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
Disaster Preparedness
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