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Hospital Planning For Terrorist Disasters: A Community-Wide Program - $49.00
Hospital Planning For Terrorist Disasters: A Community-Wide Program will assist hospital leaders in preparing for terrorism events and other disasters.
This activity includes 4 AMA PRA Category 1 CreditsTM
Date of original release: December 1, 2009
Authors:
Solisis Deynes, MD, MPH
Emergency Department, Children’s Medical Center at Legacy, Baylor Medical Center at Carrolton, Baylor University Medical Center, Dallas, TX
Christopher Kahn, MD, MPH
Assistant Professor of Emergency Medicine, Base Hospital Physician Director, University of California at Irvine, School of Medicine, Orange, CA
Kristi L. Koenig, MD, FACEP, FIFEM
Professor of Emergency Medicine, Director of Public Health Preparedness, Co-Director, EMS and Disaster Medical Sciences Fellowship, University of California at Irvine, School of Medicine, Orange, CA
Peer Reviewers:
Dan Hanfling, MD
Director, Emergency Management and Disaster Medicine, Inova Health System; Clinical Professor, Department of Emergency Medicine, George Washington University, Department of Emergency Medicine, Inova Fairfax Hospital, Falls Church, VA
Selim Suner MD, MS
Associate Professor, Brown University; Director, Disaster Medicine and Emergency Preparedness, Department of Emergency Medicine; Chairman, Emergency Preparedness Committee, Rhode Island Hospital; Team Commander, Rhode Island Disaster Medical Assistance Team (RI-1 DMAT), NDMS/DHHS; Medical Simulation Center, Providence, RI
Click here to read a review of this product by Dr. Joseph Sabota from The University of Florida College of Medicine
Excerpt from the article:
Terrorist attacks may be less likely to occur than other types of disasters, but they can have far greater impacts on hospital operations. Historically, hospital emergency preparedness programs have not included provisions for terrorism events. September 11, 2001 was the catalyst that convinced many emergency management officials of the need for such plans.
The US Centers for Disease Control and Prevention (CDC) began focusing intensely on emergency operations systems for public health facilities after the anthrax bioterrorism attacks in late September 2001. Despite the limited number of direct victims (22 people) in that attack, the public health effects were widespread, with large numbers of people receiving antibiotic prophylaxis. Psychological effects were also felt across the nation.1,2 The fact that anthrax had been dispersed as a biological weapon through the US mail system also heightened the need for preparedness.
In order to develop a robust and effective emergency preparedness plan, hospital leaders should build on previous experiences with disaster management, especially with respect to human behavior, as well as on published research. This article is intended to complement resources such as the US Department of Health and Human Services’ Public Health Emergency Response Guide and assist hospital planners in preparing for terrorism events and other disasters.3
The goal of terrorism is to induce fear in order to disrupt society or create a change in behavior. However, unless terrorists announce an attack or use a weapon with an immediate effect (eg, high explosives or chemical weapons), it may be unclear in the initial assessment that an act of terrorism has occurred. Once this fact has been established, management of a terrorist event is similar to that for other disasters. All potential scenarios and hazards (eg, explosions, chemical events, biological events, and shootings) should be considered. In addition, the medical and health response to terrorism will always be accompanied by a law enforcement response. Evidence collection in the ED as well as in out-of-hospital crime scenes will be a priority for law enforcement officials, including those with the Federal Bureau of Investigation (FBI), and must be accommodated.
Integration and coordination with the community is also vital to avoid operating in isolation, to minimize the negative effects on society, and to ensure a robust plan that addresses the 4 phases of emergency management: mitigation, preparedness, response, and recovery.4,5
In “Hospital Planning For Terrorist Disasters: A Community-Wide Approach,” expert authors discuss information to assist emergency physicians and hospital leaders in preparing for terrorism events and other disasters. Integration and coordination with the community as well as the 4 phases of emergency management (mitigation, preparedness, response, and recovery) is also discussed.
Table of Contents:
- Introduction
- The Four Phases of Comprehensive Emergency Management: Mitigation, Preparedness, Response and Recovery
- Incident Command System
- Emergency Operations Center
- Disaster Triage
- Cadaver Identification and Disposal
- Victims
- Hospitals
- Staff
- Security
- Facility Evacuation and Alternate Care Sites
- Community-Wide Planning
- Disease Control
- Communications
- Media
- Credentialing Health Care Staff
- Non-Medical Volunteers and Donations
- Personal Protective Equipment (PPE)
- Decontamination
- Surge Capacity
- Conclusions
- References
Additional Resources Included:
- Table 1: Incident Command System Sections and Responsibilities
- Table 2. Personal Protective Equipment Limitations for Levels A, B, C
- Figure 1. Hospital Incident Command System Chart
- Figure 2. START Triage Flowchart
- Figure 3. Tag Classification using START Triage System
This special report presents an excellent foundation, based on accepted key principles and the experience of prior events, for hospital planning for terrorism that can be readily adapted to a number of threats. The principles of incident command and the Hospital Incident Command System (HICS) are introduced, and the need for multi-agency coordination in terrorist events is emphasized. Education and ongoing training are emphasized as key areas for successfully implementing plans. Security, the development of alternative care site strategies, psychological support services, surveillance, media, volunteers, personal protective equipment, decontamination, communications and surge capacity are discussed as important components of the plan and response.