132 CCDHB Earthquake Response Plan.pdf

Document facilitator: Service Leader EMS
Senior document owner: HHS Management Team
Document number:  1.1449 Issue Date: 26th March 2012 Review Date: 26th March 2017

Type:
Procedure

Name:
Earthquake Response Plan

Immediate actions ................................................................................................................2
During an earthquake.................................................................................................2
After an earthquake....................................................................................................2
Initial post-earthquake actions .............................................................................................2
Individual staff actions...............................................................................................2
Workplace actions......................................................................................................3
Damaged utility services......................................................................................................6
Water management ....................................................................................................6
Sewerage management ..............................................................................................8
Incident management...........................................................................................................9
Civil Defence declarations.........................................................................................9
Key locations .............................................................................................................9
Emergency communications......................................................................................9
Equipment and supplies available............................................................................10
Obtaining supplies and other assistance ..................................................................10
Damage assessment .................................................................................................10
Risk assessment .................................................................................................................10
Expected casualties ..................................................................................................12
Expected recovery time ...........................................................................................12
Appendix 1 – rescue and clean up equipment ...................................................................13
Emergency Management stores ...............................................................................13
Earthquake cabinets .................................................................................................13

Earthquake Response Plan
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Immediate actions
During an earthquake
Protect yourself
•  Get under something that will give protection from falling objects
•  Watch for danger – be prepared to move out of the way if necessary
After an earthquake
Use the Earthquake Action Pack as a guide for the
initial actions to follow – see the Emergency
Management Document Pack in this folder
•  Deal with life threatening problems such as serious injuries, fire, unsafe
structures
•  If the area is unsafe, evacuate
•  If the area is safe, remain and follow the procedures in this plan
Initial post-earthquake actions
Earthquakes can inflict a wide range of damage, and it is difficult to prescribe a
specific course of action to follow.
The initial assessment may be misleading, and the situation may change significantly
over time, or as the result of the aftershocks that commonly follow a large
earthquake.
•  Even if an earthquake does not appear to have caused damage in the
immediate area, other buildings on site (or other parts of the Region) may
have suffered extensively
•  Small breakages may cause significant damage in the long term (e.g. a burst
water pipe causing flooding)
•  While utility services may still be working immediately after an earthquake,
they may be lost shortly after. For example water supplies may fail when the
header tanks drain; and telephone and emergency lighting systems may fail
when backup batteries are exhausted
The following actions are important initial steps after an earthquake that has caused
damage. They are based on the assumption that initially, the most demand for
assistance will be at hospitals.
Individual staff actions
Staff on duty at a hospital
Staff on duty at the time of an earthquake should remain at the hospital and assist
with the initial response. This may include caring for any casualties in their own
Earthquake Response Plan
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areas; undertaking the evacuation of damaged areas; assisting with mass casualties
arriving at the hospital; and restoring damaged services within their area.
Staff on duty in the community
Staff on duty in the community (at clinical, support, and corporate bases) should
follow any specific earthquake procedures in their Service Mass Casualty Plan
(usually related to the care of patients in the community). If there is no immediate
need to continue with duties in the community, staff should try to make their way to a
hospital and offer their assistance there.
Staff who are not on duty
Staff who are not on duty at the time of the earthquake are requested to return to
duty as soon as possible. The following points should be noted:
•  It is accepted that the first priority of staff will be to ensure the safety of their
families and homes
•  Staff should return to duty without being asked. It will probably not be possible
to contact off duty staff in the first hours (or even days) after an earthquake
•  Initially, if it is not possible to return to their normal workplace, staff should
report to another appropriate centre (e.g. depending on their role - another
hospital, GP surgery, or Civil Defence Centre)
•  Identification may be required if it is necessary to pass through a cordon or to
seek assistance with transport. Suitable forms of identification include a DHB
identification card or a payslip
•  Staff should be prepared to spend longer periods at work than usual, and to
work differently (normal services and facilities may not be available and the
initial focus is likely to be on the management of mass casualties)
Staff with senior management or Emergency Operations Centre roles
Senior management staff, and those trained in emergency management roles should
report to the Emergency Operations Centre at either Wellington or Kenepuru Hospital
as soon as possible.
Workplace actions
The initial actions that should be undertaken in each Ward, Unit, or Service Area
immediately after a damaging earthquake are set out in the Earthquake Action
Pack in the Emergency Management Document Pack in this folder.
The key points include:
Senior person to assume control
The person in charge of each area is expected assume responsibility for ensuring
that the initial tasks are undertaken in their area.
In some areas there may be advantages in adjoining areas working together – it may
be especially beneficial for small groups sharing one floor of a building to combine
their resources.
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Start actions immediately
Each area should undertake their initial actions without waiting for further direction.
It is unlikely that key staff will be able to visit all areas within a hospital shortly after a
large earthquake – it may be hours before some areas can be advised of the extent
of the damage.
IMPORTANT
It may be some time before emergency
management systems are in place. Staff in each
area should undertake the initial actions without
waiting for further direction
Check the area
Undertake a methodical check of the whole area to ascertain what damage has been
caused to people, to services, and to the building structure.
It is important to:
•  Complete the check before deciding on a course of action
•  Ensure that every part of the area is checked

Deal with life threatening problems
Deal with injuries, fires, exposed electrical components and other potentially life
threatening problems as required.
If necessary, try to call for help by the usual means (dialling 777 and/or activating the
fire alarms), or by sending runners; but do not depend on assistance arriving.
Response Teams and Emergency Services may be overwhelmed or incapacitated.
Assess the extent of the damage
The Post-earthquake Situation Report form in the Earthquake Action Pack
should be used as a guide for recording damage.
An initial damage assessment will assist staff in an area to decide whether to remain
in the area or to evacuate; and it will be the first stage of compiling information on the
overall status of DHB facilities.
Decide whether to evacuate or to remain in the area
IMPORTANT
The initial decision to evacuate an area will need to
be made by staff on duty in each area at the time of
the earthquake.
The decision should take account of factors such as:
•  Any problems that may require immediate evacuation (e.g. uncontrolled fire,
extensive building collapse)
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•  Whether or not the damage is to the structure of the building  (load bearing
walls, cross beams etc) or just to internal partitions, ceiling tiles and fittings
•  The ability to evacuate the area unaided – especially if dependent patients
are involved, and/or escape routes are damaged
•  Whether or not there is a safer place to evacuate to – in some situations the
adjoining areas may be in no better condition, and evacuating outside may
pose additional problems
Evacuation guidelines
If a decision is made to evacuate an area, and there is time, the following points
should be noted:
•  At least 2 people should be sent to check that it is in fact possible to
evacuate, and that the intended destination is still functional
•  If injured or dependent people need to be evacuated, it may be best to
evacuate in small groups so that available able bodied people can assist each
group
•  In some cases it may be necessary to first evacuate to an intermediate point
•  Where possible, evacuation should be to an area where appropriate facilities
and supplies are available (e.g. evacuate wards to other clinical areas; mental
health units to alternate secure sites)
•  The following areas have pre-designated evacuation plans – refer to the Fire
and Hazardous Materials Plan in this folder for more information :
−  Operating Theatres (at both Wellington and Kenepuru)
−  Intensive Care Unit
−  Neonatal Intensive Care Unit
− Delivery
Suite
− Call
Centre
•  The Emergency Operations Centre staff should be advised of the evacuation
as soon as possible
•  As soon as possible after arriving at the evacuation area, the measures
outlined in the following sections should be followed
Remaining in the area
If it is decided not to evacuate, the following points should be noted:
•  Expect aftershocks – consider what actions may be necessary to prevent
further injuries or damage in the area. This may include :
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−  Cordoning off sections of the area that may pose a danger
−  Moving people away from glassed areas
−  Securing, moving, or demolishing equipment, partitions etc which may
have become unstable in the initial shaking
•  Limited supplies of equipment (ropes, gloves, dust masks etc) are available in
most hospital buildings – see appendix 1 for further information
•  Commence water conservation measures (see the Water Management
section)
•  Implement the Sewerage Management Plan (see the Sewerage
Management section)
• Complete
the
Situation Report in the Earthquake Action Pack and send it
to the Emergency Operations Centre by whatever means are possible
•  Implement the Service Mass Casualty Plan if appropriate
Damaged utility services
It is expected that a large earthquake will cause widespread damage to utility
services in the region.
While hospital buildings have backup systems in place for all essential services, it is
still possible that they may be disrupted – either completely, if the backup systems
are damaged; or partially, if there is damage to reticulation systems (pipes, cables
etc)
Guidelines for dealing with failed utility services are set out in:
•  The Essential Services Failure Plan in this folder
•  Specific backup procedures operating in some wards or departments
After an earthquake, it is especially important that the following water and sewerage
management measures are implemented – even if it appears there is no damage
to these systems.
Water management
The careful management of water is critical after an earthquake.
It is expected that a large earthquake will cause extensive damage to the region’s
water supply system; and that damage to the water reticulation systems within
hospital buildings could cause significant damage.
Water management measures include:
•  Maintaining emergency supplies of potable water
•  Dealing with water leaks as a high priority
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•  Conserving water through changed practices
Emergency water supplies
Emergency supplies of at least 100 litres of potable water are maintained in each
inpatient area (and many other areas).
A 2.5M litre reservoir is maintained at Wellington Hospital.
100,000 litres of potable water are kept in stand alone tanks at the Porirua campus,
and 50,000 litres is stored at the Kapiti Health Centre
In addition, various storage tanks within buildings hold another 114,000 litres at
Wellington Hospital and 35,000 litres at Porirua.
Other possible sources of drinks include fruit juices, milk and soft drinks available
from cafeterias and vending machines.
Managing water leaks
The reporting and management of water leaks following an earthquake is a high
priority.
•  Large amounts of water can be lost in a very short period – even through
what appears to be minor damage
•  Water can quickly cause extensive damage to buildings; equipment; and
supplies
All staff are expected to:
•  Report any water leaks to the Emergency Operations Centre or Technical
Services staff as a matter or urgency
•  Take whatever measures are possible to control or minimise any leaks. This
may include :
− Closing
valves
−  Taping, blocking or crimping damaged pipes
−  Damming or diverting water away from vulnerable areas
Conserving water
Every effort must be made to conserve water after a damaging earthquake. The
following measures should be implemented immediately, and remain in place until
the Incident Controller advises that they are no longer required.
Hand washing
Do not use running water for hand washing. Where possible waterless cleaners such
as antimicrobial hand gel and / or gloves should be used. Where hand washing is
needed, the ‘two bowl’ method should be used:
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•  Two bowls should be filled with water – hands should be washed in one and
rinsed in the other
•  The water should only be changed when necessary, and if sufficient supplies
are available
Washing and showering patients
Patients must not be showered, and washing is to be kept to the minimum necessary
to maintain safe care.
Flushing toilets and sluice facilities
Toilets must not be flushed, and sanitisers must not be used (see the sewerage
management measures for more information).
Automatic flushing systems on urinals must be shut down.
Sewerage management
The post-earthquake sewerage management guidelines are intended to:
•  Assist with the conservation of water
•  Minimise contamination and health problems arising from sewerage leaking
from damaged pipes either within buildings, or in the surrounding grounds
The guidelines must be implemented immediately after a damage causing
earthquake, and remain in place until the Incident Controller advises the
sewerage system is safe to use, or other arrangements are made.
Specific actions
Toilets and urinals
The number of toilets in any area must be kept to the minimum (1-2 per floor). Other
toilets and all urinals are to be locked off.
The toilets that are to be used are to be fitted with ‘double bagged’ standard plastic
rubbish bags and used as latrines.
When they are ready to be changed, the bags should be tied securely and stored in
an appropriate place in the area – possibly one of the toilet cubicles that are not
being used.
Emergency Operations Centre staff will arrange for the bags to be removed from the
building at regular intervals.
Bedpans
Bedpans should be fitted with plastic bags before use (and the waste collected in the
bag).
The bags should be managed in the same way as the toilet bags.
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Incident management
The management of the aftermath of a major earthquake will require a different
organisational structure and procedures – at least until the expected mass casualties
have been dealt with, and damaged services restored.
In general, the structures and relationships outlined in the Mass Casualty Plan will
be followed. Some key elements of the management of such an incident would
include the following:
Civil Defence declarations
A state of Civil Defence Emergency would be declared in areas affected by the
earthquake. In the DHB region it is likely that declarations would made by:
•  Locally (Wellington and Porirua City Councils, and the Kapiti Coast District
Council)
•  Regionally (The Greater Wellington Regional Council)
•  Nationally (The Ministry of Civil Defence and Emergency Management
National Crisis Management Centre at Parliament Buildings)
Key locations
Details of the key contact points within the DHB are listed in the Major Incident
Directory in the Emergency Management Document Pack within this folder.
Emergency communications
It is expected that telephone and computer network services will be lost immediately
after an earthquake and may take some days to restore.
Handheld radios are available at both Wellington and Kenepuru hospitals to provide
emergency on-site communications.
Base radios in the Emergency Operations Centres at both hospitals also provide
communication with:
•  Other hospitals in the region including private surgical hospitals
•  Civil Defence centres at :
− Wellington
City
Council
− Porirua
City
Council
−  Kapiti Coast District Council
−  Greater Wellington Regional Council
Two satellite phones are held in the Wellington Hospital Emergency Operations
Centre
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Equipment and supplies available
Medical supplies, food and water
Stores of basic medical supplies, food, water, and some support items are available
at hospital sites. Requests for supplies should be made to the Logistics
Coordinator in the Emergency Operations Centre.
Rescue and clean-up supplies
Some basic supplies are available at both Wellington and Kenepuru hospitals. Refer
to Appendix 1 for more information.
Obtaining supplies and other assistance
It is likely that normal supply arrangements will be disrupted by damage to roads,
airports, and communications; and that demands for some services and supplies will
be very high.
It is essential that the use of resources is coordinated to ensure ‘the greatest good for
the greatest number’.
All requests for supplies and services must be made through the Emergency
Operations Centre.
In some cases Emergency Operations Centre staff will coordinate requests with Civil
Defence Centres (especially if the supplies or services may be needed by a number
of different agencies).
Damage assessment
A Damage Assessment Coordinator will be appointed by the Incident Controller to
oversee the assessment of buildings and facilities as soon as possible after an
earthquake.
The initial assessments will be focussed on:
•  The need to provide facilities for the expected mass casualties, and current
inpatients
•  An engineering assessment of areas that have been damaged (and/or
evacuated) to determine whether or not they are safe to occupy
Further tasks will include:
•  The ongoing assessment of damage following significant after shocks
•  The coordination of (interim) repairs of services and facilities
•  The identification of suitable alternate accommodation for essential services
Risk assessment
The earthquake risk in New Zealand, and in the Wellington Region in particular, is
well documented.
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There are a number of fault lines in the region. The most significant ones are shown
in the diagram below.

Assessments of the likelihood of a damage causing earthquake occurring in the
region include the following:

A Geological and Nuclear Sciences Institute assessment that there is a 15%
chance of an earthquake of magnitude 7.5 or greater occurring on the Wellington
fault in the next 50 years, and that such an event could result in up to 4000 casualties
and between 200 and 600 deaths.
The Earthquake Commission advise in their public awareness programme that
there is a 1:12 chance of being involved in a damage causing earthquake this year.
The Wellington Regional Council describes the earthquake risk in the region in the
following terms:
“OUR BIGGEST QUAKE”
On January 23 1855, the Wairarapa Fault ruptured and the entire Wellington Region
was tilted westward. About 5000 km2 of land was shifted vertically, with uplift of 6m
near Turakirae Head and 1-2m in the Wellington Harbour. Some subsidence
(lowering of the ground) occurred in the Wairarapa. The greatest horizontal
movement along the fault was 12m. Features like streams were displaced along the
fault. The magnitude 8.1-8.2 quake caused 50 seconds of strong shaking and there
were hundreds of aftershocks greater than magnitude 5 in the following weeks.

THE BIG ONE
Many of the Region’s faults can produce large earthquakes. A large, shallow quake
along the Wellington Fault, say magnitude 7.4, would cause strong shaking and
considerable damage around the Region. If it happened during the day there could
be about 500 deaths, 4,000 injuries and perhaps 1,800 people trapped. If the quake
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hit at night, fewer people would be hurt. We could expect about 2,800 homes and
other buildings to be destroyed and another 100,000 buildings to be damaged in
some way.”

Expected casualties
Estimates of casualty numbers vary, and would depend on a number of factors, but
there is agreement that thousands would be injured in a large earthquake, and that
primary health providers along with both public and private hospital resources would
initially be overwhelmed .
It is expected that up to 2% of the population in the region could be injured or killed in
a magnitude 7.5 earthquake:
•  95% of those injured would have comparatively minor injuries and could be
treated with first aid or as outpatients
•  At least 200-300 patients may require admission to hospital
Expected recovery time
It is generally accepted that Wellington’s geography, and the age of some parts of
the infrastructure, pose significant challenges to the recovery from a large
earthquake.
Of most concern in the short term are the restoration of water supplies and the
opening of key roads.
The most recent assessments of the time to repair these services have concluded:
•  For the first 3 weeks, water supplies to Wellington City would be extremely
limited, and it would be up to six months before a reliable, treated water
supply was restored to all users. Recovery times for Porirua and the Kapiti
Coast are expected to be comparable
•  It is expected to take approximately 10 days to open major roads to essential
traffic, and many months before traffic could move freely around the region
Many other aspects of recovery are dependent on these services being available, so
lack of water for clean up operations; and lack of access, is likely to contribute
significantly to delays in repairs of equipment and buildings, and the replenishment of
supplies.

Disclaimer: This document has been developed by Capital & Coast District Health
Board (C&C DHB) specifically for its own use. Use of this document and any reliance
on the information contained therein by any third party is at their own risk and C&C
DHB assumes no responsibility whatsoever.

Earthquake Response Plan
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Appendix 1 – rescue and clean up equipment
Emergency Management stores
The following items are available from the Emergency management store situated on
at Wellington and Kenepuru hospitals
• Blankets
• Camp
stretchers
• Portable
lighting
• Heaters
• Emergency
shelters
• Portable
generators
• Salvage
kits

Earthquake cabinets
The cabinets illustrated below are available in all staff areas
CONTENTS
Stretcher
First aid supplies and foil blankets
Gloves
Dust masks
Goggles
Hard hats
Battery operated lamps
Broadcast radio
Basic tools
Ladder
Rope
Barrier tape
Tarpaulins

Buckets
Duct tape
2000 kg capacity Jack

Earthquake Response Plan
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