How Pipe Ruptures Disrupt Health Care

Health care emergency managers need to make water a top priority

September 03, 2024

Water can hydrate, nourish, clean, and soothe us. When boiled, it can cook our food. As ice, it cools our drinks. It’s essential to sanitize, sterilize, and disinfect. It can erode a shoreline, or it can be used to power an electrical grid. But, too much or not enough water can lead to headaches in health care.

Recently, many people in Pennsylvania experienced a few days of frustration when severe weather contributed to a massive water main break. Many health care facilities, businesses, and homes were left with little, low, or no water pressure. Essentially, too much rainwater meant there was not enough water for normal daily tasks and health care operations. These outside forces can create a bucketful of issues for emergency managers, bedside providers, and health care leaders.

The loss of water and water pressure can impact many health care operations like sterilization, dialysis, fire suppression systems, HVAC, water-cooled medical equipment, sanitation and cleaning, decontamination, and simple hygiene like handwashing.

To prepare of these events, facilities should:

• Familiarize themselves with regional partners like local and county emergency managers and be active members within their health care coalitions (HCC). These partners might have useful solutions and equipment like water purification systems, bladders and tanks, and other supplies that can help you during these events.
• Limit, reduce, or eliminate usage of non-mission critical operations requiring water
• Highlight water-less alternatives—hand sanitizer; disposable wipes; solutions for human waste (caution: sanitation issues).
• Have a preestablished formula for determining needed quantities of bottled and potable water.

Ruptured pipes cause concerns

A few weeks ago, a hospital north of New York City initiated an internal evacuation after a fire suppression system ruptured. Local news reports give a glimpse of what staff was up against as water cascaded down stairwells and flooded floors.

A few weeks prior, another facility relocated nearly two dozen patients after a pipe rupture in a physical therapy unit and flooded an entire floor. The event caused some structural damage to walls and floors.

Earlier this year, in North Carolina, after a pipe rupture and flooded multiple areas of a hospital, first responders supported an incident and utilized equipment to help stabilize the incident.

Pipe ruptures are little- to no-notice events that can catch staff off guard. And, when these events occur, there is not a quick one-size-fits-all solution for navigating and managing them. What is known are some of the likely causes—aging infrastructure, freezing temperatures and severe weather (tropical storms, heavy rainfall), corrosion, clogs, high pressure, shift in structures, and fatigue from repeated stress or vibrations.

But, these events can be man-made like an incident where a disgruntled patient used a “heat source to compromise” a sprinkler head, in an emergency department bathroom which discharged “60 gallons of water per minute into two bathrooms, the adjoining hallway, and three hospital rooms.”

If these are concerns of yours or if you have experienced a similar recent event, the probability of something occurring could be higher.

Realistic alternatives

The first step in managing these events is safely shutting off the source of the water. Utilzing folded or rolled-up linen as a barrier seems to be a reoccurring action in real world events, and it can help, but there might be more effective actions. While there are some limitations, rapidly deployable barriers, water vacuum barriers, and/or general purpose spill kits might be useful.

If there are concerns for ruptures in units and offices unoccupied or closed after normal business hours, consider installing water sensors and alarms. A leak or rupture in these areas can go unnoticed for quite some time and cause far greater damage than those that are immediately recognized in high utilized and trafficked areas.

It is important to state that preparedness activities should be realistic, though. Often, plans reference utilizing melted snow for activities like flushing toilets. While this can work, snowmelt yields low amounts of water, and the process can take longer than anticipated and imagined. Some plans reference moving buckets of water into place. Again, these activities can work, but keep in mind that one gallon of water weighs over eight pounds, which means a five-gallon bucket is over 40 pounds—transporting these can be awkward, cumbersome, difficult, and potentially dangerous.

It's not just external events that frustrate and disrupt operations, internal flooding can cause headaches, as well.

As mentioned, too much or too little water can cause great frustrations. But we do know those aggravations can be minimized. Discussing potential actions, identifying shut off valves, planning, procuring supplies and equipment to help minimize damage, and educating staff will certainly yield better results and get our facilities back to normal operations quicker.

For further information on preparing for these events, refer to the CDC: Emergency Water Supply Planning Guide for Hospitals and Healthcare Facilities.