Public Health Emergency Preparedness

Tabletop Exercises

A tabletop exercise was conducted at the Brookline Public Schools in April 2004. The exercise was undertaken to evaluate the emergency response systems that the high school had developed over the previous years. The scenario given was the explosion of a chlorine gas tank that was attached to the nearby town swimming pool, adjacent to the high school. The scenario tested the school's response to a rapidly moving cloud plume of highly toxic chlorine gas. Participants of the drill included the school headmaster, crisis team, school nurse, and custodian, but also the supervisor of Brookline EMS, representatives from the Brookline Fire Department, the Brookline Police Department, and Brookline Department of Public Works. Subsequent tabletop drills have been increasingly effective (Appendix E: Tabletop Exercise Resources).

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Education and Training of School Nurses

As part of the Brookline Schools project, we provided 4 hours of continuing education to the 7 school nurses. Over the course of the year, didactic conferences that outlined principles of school-based emergency preparedness were given. Two hours were devoted to open forums/discussions where nurses would provide feedback on issues they were facing at each of their schools. Conferences were provided in a didactic format and included the topics: 

• Principles of Terrorism and its Impact on Children.
• Principles of Syndromic Surveillance.

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Creation of an Emergency Response Manual and Handbook

The Emergency Response Manual

It became apparent, after reviewing manuals from several school systems, that the information in the manual would be more useful if it were clearly indexed and specific to the roles of the various people who need to respond quickly and effectively. We critically reviewed the manuals we had received and incorporated parts of each of them into a Brookline Schools Emergency Response Manual. Articles in the manual include general crisis management guidelines and various examples of checklists for crisis readiness and examples of forms that can be used to document various kinds of crises. Other sections in the manual provide various scenarios for "tabletop" exercises and articles related to trauma and grief in children. 

The Emergency Preparedness Handbook

The Emergency Preparedness Handbook is unbound, in a three ring binder, so that pages can be inserted and removed as necessary. The first section of the handbook is comprised of two documents: a document noting building-specific accommodations, and a second document that is to be completed annually by the principal. We used a vertical "flip-book" format, with tabs identifying the plan for each type of crisis. Each crisis is written with specific appropriate responses for teachers, principals/crisis team members, nurses, custodians, and upper administration. We also included protocols for evacuation, lockdown, and sheltering-in-place. There are spaces for the names of those personnel responsible for particular duties, lists of supplies needed in an emergency, and lists contact numbers for town emergency responders and local support resources. 

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Creation of a Final Report to the Brookline Public Schools

Upon completion of the data analysis, training of the nurses, implementation of the Tabletop Exercise and creation of the Handbook and Manual, we met again with the Superintendent and School Committee of Brookline Public Schools to report our findings and present the handbook and manual.

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Conclusion

Spending a complete academic year in the Brookline Public Schools, we were able to witness first-hand the challenges in creating a school emergency response plan. At the same time, we provided assistance to the district, leaving them an Emergency Response Manual and Handbook.   The dedication of the staff to protecting their students was exemplary.  The School Committee and Superintendent made a commitment to seek the funds and resources necessary to implement the plan. A followup visit is planned to examine the retention of these school initiatives.

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