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Sample Emergency Action Program

Sample Emergency Action Program

 

Emergency Action Plan

Sample Written Plan

This sample Emergency Action Plan is provided by the Missouri On-Site Safety and Health Consultation Program.  In order to comply with OSHA’s standard for Emergency Action Plans, 29 CFR 1910.38, this written program must be site specific.  Modify the template to reflect the policies and procedures of your company.  Since OSHA regulations set minimum requirements, you may choose to add additional information to your site specific plan. There is no requirement to follow this sample and its use does not guarantee compliance with the OSHA standard.

An Emergency Action Plan describes the actions employees should take in case of fire or other emergency situations. Most workplaces must have an emergency action plan. For workplaces with more than 10 employees, the plan must be in writing.  If a company has fewer than 10 employees, they may communicate the plan orally.

To prepare your plan, follow these steps:

1. Read the Emergency Action Plans Standard, 29 CFR 1910.38

2. The following information may be useful in developing your program:

3. Add information to make it site specific to your company.

4. For clarification or assistance, contact the Missouri On-Site Safety and Health Consultation at 573-522-SAFE.

 

Emergency Action Plan

(To customize, please complete and remove the highlighted areas of the program)

Date Created:

Date Reviewed:

1. Company Policy

The objective of the Emergency Action Plan is to comply with the Occupational Safety and Health Administration’s (OSHA) Emergency Action Plans Standard, 29 CFR 1910.38, and to prepare employees for dealing with emergency situations.  This plan is designed to minimize injury and loss of human life and company resources by training employees, procuring and maintaining necessary equipment, and assigning responsibilities.  This plan applies to all emergencies that may reasonably be expected to occur at (Name of Company).

2. Assignment of Responsibility

(Name of person or job title) is the Emergency Coordinator.  Their responsibility is to manage the Emergency Action Plan for (Name of Company).   The Emergency Coordinator shall also maintain all training records pertaining to this plan and coordinating with local public resources, such as the fire department and emergency medical personnel, to ensure that they are prepared to respond as detailed in this plan.

The following employees can be contacted for more information about the Emergency Action plan:

 

Name

Position

Phone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

3. Emergency Reporting

The following emergencies are to be reported to the Emergency Coordinator or area supervisor:

  • Fire;
  • Natural Disasters (tornado, flood, earthquake);
  • Medical;
  • Workplace Violence;
  • Hazardous Material Spill;
  • Off Site Injury or Vehicle Accident;
  • (Other Emergencies)

 

4. Evacuation Plans (Attach Routes)
Emergency evacuation escape route plans are posted in key areas throughout the buildings. All employees have been trained concerning these plans and should also be familiar with the evacuation plans for the other buildings within the company.

5. Employee Accountability Procedures after Evacuation

After evacuation, each (Name of person or job title) is responsible for accounting for each employee assigned to them at their predetermined rally point by conducting a head count. Each employee will be accounted for by name. Each employee is responsible for reporting to his or her supervisor so an accurate head count can be made. All supervisors are required to report their head count to the Emergency Coordinator.

 

6. Rescue or Medical DutieS

*(NOTE)* Your company must decide how/if you will have employees perform rescue or medical duties.  There are several options for responding to an emergency. Pick what option(s) that applies to your facility.

  • (Name of Company) is going to rely on local resources such as hospitals or fire departments to provide rescue and medical services.
     
  • (Name of Company) has trained employees, but DOES NOT REQUIRE certain employees to administer first aid and CPR.  If the employee chooses to administer aid, then they will be acting as a "Good Samaritan" and are not included in a Bloodborne Pathogen program.
     
  • (Name of Company) has trained and REQUIRES certain employees to administer first aid and CPR.  All employees assigned to perform such duties have been properly trained and equipped to carry out their assigned responsibilities.  These employees will be included in a Bloodborne Pathogen program.

 

7. Critical Operations

In the event that evacuation of the premises is necessary, some items may need to be secured to prevent further detriment to the facility and personnel on hand (such as securing confidential/irreplaceable records, or shutting down equipment to prevent release of hazardous materials).

All individuals remaining behind to shut down critical systems or utilities shall be capable of recognizing when to abandon the operation or task.  Once the property and/or equipment has been secured, or the situation becomes too dangerous to remain, these individuals shall exit the building by the nearest escape route as soon as possible and meet the remainder of the employees at the designated rally point.  Only the following individuals may remain in the building for the prescribed amount of time to secure the property and equipment to which they have been assigned.

 

Name

Property or Equipment to Secure

Location of Property or Equipment

Estimated time to complete security process

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8. Training

Training is provided to employees:

  • When the plan is initiated;
  • When employee’s required actions and responsibilities change;
  • When there are any changes to the plan;
  • Initially for new employees;
  • Refresher training annually
     

Items reviewed during training:

  • Emergency escape procedures and rally points;
  • Escape route assignments;
  • Fire extinguisher locations and training;
  • Procedures to account for employees;
  • Major workplace fire hazards;
  • Employee training programs;
  • Fire prevention practices;
  • Means of reporting fire and other emergencies;
  • Alarm system(s);
  • Proper housekeeping;
  • Emergency action plan availability;
  • Hazardous Weather Procedures;
  • Medical Emergencies;
  • Any other emergency procedures needed for this facility (bomb threat, workplace violence, etc).

 

 

Emergency Phone Number List

(post in key areas throughout facility)

 

 

Fire Department

 

Police Department

 

Paramedic/Ambulance

 

Security/Alarm Company

 

Building Manager

 

Electric Company

 

Water Company

 

Gas Company

 

Telecommunication Company

 

 

 

 

Fire Emergency

 

When fire is discovered:

  • Activate the nearest fire alarm (if installed)
  • Notify the local Fire Department by calling                                                .
  • If the fire alarm is not available, notify the site personnel about the fire emergency by the following means: voice communications, radio, phone paging, other. (pick options)
     

Fight the fire ONLY if:

  • The Fire Department has been notified;
  • The fire is small and is not spreading to other areas;
  • Escaping the area is possible by backing up to the nearest exit;
  • The fire extinguisher is in working condition and personnel are trained to use it.

 

Upon being notified about the fire emergency, occupants must:

  • Leave the building using the designated escape routes;
  • Assemble in the designated area (specify location);                            
  • Remain outside until the competent authority (Designated Official or designee) announces that it is safe to reenter.
     

Emergency Coordinator or supervisors must:

  • Coordinate an orderly evacuation of personnel;
  • Perform an accurate head count of personnel reported to the designated area;
  • Notify Fire Department about missing personnel;
  • Provide the Fire Department personnel with the necessary information about the facility.
     

Supervisors must:

  • Ensure that all employees have evacuated the area/floor;
  • Report any problems to the Emergency Coordinator at the assembly area.

 

Natural Disasters (tornado, flood, earthquake)

Tornado:

  • Emergency Coordinator will monitor the weather conditions;
  • Notify the site personnel about the emergency by the following means: voice communications, radio, phone paging, other; (pick options)
  • When a warning is issued by sirens or other means, seek inside shelter (add designated shelter point);
     

Consider the following: Small interior rooms on the lowest floor and without windows, Hallways on the lowest floor away from doors and windows, and rooms constructed with reinforced concrete, brick, or block with no windows.                  

  • Stay away from outside walls and windows;
  • Use arms to protect head and neck;
  • Remain sheltered until the tornado threat is announced to be over.
     

Flood:

  • Be ready to evacuate as directed by the Emergency Coordinator and/or the designated official;
  • Notify the site personnel about the emergency by the following means: voice communications, radio, phone paging, other; (pick options)
  • Follow the recommended evacuation routes.
     

Earthquake:

  • Stay calm and await instructions from the Emergency Coordinator or the designated official;
  • Keep away from overhead fixtures, windows, filing cabinets, and electrical power;
  • Evacuate as instructed by the Emergency Coordinator and/or the designated official.

 

Medical

The Emergency Coordinator or supervisor shall call the appropriate emergency responder.  Do not move victim unless absolutely necessary.

Provide the following information:

  • Nature of medical emergency;
  • Location of the emergency (address, building, room number);
  • Your name and phone number from which you are calling;
  • Notify personnel trained in CPR and First Aid to provide the required assistance prior to the arrival of the professional medical help. (If applicable)

 

 

Workplace Violence

(Name of Company) resources may not be used to threaten, stalk or harass anyone at or outside the workplace. Indirect or direct threats of violence, incidents of actual violence and suspicious individuals or activities should be reported as soon as possible to the Emergency Coordinator or supervisor.  When reporting a threat or incident of violence, the employee should be as specific and detailed as possible. Employees should not place themselves in peril, nor should they attempt to intercede during an incident.

Consider creating a detailed plan about active shooter, bomb threat, or disgruntled employee/customer.  

 

Hazardous Material Spill

Safety of personnel during chemical exposure is of paramount importance. 

  • Report all material spills to the Emergency Coordinator or supervisor;
  • Emergency Coordinator will notify a local spill cleanup company or the Fire Department (if arrangements have been made) to perform a large chemical spill cleanup;
  • Only those trained in emergency operations shall perform clean-up operations;
  • Trained personnel shall take precautions to prevent the spread of chemical spills;
  • Utilize Safety Data Sheets (SDS) to determine appropriate response measures.  SDS are located in (SDS location);
  • Spills must be handled in a safe manner, while wearing the proper PPE.

 

Off Site Injury or Vehicle Accident

In the event a worker is conducting working operations at any off-site location and experiences any accident or injury, the Emergency Coordinator is to be notified immediately.

State the location, the nature of the accident, type of injury and location being transported to.  Emergency Responders are authorized to exercise judgment in transportation to the appropriate medical facility. 

The Emergency Coordinator shall make appropriate notification to the worker’s emergency contacts, and if practicable, meet them at the medical facility.

In the event of a transportation accident, in addition to the steps listed above, a report shall be made with the appropriate locality law enforcement.


 

Emergency Action Plan Training Roster

Training Performed By:

 

Employee Name

Employee Signature

Training Date