By June Isaacson Kailes, Disability Policy Consultant

© June Isaacson Kailes, Disability Policy Consultant, Playa del Rey, California and The Center for Disability Issues and the Health Profession, Western University of Health Sciences, Pomona, California http://www.cdihp.org

Permission is granted to copy and distribute this material provided that:

(1) Proper copyright notice and citation is attached to each copy;

(2) No alterations are made to the contents of the document;

(3) The document is not sold for profit; and

(4) The Center for Disability Issues and the Health Professions is notified of such use. Please contact the center by fax (909) 469-5503 or e-mail at evac@westernu.edu.

Required citation:

Kailes, June Isaacson. Evacuation Preparedness: Taking Responsibility For Your Safety: A Guide For People With Disabilities and Other Activity Limitations, 2002. Published and distributed by Center for Disability Issues and the Health Profession, Western University of Health Sciences, 309 E. Second Street, Pomona, CA 91766‑1854, Phone:  (909) 469‑5380, TTY (909) 469-5520, Fax: (909) 469‑5407, Email: evac@westernu.edu,

This material is also available at http://www.cdihp.org, or for a hard copy, send a check payable to:

CDIHP for $24.00 (includes shipping, handling and applicable tax) to the address above. 

Call CDIHP for pricing on bulk or international orders.

ISBN # 0-9726450-0-4

The development of this publication was supported by grants from the Christopher Reeve Paralysis Foundation and from Bank of America. 

GUIDE AT A GLANCE

Your Feedback

The Center for Disability Issues and the Health Professions is always trying to improve its resource materials. The best way do this is to get your reactions. At the end of this guide you will find a postage paid response form asking several questions. We would appreciate your taking the time to return it to us. We welcome your comments.

Introduction

Who Should Read This Guide?

This guide focuses on people with disabilities and activity limitations successfully evacuating buildings.

Its goal is to help you strengthen your evacuation preparedness. It does not address area evacuations sometimes needed in response to hurricane and flood warnings.

If you answer yes to any of the questions below, you should read this guide.

Will you need assistance in an emergency evacuation?

A Day to Remember

Here are the stories of two men, Ed Beyea and John Abruzzo‑‑both wheelchair users‑‑who were working on separate floors of the World Trade Center on Sept. 11, 2001. True to the human drama of that day, one lived and one died...

John Abruzzo, a staff accountant for the Port Authority of New York and New Jersey, was working at his computer on the 69th floor of One World Trade Center when the first hijacked jet sliced into the tower. "It felt like the building was punched," he says. "My desk faces north ... the side the airplane hit. Paper was just coming down." Worse, the building swayed‑‑and only in one direction.

By the time Abruzzo, a C5‑6 quad, had maneuvered his power chair into the hallway, he saw only 10 of his coworkers‑‑everyone else had already evacuated. Someone found the office EVAC+ CHAIR and transferred Abruzzo out of his new, customized Arrow into the rescue device, which resembles a large, folding baby stroller with rear wheels that pop up and a sled‑like component that takes their place when going down stairs.

Nine of his 10 coworkers worked in shifts of three to four, carefully lowering Abruzzo down each flight of stairs. One of them couldn't help physically, so he scouted ahead. When he returned, he warned of heavy smoke around the 40th floor, so the group, with Abruzzo in tow, cut across to a stairwell on the other side of the building.

Somewhere near the 30th floor, the crew of coworkers carrying Abruzzo had to move aside as firefighters rushed up the stairwell. "We saw them carrying hundreds of pounds of equipment‑‑axes, hoses‑‑and they were trying to catch their breath, they were exhausted," Abruzzo says.

At the 20th floor they heard a rumble that seemed to come from the other tower‑‑steel and concrete collapsing. At the 10th floor they heard another rumble but kept going. "Nothing was going to stop us." Finally they made it to the lobby, where Abruzzo had to be carried over chunks of fallen concrete. Damage and debris had made the exit impassable. Firefighters directed Abruzzo's helpers to lift him‑‑still in the EVAC+CHAIR‑‑through a knocked‑out window and out onto the sidewalk.

They looked up and saw fire engulfing the top of the tower. "We thought we were fine now, we were out, but a fireman said, 'Get out, GET OUT!'" They squeezed into the mob streaming up the streets away from Lower Manhattan, taking turns pushing Abruzzo, still in the rescue device. At one point the group stopped to look back. "It was like Christmas, everything covered in white. Except we saw debris coming down," says Abruzzo, "and bodies falling."

They didn't look back again until they reached the corner of Vesey and West. "We couldn't see the tower I was in, but that's when it came down. There was a cloud of debris chasing the firemen and policemen. One of the firemen grabbed my chair, carried me into Stuyvesant High School, and then everything just went black."

Once the blackness lifted, an ambulance took Abruzzo to a hospital for smoke inhalation. Gone was his new power wheelchair, left on the 69th floor. His van, parked three blocks away, was never found.

Ed Beyea, 42, had just celebrated the 20th anniversary of his diving accident. Many of us do it‑‑look back and celebrate how far we've come. Beyea, a C3 quad, had logged 14 years at Blue Cross/Blue Shield since his injury and was now a high‑level program analyst working on the 27th floor of One World Trade Center....

(Abe) Zelmanowitz (a close friend) had just arrived at Beyea's side when a man approached and asked, "Can I help? Can I take you down the stairs?"

Beyea said no, he would wait. He was a big man‑‑nearly 300 pounds, very difficult to lift. Irma (Beyea’s personal assistant) knew he wanted to be carried properly so he wouldn't break any bones, which had happened before. "He needed more than one man to carry him," she says. "He needed at least two or three firemen. And knowing him, he wanted others to go first. He didn't want to be in the way. None of us were thinking then that the building might collapse."

Zelmanowitz volunteered to stay with Beyea, suggesting Irma leave because she was coughing. When she reached the lobby she found a fireman and told him where Beyea was. "Please take care of him," she pleaded. "He needs oxygen." Usually he required oxygen only when sleeping at night, but conditions were severe. The fireman said he would find him. A chain of men directed people outside. Irma got caught up in the crowd of people evacuating the building.

Back on the 27th floor, Zelmanowitz was talking on his cell phone, telling his family he was OK. His elderly mother pleaded with him to get out, but he was determined to stay by Beyea's side. He would wait with his best friend of more than 12 years. (Neither Ed nor Abe were heard from again).

Reprinted with permission from New Mobility, September 11, 2001: A Day to Remember, By Josie Byzek and Tim Gilmer, V15, 98. pp. 20-21

Never Assume You have been Included in Emergency Plans

Probably the least likely disaster to happen, happened on September 11^th, 2001.  The September 11, 2001 terrorist attacks, like other disasters have increased awareness worldwide of the need to be prepared for disasters and emergencies. While these events were unpredictable, lessons learned can be applied to a wide range of disasters.  People need to plan for emergency evacuation in anticipated and unanticipated situations including chemical, biological, radiological, explosion, transportation accidents, fires, floods, earthquakes, mud slides, hurricanes, tornadoes, snow storms power outages, etc.)

The attacks prompted many individuals responsible for people in office buildings to re‑evaluate their disaster and evacuation plans for all occupants, including taking a close look at how to get people with disabilities out safely. (iCan News Service 2001) These attacks, once again brought attention to the complex question that fire safety professionals and disability advocates have been wrestling with for years: How do people with mobility and sensory limitations quickly evacuate multi-story buildings during emergencies?

For people with disabilities, barrier free, as well as, barrier-ridden environments become a great deal more hostile and difficult to deal with during and after an emergency.  For example, people with physical disabilities may have reduced ability to get to accessible exits, as well as reduced access to their personal items and emergency supplies. People with vision and hearing loss and people with speech related disabilities often encounter many more communication barriers, especially when regular communication channels are down or overloaded.  These barriers appear at a time when rapid communication may be crucial to survival and safety. 

The September 11, 2001 Wake-up Call

No matter what laws and public policies say, it's up to us as people with disabilities to individually and collectively prepare for disasters. If we just rely on employers, building managers, or fire inspectors to make sure things are in place, it may or may not happen. It is not safe to assume that people with disabilities have been included in evacuation plans.  People with disabilities must be assertive to ensure that our safety needs are included in all emergency planning.

We need to be proactive, and rely as much as possible on ourselves (and not to count on others), to find the exits and to make decisions about our safety. Hopefully this can be done in conjunction with, but possibly without the cooperation of the management of the places where we spend a great deal of our time (school, work, volunteer work, home).  (Kailes 1996)

Avoid Avoidance

Integrate disaster planning into your life. Avoid the universal human tendency to not think about possible emergencies.

September 11, 2001 is just one more wake‑up call for the disability community, requiring us to pay attention to these issues.  Unfortunately these wake‑up-calls only have a shelf life of 6 - 12 months and then people seem to slip back into old ways, back into complacency and back to a denial mode. That is, ignoring the threat and avoiding thinking about it because it creates stress, fear and apprehension. (Kailes 1996)

When disaster strikes, systems on which everyone relies don't function as well as they usually do, otherwise we'd call them something besides disasters (inconveniences, maybe). In a major emergency or disaster, hazards are often multiplied for people with disabilities.  In fact, all people are suddenly confronted with a wide range of new disabling conditions. (Kailes 1996)

The immediate temporary response of increased sales of evacuation devices as well as businesses and building managers dusting off their safety plans and taking a new look at how they can assure their workers' safety, needs to become a regular activity. 

Emergency Evacuation Preparedness: Take Responsibility for Your Safety

The media repeatedly reported stories about the two wheelchair users who successfully escaped from the World Trade Center using evacuation chairs on September 11^th, 2001. We also heard about one wheelchair user who died (see “A Day To Remember”).

We did not hear about others whose activity limitations prevented them from successfully evacuating. But we heard reports from those who successfully evacuated the towers and who told of passing people who could not keep up (e.g., older people, people with respiratory conditions and limited endurance, and other people with no apparent disability).

Their chances of surviving could have significantly improved if evacuation plans had been in place:

• which included them.

• that were regularly practiced by reviewing procedures using announced as well as surprise drills.

If you just rely on the employer or the building manager to make sure things are in place, it may or may not happen.

Paul Ray of Dearborn Heights, Mich., is a contractor for Ford Motor Co. His office had a fire drill about a month ago. Ray, who has quadriplegia and works on the second floor, said it was the first fire drill in the 18 months he's worked there. When the alarm went off, he went to the elevator bank, where Ray said designated fire wardens seemed surprised to see him. He said he had never been told about the building's evacuation plan.

"My confidence was not exactly inspired," said Ray, a programmer. "I was a little surprised. I thought Ford would have a little better control over the situation."

"I'm hoping that they're at least a little more aware of the fact that I am there, working on their second floor," Ray said. "I don't know if it's something they just don't think about it or everybody's just so stressed out with their other nonsense that they don't have time to deal with it. As a quadriplegic I do not go down stairs, period. I don't have the balance for it. It's a little disturbing.”  (Bondi 2001)

A Harris Interactive survey commissioned by the National Organization on Disability, December 2001, found that "50 percent of employees with disabilities say no plans have been made to safely evacuate their workplace, compared to 44 percent of people without disabilities.  Eighteen percent of people with disabilities feel extremely or very anxious about their personal safety in the event of a crisis, compared to 8 percent of people without disabilities.”  (National Organization on Disability 2002)

Preparing Takes Time and Effort

Preparation may seem like work.  It is.  Preparing does take time and effort.   You can do a little at a time. The important thing is to start preparing.  The more you do, the more confident you will be that you can protect yourself. Don’t assume you have been included in emergency plans.

What the Law Says

Because there are no federal guidelines requiring disaster or evacuation plans, many people are unclear exactly whose responsibility it is. (Bondi 2001)

The Americans with Disabilities Act of 1990 (ADA) does not require formal emergency plans. But ADA’s Titles I, II and III do require that employers, public services, and public accommodations and services operated by private entities modify their policies and procedures to include people with disabilities.  Therefore when plans are created or revised they need to include people with disabilities and activity limitations.

Give Attachment A: “Disability-related Issues for Emergency Plan Coordinators” to personnel who are responsible for creating, reviewing, maintaining, practicing and revising emergency plans.

Get Involved in the Planning Process

Create, Review and Practice Emergency Plans

Seek out the risk management team to determine if there is a CURRENT plan. Review the plan. Make sure your site is not just using a boilerplate, nonspecific or generic disaster plan. Each building and sometimes each area [in large buildings] is unique and should have its own plan.  It is important to treat all people with disabilities as individuals. Do not "lump" all people with disabilities into one category. For example, there are some emergency plans where all people with disabilities were "directed" to go to the area of rescue assistance to await members of the emergency team to escort them to safety. As a general rule there is no reason that individuals with hearing or vision loss cannot use the stairs to make an independent escape as long as they are effectively notified of the need to evacuate and can find the stairway. (Bondi 2001)

When there is no plan, or when the plan is not current, encourage management to develop one and become involved in the planning process.

Include yourself and others with or without disabilities who:

• have a user's perspective and are knowledgeable about the relevant federal, state and local accessibility building codes;

• can share information from a cross‑disability perspective, (they have experience  and can consider the needs of those with different types of disabilities [hearing, vision, mobility, speech, cognitive and sensitivity to airborne chemicals]);

• can provide concrete, practical knowledge.

Make sure you are included in the decisions regarding which equipment and procedures will work for you.

You need to be a part of the discussion regarding the selection of and use of the accommodation, procedures, equipment and assistive devices that will work for you to provide a safe evacuation. You are the best provider of information regarding your specific abilities and limitations and how best to provide you appropriate and effective assistance.  (Cameron)

Individuals with disabilities don't always agree on the best ways to provide accessibility services. Be prepared for some debate. Usually there is an easy, appropriate solution that provides adequate accommodation options.

Talk to the emergency services coordinator regarding how qualified people with disabilities can be recruited. Sometimes you can find qualified people with disabilities by contacting a disability‑related organization such as an ATA (Alliance for Technology Access) Center or Independent Living Center (ILC).  ATA centers are community‑based, consumer‑directed centers focusing on technology. Independent living centers (ILCs) are private, nonprofit corporations that provide advocacy and services to maximize the independence of individuals with disabilities and the accessibility of communities. To contact an ATA Center or an ILC in your area, and for a listing of other disability related organizations (see References and Resources.)

Fire Department Issues

Be aware that some police and fire department personnel are more experienced and knowledgeable regarding disability-related evacuation access issues. Other fire departments may not have the most updated information regarding evacuation issues for people with disabilities and activity limitations.  Therefore, open discussions and give and take debates are important. If you get advice you do not agree with, decide what is best for you.

Approaches vary among local fire and police departments, regarding:

• Empowering people to be experts.

• Whether individuals with disabilities and other activity limitations should remain in the building and when provided, assemble in an area of refuge to await the arrival of the fire fighters to get help with evacuation.

• Whether evacuation chairs (fold‑up chairs, which can be stored near emergency exits and allow for people to be moved up or down stairs) should be used? Some fire departments mistakenly believe that they can jam up the stairways.  This is not the case. It has been proven by one company that someone operating an EVAC+CHAIR can keep up with people without disabilities. “At least one other person can walk beside this evacuation device at a normal rate of descent. “(Byzek 2001) On September 11, 2001 two wheelchair users escaped from the World Trade Center using “evacuation chairs with inexperienced helpers because they broke the rules. Most who did what they were expected to do--wait to be rescued—died.” (Byzek and Gilmer 2000)

• Whether service animals should be permitted to evacuate down the stairway with their owners. Tthere are examples of the fire department instructing that the dog be separated from its owner. This is typically not necessary and clearly proven by Michael Hingson, a survivor of the September 11th attacks who was working in the North Tower of the World Trade Center Tower when it was struck.  Evacuating from the 78th floor, Michael, who is blind, relied on his own instincts, his guide dog, Roselle, and his business associates to make it to safety.  He recounts, “I feel like I was as prepared as possible.  I knew the evacuation procedures, I attended all the building fire drills, I knew the exit routes.  So when the attacks hit, I had a sense of preparedness, self-sufficiency, and the confidence to take a leading position in evacuating myself and others to safety.”

Practice Plans Through Regular Drills

Practice is very important; it increases skill and instills confidence in one's ability to cope in an emergency. On September 11, 2001 one wheelchair user who did escape from the World Trade Center using an evacuation chair explained to the press that she had forgotten that the evacuation chair was under her desk. Two secretaries remembered and reminded her where it was!  (Byzek and Gilmer 2000)

Her forgetting about the device, combined with another wheelchair user who worked at World Trade Center recalling only a single demonstration of the device shortly after the 1993 bombing, indicates that the need for preparedness had worn off soon after the first attack. Whatever evacuation plan existed had not been practiced regularly.  When disaster struck, the plan fell apart. Most of those who had been assigned to help with rescue devices were frightened and fled downstairs. (Byzek and Gilmer 2000) 

Practice and drills consist of one of three types of activities:

• walk through procedures,

• announced drills,

• surprise drills.

Plans should ensure that shift workers and others who work on the premises or are at the site outside typical hours, (cleaning crews, evening meeting coordinators, etc.) are included in drills. Identify and plan for times (of the day and the week) plus locations in the workplace where the basic life safety or emergency contingency plans have not been put in place or due to some other factor, might not work.  

Walk Through Procedures

Recommend that a portion of staff meetings be devoted to discuss and practice separate parts of a plan. This allows you and your colleagues to concentrate efforts on the particular parts of the plan and particular individuals requiring more extensive practice. This time can be used, for example, to practice evacuation techniques, methods of transferring in and out of evacuation devices, carrying techniques, use of evacuation devices, and use of two-way communication systems in areas of rescue.  It is critical that members of an emergency response team (e.g., fire wardens, floor monitors) be involved in this practice. This is also a way of introducing new people to important parts of the plan.  (United States Fire Administration 1995)

Innovative educational techniques such as role-playing or the use of audio‑visual aids can also be helpful.

Don't assume you'll know how to use the evacuation chair when you need it. Make sure you and your support network practices using it.

Know how to get to all the exits. Practice this as part of your regular drills.

Know how to report safety hazards (i.e. fire extinguishers that need servicing, exits which are not kept clear, furniture and other items that block barrier‑free passages).

Teach your support network how to operate your equipment in an emergency (for example, how to disengage the gears of a power wheelchair).

If you are hard of hearing or deaf, practice having co-workers communicate important information to you through gestures.

If you are blind have co-workers practice guiding you.

If you use a service animal be sure you include the animal in all drills.

When there are people whose knowledge of English may be limited, training should cover techniques so they are understood and can be practiced without additional translation (pictures, simple plan language).

Announced Drills

As with the walk through procedures, these drills serve as training tools. Such drills will also help identify crucial coordination activities and communication links. Announced drills are also a good time to practice:

• communicating emergency information to people with vision and hearing loss,

• coping with different scenarios and unforeseen situations such as blocked paths or exits.

Surprise Drills

The emergency plan should include conducting surprise drills two or three times a year, at different times of the day and different shifts. These drills should include some realistic elements (e.g., blocked paths or exits), forcing people to use alternative routes.  Performance of these drills should also be evaluated and feedback given to all participants.  Plan revisions and updates typically need to be made after these evaluations.

Emergency Health Information

Carry on you at all times emergency health information containing your critical health information and emergency contacts.  Emergency health information communicates to emergency and rescue personnel what they need to know about you if they find you unconscious, confused, in shock, or just unable to provide information.  Make multiple copies of this information to keep in your: emergency supply kits, car, work, wallet (behind driver's license or official identification card), wheelchair pack, etc. See Attachment B: EMERGENCY HEALTH INFORMATION.

Evaluate Your Need to Identify as Someone Who Requires Assistance During an Evacuation

You do not have to identify as a person with a permanent disability to qualify for needing assistance. There are many people, including those who identify and those who do not identify as having a disability or who have no visible disability, who may also need assistance.  Some people may need assistance because of conditions that are not apparent. Others may have obvious disabilities or conditions but may not need assistance. Some people may perform well in a drill but some will experience problems in emergency situations.

People with respiratory conditions, who were interviewed after going through the 1993 and 2001 World Trade Center evacuations, described the terror they experienced when faced with the grim reality of extreme exertion required to escape down the many flights of stairs in unfamiliar and smoke‑filled stair towers. They also acknowledged that prior to that emergency evacuation they had never considered themselves as having a disability that would qualify them for inclusion in the emergency evacuation plans for those requiring specific assistance. (Bondi 2001)  (Juillet 1993)

Two men who helped a wheelchair user transfer to an evacuation chair hanging in the stairwell of the World Trade Center on September 11, 2001, and transported her safely down from the 68^th floor, observed that they passed a number of older people and some people who were overweight and could not keep up. (Horovitz 2001) People who were deaf and hard of hearing could not receive instructions on the stairwell after the power and lights went out.         

Some people with disabilities in the interest of privacy or because they do not need specific assistance, choose not to identify themselves among those listed as “needing assistance or disabled” in the emergency management plan. The danger in doing this is that if you do need assistance, it will not be there when you need it. Many realized after the incident that they did need assistance. Others had not realized how vulnerable they were outside of normal working hours when there were few co‑workers around to provide emergency assistance. (FEMA & United States Fire Administration 2001)

Many do not recognize their own need for assistance. Encourage your friends and colleagues to identify themselves, if you think they may need specific assistance during an emergency. Use a checklist to help people feel free to self-identify as needing assistance (see Will you need assistance in an emergency evacuation?) Let people know that while self-identification is voluntary, you can ask that the information be kept confidential and that it only be shared with those who have responsibilities for emergency response.

• Is your name on the current log containing the names of all people needing assistance?

• Is the list maintained by the building managers and kept at all security stations?

• Is the list updated frequently so it can also include people who may have temporary activity restrictions? 

Master the Skill of Giving Quick Information on How Best to Assist You

Be prepared to quickly give emergency responders critical information on how they can assist you without causing injury. Take charge and practice how to quickly explain to people how best to assist you. Be prepared to give clear, specific and concise instructions and directions to rescue personnel. Determine how much detail is needed. Be prepared with additional instructions if more details are needed. You know your abilities and limitations and the best way that someone can assist you or ways in which you can assist them. Practice giving these instructions clearly and quickly, not in four paragraphs but a few quick phrases, using the least amount of words possible, for example:

• Take medication from top drawer of desk by window.

• Take my communication device from that table. I am hard of hearing.

• Take my manual wheelchair .

• The traditional "fire fighter's carry" is hazardous for me because of my respiratory condition. Carry me by …..

• I can manage steps independently, carry my other crutch and walk in front of me. 

• I’m blind, let me take your left arm above the elbow and I’ll follow you out.

• I need to hang on to you, I have poor balance, but I can walk steps.

• You have to carry me out, wheelchair user evacuation chairs are hung at the top of “stairway two, north end” and “stairway three, south end.”

Consider using a carry-with-you preprinted message. Customize a message for yourself, for example:

• I’m deaf, do not speak, I use American Sign Language (ASL). Use gestures or write instructions using simple words.

• I cannot speak, but I do hear and understand.  I communicate using an augmentative communication device.  I can point to simple pictures or key words, you will find a communication sheet in my wallet.

• I may have difficulty understanding what you are telling me, so speak slowly and use simple words.

• I have a psychiatric disability.  In an emergency I may become confused.  Help me find a quiet corner and I should be fine in about 10 minutes.

• I have a panic condition.  If I panic and appear very anxious, speak to me calmly and slowly. Be patient. Ask me if I need my medication and I will direct you.  You may need to ask me more than once. Please stay with me until I calm down.

• Diesel exhaust can kill me. Do not put me in or near idling emergency vehicles.

Establish a Personal Support Network

A personal support network is made up of individuals who will check with you and assist when needed.  This network consists of people who are regularly in the same area as you. 

If you rely on personal assistance services (attendants), they may not be available at the time needed. Therefore it is vital that your personal support network consist of additional people.

Do not depend on any one person. Buddy systems (choosing and training one person to assist you in an emergency) that are commonly used have major weaknesses. To be effective, the person and the buddy must be able to make contact with each other quickly when the need arises. In many situations this can be unrealistic because: the person may be absent, you may be in an area different from your usual location or you may be at the site after regular hours when your buddy is not available (co-workers, fellow students, etc.).

Work out support relationships with several individuals. Identify a minimum of three people at each location where you regularly spend a significant part of your week: job, home, school, volunteer site, etc.  Consider speaking with and training as many people as possible to assist you in an emergency. This is especially critical in settings where people have wide-ranging work and travel schedules and it is difficult to predict who will be at the site in the event of an emergency.

Choose people who are dependable and have the physical and emotional ability to reliably assist you. Usually, people will chose people they like, but sometimes these individuals do not have the qualities you really need for this type of assistance.

Know how you will instantly create a personal support team.  In spite of your best planning, sometimes a personal support network must be created on the spot. Think about what you will need, how you want it done and what kind of people you would select if given a choice of people. (See Give Quick Information on How Best to Assist You)

Establish a Personal Support Network

Ability Self-Assessment

Evaluate your capabilities, limitations and needs, as well as your surroundings to determine what type of help you will need in an emergency.

Please let the author know of other items to include in future versions of this list – jik@pacbell.net

Emergency Evacuation Options

Determine All Your Evacuation Options and Prioritize Them

Use your judgment given your specific situation and the information you have available during an emergency.

For example, you don’t have specific information regarding the emergency. Most people are evacuating the building.  It is 20 degrees Fahrenheit / -.6 Centigrade outside, a temperature that would place you in immediate danger given your specific disability (given your zero tolerance for cold). You choose to stay indoors until you see that it is critical that you leave.

You have the right to make your own decisions about your life-safety. If you will need evacuation assistance, you have to carefully think through all your options in terms of your plan. All options have pros and cons:

Even in buildings equipped with sprinkler systems it is recommended that areas of refuge be provided.  There is the small possibility that the sprinkler system will fail to extinguish the fire and that there would be heavy smoke. It is quite possible that you could be stranded and overcome with smoke before the arrival of the rescue personnel, given the difficulty in locating someone in a smoke‑filled building. For these possibilities, there needs to be contingency plans for providing evacuation assistance for all occupants, as well as those needing specific assistance. (FEMA 2001)

If you are in an older building that does not have these designated areas, consider designating some areas by consulting with the fire department. These areas should have:

1. An operating phone, cell‑phone and two‑way radio so that emergency services at the site, and the fire department, can be contacted

2. A closing door

3. Supplies that enable individuals to block smoke from entering the room from under the door

4. A window

5. A large pre-printed sign which can be taped to the window requesting help

6. Respirator masks

A study of areas of refuge conducted by the National Institute of Standards and Technology (NIST) for the General Services Administration (GSA), found that the operation of a properly designed and maintained sprinkler system eliminates the life threat to building occupants regardless of their individual abilities and can provide superior protection for people with disabilities. Sprinkler systems will, in most circumstances, provide the protection to permit evacuation that is limited to the area under immediate threat from the fire (horizontal exits versus total evacuation from the building).  Horizontal exits, which use fire barriers, separation, and other means to help contain the spread of fire on a floor, can substitute for areas of rescue assistance (see above) provided they meet applicable building codes.  Horizontal exits enable occupants to evacuate from one area of a building to another area or building on approximately the same level. They provide protection from smoke and fire.(FEMA 2001)

The fire department can operate elevators with a special key and may use them to move their people and equipment, or for evacuation of occupants. This means that without the fire department, persons with disabilities and other activity limitations are forced to use the stairs or must await rescue.

Newer "evacuation elevators” are designed to remain in use during emergencies. They have a back-up power supply and pressurization and ventilation systems to prevent smoke and heat build-up. They are fire‑rated to withstand the heat and smoke and come equipped with a firefighter's key, which allows emergency workers to load their equipment in the elevator and ascend to the upper floors. Smoke systems are built in to alert officials when the elevator becomes dangerous to use. In a study conducted for GSA, NIST found that the use of both elevators and stairs can improve evacuation times by as much as 50% over stairs alone. (FEMA 2001)

Determine Your Evacuation Options When Traveling

When staying in hotels/motels/cruise ships and other lodging facilities:

• When you have a choice, do you think about whether you want the view or the safety of a lower floor? If you have difficulty using stairs, do you ask for a guest room on a lower floor? Do you identify yourself to registration staff as a person who will need assistance in an emergency and state the type of assistance you may need?

• If you have a significant hearing loss, do you ask for a room equipped with visual alarms that are connected to the fire alarm system, and other notification devices (for doors and telephones)?  These devices alert guests by way of blinking and strobe lights to fire alarms, telephone calls and to persons knocking on the door and/or ringing the doorbell. While visual alarms must be connected to the fire alarm system, other notification devices (for doors and telephones) may be provided in kits available at the lodging facility's registration desk.

• Do you check exit routes on the back of guest room doors and familiarize yourself with the exits (by tracking the escape route, noting the number of doors between your room and the emergency exit)?  Maps may be confusing unless you check them out. 

Create an Emergency Plan for Your Home

Have a disaster or fire plan at your home. While high‑rise buildings have built‑in technology and safety features, houses or apartment buildings are often less safe. People are more likely to die in a fire at home than at work, and that risk is even greater for people with disabilities, said Brian Black, director of building codes and standards for Eastern Paralyzed Veterans Association. (Bondi 2001)  In addition to basic fire safety guidelines such as installing smoke alarms and changing the batteries regularly, make sure you have more than one way to exit your homes and a planned meeting place for family members during an emergency. For more information on home safety see Resources and References.

References and Resources

References

Bondi, N. (2001). Evacuation chairs see sales spike, iCan News Service, (ican.com), http://www.ican.com/news/fullpage.cfm?articleid=CD3EA567-1070-4735-912B372B5FE9FAA2&cx=news.special_reports.

Bondi, N. (2001). Guide To Disaster Planning: Ten Ways to Make Yourself Safe at Work, iCan News Service, (ican.com),http://www.ican.com/news/fullpage.cfm?articleid=B0547F84-4752-42B7-81592B326706E119.

Bondi, N. (2001). Tall buildings explain safety plans, iCan News Service, (ican.com), http://www.ican.com/news/fullpage.cfm?articleid=89801EFB-3BD4-445E-BB53CDC323F269AC&cx=news.special_reports.

Byzek, J., & Gilmer, T. (2001). Why Wait, Evacuate! New Mobility. 13: 20-21.

Byzek, J. and T. Gilmer (2000). Unsafe Refuge, Why did so many wheelchair users die on Sept. 11? New Mobility: 21-22, 24.

Cameron, C. (no date). Emergency Planning for People with Disabilities and Other Special Needs,

http://www.disabilitypreparedness.com/emergency_planning_for_people_wi.htm.

FEMA (2001). Emergency Procedures: Special Equipment and Devices (ican.com)

http://www.ican.com/news/fullpage.cfm?articleid=E778C428-9D78-4687-9B0777B461E3A4EF.

FEMA & United States Fire Administration (2001). Emergency Procedures: Providing Assistance (ican.com)

http://www.ican.com/news/fullpage.cfm?articleid=0F9E8D43-25E2-46B8-98787F369AABD5C6.

Horovitz, B. (2001). Some surprised to find themselves heroes. USA Today: 3B.

iCan News Service (2001). Employers should plan for workers' safety, http://www.ican.com/news/fullpage.cfm?articleid=4E2614ED-227E-4F75-AEE7B5EC2323E86D&cx=news.special_reports.

Job Accommodation Network (2002). Searchable Online Accommodation Resource, (SOAR) Emergency Evacuation Devices, http://www.jan.wvu.edu/soar/motor/emergevac.html.

Juillet, E. (1993). Evacuating People with Disabilities. Fire Engineering. 146.

Kailes, J. (1996). Living and Lasting on Shaky Ground: an Earthquake Preparedness Guide for People with Disabilities, KAILES - Publications, 6201 Ocean Front Walk, Suite 2, Playa del Rey, CA 90293, http://www.jik.com/resource.html, jik@pacbell.net.

National Organization on Disability (2002). People with Disabilities Unprepared for Terrorist, Other Crises at Home or at Work, New Poll Finds.

United States Fire Administration (1995). Emergency Procedures for Employees with Disabilities in Office Occupancies, U.S. Fire Administration, Publications Center, 16825 South Seton Avenue, Emmitsburg, MD  21727, Phone 301 / 447-1189, 800 / 561-3356, M-F 7:30 am - 5 pm, Fax 301 / 447-1213, www.usfa.fema.gov, usfapubs@fema.gov: 26.

Resources

Bondi, N., Few regulations exist for evacuation plans, iCan News Service, (ican.com), http://www.ican.com/news/fullpage.cfm?articleid=CC0AC2E5-D0B2-44B9-B145CB76A126365E&cx=news.special_reports, 2001.

Bondi, N.,Few Regulations Exist For Evacuation Plans, iCan News Service, (ican.com), http://www.ican.com/news/fullpage.cfm?articleid=CC0AC2E5-D0B2-44B9-B145CB76A126365E, 2001.

Cabrillo College, Emergency Response Management - Assisting People with Disabilities http://www.cabrillo.cc.ca.us/busserv/purchasing/emergency/16.htm

Cameron, C., Emergency Planning for People with Disabilities and Other Special Needs, http://www.disabilitypreparedness.com/emergency_planning_for_people_wi.htm, (no date).

Community Emergency Response Team – Los Angeles, Lifts and Carries, http://www.cert-la.com/liftcarry/Liftcarry.htm, 2001.

FEMA & United States Fire Administration, Emergency Procedures For Employees With Disabilities In Office Occupancies, Pub. No. FA154, June 1995, (ican.com), http://www.ican.com/news/fullpage.cfm?articleid=5C02D127-AA19-4B92-986031A11BC8CDD6&cx=independence.get_independent , 2002.

Kailes, J.I., Disaster Preparedness for People with Disabilities, http://www.jik.com/disaster.html, 2001.

United States Access Board, Evacuation Planning, http://www.access-board.gov/news/evacplanning.htm, 2002.

United States Access Board, Procedures & Technologies for People with Disabilities, Final Report of a State of the Art Review with Recommendations for Action, ATBCB 1988.

United States Access Board, Resources on Emergency Evacuation and Disaster Preparedness http://www.access-board.gov/evac.htm, 2001.

Emergency Evacuation Devices

Emergency evacuation devices are available to help evacuate individuals with mobility limitations from buildings. These devices can help individuals quickly move people with mobility limitations down the stairs or across rough terrain. Evacuation chairs and other devices are not mandatory or required by law, although many building management companies and corporations purchase them voluntarily. (Job Accommodation Network 2002) (Bondi 2001)

Portable chairs permit a relatively small person to transport a larger person. With other devices, both individuals ideally should be about the same weight. These chairs are designed to travel down stairs on special tracks with friction braking systems, rollers or other devices to control the speed of descent.

When selecting a device consult the intended user. The advantages or disadvantages of these devices are dependent on the capabilities, acceptance, and understanding of the end user(s). The effectiveness or failure of evacuation chairs as a rule can be attributed to the fact that the user was not consulted on the equipment selection. Chairs that do not accommodate the physical needs of the user create problems, which may lead to a refusal to use them in an emergency.  Evacuation chairs or other devices are not mandatory or required by law, although many buildings or corporations purchase them voluntarily.

EVAC+CHAIR Weighs 18 pounds and has a 300‑lb. carrying capacity.  Allows one person to help another get out of danger.

EVAC+CHAIR Corporation

PO Box 2396

New York, NY 10021

212‑734‑6222

http://www.evac‑chair.com/

EVACU‑TRAC is designed so the passenger's weight propels it down the stairs, while a governor limits the maximum descent speed. It has a 360‑lb. carrying capacity.

Garaventa (Canada) Ltd.

7505‑134A Street

Surrey, B.C.

Canada V3W 7B3

1‑604‑594‑0422

Toll Free (within Canada and the United States)

1‑800‑663‑6556

http://www.garaventa.ca/et/index.html

MAX‑Ability, Inc.

1275 Fourth Street, Suite 304

Santa Rosa, CA  95404

800‑577‑1555/707‑575‑5558

http://www.max‑ability.com/evac.html

Rescue Chairs enable the transport of an individual in an emergency down or up a flight of stairs. These are emergency rescue chairs that are designated specifically for use in buildings and emergency vehicles.  Chairs have 300‑lb. carrying capacities.

AOK Global Products, Ltd.

90 Jefryn Blvd.

Deer Park, New York, 11729

800‑649‑4265/800‑649‑4AOK

http://www.rescuechair.com/index.html

Scalamobil is a battery operated portable stair climber that attaches to most manual folding wheelchairs. This device can ascend or descend almost any type of stair from spiral staircases to wood or stone step surfaces. It has a 264‑lb. carrying capacity.

Frank Mobility Systems, Inc.

1003 International Drive

Oakdale, PA 15071

888‑426‑8581/724‑695‑7822

http://www.frankmobility.com/

Ferno Rescue Seat, Evacuation Chairs, and Cots are adjustable, portable devices that position individuals and enable easy maneuvering through narrow hallways, elevators, and other confined spaces. They typically have 350‑lb. carrying capacities.

Ferno‑Washington, Inc.

70 Weil Way

Wilmington, OH  45177

800‑733‑3766

http://emergency.ferno.com/chairs/chairs.htm

LifeSlider is a flat-bottomed, toboggan-like device that slides down stairs, around landings, through small doorways, around inside corners, and across pavement.

LifeSlider, Inc.

25553 61st Road

Arkansas City, KS  67005

888-442-4543

http://www.lifeslider.com

Respirators, Lab Safety Supplies

Lab Safety Supply

Box 1368,

Janesville, WI 53547-1368

800-356-0722

www.labsafety.com.

Controlled Descent Devices (cables and chutes)

A number of unique escape devices have been developed over the years. These include controlled descent devices of various types. These cable devices usually use a strap or chair secured to the cable by a device that is squeezed to allow descent. The more you squeeze, the faster you go. Letting go stops your descent. Most people are reluctant to evacuate down the outside of a building.  The chutes may be solid or flexible fabric tubes that generally rely on friction to control speed. They have the advantage of not letting you see out, so they are more acceptable than cable devices. However, their acceptance in practice in this country has been limited. There is little objective data and research information available as to the performance of these devices.  (FEMA 2001)

Permanently Installed Systems

There are several types of controlled descent devices that can be permanently installed within stairways. In some, the individual transfers from a wheelchair to the portable controlled descent chair. These chairs are designed to travel down stairs on tracks with friction braking systems, rollers or other devices to control the speed of descent.

Another type of controlled descent device is designed so the wheelchair user rolls onto the transport device and the wheelchair is secured to the device.  Wheelchair users do not have to transfer from their wheelchairs. The wheelchair lift is a motor‑driven device that installs in a stairway. Vertical wheelchair lifts are differentiated from elevators because they are limited in the height of their vertical lift, are not enclosed, and do not go through a floor level. These lifts were originally intended for private residences, but are now being used in assisted living facilities, nursing homes, churches and public buildings. (FEMA 2001)

Evacuation Assistance Devices

VISUAL and TACTILE ALERTING DEVICES

http://www.jan.wvu.edu/soar/hearing/alerting.html

Alerting devices can be used to notify a person who is deaf or hard of hearing to sounds in the environment. An individual can be alerted to sounds such as an emergency alarm through vibration or a light signal.  A transmitter detects certain sounds and then sends a signal to a receiver that vibrates or blinks a light.

BRAILLE and/or "ADA" SIGNAGE

http://www.jan.wvu.edu/soar/vision/braillesignage.html

Dog gear:  protective booties (Velcro pad protectors for hot metal stairs, asphalt, glass)

Wolf Packs, Inc.

1940 Soda Mountain Rd. # I

Ashland, OR 97520

541- 482-7669

http://www.wolfpacks.com

Disability-related Organizations

Alliance for Technology Access (ATA) is a national network of Independent nonprofit, community‑based, consumer‑driven technology Resource Centers around the country that serve children and adults with disabilities, parents, teachers, health care and other service providers, employers, technology professionals and community organizations

Alliance for Technology Access

2175 East Francisco Blvd., Suite L

San Rafael, CA 94901

Voice: 415‑455‑4575, TTY: 415‑455‑0491

Email: ATAinfo@ATAccess.org

Web: www.ATAccess.org

Independent Living Centers (ILCs) are private, nonprofit corporations that provide advocacy and services to maximize the independence of individuals with disabilities and the accessibility of communities. To locate your nearest Independent Living Center call or visit these web sites:

Independent Living Research Utilization (ILRU)

2323 Shepherd, Suite 1000

Houston, TX 77019

713.520.0232 (Voice), Phone: 713.520.5136 (TTY)

http://www.ilru.org/jump1.htm

http://www.jik.com/ilcs.html

Statewide Independent Living Councils - collaborate with state vocational rehabilitation agencies to develop state independent living plans--including determining use of independent living funds provided through Part B of the Rehab Act and monitoring, reviewing, and evaluating implementation of the state plan.

http://www.ilru.org/silc/silcdir/index.htm

National Parent Network on Disabilities

1727 King Street, Suite 305

Alexandria VA 22314

Phone: 703-684-6763 Fax: 703-836-1232

http://www.npnd.org

npnd@cs.com

National Organization on Disability promotes the full and equal participation and contribution of America’s 54 million men, women and children with disabilities in all aspects of life.

National Organization on Disability

910 Sixteenth Street, N.W., Suite 600

Washington, DC 20006

(202) 293-5960

http://www.nod.org/

Office of Disability Employment Policy (ODEP)- US Department of Labor, programs and staff of the former President’s Committee on Employment of People with Disabilities has been integrated in this new office.   The ODEP goal is to increase employment of people with disabilities through policy analysis, technical assistance, development of best practices, and outreach, education, constituent services, and promoting ODEP's mission among employers.

http://www.dol.gov/dol/odep/

American Association of People with Disabilities - nonprofit, nonpartisan, cross-disability organization whose goals are unity, leadership and impact.

http://www.aapd-dc.org/index.html

Other Resources

Adapted Fire Extinguisher

A trigger mechanism eliminates the pull pin from the unit and instead has a spring device that locks the trigger in place. Some people with limited strength and mobility can manipulate it more easily.  The gauge is enlarged and has a tactile feature for easy viewing by people with low vision.

http://www.helpusafety.org/extinguisher.html

Home Safety

Family Disaster Preparedness - describes four steps to disaster safety--finding out what can happen, planning, preparing, and practicing. These versions are available on-line: Chinese, English, Korean, Spanish, and Tagalog.  http://www.redcross.org/services/disaster/beprepared/familyplan.html

Ideas for What to Include in a Plan

United States Access Board, Evacuation Planning,

http://www.access-board.gov/news/evacplanning.htm, 2002.

About the Guide’s Sponsor

Center for Disability Issues and the Health Professions

The Center for Disability Issues and the Health Professions (CDIHP) at Western University of Health Sciences, in Pomona, California, works to enhance health professions education, and to improve access for people with disabilities to health, health education and health care services.

Western University established CDIHP in 1998 in response to the concerns of the disability community, which is one of the nation's fastest growing and least understood minority groups. The Center focuses on:

• Improving the capabilities of health care providers to meet the needs of people with disabilities.

• Increasing the number of qualified individuals with disabilities who pursue careers in the health professions.

• Supporting people with disabilities in becoming more vocal and active participants in their health care.

• Conducting and disseminating research on community based health education, prevention and health care services for people with disabilities.

• CDIHP sponsors educational activities and curriculum development for health professionals serving people with disabilities. The Center also conducts applied research to develop continuing education programs for current health care providers. These activities are designed to improve patient care delivery through advocating basic changes in social and policy issues affecting the health of people with disabilities. To learn more visit http://www.cdihp.org

Center for Disability Issues and the Health Professions

Western University of Health Sciences

309 E. Second Street/College Plaza, Pomona, California 91766‑1854

909.469.5380

E-mail evac@westernu.edu 

About the Guide’s Author:

June Isaacson Kailes has operated a full‑time consulting practice since 1989. She consults, writes and trains on: ADA implementation, advocacy training and skills building; health, wellness and aging with disability; developing and analyzing disability-related public policy; planning barrier free meetings, disability diversity training, reaching the disability market; customer service and product design, accessible telecommunication, disaster preparedness for people with disabilities and incorporating universal design and usability principles into existing and new environments.  She has received many awards and written over 80 publications including: A Guide to Planning Accessible Meetings, Be a Savvy Health Care Consumer - Your Life May Depend on It! and Health, Wellness, and Aging with Disability.

June is also well known for her national and international work in disaster preparedness for people with disabilities. Her publications Living and Lasting on Shaky Ground: An Earthquake Preparedness Guide for People with Disabilities, is distributed by California Office of Emergency Safety and Creating a Disaster - Resistant Infrastructure for People at Risk Including People with Disabilities is used and published in several countries.

She held many offices on the boards of the National Council of Independent Living and the California Foundation of Independent Living Centers and served as the Executive Director of the Westside Center for Independent Living in Los Angeles. June has a presidential appointment to the United States Access Board and has served as both its Vice Chair and Chair.  To learn more about June, visit www.jik.com.

Acknowledgements

CDIHP is grateful to the Bank of America Foundation for recognizing the importance of these life safety issues.

This Guide is enriched by the work of a diverse group of talented reviewers. Their contributions are reflected on every page. For their generous giving of time, attention to details, and thorough content reviews of various sections. The author gratefully acknowledges and thanks:

Jacquelyn Brand, President, Independent Living Network, San Rafael, California

Lane Braver, PA-C, Master of Science in Health Professions Education, Department Chair, Medical Services, Mt. San Antonio College, Walnut, California.

Michael Collins, Executive Director, California’s Statewide Independent Living Council, Sacramento, California

Paula Dunn, RID Certified Sign Language Interpreter, Garden Grove, California

Alexandra Enders, OTR, Senior Research Associate, RTC Rural:  Research and Training Center on Rural Rehabilitation , University of Montana, Missoula,

Pam Holmes, Director, Consumer & Regulatory Affairs, Ultratec, Inc., Madison, Wisconsin

Edwina Juillet, Consultant, Fire and Life Safety for People with Disabilities, Luray, Virginia

Kenneth Gerhart, PT, MS, Craig Hospital, Englewood, Colorado

Mary Lester, Executive Director, Alliance for Technology Access, San Rafael, California

Tina M. Meyer, LPTA, PA-C, Clinical Consultant, Faculty, CDIHP, Western University of Health Sciences, Pomona, California.

Susan Molloy, M.A., Disability Policy Consultant, Snowflake, Arizona

Brenda Premo, MBA, Director, Center for Disability Issues and the Health Professions at Western University of Health Sciences, Pomona, California.

Attachment A: Disability-Related Issues for Emergency Plan Coordinators

(Give a copy of this checklist to personnel who are responsible for creating, reviewing, maintaining, practicing and revising emergency plans.)

DISABILITY-RELATED ISSUES FOR EMERGENCY PLAN COORDINATORS

Fire Department Coordination

It is important that a relationship with the local fire department be established and renewed at least once a year.  It is also important that your plan be coordinated and practiced with the local fire and rescue services.

The plan should insure that the fire department knows that people with disabilities and others with activity limitations are at the site and will need specific assistance in an emergency.

Have you asked the local fire department to:

• Keep a copy of a current log containing the names of all people needing assistance. Let  fire personnel know that you will send them updated copies.  Also let them know where the most current copies will be kept (i.e. command or control center for your building security stations, etc.)

• Walk through your facility and offer advice to increase building safety.

• Review the plan. 

• Observe a surprise drill and make comments.

• Review evacuation procedures for people with disabilities and other activity limitations. (If you will be using evacuation devices, make them aware of this fact). 

EMERGENCY HEALTH INFORMATION

From Be a Savvy Health Care Consumer, Your Life May Depend on it!         

© 2002 June Isaacson Kailes, Disability Policy Consultant, Playa del Rey, California and The Center for Disability Issues and the Health Profession, Western University of Health Sciences, Pomona, California

Attachment B: Emergency Health Information

It is good practice to carry on you at all times emergency health information containing your critical health information and emergency contacts.  An alternative would be to wear a Medic Alert tag or bracelet (see Resources).  These bracelets can be engraved with the type of disability or any medical condition of importance.  An 800 number keeps your current medication, diagnosis, etc., on file.  You can order these from your local pharmacy.

Emergency health information communicates to emergency and rescue personnel what they need to know about you if they find you unconscious, confused, in shock, or just unable to provide information. Make multiple copies of this information to keep in your: emergency supply kits, car, work, wallet (behind driver’s license or official identification card), wheelchair pack, etc. (Kailes 1996)

Why You Should Carry Emergency Health Information

The care you receive in emergency situations depends on how much information physicians have at the time of the emergency. In emergency rooms you may be unable to give a full medical history and may not have someone with you to provide it. (Lollar 1994) p. 72‑73  Sometimes emergency personnel only have seconds to make decisions about your care.

Make multiple copies of your emergency health information to keep at work, in your wallet or purse with your driver’s license or primary identification card, in your wheelchair pack, etc. Review and update this information whenever your medications or other information changes, but no less than twice a year.

Tips on Completing Emergency Health Information

• I have diabetes.  If I lose consciousness or my behavior appears peculiar, I may be having a reaction associated with my diabetes.  If I can swallow, give me sugar in some form such as candy, syrup, cola or a beverage that contains sugar like orange juice.  If my breath smells fruity, don't give me anything to eat and make sure I get medical help. 

Medications:  If you take medication that cannot be interrupted without serious consequences, make sure this is stated clearly and include:

• Penicillin or other antibiotics

Communication/Devices/Equipment/Other

• With a communication or speech-related disability, list specific communication needs:

• I speak using an artificial larynx, if it is not available, I can write notes to communicate.

• If (under stress after a seizure), I may not make sense for a while. Leave me alone for 10-15 minutes and my mind should clear.

• I speak slowly, softly and my speech is not clear. Find a quiet place for us to communicate. Be patient! Ask me to repeat or spell out what I am saying if you cannot understand me!

• I use a (word board, augmentative communication device, etc.) to communicate. In an emergency, I can point to words and letters.

• I cannot read. I communicate using an augmentative communication device. I can point to simple pictures or key words on a sheet which you will find in my wallet or emergency supply kit.

• I may have some difficulty understanding what you are telling me, please speak slowly and use simple language.

• My primary language is ASL (American Sign Language). I am deaf and not fluent in English, I will need an ASL interpreter. I read only very simple English. Try using gestures.

• I am hard of hearing. Get my attention before speaking to me. Look at me when you speak so I can speechread.

Equipment examples:

• Motorized wheelchair

• Suction machine

• Home dialysis

• Respirator

• Cochlear implant

• Indwelling catheter

Other examples:

• I need specific help with: walking, eating, standing, dressing, transferring, etc.

• I need assistance with walking.  The best way to assist is to allow me to hang onto your arm for balance.

• I am blind, please tell me what you are doing before doing it. I read Braille and I need paper work read to me.

• I have a panic condition.  If I panic and appear very anxious, speak to me calmly and slowly. Be patient. Ask me if I need my medication and I will direct you.  You may need to ask me more than once. Please stay with me until I calm down.

• I use a respirator full time, but I can breath without it for up to 15 minutes.

References

Kailes, J. (1996). Living and Lasting on Shaky Ground: An Earthquake Preparedness Guide for People with Disabilities, Governor’s Office of Emergency Services, P.O. Box 419047, Rancho Cordova, CA 95741-9047, http://www.oes.ca.gov (earthquakes->resources).

Lollar, D., ed. (1994). A Preventing Secondary Conditions Associated with Spina Bifida or Cerebral Palsy: Proceedings and Recommendations of a Symposium, Spina Bifida Association of America, 4590 MacArthur Blvd., N.W., Suite 250, Washington, DC 20007-4226.