Evacuation Plans of Full time wheelchair users with spinal cord injuries

1. Evacuation Plans of Full time wheelchair users with spinal cord injuries Nathan Hogaboom Department of Rehabilitation Science and Technology University of Pittsburgh Human Engineering Research Laboratories VA Pittsburgh Healthcare System

2. Co-Authors • Michelle Oyster • HERL • University of Pittsburgh PM&R • Melissa Riggins • University of Arkansas for Medical Sciences • Michael Boninger • HERL • University of Pittsburgh PM&R

3. Background

4. Natural disasters are becoming more common1 • Hurricane Katrina • Haitian Earthquake • Recent efforts to improve preparedness2 • People with disabilities • Large percentage with locomotive and/or functional impairments3 • Problematic during evacuation4

5. ~273,000 people with SCI5 • Mobility limitations that could make it difficult to evacuate effectively • McClure, et al.6 • 487 full-time wheelchair users (WCUs) with SCI • Whether or not they felt they could safely evacuate • 64% had plans from home, 31% from towns/cities

6. Purpose & Hypothesis • How effective were their plans? • What was missing from their plans? • Identifying missing elements will provide information on how preparedness in this population can be improved • Hypothesis: • Evacuation plans would be missing critical elements • Indicates previous study6 overestimated preparedness of people with SCI

7. Methods

8. Participated in McClure, et al.6 • University of Pittsburgh Model Center on SCI • Wheelchair users at least 1 year post SCI • Phone interview and transcription • No warning – simulate emergency situation • Open- and closed-ended questions about evacuation plans • Open: detailed evacuation plans from each location • Closed: frequency of practice, human/technology assistance, levels/stories in building • 10 criteria for optimal plans derived from preparedness checklists • Scoring system applied to transcriptions • Each plan given a score 0 – 10

9. Derived from Federal Emergency Management Agency (FEMA)7, American Red Cross (ARC)8, Center for Disability Issues and the Health Professions (CDIHP)9 emergency preparedness publications

10. Results

11. 47 participants selected • Data from 20 used • No difference in groups • 20 with plans from home, 10 from towns/cities • All who reported a town plan had a home plan • Those with high scores in one had high scores in the other • r = .882, p = .001

12. Median of 3 criteria mentioned in bothlocations Black: home plans Grey: town/city plans

13. Lifting devices were the most commonly used AT Black: home plans Grey: town/city plans

14. Discussion

15. Evacuation plans missing critical elements • From homes: • Most participants mapped escape route, defined assistance, and gave clear and concise directions • Fewer mentioned personal support network communication, supplies, or vital records/documents • From towns/cities: • Similar to home plans • Most mentioned accessible transportation • Few able to give clear and concise directions or had practiced plans • Forethought being put into evacuation preparedness • Critical elements are being omitted

16. What next? • Consult evacuation preparedness literature: • FEMA7, ARC8, CDIHP9 • Report of the Online Forum on Disabled and other Vulnerable People in Natural Disasters – World Bank Disability & Development Team10 • Importance of personal support network communication • Network of friends, family, neighbors, co-workers, etc. • People who will plan before and help during an evacuation • One of the first steps in creating a plan • Recommended one for every location where a lot of time is spent • School, work, home, etc. • At least 3 members7-9

17. What next? • Assistive Technology • Necessary in the planning process • Lifting devices needed if individual cannot lift him or herself independently • Accessible vehicles or transportation • Able to give directions on AT use to emergency personnel • Educational efforts targeting people with disabilities, their personal support networks, and emergency personnel • Fill gaps in evacuation plans • Proper use of vital AT

18. More information • Evacuation preparedness in full-time wheelchair users with spinal cord injury. Journal of Spinal Cord Medicine 2013;36(4):290-295. • NSH15@pitt.edu

19. References • Guha-Sapir D, Vos F, Below R, Ponserre S. Annual Disaster Statistical Review 2010: The Numbers and Trends. Brussels:CRED; 2011. p. 12-3. • Nelson C, Lurie N, Wasserman J, Zakowsi S. Conceptualizing and defining public health emergency preparedness. Am J Public Health 2007;97(S1):S29-S11. • StatsRRTC. Annual disability statistics compendium: 2010 [document on the Internet]. 2010 [updated 2010; cited 2013 Oct 14]. Available from http://disabilitycompendium.org/pdf/Compendium2010.pdf • Bethel JW, Foreman AN, Burke SC. Disaster preparedness among medically vulnerable populations. Am J Prev Med 2011;40(2):139-43. • National Spinal Cord Injury Statistical Center. Spinal cord injury facts and figures at a glance. J Spinal Cord Med 2013;36(2):170-171. • McClure LA, Boninger ML, Oyster ML, Roach MJ, Nagy J, Nemunaitis G. Emergency evacuation readiness of full-time wheelchair users with spinal cord injury. Arch Phys Med Rehabil;92(3):491-498. • FEMA. Preparing for disaster for people with disabilities and other special needs [document on the Internet]. 2004 [updated 2004; cited 2013 Oct 14]. Available from http://www.fema.gov/library/viewRecord.do?id=1442. • American Red Cross. Disaster preparedness for people with disabilities [document on the Internet]. 2006 [updated 2006; cited 2013 Oct 14]. Available from http://www.redcross.org/museum/prepare_org/disabilities/disability.pdf • Center for Disability Issues and the Health Professions. Emergency evacuation preparedness: Taking responsibility for your safety, a guide for people with disabilities and other activity limitations [document on the Internet]. 2002 [updated 2002; cited 2013 Oct 14]. Available from: http://www.cdihp.org/evacuation/emergency_evacuation.pdf. • World Bank Disability & Development Team. Report of the online forum on disabled and other vulnerable people in natural disasters. 2006 May 22-June 9; online discussion. Published December 2006 [document on the Internet]. Available from http://web.worldbank.org/WBSITE/EXTERNAL/TOPICS/EXTSOCIALPROTECTION/EXTDISABILITY/0,,contentMDK:20922979~pagePK:210058~piPK:210062~theSitePK:282699,00.html.