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Key Steps to Take in Your Practice During a Power Outage



A Public Safety Power Shutoff (PSPS) is a practice used by utility companies to preemptively shut off power in high fire risk areas during potentially dangerous weather conditions. Public Safety Power Shutoffs can last several hours to many days. Their impact may extend across city and county lines.

 

You can register  with your utility company’s and county’s emergency alert systems to receive alerts of power shut-offs. Links to California’s three main utility companies are below.

 

Pacific Gas and Electric Company

Southern California Edison

San Diego Gas & Electric

 

Utilities

  • Does your practice have contingency plans for managing loss of power and other utilities?
  • Does your office have emergency lighting that will activate during a power outage, or does the office have ample natural light to ensure visibility during an outage? Are there flashlights, with spare batteries, located throughout your office?
  • Does your practice have an emergency generator to supply power during outages? If so,
    • Is the generatr located in the safest area possible (e.g., a cool, dry location that won’t be at risk for flooding)? Will your emergency generator power all of your systems or only critical systems?
    • Have yu identified which systems should remain available during a power outage?

 

Vaccines - Protecting Your Vaccines in the Event of Power Loss

 

If you participate in the Vaccine for Children Program (VFC) you should refer to your VFC approved vaccine management plan which includes guidance on what to do in the event of a refrigerator or freezer malfunction or power failure that might compromise vaccine viability.  For more in-depth information related to VFC vaccine management, see the CDHP link http://eziz.org/vaccine-management/power-shut-offs/

 

Click here for a template of a Vaccine Management Plan.

 

Short-Term Power Outage (<4 hours)

Any facility storing vaccines must have a trusted system to follow in case of power failure. Here are a few key points to keep in mind when making your plans for safe cold chain management during power outages.

 

Do not open refrigerator or freezer doors at the immediate start of the outage.  Place a “DO NOT OPEN” sign on the vaccine storage unit(s).  Many blackouts will not last long and most units will maintain their interior cold temperature if the door remains closed. As soon as the power returns, be sure to record the interior temperature with extra care, paying close attention to maximum temperature observed and duration of exposure. If unsure whether vaccines are still effective, contact Riverside County Public Health (951) 358-7125 and keep these temperature records on hand. While many vaccines will retain their properties in slight temperature changes, certain sensitive vaccines such as MMR or Varivax may be unusable. Get the facts before discarding or administering any exposed vaccines.

 

Temperature Monitoring

Monitoring the interior temperature after a power outage should be your priority in vaccine protection. If you have a battery powered thermostat, record the temperature readings and remember to mark the time. If not, wait until power is restored. DO NOT open the door to take temperature readings, as doing so will expose contents to ambient higher temperatures. Remember to be extra diligent in recording temperature following an outage, keeping track of maximum and minimum temperatures until the unit stabilizes.

 

This is a key reason why all refrigerators that are storing vaccines should be equipped with a temperature logger. Many loggers are battery powered (or include back-up batteries) and will continue to record during a power outage.

 

4+ Hour Power Outage

Alternate Refrigeration

If possible, keep a generator-powered refrigerator in your facility to store vaccines in case of power failure. Remember to continue to monitor the interior temperature in this unit, as well as the interior of the original unit as soon as power is restored. The CDC recommends vaccine providers establish working agreements with other facilities (such as hospitals, VFC centers or pharmacies) to serve as emergency storage facilities in case of power outages. Having this preexisting relationship will be valuable in such an event.

 

Transporting Vaccines

If you are moving vaccines to another facility, take extreme caution in transporting these items to maintain the cold chain. Here are a few points to keep in mind:

 

  1. Keep refrigerator and freezer doors closed, opening them only when absolutely necessary to transfer materials to their travel container. Make transportation preparations before opening the door to ensure a cold-safe environment for as long as possible.
  2. Transport the materials using properly insulated containers. Portable DC powered refrigerators and freezers are a great solution to this problem, as they can plug into the lighter socket of any vehicle and act as a regular refrigerated unit.  Otherwise use a hard-sided coolers with frozen water bottles and cold packs.  Make sure to have bubble wrap on hand to protect the vaccines.
  3. Monitor the temperature during the transportation process.
  4. Take extra care in keeping records of all stored vaccines, noting the vaccine type, date, time, and temperature before and after the transportation process.
  5. Pay attention to the individual needs of each vaccine type. Certain vaccines will remain effective when refrigerated with cold packs, but others, such as Varicella, may require temperature control with dry ice packing.

 

Keep Track of Exposed Vaccines

Identify which vaccines have been exposed to ambient temperature by marking them with the time power was lost. Do not discard these materials, as they may still be effective and safe to administer. Simply record the temperature details and keep them separated from any other stored vaccines.  Vaccines are costly materials with precise cooling needs. Medical Practices must be prepared to handle power outages and refrigerator breakdowns in order to save thousands of dollars and product integrity.

 

Technology

  • Has your practice developed protocols for managing computer system failures, loss of Internet connectivity, and loss of phone services?
  • Has your practice assessed all of its information technology (IT) applications, services, and data to identify the most critical?
  • Is onsite IT euipment (e.g., servers, laptops, etc.) kept in the safest place possible within your practice?
  • Are safeguards, such as surge protectors, in place to maintain and/or protect critical systems?
  • Is a contingency plan in place for the continued provision of care, especially related to medication refills at pharmacies outside of the power outage area, even if IT systems (such as electronic health records and VOIP phones) are not available?
  • Does your practice have a protocol for shutting down all systems or moving IT euipment offsite prior to an impending disaster?
  • Does your practice consistently and freuently back up its data?
  • Is backup data stored offsite or in multiple locations to prevent loss or destruction if the office is damaged?
  • Does your practice maintain documentation for critical IT hardware and software (e.g., serial numbers, versions/models, lease information, suppliers, etc.)?
  • Do your practice’s IT vendors have emergency response plans?
  • Do they offer emergency services as part of their contracts?

 

 

Supplies

  • Have you considered the types of emergency euipment and supplies your practice should maintain based on the most probable emergency scenarios?
  • Does your practice have basic emergency supplies onsite, such as basic tools, flashlights, a first aid kit, fire extinguishers, a portable radio, extra batteries, water, and nonperishable food?
  • Does your emergency response plan specify the need for periodic auditing of emergency supplies and routine testing of emergency euipment?

 

Resources:

California Public Utilities Commission Website: https://www.cpuc.ca.gov/deenergization/

Public Safety Power Shutoff Website: https://prepareforpowerdown.com

CAL FIRE’s wildfire preparedness website: http://www.readyforwildfire.org/

California Governor’s Office of Emergency Services website: https://www.caloes.ca.gov/

 



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