West Coast Hospitals Examine Emergency Power
Nov. 06--The stories were dramatic and frightening: Newborns who were on respirators when Hurricane Sandy knocked out power being rushed down nine flights of stairs in the dark as nurses manually squeezed bags to deliver air to the babies' lungs.
Despite assurances that it would not happen, backup power systems failed at several East Coast hospitals last week as the storm swept through, forcing risky evacuations of critically ill patients.
Could a similar hospital nightmare unfold in the earthquake-prone Bay Area?
The answer is unclear, but the power failures and other hurricane-related problems should be a wake-up call to hospital leaders, said Dr. William Walker, director of Contra Costa Health Services.
"It's probably implicit for every hospital to be re-examining not only the location of their generators, but also what could happen in a major storm surge," Walker said.
Hospital leaders in Contra Costa County meet regularly for disaster planning and "this will be high up on the agenda," he predicted.
In 2007, the state building code set seismic standards for hospitals' standby power systems to help ensure that the units would work after an earthquake. But generators installed before that date do not have to comply with the requirements.
Hospitals that typically compete aggressively with one another should coordinate on emergency evacuation plans and assess how long they might need to operate without their regular power supply,
said Bruce Altevogt, senior program officer at the National Academy of Sciences' Institute of Medicine, in Washington, D.C., who has studied crisis care.
"Hopefully this will open the eyes of hospital leadership," Altevogt said.
State law requires California hospitals to have backup generators and enough on-site fuel to power the facility for 24 hours. The generator is supposed to kick in within 10 seconds of an outage.
Hospitals must run 30-minute tests of their generators every 20 to 40 days to make sure they operate correctly. To monitor compliance, inspectors from the California Department of Public Health review the facilities' testing logs during annual hospital inspections.
If hospitals fail to conduct such tests or if their generators do not operate properly, state inspectors issue a notice requiring the facilities to correct the problem, said public health department spokesman Ralph Montano. The state keeps no record of how often this has occurred, he said.
Such tests are beneficial, but as Altevogt noted, "we've seen that these tests weren't able to pick up the difficulties that arose during Sandy."
Hospital leaders learned during Hurricane Katrina and other major storms that backup generators in basements or other low lying areas will fail when flooded, leaving frail, sick and elderly patients without the lifesaving equipment and monitoring they may need.
Investigations are under way to determine exactly what led to the backup power failures in East Coast hospitals last week, but in one instance, early reports indicate that though a hospital's generators were above ground, the device that pumps fuel to the generator was in an area that flooded, rendering the pump and the generator useless.
Regional Medical Center of San Jose has three backup generators at ground level in an area that is not expected to flood and has a supply of fuel to run the generators that far exceeds state requirements -- enough to power the current hospital for several months, or three to four weeks after the new tower opens in 2014, said Paul Tucker, associate administrator.
He noted that hospital leaders in Santa Clara County meet regularly to do disaster planning and drills.
Doctors Medical Center in San Pablo has a generator in a seismically safe building adjacent to the hospital and enough fuel to operate it for four days, said Eric Zell, who chairs the hospital's governing board. The hospital also has a contract with a diesel provider to deliver additional fuel within 90 minutes, and with a contractor to provide a new generator within an hour if the hospital's unit fails, he said.
Santa Clara Valley Medical Center has enough fuel on-site to run its generators for five days. It also has generators at many of its outpatient buildings, including Valley Specialty Center and health clinics in San Jose, Gilroy, Sunnyvale and Milpitas, said spokeswoman Joy Alexiou.
"We don't think flooding is a likely occurrence, but all of our generators are above ground," she said. "None of them are in a basement."
Contra Costa Regional Medical Center in Martinez has its generators on concrete blocks above ground, Walker said.
Beginning Jan. 1, 2014, the California building code will require new hospitals to place generators above any flood plain and to have enough fuel on-site to run the generators for 72 hours. But that will not apply to existing hospitals.
Sandy Kleffman covers health. Contact her at 510-293-2478. Follow her at Twitter.com/skleffman.
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