Ohio Committee for Severe Weather Awareness Preparedness Kit for Ohioans with Special Needs

Disability Rights Ohio

Readiness Checklists for
Ohioans with Daily Functioning Needs

Emergencies are situations that are unexpected, sudden, and often dangerous. Some emergencies are caused by natural disasters that affect a large number of people and cause great destruction, such as a flood or tornado. Large numbers of people may also be affected in a man-made disaster, such as an act of terrorism. Other emergencies may involve a person or their family, such as an accident or medical emergency.

For people with disabilities and their families, emergencies could result in a disruption of services and supports that they need to stay safe and healthy. It is important to create an Emergency Plan now - before an emergency of disaster happens.

For additional information and links, visit the Disability Rights Ohio Web site at
http://www.disabilityrightsohio.org/

Emergency Supplies

 Battery-operated radio and extra batteries

 Flashlight and extra batteries

 Signaling device, such as a whistle, beeper or bell

 Non-perishable foods to sustain for at least three days

 Non-electric (manual) can opener

 Extra blankets, especially for winter emergencies

 First-aid kit with Band-Aids, bandages, hand sanitizer, insect repellent, topical ointments, flu and cold remedies, and vitamins to boost general health

Medications

 Extra supply of medicines you'll need to take (if possible, a two-week supply). Check expiration dates every few months

 Extra copies of prescriptions (ask your doctors and let them know the prescriptions are for your emergency supply kit)

 Ice chest, if your medication needs to be cold (keep your ice trays filled in your freezer, in case you need ice)

Equipment and Assistive Devices

 Equipment and assistive devices that are easy to locate during an emergency

 Back-up equipment, such as spare batteries, oxygen tanks, manual wheelchair

 Written instructions on how to operate and move your medical and adaptive equipment

Readiness

 Know where main valves and switches are for gas, water and electricity. Get help adapting handles, valves and switches, if it makes a difference to help you to turn them off

 Fire extinguisher

 An emergency plan, including transportation, if you need to evacuate to a shelter

 Written instructions and copies of important papers

Evacuation Checklist – Communication

	Sign language interpreter	( ) Yes	( ) No
	I read others' lips	( ) Yes	( ) No
	TTY or TDD (telecommunication device for the deaf)	( ) Yes	( ) No
	Large print materials	( ) Yes	( ) No
	Braille material	( ) Yes	( ) No
	Recorded material	( ) Yes	( ) No
	Someone to read and explain information to me	( ) Yes	( ) No
	Other: ____________________________________	( ) Yes	( ) No

Evacuation Checklist – Adapting to a New Place

	I have a hard time adjusting to new places	( ) Yes	( ) No
	I have a hard time adjusting to being around people I don't know	( ) Yes	( ) No
	It is difficult for me to adjust to crowded and noisy rooms	( ) Yes	( ) No
	I am blind or visually impaired and need someone to help Orient me with the layout of the shelter	( ) Yes	( ) No
	Braille material	( ) Yes	( ) No
	Other: _____________________________________	( ) Yes	( ) No

Evacuation Checklist – Medications

	I need help to remind me when to take medications	( ) Yes	( ) No
	I am allergic to the following medications:	( ) Yes	( ) No
	____________________________________________

Evacuation Checklist – Medical Needs

	I have a medical condition that is unstable or another health issue that needs continual attention (example: seizures)	( ) Yes	( ) No
	I need help with on-going medical therapy, such as IV therapy, catheterization, or wound care	( ) Yes	( ) No
	I need essential medical supplies (diabetic needles, etc)	( ) Yes	( ) No
	I have a medical device implant (heart defibrillator, nerve stimulator, pacemaker, etc.	( ) Yes	( ) No
	I have environmental allergies or chemical sensitivities	( ) Yes	( ) No
	I cannot tolerate excessive heat or cold	( ) Yes	( ) No
	I have a weakened immunity system and need to stay away from others because I catch illnesses easily	( ) Yes	( ) No

Evacuation Checklist – Mobility

	I use a wheelchair or other mobility device	( ) Yes	( ) No
	I can walk, but have trouble standing for extended periods	( ) Yes	( ) No
	I am unable to walk and need someone to help me get into different seating or laying positions	( ) Yes	( ) No
	I need a lift, such as a Hoyer lift, to transfer me from one place to another.	( ) Yes	( ) No

Evacuation Checklist – Service Animals

	I use a service animal	( ) Yes	( ) No
	My service animal does not adapt well to emergencies	( ) Yes	( ) No
	I need help while my service animal adjusts	( ) Yes	( ) No

Evacuation Checklist – Adapted and Medical Equipment

	Oxygen	( ) Yes	( ) No
	Glasses	( ) Yes	( ) No
	Cane/Walker	( ) Yes	( ) No
	Wheelchair	( ) Yes	( ) No
	Communication device	( ) Yes	( ) No
	Diabetes kit	( ) Yes	( ) No
	Ventilator	( ) Yes	( ) No
	Feeding pump	( ) Yes	( ) No
	Suction Machine	( ) Yes	( ) No
	Other: ____________________________________	( ) Yes	( ) No

Evacuation Checklist – Using the Restroom

	I need disposable undergarments	( ) Yes	( ) No
	I need help changing undergarments	( ) Yes	( ) No
	I need an adapted toilet	( ) Yes	( ) No
	I need to be catheterized	( ) Yes	( ) No
	Additional information? ____________	( ) Yes	( ) No

Evacuation Checklist – Eating and Drinking

	I need special formula	( ) Yes	( ) No
	I need modified plates or silverware	( ) Yes	( ) No
	I need straws or modified cups	( ) Yes	( ) No
	I have food allergies	( ) Yes	( ) No
	I need special food because of an illness	( ) Yes	( ) No

Evacuation Checklist – Bathing, Dressing and Grooming

	I need help taking a shower or bath	( ) Yes	( ) No
	I need help buttoning or fastening clothes	( ) Yes	( ) No
	I need help with grooming (brushing hair, brushing teeth, etc.)	( ) Yes	( ) No

Evacuation Checklist – Sleeping

	I need help getting into and out of bed	( ) Yes	( ) No
	I need to be repositioned while I sleep	( ) Yes	( ) No
	I have medical issues when I sleep that require monitoring (sleep apnea, seizures, etc.)	( ) Yes	( ) No