Laboratory of Pathology - Staff

Emergency Management

This policy is to supplement the National Institutes of Health (NIH) Clinical Center's Emergency Management Plan and to identify specific roles and responsibilities for Laboratory of Pathology staff during internal and external emergencies and disaster preparedness. 

General Plans for LP Clinical Services

• All employees are trained in emergency management by their section area when hired. Documentation of training is done with the New Employee Orientation worksheet.
• Plans are part of the LP Policies Manual and are reviewed by employees on an annual basis.
• Fire and evacuation drills are carried out bi-annually.
• Each section should have an adequate supply of flashlights and batteries.
• Emergency Power is limited, but is currently being addressed for critical functions. Submit a Facility Maintenance work order or contact 301-435-8000 to request evaluation of emergency power, if needed.

Key Elements of the Clinical Center's Emergency Management Plan

• Part D. Section 2: Code Yellow
• Section 14: Building Evacuation Plan
  • Roles and Responsibilities
  • Evacuation Guidelines
  • Evacuation Levels
• Part E: Internal Emergencies and External Disasters
  • Biological, Chemical, Bomb or Radiological Threat
  • Fire Emergencies
  • Loss of Power or Utilities
  • Active Shooter
  • Community Disasters with Casualties (Role of the Clinical Center)
  • Inclement Weather Policy
• Part F: Continuity of Operations

Communication

Note: Use the Emergency Red Phones located in the stairwell main entrances to the LP Clinical Labs in the 3N and 2N corridors. if there is a loss of telephone communication. Emergency phone numbers and instructions are attached to the red phone and listed in the front of the NIH phone book. Dialing on the red phones does not work the same as our regular system.

Someone calling from the outside will just hear normal ringing when the Merlin phones are out-of-operation. Calls will not transfer to voice mail. If phone disruption cannot be addressed immediately, notify all customers to use Emergency Red Phones for critical needs. If it is after regular business hours, call the Admissions Desk at 301-496-3141.

Roles and Responsibilities During Emergencies and Activation of Codes

A. Medical Emergency

• Call 111 for the Clinical Center Emergency Response Team (CERT) to initiate a “Code Blue” for any type of medical emergency. Request a “Pediatric Code Blue” for all victims under the age of 18.
• Automated External Defibrillators (AEDs) are available throughout the NIH Clinical Center (CC). The first responder may use the AED in the event of a cardiac arrest in an adult or child over 8 years of age (victim is found unconscious and without a pulse).
• Trained staff on the scene may administer first aid or basic life support when appropriate. Emergency resuscitative equipment boxes containing gloves and Laerdal resuscitation masks are located at most elevator banks and in other public areas in the Clinical Center. When the members of the Clinical Emergency Response Team (CERT) arrive, they will identify themselves and assume responsibility. The first CERT physician to arrive is responsible for initiating care of the victim. All individuals already on the scene should immediately relinquish care of the victim to the CERT.
• For all emergencies outside the Clinical Center and for non-life threatening events in the hospital, call 911 for the NIH Rescue Squad. When off of the NIH campus, call 9-911, for local rescue services.
• When OMS is closed and an NIH employee has a blood or body fluid exposure, promptly call the Clinical Center operator at 496-1211 to contact an OMS physician immediately.
• If an NIH employee sustains a work-related injury or illness, it is the responsibility of the employee or his/her immediate supervisor to notify OMS of the incident.
• The CC Policy (M-95-1) regarding Emergency Medical Services can be found at http://intranet.cc.nih.gov/od/emergencyplan/pdf/emergency_management_plan.pdf

B. Emergency Evacuation

Employees must follow evacuation policy 1430 -- See NIH Manual #1430 “NIH Occupant Evacuation Plan” 

1. Occupants should follow the instruction broadcast over the fire alarm system or instructions given by the Fire Officer in Charge. Individuals who are the designated floor and area occupant emergency coordinators shall assist visitors and employees in moving to exits and evacuation routes. Individuals should leave the zone in alarm via the closest stairs. 

2. Persons with disabilities:

   1. Staff should assist individuals with disabilities to one or two levels below the zone in emergency. 

   2. Individuals should call the NIH Fire Department on 911 for immediate assistance to evacuate mobility-restricted occupants.

   3. Persons who use TTY telephone lines can call the NIH Police or Fire Department on 301- 496-0063.

3. The Occupant Emergency Coordinator (OEC) for LP is an NCI Administrator on duty (e.g., LP Clinical Manager, Medical Director, Section Head).
   
   

4. The LP Safety Committee Members and Chair work together to function as the Floor Team/Area Team Coordinators (FTC/ATC) for evacuation procedures.
   
   

5. The FTC/ATCs:

   1. Expedite evacuation

   2. Assist individuals requiring assistance

   3. Report conditions and evacuation status to the OEC

   4. Advise the location of persons needing evacuation and/or assistance by the fire department.

   5. Monitor stairways, restrooms and elevators
      
      

6. The designated meeting place for all LP employees (except off-site and ancillary LP labs) evacuating the building is the parking lot behind Building 1.
   
   

7. Specific plans for any persons with disabilities are established in appropriate sections, as needed. The Safety Officer is responsible for notifying hearing-impaired persons of alarm situations.
   
   

8. Evacuation routes are posted in each section.

C. Shelter-in-Place

1. In the event the NIH would need to react immediately to a crisis situation, the following "Shelter-in-Place" guidelines have been developed to aid NIH employees. These guidelines apply to any emergency or potential emergency caused by natural disasters, chemical, radiological or biological incidents, terrorist threats, and other crisis situations where the safest course of action for an employee would be to remain inside a building.
   
   
2. Recent heightened security on campus due to potential terrorist threats to government employees and facilities emphasizes the importance of these guidelines. However, the NIH wants to assure employees, these guidelines are not being issued as a result of the recent elevation of the national threat level. Rather, these guidelines, created in consultation with the NIH Community Advisory Board for Security (CABS), are being issued to aid all employees in the event of any future emergency situation.
   
   
3. In the event of an emergency during the workday, you may be advised to seek shelter-in-place. The term “shelter-in-place” means to seek immediate shelter inside a building and to remain there until an all-clear signal has been given. The term has historically been used in an instance of weather emergency, such as a hurricane. However, shelter-in-place will now be used in any situation in which the safest course of action is to remain in place for a short period, such as when there is a phased dismissal of the campus following an emergency. Although such shelter should not last more than a few hours, you should make sure that you have available appropriate supplies, such as drinking water and any medications that you might need. In some situations, you may be asked to remain at your workstation, and in others, to relocate to a pre-determined location or area of refuge. In the event of an emergency that requires you to shelter-in-place, you will be provided more detailed instructions specific to the building in which you work.
   
   
4. Some key points to keep in mind are:
   1. Keep calm – follow these directions.
   2. If you are outdoors, go inside immediately to an area of refuge or an area designated by your safety officer or supervisor.
   3. Do not attempt to leave campus to pick up children or other family members – they will likely be sheltering in place wherever they are located.
   4. Unless you have an emergency in your shelter, stay off the phones, including personal cell phones. It is critical to keep lines open for fire, police, medical and other responders, for people reporting emergencies to 911, and for other official communications.
   5. Also note that shelter-in-place is the default mode of the NIH Clinical Center in most emergencies because of the impracticalities of evacuating patients and the low likelihood of an emergency that would require evacuation of the entire building.

D. Code Yellow

1. To assure coordinated and timely communication of critical information during an emergency, the NIH Clinical Center is implementing a new communication process using emergency e-mail notifications and walkie talkies set to the CC frequency.
   
   
2. The emergency e-mails are sent to the Director of Clinical Operations and the Clinical Laboratory Manager. They will be forwarded to LP employees as appropriate. All emergency employees are included in the NCI CCR LP-Emergency e-mail list, located on the NIH global directory and this may be used, if needed.
   
   
3. The Laboratory Manager (or designee) reports to the CC Emergency Management Communication Center (EmaCC) and establishes communication between emergency leaders in LP.
   
   
4. The Clinical Laboratory Manager assists with EMaCC, as needed.
   
   
5. The EmaCC may establish a gathering place for displaced staff and visitors, most likely Lipsett and/or Masur Auditoriums.
   
   
6. The Surgical Pathology Office (10/2B50) will become the central location for LP communications with a FAX machine (301-480-9488), e-mail, red phone, computers, and emergency supplies (TBD).
   
   
7. Secondary location (back-up) will be Cytopathology Office (10/2A33). Back-up FAX is 301-402-2585.
   
   
8. Supervisors begin to assess their areas and advise Chiefs regarding support needs, assign staff responsibilities to support the situation or release employees to the CC labor pool.
   
   
9. The Archivist would begin assessing the attendance of the department, using a roster log to determine clinical staff by each area, to determine current staff, staff needed, and deployable staff. The Chief, Clinical Chiefs, PIs Director of Clinical Operations, Director of Research Operations, and Clinical Lab Manager will report to the central location if a code yellow is activated for emergency response meeting. This team does the following:
   
   
   1. Designates staffing requirements for a disaster and determines who can be deployed to help the emergency labor pool.
   2. Addresses operational issues surrounding staffing, equipment, and space necessary for response or movement in the event of a disaster. Need to determine critical functions and requirements (staff, equipment, transportation, information technology, etc.) to support patients during an emergency and/or disaster.
   3. Determines ability and need to transfer or equip back-up location, should we need to evacuate the area.
      
      
10. The Laboratory Information System (LIS) Administrator monitors network and computer applications required for relief effort. The LIS Administrator also coordinates with CIT staff to provide support as needed.

E. Emergency Phone Tree/Call-Back Procedures

1. Phone tree may be activated by the Director, Center for Cancer Research or Chief, Laboratory of Pathology.
   
   

2. Red Alert Critical (RAC) employees start calling employees as specified in the phone tree.
   
   

3. Red Alert Essential Staff (RES) are called by callers designated on the tree.
   
   

4. All callers contact the Clinical Laboratory Manager (Technical Laboratory Manager, as back-up), to confirm all secondary calls were placed, or report problems. Managers will relay summary of information to Chief.

F. Department Disaster Response Team

The morgue may be utilized if presented with a disaster with mass casualties.

1. The Autopsy Section maintains an inventory of at least 100 body bags on site (adult and peds sizes), but we may need to identify additional space to place bodies after morgue capacity is exceeded.
   
   

2. Work with the NIH Police Department and NIH Clinical Center Leadership to establish a security plan to guard bodies and personal belongings if morgue operations are relocated.

G. Emergency Employees (Essential Personnel)

1. Emergency employees provide services that are vital for direct patient care or patient care support at NIH.
   
   

2. During emergencies, clinical services can be expected to continue for NIH Clinical Center patients.
   
   

3. In general, all employees supporting a clinical service will be classified as Emergency or Essential, and only the section supervisor can excuse staff. Emergency employees are required to report for, or remain at work in emergency situations.
   
   

4. Emergency personnel will report to work during weather emergencies resulting in government closure notification. Dismissal or closure announcements will not apply to emergency (essential) employees unless otherwise instructed by the section supervisor. Employees who cannot report to work must call their supervisor to be excused.
   
   

5. Each supervisor must review their coverage policy for their staff, and each section should have a schedule for coverage of their service during an emergency.
   
   

6. Section supervisors (medical officers) have access to the Emergency Call List available in our local network drive folder: L:\LP\Emergency Contact.

Continuity of Operations: NCI Emergency Management and Physical Security Branch (EMPSB)

Can assist with addressing facility and operational issues involving NCI Laboratories

Phone: 240-276-7660
Email: ReadyNCI@nih.gov
Intranet: https://mynci.cancer.gov/ReadyNCI
Internet: www.cancer.gov/ReadyNCI
Twitter: @ReadyNCI

Or contact individually:

Shane Hebert, CFM
Chief of Emergency Management & Physical Security
National Cancer Institute
Phone: 240-276-5015
Cell: 240-507-8508
Fax: 301-496-1503
email: shane.hebert@nih.gov

Jeff Alderdice, MS, MDPEMP
Emergency Preparedness Manager
National Cancer Institute, Contractor
Global Solutions Network, Inc.
KC3DXM, Skywarn Spotter #MO283
Phone: 240-276-5138
Cell: 240-428-9838
E-mail: jeffrey.alderdice@nih.gov
Follow us on Twitter: @ReadyNCI