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Liability LandscapeBY LINDA WILLIAMS, RN June 2006

BannerNursing facilities need to make emergency preparedness a priority in their organization because a crisis can happen anywhere and at any time. Please take the time to review the circumstances surrounding the following compounded emergency situation and make changes as appropriate in your facility.

The Situation

One cold winter morning, the water lines in the center of a nursing facility froze and burst, causing flooding in one wing of the building. The maintenance workers and the administrator were not present at the time, so the staff called the fire department. Firefighters rushed to the facility and asked the staff to evacuate all four wings of the building by moving the residents to the dining room area as soon as possible.  The firefighters feared that the leaking water could cause an electrical fire, and the dining room area was the only safe place for the residents. Unfortunately, that meant the staff would need to transfer the residents in the affected wing 100 feet outdoors, in freezing weather, to get to the dining room quickly.

So, the staff hastily dressed the residents for the cold weather and wrapped them in blankets for added warmth. A combination of staff, firefighters, and relatives (who lived close by) helped to transfer the residents. In the flurry of activity, a housekeeper grabbed the handles of a wheelchair carrying an elderly lady, partially paralyzed from a stroke years ago, who had lived in the facility for nine years. She was wrapped warmly in a blanket awaiting her turn to leave. As the housekeeper hurriedly pushed the wheelchair outside, the wheels suddenly jolted to a stop, causing the resident to be flung violently to the ground, head first. Apparently, the blanket had become entangled in a spoke on the wheel of the wheelchair during the rush, causing the abrupt stop.

Both the nursing staff and an EMT fire- fighter assessed the woman’s injuries and decided the best course of action was to get her out of the cold. They carefully moved her into the dining room area and called for an ambulance. Unfortunately, the lady suffered a severe skull fracture and a broken neck. She died at the hospital within hours after the accident.

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