Not If but When - Earthquake Preparation

By Douglas H. Stutz, Naval Hospital Bremerton Public Affairs

BREMERTON, Wash. (NNS) -- 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 your area, there are two structures that need to remain standing and a hospital is one of them (the other is the jail).

Naval Hospital Bremerton preemptively prepares as much as possible for the 'if' factor and has also proactively ensured the military treatment facility is still functional after an earthquake with a seismic retrofitting project.

In the wake of the Napa, California quake of 6.0 Aug. 25, and another 4.3 rumbling along a well-known fault line centered approximately six miles north of Mount St. Helens Aug. 26, the possibility of a quake striking closer to home became a vivid reminder to emergency management coordinators.

According to Terry Lerma, NHB Emergency Preparedness coordinator, if such a quake happened to impact NHB instead of the Napa area on Sunday, the immediate actions for staff after drop, cover, hold, would be "not to run outside," he 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.

"We would also need to prepare for a possible mass casualty situation for non-military affiliated civilians possibly showing up at the front gate requesting assistance and be prepared for the Navy Fleet and Family Accountability Assessment Service (NFAAS) to be activated," Lerma said.

Coincidently, NHB recently held a command-wide exercise Aug. 5 to respond to a earthquake as well as handle mass casualties as a result of the natural disaster.

Those who think it can't or won't happen only have to look to 2001, when the Nisqually earthquake, a measured 6.8 Richter scale earthquake shook NHB with reverberations and gave staff members a forewarning of just what it was like to experience a sizable seismic shaking, as the epicenter is just 50 miles south of Bremerton.

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 45-second long 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 the past experience 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.

"We were the first Navy medical facility to undergo the seismic retrofit project," said Russ 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."

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

"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," Kent said.

Lerma attests that NHB Facilities Management department has done a great job to retrofit the core building with the Seismic Retrofit - shock absorbing inertia dampeners - to prevent the upper floors of NHB from transitioning from the initial shaking to the rolling circular motion experienced in the 2001 Nisqually Quake.

"We were 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.

Part of NHB's overall command readiness and emergency response is effectively and rapidly respond to a natural disaster like an earthquake, as well as provide medical care and prepare to handle 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.

Lerma stresses 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 if/when an earthquake strikes. NHB staff might very well need to provide care for an extended timeframe until relief arrives or back to normal operations. We have to have the ability to sustain ourselves, and also know our families are prepared to survive with emergency supplies 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, injured 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. Some of the main objectives of a mass casualty exercise are to 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.

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 the 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 (as announced); and provide for evacuee physical and emotional care, including facilitation of communication to loved ones/family members.

"It is every staff member's responsibility to know their role in evacuation of the building," Lerma said.

Holding earthquake drills helps NHB maintain the high standard of readiness and staying prepared for serious conditions such as disaster, weather, and mass casualty situations.

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.