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Millinocket Regional Hospital Hospital Evacuation Plan
Please take note: 
This evacuation plan is not appropriate for disaster situations such as fire that requires a more immediate removal of patients from the building. In which cases, the nearest exit would be used to remove patients from immediate jeopardy. 

The evacuation plan is to be utilized in the event of a disaster which requires an evacuation from the hospital premises to a safe shelter. 

The safe shelter will normally be the Millinocket Regional Hospital's General & Orthopedic Practice Building located on the hospital campus near the Poplar street entrance. The alternate safe shelter is the Granite Street School. An evacuation shall be declared when facilities capacity for the safe care of patients is compromised or at high risk of compromise and cannot otherwise be immediately remedied. 

The authority declaring the evacuation must designate a safe area within the hospital. This will be a place where staff available to assist will gather to receive instruction. It is also where patient will be initially taken prior to transfer outside of the hospital. This is typically the Main Lobby or the Multi purpose Room.

This plan provides guidance on first moving all people inside the building to a safe area within the hospital and then to the safe shelter outside of the building. 

General Provisions
A disaster (internal or external) must be declared prior to any evacuation. See Internal and External Disaster Plans for details.

An evacuation may be declared by the administrator, administrator - on call  or the police or fire chiefs.  

When notification is from the Police or Fire Chief:
1. The call will be forwarded to the Nursing Administrator or Manager.

2. The Nursing Administrator / Manager will contact the Administrator to explain situation, determine the disaster call, the safe area and the order for evacuation.

3. The Administrator or his/her designee will announce :

a. “deployment“ Main Lobby or Deployment Multi purpose Room three times.
b. in the case of a drill the operator will state “deployment –drill – and the specified safe area.

When notification is from the Administrator:
1. A departmental manager or Nursing Supervisor recognizing the need to declare a disaster and the need for evacuation must contact the administrator with all pertinent information.

2. The Administrator shall contact and inform the Nursing Administrator on call to provide the disaster call, the safe area and the order for evacuation as above. 

a. “deployment“ Main Lobby or Deployment Multi purpose Room three times.
b. in the case of a drill the operator will state “deployment –drill – and the specified safe area.

The Nursing Administrator will assume the role of disaster chief until the Senior Administrator is on site.

Basic Plan regarding he holding area exits 
1. The safe area  shall be the main lobby unless this is determined unsafe, in which case the Multipurpose Room would be the designated area;

2. The OR and/or Special care rooms on Inpatient shall be used as the safe are for patients who require life support. 

3. All stairwells and elevators will be used to get patients, visitors and personnel to the lower level (when the main lobby is unavailable) as quickly as possible;

4. Personnel who are not involved directly in patient care shall report to the safe area and await further instructions.

5. Personnel involved with patient care shall evacuate patients to the safe area via stairwells and elevators as necessary.

6. Personnel involved with patient care shall contact the personnel pool in the multipurpose or main lobby for assistance in evacuation patients.

7. Evacuation from the hospital will normally be to the General and Orthopedic Office Building. If this cannot be used the alternate location will be Granite Street School.

8. Evacuation to these areas will be accomplished via ambulance and bus (Mike Bragdon's Bus Service (723-8179).

9. Outpatients and visitors who have their own transportation will be directed toe leave the building immediately, other w ill be directed to the safe area.

The Goal is to remove all patients, personnel and visitors to the “safe” area as quickly and as safely as possible.

Inpatient Unit

On notice for evacuation 
The nursing staff will determine which IVs can be saline lock only, clamp NG tubes and transfer all oxygen to portable tanks. 

The RN and/or the Nurse Manager will ascertain which patients are ambulatory, wheelchair or bed transports.

The patients will be escorted on foot, wheelchair and bed/stretcher as appropriate.

Under the guidance of the Nursing staff and manager the least skilled staff will accompany the more stable patients and the skilled and licensed staff will accompany the less stable patients. 

If there is a patient requiring mechanical ventilation for life support these patients will be remain until arrangements for transfer can be made ( For example transport of the patient to another hospital or by ambulance to a safe shelter that arrangements have been made for the the necessary equipment.)

OR/ASU/Endo/Recovery Room
Patients in these areas will be evacuated as soon as possible as determined by the surgical and anesthesia staff. Nursing staff will remain only as necessary to complete any procedures that are in progress and at the earliest time possible will transfer the patient to the safe area.

Staff available will assist in transferring patients from wall units to portable oxygen as needed. 

Upon notification of the “deployment “ alert all employees in the lab will immediately shut off power and disconnect the major electrical equipment and secure the storage cupboards, windows and doors to the corridor. Employees from the laboratory will assist patients and visitors that may be exiting at the elevators and stairwells. Once it appears that all patients and visitors have been or are being assisted, the Laboratory staff should report tot the safe area for further instruction. 

Diagnostic Imaging
The DI transcription staff if in house should alert staff in the department of the evacuation and will direct any ambulatory patients or family who are waiting to the safe area. 

All technologists (Nuclear Med, CT, Radiology and Ultrasound staff) will be responsible for getting their patients to the safe area. The DI staff should stay with their patients until they have been given direction to do otherwise.

Physical Therapy
All ambulatory patients in the department are directed to the safe area. 

All non ambulatory patients in the department are assisted tot the safe area for evacuation by the PT staff.

Emergency Department
On notice for evacuation the RN will determine which patient may be transported to the holding area and ambulatory patients will be accompanied to the safe area. If there are severe traumas or cardiac patients an attempt to transfer will be made, until then all critical patients should be cohorted in an area that is most safe – either the Recovery area or the Special Care Rooms.

If all patients can be moved to the safe area the staff form the ED will also report there.

Business Office
Personnel report to the safe area.

Information System
Shut down the system.

Housekeeping and Laundry
Personnel report to the safe area.

Plant Operations
Shut off LP gas supply at the tank.

Obtain approval from Inpatient EKG, ED, OR, SCU prior to shutting off O2 supply valve in the crawl space.

Assist Materials management in fulfilling supply needs and transfer to safe shelter

Materials Management
Report to the safe area and determine supplies and quantities required to go off site to the safe shelter-obtain input from Nursing and other clinical staff.

Maintenance will assist to transfer supplies –lock department after supply requests have been completed. 
Health Information
Personnel report to the safe area.

Human Resources
Personnel report to the safe area.

Social Services/Utilization Review
Staff report to the Nurses station on Inpatient to assist in evacuation of inpatients to safe area.

Dietary Department
Turn off steam, shut doors and windows.
Push dining room tables to one side. 
Unlock storage room.
Report to the safe area.

Physician Practices/Outpatient locations: 
899 Central Street Building

125 Connecticut Avenue

165 Poplar Street 

Medical Office Bldg #2 at 200 Somerset Address

If evacuation is necessary shutdown all power, closing doors behind and assuring all staff and patients are assisted to a safe area outside the building.