Alternate Site Surge Capacity in Times of Public Health Disaster Maintains Trauma Center and Emergency Department Integrity: Hurricane Katrina

Eastman, Alexander L.; Rinnert, Kathy J.; Nemeth, Ira; Fowler, Raymond L.; Minei, Joseph P.

doi:10.1097/ta.0b013e3180d0a70e

Cited by 38 publications

(39 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This centre, which was specifically designated to manage the surge of injured patients, quickly ran out of critical stores, taking almost a week to acquire adequate supplies. 15 The 2004 Indian Ocean tsunami damaged 61% of health facilities and killed 7% of health workers in the province of Aceh, Indonesia, limiting disaster relief. 23 Mass casualty incidents such as these have shown that a hospital's ability to function relies on lifelines and other basic services such as electrical power, waste management disposal, water and sanitation.…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12][13][14][15]17 We identified 6 domains as critical to disaster preparedness. These domains were leadership, hazard planning, communications, sustainability of peak operations, education and interagency cooperation.…”

Section: Survey Methodologymentioning

confidence: 99%

“…However, reviews of a number of recent MCIs, such as the 9/11 New York terrorist attacks, the London and Madrid bombings and Hurricane Katrina, suggest that trauma centres' preparedness is limited in several critical domains. These domains include leadership, 9 hazard planning, 9 communications, 9-14 sustainability of peak operations, 15 education, 16 interagency cooperation 17 and funding. 18 These vulnerabilities have been identified previously by the World Health Organization (WHO) 1 and by centres that have provided assistance during MCIs.…”

mentioning

confidence: 99%

“…18 These vulnerabilities have been identified previously by the World Health Organization (WHO) 1 and by centres that have provided assistance during MCIs. [9][10][11][12][13][14][15]17 These deficiencies also indicate that the medical and surgic al response to disasters is heavily dependent on an array of nonmedical institutions and external services and needs to be integrated into a regional response.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Disaster preparedness of Canadian trauma centres: the perspective of medical directors of trauma

Gomez

Ahmed²,

Tien³

et al. 2011

Can J Surg

View full text Add to dashboard Cite

Background: Owing to their constant readiness to treat injured patients, trauma centres are essential to regional responses to mass casualty incidents (MCIs). Reviews of recent MCIs suggest that trauma centre preparedness has frequently been limited. We set out to evaluate Canadian trauma centre preparedness and the extent of their integration into a regional response to MCIs. Methods:We conducted a survey of Canadian level-1 trauma centres (n = 29) to characterize their existing disaster-response plans and to identify areas where preparedness could be improved. The survey was directed to the medical director of trauma at each centre. Descriptive statistics were used to analyze responses.Results: Twenty-three (79%) trauma centres in 5 provinces responded. Whereas most (83%) reported the presence of a committee dedicated to disaster preparedness, only half of the medical directors of trauma were members of these committees. Almost half (43%) the institutions had not run any disaster drill in the previous 2 years. Only 70% of trauma centres used communications assets designed to function during MCIs. Additionally, more than half of the trauma directors (59%) did not know if their institutions had the ability to sustain operations for at least 72 hours during MCIs. Conclusion:The results of this study suggest important opportunities to better prepare Canadian trauma centers to respond to an MCI. The main areas identified for potential improvement include the need for the standardization of MCI planning and response at a regional level and the implementation of strategies such as stockpiling of resources and novel communication strategies to avoid functional collapse during an MCI. Contexte :Comme ils sont constamment prêts à traiter des patients traumatisés, les centres de traumatologie jouent un rôle essentiel dans les réponses régionales aux incidents qui font de nombreuses victimes (multiple casualty incidents -MCI). Des analyses de ce type d'incidents survenus récemment indiquent que la préparation des centres de traumatologie a souvent été limitée. Nous avons cherché à évaluer l'état de préparation des centres de traumatologie au Canada et l'importance de leur intégra-tion dans les réponses régionales aux MCI. Méthodes :Nous avons sondé les centres de traumatologie de niveau 1 du Canada (n = 29) afin de caractériser leurs plans actuels d'interventions en cas de catastrophe et de déterminer les aspects de leur préparation qui pourraient être améliorés. Le sondage était adressé au directeur médical de la traumatologie de chaque centre. Des statistiques descriptives ont servi à analyser les réponses.Résultats : Vingt-trois (79 %) centres de traumatologie de 5 provinces ont répondu. La plupart (83 %) ont signalé l'existence d'un comité chargé de la préparation aux catastrophes, mais la moitié seulement des directeurs médicaux de la traumatologie étaient membres de tels comités. Presque la moitié (43 %) des établissements n'avaient pas fait d'exercice de simulation d'une catastrophe depuis 2 ans. Seulement 70 % des...

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Survey Methodologymentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Disaster preparedness of Canadian trauma centres: the perspective of medical directors of trauma

Gomez

Ahmed²,

Tien³

et al. 2011

Can J Surg

View full text Add to dashboard Cite

show abstract

“…105 In areas that received large numbers of evacuees, EDs did experience significantly increased service demands, 111,112 although off-site activities helped blunt the expected surge in hard-hit sites such as Houston. 113 Of note, emergency physicians (EPs) were the last to leave New Orleans during Katrina. Overall, EPs were pivotal in the response, from on-site triage and care, care during transport, triage and stabilization on the receiving end, and ongoing care for displaced populations in their new environs.…”

Section: Climate Change Is Almost Certain To Alter the Severity Of Sementioning

confidence: 99%

Climate Change and Emergency Medicine: Impacts and Opportunities

Hess

Heilpern

Davis

et al. 2009

Academic Emergency Medicine

View full text Add to dashboard Cite

There is scientific consensus that the climate is changing, that human activity plays a major role, and that the changes will continue through this century. Expert consensus holds that significant health effects are very likely. Public health and health care systems must understand these impacts to properly pursue preparedness and prevention activities. All of medicine will very likely be affected, and certain medical specialties are likely to be more significantly burdened based on their clinical activity, ease of public access, public health roles, and energy use profiles. These specialties have been called on to consider the likely impacts on their patients and practice and to prepare their practitioners. Emergency medicine (EM), with its focus on urgent and emergent ambulatory care, role as a safety-net provider, urban concentration, and broad-based clinical mission, will very likely experience a significant rise in demand for its services over and above current annual increases. Clinically, EM will see amplification of weather-related disease patterns and shifts in disease distribution. In EM's prehospital care and disaster response activities, both emergency medical services (EMS) activity and disaster medical assistance team (DMAT) deployment activities will likely increase. EM's public health roles, including disaster preparedness, emergency department (ED)-based surveillance, and safety-net care, are likely to face increasing demands, along with pressures to improve fuel efficiency and reduce greenhouse gas emissions. Finally, EM's roles in ED and hospital management, particularly related to building and purchasing, are likely to be impacted by efforts to reduce greenhouse gas emissions and enhance energy efficiency. Climate change thus presents multiple clinical and public health challenges to EM, but also creates numerous opportunities for research, education, and leadership on an emerging health issue of global scope. ACADEMIC EMERGENCY MEDICINE 2009; 16:782-794 ª 2009 by the Society for Academic Emergency MedicineKeywords: emergency medicine, emergency services, hospital, emergency medical services, disaster planning, climate, weather, greenhouse effect, health policy T here is abundant evidence and clear consensus among climate scientists that human activity is changing the world's climate. Lay opinion in the United States has begun to reflect this concern. Projections for future climate change include a global average surface temperature rise of 1.8 to 4.0°C, sea level rise of 0.18 to 0.59 m, and significantly increased weather variability.1 These changes will very likely have net negative health effects through a range of direct and indirect exposures, both globally and in the United States, and place greater demands on acute care, disaster response, and public health services. 2,3 These increased demands are likely to burden health care generally and emergency medicine (EM) in several areas specifically. EM's clinical care mission is very likely to be influenced as the populations at gre...

show abstract

Disaster Metrics: Quantitative Benchmarking of Hospital Surge Capacity in Trauma-Related Multiple Casualty Events

Bayram

Zuabi²,

Subbarao

2011

Disaster med. public health prep.

View full text Add to dashboard Cite

ABSTRACTObjectives: Hospital surge capacity in multiple casualty events (MCE) is the core of hospital medical response, and an integral part of the total medical capacity of the community affected. To date, however, there has been no consensus regarding the definition or quantification of hospital surge capacity. The first objective of this study was to quantitatively benchmark the various components of hospital surge capacity pertaining to the care of critically and moderately injured patients in trauma-related MCE. The second objective was to illustrate the applications of those quantitative parameters in local, regional, national, and international disaster planning; in the distribution of patients to various hospitals by prehospital medical services; and in the decision-making process for ambulance diversion.Methods: A 2-step approach was adopted in the methodology of this study. First, an extensive literature search was performed, followed by mathematical modeling. Quantitative studies on hospital surge capacity for trauma injuries were used as the framework for our model. The North Atlantic Treaty Organization triage categories (T1-T4) were used in the modeling process for simplicity purposes.Results: Hospital Acute Care Surge Capacity (HACSC) was defined as the maximum number of critical (T1) and moderate (T2) casualties a hospital can adequately care for per hour, after recruiting all possible additional medical assets. HACSC was modeled to be equal to the number of emergency department beds (#EDB), divided by the emergency department time (EDT); HACSC = #EDB/EDT. In trauma-related MCE, the EDT was quantitatively benchmarked to be 2.5 (hours). Because most of the critical and moderate casualties arrive at hospitals within a 6-hour period requiring admission (by definition), the hospital bed surge capacity must match the HACSC at 6 hours to ensure coordinated care, and it was mathematically benchmarked to be 18% of the staffed hospital bed capacity.Conclusions: Defining and quantitatively benchmarking the different components of hospital surge capacity is vital to hospital preparedness in MCE. Prospective studies of our mathematical model are needed to verify its applicability, generalizability, and validity.(Disaster Med Public Health Preparedness. 2011;5:117–124)

show abstract

Alternate Site Surge Capacity in Times of Public Health Disaster Maintains Trauma Center and Emergency Department Integrity: Hurricane Katrina

Abstract: Alternate-site medical surge capacity provides for safe and effective delivery of care to a large influx of patients seeking urgent and emergent care. This protects the integrity of existing public hospital TC/ED infrastructure and ongoing operations.

Cited by 38 publications

References 6 publications

Disaster preparedness of Canadian trauma centres: the perspective of medical directors of trauma

Disaster preparedness of Canadian trauma centres: the perspective of medical directors of trauma

Climate Change and Emergency Medicine: Impacts and Opportunities

Disaster Metrics: Quantitative Benchmarking of Hospital Surge Capacity in Trauma-Related Multiple Casualty Events

Contact Info

Product

Resources

About