Long-Term Care Toolkit Annex H: Severe Weather

On this page:
Guidance
Heat and humidity
Thunderstorms
Tornadoes
Winter weather
Heating, ventilation, and air conditioning (HVAC) failure

Guidance

Before, during and after severe weather take these steps:

• Sign up for notifications: know how your community sends warnings like outdoor sirens, smart phone alerts.
• Check your county emergency management website.
• Listen to local news or a NOAA Weather Radio.
• Review your shelter-in-place and evacuation plans.
• Review your communication plan.
  • Use social media tools if you have them to let families know your status.
• Assess the damage: after you are sure the severe weather threat has ended.

Heat and humidity

Rapid response checklist – heat

• Activate facility’s EOP and appoint a Facility Incident Commander (IC) if warranted.
• Assess residents for signs of distress and/or discomfort.
• Call 9-1-1 if any resident appears to be suffering from heat-related illness such as heat cramps, heat exhaustion or heat stroke.
• Consider relocating residents to a cooler part of the facility.
• If the outdoor temperature is cooler than the internal facility temperature, consider opening windows and using fans to bring cooler air into the building. If the outdoor temperature is not cooler, keep the windows closed and shades drawn. (Note: it may be necessary to increase security to accommodate open windows, etc.)
• If the internal temperature of the facility remains high and potentially jeopardizes the safety and health of residents, consider evacuation to another facility.
• Provide cool washcloths and cooling fans for air circulation.
• Encourage residents to drink fluids to maintain hydration.
• If considering the decision to evacuate the facility, see Appendix I for evacuation information.
• Notify appropriate state survey agency to report an unusual occurrence and activation of facility’s EOP.

Helpful links

• MDH: Extreme Heat Tip Sheet (PDF)
• Heat Vulnerability in Minnesota
• MDH: Extreme Heat Events

Extreme heat

A heat wave is a period of abnormally hot weather generally lasting more than two days. Heat events have the possibility of impacting the infrastructure in the area. Extreme heat can impact vulnerable populations such as, pregnant women, children, the elderly, and people with chronic illnesses. For this type of severe weather, it’s important to know the difference between NWS: Heat Watch vs. Warning:

• Excessive heat watch: Issued when conditions are favorable for an excessive heat event in the next 24 to 72 hours. A watch is used when the risk of heat wave has increased but its occurrence and timing are still uncertain.
• Excessive heat advisory: issued within 12 hours of the onset of extremely dangerous heat conditions. The general rule of thumb is when the maximum heat index temperature is expected to be 100 degrees or higher for at least 2 days, and nighttime air temperatures will not drop below 75 degrees
• Excessive heat warning: Issued within 12 hours of the onset of extremely dangerous heat conditions. The general rule of thumb is when the maximum heat index is expected to be 105 degrees or higher.

Heat and humidity chart

The combination of heat and humidity can create dangerous "heat index" temperatures:

•  Heat Index Chart (CSV)
• The National Weather Service Heat Index Chart

Tips to keep cool 

• Keep the air circulating.
• Draw all shades, blinds and curtains in rooms when exposed to direct sunlight.
• Remove residents from areas that are exposed to direct sunlight.
• Keep outdoor activities to a minimum.
• Check to see that residents are appropriately dressed.
• Provide ample fluids and provide as many fluids as the resident will take.
• Increase the number of baths given.
• Relocate to a cooler part of a building (heat rises, so go to a lower level).

Heat exhaustion: A disorder resulting from overexposure to heat or to the sun. Early symptoms are headache and a feeling weakness and dizziness, usually accompanied by nausea and vomiting.

• There may also be cramps in the muscles of the arms, legs, or abdomen. The person turns pale and perspires profusely, skin is cool and moist, pulse and breathing are rapid.
• Body temperature remains at a normal level or slightly below or above. The person may seem confused and may find it difficult to coordinate body movements.

Heat stroke: A profound disturbance of the body's heat-regulating mechanism, caused by prolonged exposure to excessive heat, particularly when there is little or no circulation of air.

• The first symptoms may be headache, dizziness, and weakness. Later symptoms are an extremely high fever and absence of perspiration. Heat stroke may cause convulsions and sudden loss of consciousness. In extreme cases it may be fatal.

*See MDH: Extreme Heat Events to get additional on extreme heat and humidity*

Thunderstorms

Warm, humid conditions often create thunderstorms. They can be dangerous, especially when combined with lightning, strong winds, and hail. Flash flooding can also be caused by the heavy rainfall that severe thunderstorms produce. For this type of severe weather, it’s important to know the difference between NWS: Heat Watch vs. Warning:

• Severe thunderstorm watch — This is issued when severe thunderstorms may be in the area. When a watch goes into effect, it’s recommended that individuals stay informed as the storm develops in case it turns into a warning.
• Severe thunderstorm warning — This is issued when a severe thunderstorm is observed and reported by individuals or a weather radar. It’s recommended that individuals take protective action when a warning occurs.

Prep steps for severe thunderstorms

• Postpone outdoor activities if thunderstorms are in the forecast.
• Ensure all employees and residents are sheltered if a warning is issued.
• Learn about the community’s emergency warning system for severe thunderstorms, and train staff on the system.
• Discuss thunderstorm safety and lightning safety with all staff members. 
• Pick a safe place for members to gather during a thunderstorm.
  • This should be away from windows, skylights and glass doors that could be broken by strong winds or hail.

Tornadoes

A tornado is often described as a narrow, violently rotating column of air (NOAA: Tornadoes). It occurs underneath thunderstorms and can extend to the ground. The rotating air becomes visible once the tornado has created condensation and has picked up enough dust and debris. While they can occur at any time during the year, most tornadoes tend to occur from May to July.

• Tornado watch — A watch is issued when the weather in certain areas has the potential to form a tornado. These are usually conditions in which extremely violent thunderstorms are occurring or are expected to occur.
• Tornado warning — A warning is issued when there has been a tornado spotted in an area. Individuals should seek shelter immediately.

Prep steps for tornadoes

1. Maintain outdoor areas by cutting down old, dying trees and removing any damaged limbs from newer trees. This will help minimize the number of branches that could be whisked away (NOAA: Tornadoes) in strong winds, potentially hurting someone or damaging property.
2. Make sure all windows and doors are closed and secure.
3. If a warning has gone into effect, have staff and residents retreat to a safe space on the lowest floor with no/minimal windows. If this is not possible, have them go into a hallway at the center of the building.

Winter weather

From freezing rain to heavy snowstorms, severe winter weather can not only be a nuisance, but it can also pose a threat to the individuals within your facility. While ice increases the chances of individuals slipping and falling, extreme winter weather can produce anywhere from multiple inches to feet of snow, making it difficult for staff to arrive for work and leave your facility. Snowstorms also make it harder for emergency transportation to hospitals when needed.

Rapid response checklist - cold

• Activate facility’s EOP and appoint a Facility Incident Commander (IC) if warranted.
• Assess residents for signs of distress and/or discomfort.
• Initiate actions to safely increase resident comfort, e.g., utilize heating pads and electric blankets (be sure to carefully monitor the temperature of residents); offer warm liquids (keeping in mind relevant dietary modifications/restrictions), etc. Contact vendors for additional heating units if appropriate.
• Do not leave residents unattended near a heat source.
• If the internal temperature of the facility remains low and potentially jeopardizes the safety and health of residents, consider re-location to a warmer part of the facility or evacuation to another facility.
• If the considering the decision to evacuate the facility, see Appendix I for evacuation information.
• Notify appropriate state survey agency to report an unusual occurrence and activation of facility’s EOP.

Winter weather terms

• Winter storm watch — This is issued when there may be severe weather conditions in your area within the next 12 to 36 hours.
• Winter storm warning — A warning goes into effect when your area is expected to receive:
  • 4”+ of snow or sleet within the next 12 hours.
  • 6”+ of snow or sleet within the next 24 hours.
  • 1/4” of accumulated ice at any point in the next 12 to 24 hours.
• Winter storm advisory — An advisory is issued when upcoming severe winter weather may create inconvenient or hazardous conditions.
• Blizzard warning — This warning indicates that the combination of snowfall and strong winds will create a blinding snow with very limited visibility. Snow drifts and extremely low wind chills may also be present.
• Ice storm warning — ¼” or more of ice accumulation
• Wind chill advisory — a wind chill advisory is when seasonably cold wind chill values, but not extremely cold values are expected or occurring. Be sure to dress appropriately and cover exposed skin when venturing outdoors.
• Wind chill watch — a wind chill watch is when dangerously cold wind chill values are possible. As with a warning, adjust your plans to avoid being outside during the coldest parts of the day.
• Wind chill warning — a wind chill warning is when dangerously cold wind chill values are expected or occurring. If you are in an area with a wind child warning, avoid going outside during the coldest parts of the day.

For more information on how cold temperatures and wind speed can create dangerous temperatures, please see the National Weather Service Wind Chill Chart.

Prep steps for winter weather

1. If weather conditions prevent staff from coming in to work or going home, have sleeping accommodations for them.
2. Have enough ice melt on hand to keep all walkways free of ice.
3. Ensure there are enough supplies (food, water, generators) available if the winter weather causes a power outage.

Hypothermia: prolonged exposure to very cold temperatures, leading to an unusually low body temperature. A temperature below 95 degrees is an emergency.

• When exposed to cold temperatures, your body begins to lose heat faster than it is produced. Lengthy exposure will eventually use up your body’s stored energy, which leads to a lower body temperature.
• A body temperature that is too low affects the brain, making the victim unable to think clearly or move well. This makes hypothermia especially dangerous, because a person may not know that they are experiencing hypothermia and may not do anything about it.
• While hypothermia is most likely at very cold temperatures, it can occur even at cool temperatures (above 40°F) if a person becomes chilled from rain, sweat, or submersion in cold water.

Frostbite: a type of injury caused by freezing.

• Signs: loss of feeling and color in the affected areas, usually extremities, such as the nose, ears, cheeks, chin, fingers, and toes.
• Chart curtesy of the Wisconsin department of health
• Actions: Go to a warm room. Soak in warm water. Use body heat to warm. Do not massage or use a heating pad.
• Frostbite can permanently damage the body, and in severe cases can lead to amputation (removing the affected body part).

Tips to keep warm

• Use extra clothing.
• Use extra blankets.
• Heating pads
• Offer warm liquids if able.
• Contact vendors for additional heating units if appropriate.
• Move to warm area of facility if able.

*See MDH Winter Weather to get additional on extreme cold*

Heating, ventilation, and air conditioning (HVAC) failure

1. Call HVAC Repair number, 24/7 number if needed (reference communications plan).
   1. In an emergency when you cannot get ahold of your main HVAC repair company, call additional HVAC companies near your location.
2. If repair can be done within a reasonable timeframe based on your facility and number of residents. Keep in mind temperature ranges identified in MN statute 4858.1415.
   1. 2013 or new buildings: 71-81 degrees regardless of season.
   2. Buildings older than 2013: maintain a minimum of 71 during heating season and reasonable cool temperature during air season.
3. Based on timeframe, determine if shelter in place or evacuation procedures need to be enacted.
   1. See Appendix H for shelter in place and Appendix I for evacuation.

Source: Severe Weather Safety: Assisted Living Emergency Preparedness

*This document can be customized to your own facility/agency needs*