Without a detailed strategy to address a flood, fire, and so on, you’ve compounded the problem.

This column’s topic belongs in the I-shouldn’t-have-to-write-it file. Why a practice would go day to day without having established protocols for unplanned events, such as: a medical emergency in the office; a flood or a fire; and the newest situation, computer hacking to siege software for ransom — is to me unnerving. Trusting to fate that A, nothing will happen, or B, if something does, staff will know what to do, is illogical.

CRISIS NO. 1: A PATIENT WITH A MEDICAL EMERGENCY

Of course you call 911, but what do you and your staff do before the medics arrive?

Act on your plan. Yes, you have an emergency kit, but do you update it regularly? This is one headache I have never wanted to deal with, so we found a company — this was many years ago — that updates the contents of our kit on an annual basis.

That update must include EpiPens, despite their cost.

A patient of ours, unbeknownst to himself, was allergic to fluorescein dye. He came to the practice for a consultation with our retina specialist. A moment or so after he was injected with the dye, he went into severe anaphylactic shock. Having an up-to-date EpiPen saved this person’s life.

But our medical plan calls for more than pulling out the emergency kit. To avoid chaos, only certain staff members are involved in emergency situations. Usually one technician calls 911, and one to two go in with the doctor. Also, be cognizant of the other patients in the office; they need reassurance. Moreover, if their appointments are going to be delayed, they need to be told.

CRISES TWO AND THREE: FIRE AND WATER

For a fire plan, it is most important that your local fire department help with the details. Those professionals can guide you through drills, show you how to work fire alarms, sprinklers and so on. They can also tell you how often you need to check your fire prevention system, which includes your fire extinguishers.

Floods happen: post-Sandy and Katrina, practices in lower Manhattan and New Orleans were underwater for weeks. And then the offices had to be renovated.

Make sure to have business-interruption insurance, as you might not be operational right away.

CRISIS NO. 4: SOFTWARE HELD HOSTAGE

At the Caribbean Eye meeting in early February, two physicians told listeners that in the last two months hackers had gotten into their computer systems, frozen all software and demanded money to allow access. The practice refused to pay, necessitating a total rebuilding of their computer system on an emergent basis.

Getting around this potential threat mandates that you have your data backed up every day. You will need to make sure your systems are current and can hold medical records, digital images and all the administrative information. If you back up your system every day and you fall victim to a computer hacker, then at most you lose one day’s work. Since most ophthalmology practices rely heavily on computers, no one can afford this type of threat. OM

Cynthia Matossian, MD, FACS, is the founder of Matossian Eye Associates. Her e-mail is cmatossian@matossianeye.com