Biomedical Engineering Reference
In-Depth Information
9 Emergency Department
Preparation
MICHAEL ZACCHERA, III AND MICHAEL F. ZANKER
training, knowledge, and expertise of the others.
This will allow for each role to know whom to
ask for help when something he is not trained in
presents itself.
Physicians obviously need to be trained at recog-
nizing and treating the effects of biological, chem-
ical, radiological, and incendiary attacks. They
should also be involved in the systematic planning
for the hospital and their department. Physicians
have a responsibility to provide leadership and to
become advocates for training and preparation.
Physician level training includes short Contin-
uing Medical Education activities (CMEs) to
multi-day conferences. Advantages to the training
include the ability to recognize the first signs of
a biological terrorist attack, appropriate treatment
of patients and use of PPE (personal protec-
tive equipment). All physicians should practice
treating patients while wearing PPE, such as Puri-
fied Air Powered Respirator (PAPR) devices. This
is important because, while it is likely that most
patients will arrive at the hospital decontaminated,
there is always the chance that one will slip through
and there may be a need for a physician within the
decontamination room.
The PCA's and aide level staff need to be
trained in a variety of tasks. These include proper
decontamination procedures, appropriate disposal
of patient belongings and the additional logistics
involved in a terror attack.
Decontamination in the hospital setting should
be performed either outside of the hospital itself or
9.1 Introduction
Preparing a hospital emergency department for the
influx of patients from a terrorist attack can be
a daunting task. Many hospitals take a “it won't
happen here” approach or the equally short-sighted
thought of “we are a small community hospital,
we'll only accept five or six patients and forward
the rest to the larger hospitals.”
The first position is untrue. Rural areas are just as
likely to be affected by terrorism as the urban areas.
The second positionwill most likely be ignored. The
patients will show up at the door regardless of the
number of patients you wish to accept.
1
All hospital emergency departments and their
staff, great and small, need to address the training,
planning, and practice needed to prepare for terror
attacks.
In this chapter, we will discuss preparation and
planning, operations during terrorist attacks and
post incident activities.
9.2 Preparation
Preparation for terrorism is both an individual
and a group responsibility. Individual preparation
is the responsibility of every healthcare provider.
Physicians and midlevel practitioners, Physician
Assistants (PAs) and Advanced Practice Regis-
tered Nurses (APRNs), may need different training
than general nursing staff who will be different
than Patient Care Assistants (PCAs) and aides. The
need does exist however, for an awareness of the
1
Remember that at such instances, there is no disaster exemption to EMTALA (Emergency Medical Treatment and Active Labor Act).
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