Sunday, September 18, 2011

will the disaster be a disaster?

To continue the conversation about disaster preparedness in hospitals, particularly in emergency question is: Why hasn't money been put into this end of emergency response to a mass casualty event?

Billions of dollars have been spent on "homeland security", even forming an entire department in the US government around this. The emphasis is on prevention mostly. However there has been significant money put into first responders, hazmat, etc. I have seen some of this affect us. There has been hazmat training, there has been a state wide emergency disaster system set up online that tracks patients and bed availability. This assumes the internet will be up.

I'm a bottom line type of gal. My interest is: There is a mass casualty, people start heading for hospitals on foot, in ambulances, in cars. How are we going to handle the rapid influx of patients? Practically, where will we put them, triage them, treat them? Do we have the supplies that we will need to deal with them? We supposedly have a couple of disaster carts. Somehow, I don't think they will be adequate. If there is a biological, chemical attack? Do we have the supplies for that in the form of medication? Medication specific to the agent involved? Who will make sure that people who are contaminated don't rush into the hospital? The most important question I have is: Why don't I, as someone who works in an ER, as an ER charge nurse know any of this stuff?

As someone who was in the military, in the medical field, I think that we should use the military, people who are already set up to deal with mass casualty to teach us how to do this. In the military we used to sometimes stage disaster drills that involved the civilian EMS system. This should happen more. Use the resources that are already there to teach us. Is this a realistic idea? Who knows. Something needs to happen.

We don't think about this much, unless we are reminded by a disaster or take a class that speaks to it. We put it out of our mind. Its too overwhelming to think about. We hope for the best. The people who rely on us in these kind of situations deserve more than our hope that it will go well.


Rick Russotti said...

You are direct and on target. Despite the money spent, little meaningful training or actual preparedness has gone on in hospitals. The expectation is that hospitals will manage whatever comes in, under any this reality? Surge capacity and triage of limited medical resources (burn trauma and vents) remain unanswered questions.
Rick -

rnraquel said...

Nobody seems to have a real plan. I wanted to do my educational project (You know the big cardboard posters that nurses are forced to do for a pay raise) on disaster plans and management in case of a biological or chemical attack. Management told me not to do that, it was too unlikely. I was supposed to pick a topic such as core measures or cranial nerve assessment.

Unknown said...

I was also in the military working with the civilian medical teams as an EMT. We did disaster training quite often. I have often wondered what the hospitals would do if there was mass casualty or mass contamination that happened in any metro area. I know that hospitals would be overwhelmed but would there be any treatment available with the cacophony likely to be going on? I am not so sure. I think everyone and everything would be so overwhelmed that the hospitals would be turning people away.

Passing Nclex said...

They just dont care or even realize the disaster, trust me its all about the man that is in charge,somewhere somehow, there a person at the top of the food chain, know that there is no profit with helping other people, the is the same issue, out of mind out of sight.

Nurse K said...

I like the color-coded triage tags. I think we should use them all the time, so that the drug seekers/toothacheurs/URIeurs, etc. have to wear a "minor" green badge all the time while in the lobby. Yeah, I'm putting a red badge on the elderly person with shortness of breath and your green-tag ass just gonna have to deal with it.

girlvet said...

K - now that i a scathingly brilliant idea!

EDNurseasauras said...

Yeah, tags for minors. Love that. Beats the present system in which minors who are "bumped" send each of their assorted relatives, kids and enablers to the desk to inquire for the 10th time how much longer the wait will be.