No abstract

No abstract

Background: Hospitals must be prepared to deal efficiently and effectively with different emergencies. To accomplish this, several countries have standardized their hospital emergency codes to improve their response capability. This is particularly important in Puerto Rico given that many health professionals, particularly physicians and nurses, provide services in more than one hospital. This study examined the emergency codes and alerts utilized in Puerto Rican hospitals. Objective: To assess hospitals' level of emergency preparedness and response capability related to the variability of emergency codes and alerts utilized to respond to a situation in Puerto Rico. Method: A survey was conducted to characterize hospital emergency department level of preparedness and response to a mass fatality incident. A total of 39 out of a sample of 44 hospitals participated in the study. Semi-structured questionnaires were administered by the research team to members of each hospital's administrative staff to explore the following: general hospital characteristics, emergency plans, emergency department capacity, collaborative agreements, personnel training, emergency communications, laboratory facilities, treatment protocols, security, epidemiologic surveillance, equipment and infrastructure. Results: Some hospitals in Puerto Rico use color coded emergency alerts, while others use key words or codes. Single color emergency codes can have different meanings in different hospitals. Conclusions: The findings clearly show that there is a lack of uniformity and clarity in the emergency codes utilized by hospitals in Puerto Rico. Single color codes have diverse meanings in different hospitals. This could adversely affect hospitals' efficient and effective emergency response.

Modern EMS systems are designed to bring sophisticated emergency medical care to the patient's side. While contemporary EMS systems do not routinely utilize physicians to deliver care, the public expects to receive equivalent care provided by EMS personnel. As such, EMS systems require knowledgeable physician participation and supervision at every level. Active physician involvement in many EMS systems has brought needed improvements, but guidelines for a medical director's quali

Background: Any healthcare facility must be prepared to handle a dramatic increase in deaths that can be produced by a catastrophic disaster. A mass fatality incident (MFI) will significantly increase the usual number of deaths that hospitals or forensic science services can manage on a daily basis. A survey was conducted to assess the hospital emergency department level of preparedness to deal with an MFI. Objective: To examine healthcare facilities level of preparedness for an MFI and morgue capacity. Methods: A total of 39 out of a sample of 44 hospitals participated in the study. Seven questionnaires were administered to explore: hospital general characteristics; emergency plans; equipment and infrastructure; collaborative agreements; personnel trainings; emergency communications; laboratory facilities; treatment protocols; security; and, epidemiologic surveillance. Results: Three-fourths (79.5%) of the healthcare facilities reported having a morgue, their average storage capacity was of three bodies. More than two-thirds (66.7%) of the institutions stated that they could not increase their morgue's capacity. Most installations without a morgue do not possess an agreement with any other institution for the management of bodies. Hospitals have a very limited number of body bags utilized for the handling and transport of bodies. Conclusion: Most of healthcare facilities have morgues, but there are limitations with the current capacity and the lack of resources to increase their capacity in case of a disaster. Management of an MFI must be part of every hospital's emergency plan, and must include collaborative agreements with forensic authorities, emergency management and public health agencies, and the community.