Public Health Emergency Preparedness
This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.
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of a Comprehensive, District-Wide, School-Based All-Hazards Emergency Response
All school-based emergency response plans should be based on
the four phases of emergency management: mitigation, preparedness, response,
- Mitigation comprises actions that reduce or eliminate
long-term risk to people and property from disasters, such as addressing the
safety and integrity of school buildings, security, and culture and climate of
schools to prevent violence.
- Preparedness focuses on planning for natural disaster
or terrorist events and involves understanding the local community emergency
plans and developing evacuation protocols prior to any event.
- Response is the actual steps taken to save lives and
prevent further damage during a crisis.
- Recovery entails methods to restore the learning and
teaching environment after a crisis.
These are not four separate, distinct phases; instead all
phases create the groundwork for a continuous process where the results of each
phase help the next phase build a stronger emergency response plan.
While this document focuses on the mitigation and
preparedness phases, a clear understanding of all the phases is needed to
coordinate an effective, robust, and comprehensive emergency response plan.
The recommendations below are based on the practical experience
of developing an all-hazards school emergency plan for a school district and
are designed to provide a template rather than a specific action plan. What is
most important in the development of school emergency plans is the
understanding that a "one size fits all" plan will not serve every school
equally; individual schools should instead adapt these guidelines for their own
Fundamentals: support from leadership. Creation of a
comprehensive school-based emergency response plan requires approval,
commitment, and support from the highest levels of school leadership; the
process must take a top-down approach. Key leaders in undertaking the project
include: (a) the district superintendent, (b) the school committee, and (c) the
local or regional public emergency response team (police, fire, and emergency
medical services [EMS]). Inclusion of the latter is essential in establishing
liaison with the group that is charged with consequence management. Communication
with response teams also assures that emergency plans created by the school do
not conflict with efforts already underway.
Planning team composition. The team creating the
district-wide school plan should include, at a minimum, at least one
representative from each of the following: school administrators, school
principals, guidance counselors or school psychologists, teachers, nurses,
secretarial staff, custodial staff, and parents. At least one member of the
team or a consultant should have experience in emergency management and the
development of emergency response plans.
Each school crisis team should also be invited to
participate in planning for their individual schools. The school crisis team is
typically composed of staff members who are trained to recognize and respond to
different types of crises that can arise at school.
Steps to Create a School Plan
Step 1. Plan regular meetings. The team creating the
plan should schedule regular meetings with school leaders, school committee
leaders, town safety officers, and public health authorities.
Step 2. Perform a needs assessment. Schools should
conduct surveys to evaluate the knowledge, opinions, and needs of their school as
perceived by the school staff (Appendix B. Needs Assessment Surveys).
Step 3. Conduct a structured interview with each school principal.
The planning team should survey all principals using an instrument that permits
a streamlined interview, identifies the specific needs of each school building,
outlines structural vulnerabilities, and recognizes the needs of special populations
(Appendix C. Principal Interview Questions).
Step 4. Conduct a site survey of every school in the
district. Knowledgeable members of the planning team should conduct a
careful walkthrough of each school in order to:
learn its structural nuances.
identify any obstacles to a comprehensive plan.
evaluate (or identify) lockdown and sheltering-in sites.
evaluate nearby hazards such as chemical industries or nuclear
Step 5. Create and plan education and training modules
for the school staff. The planning team should provide specific training
modules on key aspects of emergency response and pediatrics, including specific
training and tabletop exercises. Tabletop disaster exercises are moderator-guided
classroom exercises in emergency response. These exercises can help familiarize
staff with general response procedures and resolve perceived logistics
training is often available from local, State, or Federal emergency response programs
(Appendix E. Tabletop Exercise Resources).
Step 6. Create two documents—an all-hazards Emergency Response
Manual and a school-specific Emergency Response Handbook. It is essential
that two documents are created and the information within is practical and
All-Hazards Emergency Response
Manual. Using the information obtained
from the needs assessment surveys and borrowing from existing emergency
response plans (both within the school district and from outside districts), the
planning team should construct a comprehensive, easily accessed, and easy-to-use
manual. This all-hazards response manual, which specifies appropriate responses
to particular emergencies, is a permanent document. Information provided in
this manual should include:
Articles and documents on general crisis management guidelines
and checklists for crisis readiness.
Forms that can be used to document various kinds of crises.
Various scenarios for "tabletop" exercises.
Articles related to trauma and grief in children.
If the manual is placed on the Internet,
a paper copy should also be available in case the Web is not accessible.
Response Handbook. Using
information gained from school-specific surveys and site walkthroughs, the
planning team, in conjunction with the school crisis team, should create a
school-specific handbook with guidelines for the individual school and its
staff. This document will have information and checklists that may change with each
school year. Preferably, this handbook is unbound, in a three ring binder, so
that pages can be inserted and removed as necessary. For quick access, the
manual should be clearly indexed and specific to the roles of the various
people who need to respond quickly and effectively. A vertical "flip format"
with tabs identifying the plan for each type of crisis and specific job
descriptions for teachers, principals/crisis management, nurses, and
administration can be used. Information provided in the school-specific
handbook should include:
A comprehensive form delineating various aspects of preparedness,
reviewed annually by the school principal. There should be spaces for the names
of those personnel responsible for particular duties and lists of supplies
needed in an emergency. (Appendix F. Annual School Emergency Preparedness
Protocols for evacuation, lockdown, and sheltering-in-place.
A document that details building-specific accommodations.
A map of individual school buildings.
Contact numbers for town emergency responders and local support
Step 7. Create a timeline for accomplishing each of the
above tasks. The timeline for creating an Emergency Response plan can be
highly variable, although a reasonable goal is completion in one academic year.
Implementation may take longer, depending on the degree of changes needed,
available budget, and approval of all recommendations.
Step 8. Inform parents of the plan. Each school
should have a series of parent-teacher meetings, informing the parents of the
plan and providing them opportunities to ask questions, raise concerns, clarify
information, and offer input.
Step 9. Implement the plan. As plan implementation
begins, conduct staff meetings to inform staff members of the plan details. The
entire staff must know where they can access key information about specific
emergencies, their individual responsibilities, the names and roles of crisis
team members, and the lockdown and sheltering-in-place sites.
Step 10. Conduct practice drills. Conduct practice
drills, particularly those that would require deployment of evacuation, lockdown,
or sheltering-in-place procedures. Consider using tabletop disaster drills.
Afterwards, encourage practice drills in conjunction with local emergency
response teams to evaluate practicality and effectiveness of emergency response
Step 11. Re-evaluate the plan annually,
and revise if necessary. At the
beginning of each school year, the crisis team of each school should review the
plan and revise if necessary, based on any significant changes in staffing,
school structure, or student body.
of a School-Based Emergency Response Plan
Building security and safety. The steps essential to
creating a safe and secure school environment are:
Assure that access to school buildings is limited during the
school day; a swipe-card or code key system is a practical means of building
All adults in the building should be identified. All visitors
should check in at the office and wear a visible visitor pass.
Doors to the boiler room should always be locked.
Each school should have a building site map with exits and
HVAC/utility shut-offs clearly marked.
Schools may be located near industry, including petroleum
distilleries, manufacturing facilities, landfills, or power plants. In such
cases, special arrangements must be made since a release from any of these
sites may require immediate evacuation or, if evacuation is not possible,
sheltering-in-place. In the case of proximity to nuclear power plants, current
guidelines call for potassium iodide to be stockpiled at the school (AAP Committee on Environmental Health, 2003).
Preparation for large-scale emergencies. The
following represent key steps in preparing school personnel for responding
effectively to large-scale emergencies:
The school central office administrators, principals, and local emergency
responders should meet annually to update disaster preparedness and response
A mechanism for emergency communication should be established
between each school and the school district and town emergency responders (e.g.,
preprogrammed cell phones with group page capability, group e-mail through Internet,
or another type of mass notification system). Redundant means of communication
should be in place in the event the primary means of communication, such as
cell phones, are not available.
Crisis team members at each school should be completely aware of
their specific responsibilities after a disaster of any type. Each crisis team
should establish a command post, or meeting place, in the event of an emergency
evacuation. Each member of the crisis team should have access to a
walkie-talkie or cell phone, which is programmed with the numbers of all the
crisis team members. Crisis team members should also have ongoing training in
mental health with special recognition of the vulnerabilities of children post
event and be prepared to provide ongoing counseling or mental health referral.
Some schools use a code when using the public address (PA) system
to inform staff of emergencies requiring lockdown or shelter-in-place. We
recommend instead a straightforward announcement of an emergency over the PA
system. If the PA system is missing in some parts of the school complex, plans
should be made for alternate means of rapid communication among staff.
Children with special health care needs, including technology
dependent children, physically disabled children, and children with
developmental delays, will require specialized plans that should include a
means of rapid evacuation of physically disabled children from upper floors without
use of elevators (which may be disabled or unavailable), efficient shepherding
and evacuation of children with autism or other disorders of communication, and
access to medication for children with chronic medical needs (e.g., asthma,
Preschools, alternative high school sites, and extended-day or other
after-school programs should be included in all disaster planning.
All schools should have an emergency kit readily available for immediate
evacuation. This kit should contain the evacuation plan, a first aid kit,
student medical alert lists, the personnel directory, a student directory, the daily
attendance list, camera, flashlight, spare batteries, student emergency contact
forms, teacher schedule list, and the emergency response manual.
All classroom teachers should have an emergency folder, including
contact numbers and emergency medical information that is easily accessible for
immediate evacuation. They should also have a bag with distraction activities (e.g.,
coloring books) in the event of a prolonged relocation. Substitute-teacher
folders should include all emergency protocols for that classroom.
Evacuation, relocation, sheltering-in-place, and lockdown.
While virtually all schools have simple evacuation plans, activated for
situations including fire, suspicious packages, a bomb threat, or a nearby
hazardous material spill, few have comprehensive emergency response plans that
include protocols for temporary relocation, sheltering-in-place, and lockdown. Each
of these four key aspects of school-based emergency response should be well
established, as outlined below. Additionally, there should be annual drills of
each plan to assure that everyone in the building knows where to go and what to
do. These drills can be done with staff only or with staff and students.
Evacuation. Each school should have a map of
the surrounding area indicating a safe zone for evacuation. Such plans should
be created with the assistance of local emergency response teams since they are
likely to be key participants in a school evacuation. Plans for evacuation in inclement
weather should be included. Evacuation during adverse weather conditions can be
extremely difficult for a number of reasons:
- A rapid school evacuation does not permit students to obtain their coats (in upper grades, these coats may be in their homeroom or locker).
- During periods of active weather (e.g., snow, hail, or rain), students may become endangered by outdoor conditions.
- Snow removal efforts may produce barriers to rapid evacuation.
Rapid, efficient evacuation also requires that each school
have a sufficient number of wheelchairs for children with mobility
difficulties. Finally, when an emergency evacuation is required, the school fire
alarm should be used to ensure that all staff and students in the building can
hear the notice. (Go to Part II for a detailed protocol with job descriptions
during an evacuation.)
Relocation. Relocation plans must be created
in order to house students after events in which the school cannot be immediately
reoccupied. Relocation sites can include neighboring churches, theaters, or
auditoriums. Such sites should be identified and designated in advance; parents
should be informed of the sites so that they will know where to find their
children. As an alternative to fixed relocation sites, school buses or similar
vehicles can be used to temporarily keep students warm and secure. Relocation
protocols should also include plans to bring student medications from the
nurse's office, along with emergency evacuation materials. There should be an
annual relocation practice drill so that all personnel are familiar with the
walking route, the relocation site, and the specific area to which each grade
level will go. This can be done with staff only, or with staff and students. (Go to Part II for a detailed protocol with job descriptions during a relocation event.)
For schools that rely on the transport of students by parent
or school bus because of the school's distance from homes or public transport,
relocation plans may include the use of school buses rather than simply walking
to the relocation site. Reliance on bus fleets presents two challenges that can
impact on effective evacuation/relocation:
- There must be a means of rapidly mobilizing the school bus fleet, bringing it to the site within minutes.
- The school bus fleet must be large enough to transport all students at once rather than sequentially.
Sheltering-in-place. When threats to school children
occur outdoors, complete evacuation may not be safe, for example, after the
sudden release of a chlorine gas cloud. In such cases, there must be
well-established plans for sheltering-in-place. The sheltering-in-place site
should have the following features:
- It is ideally located as far into the center of the school as possible, away from windows.
- Where possible, it should be a large, single room (this facilitates communication and serves to "nest" students).
- The sheltering-in-place site should ideally have heating, ventilation, and air conditioning (HVAC) units that can be turned off and/or vents that can be closed.
- The school alarm for sheltering-in-place should be distinct from the evacuation (fire) alarm.
Go to Part II for a detailed protocol with job descriptions during a shelter-in-place
Lockdown. Another form of school disaster,
which has been witnessed multiple times over the last decade, is a threat
within the school. This can take the form of an angry parent, a terrorist, or a
sniper. In such cases, students are best protected by a school lockdown, in
which locks and barricades are used. Rooms with doors that can be locked form
the best lockdown site. If students are in a classroom that can't be locked
when a lockdown situation occurs, they should either be moved to an area which
can be locked, or barricades should be placed at the classroom door. Mechanisms
for communication with outdoor emergency response teams should also be created;
these may consist of signals that can be broadcast from the classroom window or
cell phone/walkie-talkie communication with the central office or emergency
response. (Go to Part II for a detailed protocol with job descriptions during a lockdown
Communication. Communication remains the foundation
of effective disaster response but also the component most likely to fail. One
method of preventing such a failure is to ensure the use of the same vocabulary
during all emergencies. The Incident Command System (ICS) is a management
system used to organize emergency response and offers a common language. ICS
permits a scalable response to an emergency (incident) of any magnitude and
provides a common framework within which people can work together. ICS is used
by all levels of government—Federal, State, and local—and by many
private-sector and nongovernmental organizations.
In creating an effective school emergency response plan, the
following elements are essential for within-school communication:
Every school should be certain that its PA system is audible in
every section of the school, or that alternate means of communication are created
for those rooms not having a PA system.
Schools should adopt a policy around student use of cell phones
during emergencies. While most schools have a strict policy of no cell phone
use during school, cell phones can be an effective means of communicating with
parents during a school crisis. On the other hand, indiscriminate cell phone
use during disasters can be deleterious by distracting students from important
messages by school staff or by increasing student anxiety via unfiltered and
inaccurate reporting. Rational but strict guidelines should therefore be
A communication system and protocol should be provided to any
school-based extended day or athletic program. Because the school's central office
is likely to be closed, the emergency response protocol may require direct
communication with local emergency response groups.
The following features are necessary for effective out-of-school
Each school should be equipped with at least two working
walkie-talkies or radio phones for the principal and the custodian. These
phones should be preprogrammed to contact the central office and town emergency
responders after an emergency.
Each school secretary should have an easily accessed, current list
of all parent phone numbers, including cell phone numbers.
In order to adapt to increasing use of parent cell phone numbers
as the emergency contact, the school/school district parent database must have
three telephone number fields (home, work, cell phone).
Every school must develop a means of rapid communication with
parents. A parent-based "telephone tree" is one simple, inexpensive means of
creating such a communication network; voice mail or call forwarding systems
are also useful options. Innovative Web-based communication systems and even
automated "dialout" systems, which can communicate with hundreds of parents quickly,
are extremely valuable.
The principal should have a protocol for communicating with
parents during or after a crisis. This could include creation of a communication
command center or designation of a school spokesperson.
There should be a designee to brief the media. Statements should
be written in advance and then modified as events unfold.
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