/when we are given the “order to account” so we can quickly assess which staff are and aren’t accounted for. NFAAS was born out of previous hurricane events and has been successfully used to account for Navy staff and family members during/after the San Diego wildfires of 2007, the Japanese earthquake and tsunami in 2011, and the Boston Marathon bombings in 2013,” Lerma said.

    If the next big one hits right now, then what?

    The immediate action for staff after drop, cover, hold, would be “not to run outside,” Lerma stressed.

    “We would then have to immediately check all work spaces for any damage and make any structural damage and/or injury to staff/visitor/patients reports,” said Lerma, also citing that the command would then have to secure any leaking water, gas, air, suction, or oxygen lines, and not use any elevators until NHB’s Facilities Management department ensures they are safe and operational.

    “We would also have to check the outside grounds for any buckled pavement, cracks, leaking water mains, or any smell of natural gas and notify Security. We would report any fires, and be prepared for possible aftershocks,” added Lerma, also noting that a phone muster would be started of all work center staff to ensure they are safe and accounted for.

    Part of NHB’s overall command readiness and emergency response plan is to effectively and rapidly handle the natural disaster, provide medical care and prepare for mass casualties.

    “Our staff should always be aware of such a possibility. We have at least two major and three minor earthquake faults running through and/or near Kitsap County. Geographically, the Kitsap Peninsula is essentially an island if the Tacoma Narrows and Hood Canal Bridges were closed. Many geologists say we are overdue for ‘the big one,’ so the possibility of a significant seismic event is possible at any time,” Lerma said.

    (Editor’s Note: The subduction zone earthquake that the New Yorker article featured was not related to faults associated to the Kitsap area)

    Lerma insists that all staff should prepare their home, work space, and personally owned vehicles with emergency preparedness kits along with structural preparations such as securing furniture from falling over, making sure the water heater is safely strapped, and knowing how to shut off their utilities. Staff should also prepare their families with a communications plan such as an out of state contact person and a rendezvous point in case the streets are blocked or closed.

    “We must prepare ourselves and family. NHB staff might very well need to provide care for an extended timeframe until relief arrives or we’re back to normal operations. We have to have the ability to sustain ourselves, and also need peace of mind that our families are okay and can sustain themselves for any such interim period. As a hospital, we must be ready to serve not only the active duty and beneficiary population, but also the ‘perfect storm’ of circumstances that has wounded civilians show up at the front gate needing care due to the inability to transit to a civilian hospital. If needed, we have backup utility systems that will provide power, heat, and water for approximately a week after a significant seismic event,” Lerma said.

    Lerma notes that NHB has routinely held mass casualty drills in conjunction with an earthquake scenario. One of the main objectives is to run a mass casualty exercise and rapidly test and evaluate damage assessment to the facility itself; assist patients, visitors and staff with injuries; and track patients through treatment areas and assess for 72 hours, if necessary.

    “We think outside the standard mass casualty scenario box and have drilled with local Fire/Emergency Medical Service (EMS) on how we would evacuate patients from the upper floors if NHB was structurally compromised. We challenge staff with incomplete scenarios to see how they react and what we learn from them. This September, we are drilling with Operational Health Support Unit and the local Fire/EMS volunteers in another hospital evacuation scenario so that a quake were to hit on a reserve drill weekend, we would have them trained to ‘buy us’ that 30 to 60 minutes we need to recall staff back to NHB and then work side by side with them to continue caring for any other additional casualties along with accounting for our staff,” said Lerma.

    Doctors, nurses, hospital corpsmen and support staff also get tested and evaluated on their ability to set up, activate, triage and transport ambulatory and non-ambulatory trauma patients to correct treatment areas, as well as provide medical care for a variety of injuries atypical to an earthquake, such as abrasions, lacerations and contusions.

    NHB’s Evacuation Plan priorities are to provide immediate assistance to visitors, outpatients, and non-essential staff; support ambulatory inpatients, stable newborns and mothers; help non-ambulatory inpatient, stable post-anesthesia care unit patients, and beneficiaries in early stage of labor; and handle critical care patients, OB patients in third stage of labor and intra-operative cases.

    The NHB Evacuation Plan also contains a check list with such information as preparing bed ridden patients by ward staff for using the Evacu-Sled; check all spaces for patients, visitors, or injured staff, some of whom might be hiding in closets or under furniture and ensure that they are evacuated before able bodied staff; ensure a safe route for evacuation - avoid elevators - and destination; and provide for evacuee physical and emotional care, including facilitation of communication to loved ones/family members.

    “It’s about preparedness, practice, and maintaining supplies. The time to stock up from the store is not right after the ground stops shaking. There is a lot of information available on what kinds of supplies, food, water, medications, pet food, to stock up on and rotate so someone does not have to spend a lot of money at one time. The time taken now to prepare and maintain supplies, the time taken to make a plan and review it with all family members is now. Hopefully, it will never have to used, but even in a severe winter weather event, the preparations or supplies just might pay off,” Lerma said.

    Holding earthquake drills helps NHB maintain the high standard of readiness for serious conditions such as disaster, weather, and mass casualty situations.
    Because shaken is one thing. Rattled is another.
    Kitsap County Department of Emergency Management (KCDEM), recommends the following for dealing with a major natural disaster such as an earthquake, flood or severe weather storm:
    • Know the safe spot in each room: under sturdy tables, desks, or against inside walls.

    • Be aware of danger spots such as windows, mirrors, hanging objects, fireplaces and tall furniture.

    • Conduct practice drills. Physically place yourself and family in safe locations.

    • Learn first aid and CPR (cardiopulmonary resuscitation).

    • Create a Family Earthquake Plan and decide where your family will reunite, if separated.

    • Keep a list of emergency phone numbers.

    • Choose an out-of-state friend or relative who family members can call after the quake to report your condition. Carry emergency contact cards with out-of-state contact phone numbers.

    • Develop a portable/auto survival kit for work and travel

    Earthquake Descriptors
    There are micro earthquakes (approx. 8,000) every day that are not felt and measure less than 2.0 on the Richter Scale.

    Earthquakes measuring between 2.0 and 2.9 are considered very minor, and are generally not felt (by humans). They are about 1,000 a day.

    Minor quakes in the 3.0-3.9 range are often felt but rarely cause damage, It’s estimated there are 49,000 a year.
    Light quakes of 4.o to 4.9 cause noticeable shaking of indoor items, rattling noises. Significant damage is unlikely. There are an estimated 6,200 per year.

    Moderate quakes of 5.0-5.9 range can cause major damage to poorly constructed buildings over small regions. At most slight damage to well-designed buildings. Example: The 1987 Whittier Narrows quake in southern San Gabriel Valley, Calif. caused $358 million in damage. There are 800 per year.

    A strong quake in the 6.0 to 6.9 range can be destructive in areas up to about 100 miles across in populated areas. Example: The 1994 Northridge, Calif. earthquake, registered 6.7, considered a moderate quake, but the ground acceleration (earth shaking) was the highest ever instrumentally recorded in an urban area in North America. There are about 120 per year.

    Major quakes measure 70 to 7.9 and can cause serious damage over larger areas. Example: The 2010 Haiti earthquake with a magnitude 7.0, caused an estimated 316,000 people fatalities, 300,000 more injured and one million made homeless. U.S. Navy assets, immediately after and still to this day provide support. There are 18 per year.

    A great earthquake in the 8.0 to 8.9 range can cause serious damage in areas several hundred miles across. On Sept. 29, 2009, U.S. Geologic Survey reported an 8.1 earthquake off Samoa Islands. The resulting tsunami flattened villages in Samoa and American Samoa which killed 189 civilians and displaced over 10,000 people. The frequency of occurrence is one per year.

    A rare great earthquake of 9.0 or greater can (and does) cause devastation in areas several thousand miles across.

    Example: Dec. 2004: The Indian Ocean quake, which registering a magnitude of 9.1-9.3. The epicenter was off the NE coast of the Indonesian island of Sumatra, caused a series of gigantic tsunamis that caused more than 229,000 fatalities and impacted many nations along the Indian Ocean. U.S. Navy involvement was in-depth, from Operation Unified Assistance on Banda Aceh province, Sumatra, to Sri Lanka and Thailand.

    NEWS INFO

    Date Taken: 08.11.2015
    Date Posted: 08.11.2015 18:21
    Story ID: 172841
    Location: BREMERTON , WASHINGTON, US

    Web Views: 259
    Downloads: 0

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