5.6 Disaster Preparedness
Key Takeaways
- Know your facility's emergency codes and what each one means
- RUN, HIDE, FIGHT is the active shooter response protocol
- Shelter-in-place means staying inside and moving to safe interior areas
- Evacuate patients in order: immediate danger, then ambulatory, wheelchair, non-ambulatory
- Participate in drills, know evacuation routes, and keep personal emergency supplies ready
Last updated: January 2026
Healthcare facilities must be prepared for various disasters, both internal and external. CNAs play important roles in disaster response, patient safety, and evacuation procedures.
Types of Disasters
| Category | Examples |
|---|---|
| Natural disasters | Hurricanes, tornadoes, earthquakes, floods, wildfires |
| Weather events | Severe storms, extreme heat/cold, ice storms |
| Infrastructure failures | Power outages, water main breaks, gas leaks |
| Human-caused | Active shooter, bomb threat, terrorism, chemical spill |
| Health emergencies | Pandemic, disease outbreak |
| Internal emergencies | Fire, explosion, hazmat spill, violence |
Disaster Response Levels
| Level | Description | Response |
|---|---|---|
| Alert | Potential threat | Staff notified, prepare for possible action |
| Standby | Threat imminent | Gather supplies, prepare for response |
| Activation | Disaster occurring | Implement emergency plan |
| Recovery | After disaster | Return to normal operations |
Emergency Codes
Know your facility's emergency codes:
| Common Code | Meaning (varies by facility) |
|---|---|
| Code Red | Fire |
| Code Blue | Cardiac/respiratory arrest |
| Code Pink | Infant/child abduction |
| Code Silver | Active shooter/person with weapon |
| Code Orange | Hazardous material spill |
| Code Yellow | Bomb threat |
| Code Black | Severe weather |
| Code Gray | Combative person |
| Code Green | Mass casualty/evacuation |
Note: Codes vary by facility. Learn YOUR facility's specific codes!
Shelter-in-Place
When staying inside is safer than evacuating:
| Situation | Shelter Actions |
|---|---|
| Tornado | Move to interior room, away from windows |
| Active shooter | Lock doors, hide, be quiet |
| Hazmat outside | Close windows, seal doors |
| Severe weather | Follow facility protocol |
Shelter-in-place principles:
- Move to designated safe area
- Stay away from windows
- Account for all patients
- Keep doors closed
- Await "all clear" announcement
Evacuation Procedures
When evacuation is necessary:
| Step | Action |
|---|---|
| 1 | Listen for instructions |
| 2 | Know primary and alternate routes |
| 3 | Help patients requiring assistance |
| 4 | Move to designated assembly area |
| 5 | Account for all patients |
| 6 | Report to supervisor |
Patient evacuation priorities:
- Those in immediate danger
- Ambulatory patients
- Wheelchair patients
- Non-ambulatory patients
Active Shooter Response - RUN, HIDE, FIGHT
| Action | When | How |
|---|---|---|
| RUN | If safe path exists | Leave belongings, help others if safe, don't move injured |
| HIDE | If can't run safely | Lock door, barricade, turn off lights, silence phones |
| FIGHT | Only as last resort | Use any available items as weapons |
After threat is neutralized:
- Keep hands visible
- Follow law enforcement instructions
- Do not pick up weapons
- Provide first aid if trained
Mass Casualty Events
When multiple victims overwhelm normal resources:
| CNA Role | Actions |
|---|---|
| Triage support | Help direct victims |
| Basic care | Provide comfort, monitor |
| Communication | Report to nurse leaders |
| Documentation | As directed |
| Supply management | Distribute supplies |
Pandemic/Outbreak Response
During disease outbreaks:
| Responsibility | Actions |
|---|---|
| PPE use | Proper donning/doffing |
| Infection control | Enhanced precautions |
| Screening | Temperature checks, symptom screening |
| Isolation | Follow isolation protocols |
| Reporting | Report symptoms in self or patients |
CNA Disaster Preparedness Responsibilities
| Before Disaster | During Disaster | After Disaster |
|---|---|---|
| Know emergency plans | Follow instructions | Account for patients |
| Know evacuation routes | Stay calm | Report injuries |
| Know location of supplies | Help patients | Assist with recovery |
| Participate in drills | Communicate clearly | Document events |
| Keep personal supplies ready | Follow chain of command | Debrief with team |
Personal Preparedness
CNAs should also be personally prepared:
| Item | Purpose |
|---|---|
| Personal bag | Change of clothes, medications, phone charger |
| Emergency contacts | Family notification plan |
| Transportation plan | How to get to/from work |
| Childcare plan | Backup care for children |
| Communication plan | How family will contact you |
After Any Emergency
| Step | Purpose |
|---|---|
| Account for patients | Ensure everyone is safe |
| Report injuries | Seek medical attention |
| Preserve scene | For investigation if needed |
| Document | What happened, when, actions taken |
| Debrief | Learn from the experience |
| Self-care | Address emotional impact |
Test Your Knowledge
What does RUN, HIDE, FIGHT refer to?
A
B
C
D
Test Your Knowledge
During a tornado warning, patients should be moved to:
A
B
C
D
Test Your Knowledge
Which patients should be evacuated FIRST?
A
B
C
D