Biomedical Engineering Reference
In-Depth Information
building. Local security and police will need to
know to allow these people into the hospital.
Other options to increase staffing include utiliza-
tion of EMS and Nursing Education personnel,
medical reserve corps and students involved in
training programs.
Most hospitals have both an EMS department
and a Nursing Education Department. These staff
members can be used to fill either clinical roles
or incident command positions. One Pittsburgh
hospital's plan allowed for the use of the EMS
department to be available to either the Emergency
Department as additional staff or to the local inci-
dent commander for use in Incident Command
System (ICS) or in treatment positions. Most
Nursing Education Departments consist of 2-10
staff members who can also be put into service
quickly.
Medical Reserve Corps have been set up by
some states. These are either retired healthcare
workers, or those who now work outside of the
healthcare field. They have volunteered to assist
in the event of a disaster or mass-casualty incident
(MCI). The concept is similar to that of the military
reserves.
The drawback to this system is that some or all of
these healthcare providers may be unfamiliar with
local operations, protocols and may have been out
of practice for years. If this system is used by a
hospital, a mustering of the medical staff reserves
should take place as part of the normal disaster
drill. Taking some time to give an orientation to
the hospital, the computer system and some MCI
training can help decrease the amount of time needed
for “on the job training” during the incident itself.
Always remember to keep the plan simple. Do
not want to run the risk of writing something no
one will be able to follow when the disaster is
occurring. Realize that this is the time when most
staff will be seeing it for the first time.
Medical reserve preparedness can be increased
by having licensing bodies allow for healthcare
professionals licensed in one jurisdiction to prac-
tice in another during an emergency. Preparing
“temporary admitting privileges” for physicians
is also another item that can be pre-planned in
advance to assist in the use of the medical reserves.
Another option to increase staff is to use
senior students to supplement the licensed staff.
Arranging for the short term emergency licen-
sure or certification of senior students can also be
pre-planned with the state department of public
health. As an example, on September 11, 2001
the Hartford Hospital Emergency Department used
paramedic students who had graduated the week
before (who had not received their licenses yet)
as additional ED staff at the paramedic level.
The same could be done with nursing, respiratory
therapy, or other allied health students.
This type of emergency licensing is something
that needs to be planned by with the state depart-
ment of health and senior hospital staff before the
need arises.
A final method of gaining staff is to utilize
the National Disaster Medical System (NDMS).
NDMS is part of FEMA and they can deploy
Disaster Medical Assistance Teams (DMAT) to
an area to supplement hospital staff. Many times
during a natural disaster such as a hurricane
these teams are pre-deployed to an area. During a
terrorist event it may take them some time, from
hours to days to be able to respond to an area.
In New York City after attacks on September 11,
2001, the Rhode Island 1 DMAT was at the federal
rendevous point in Newburgh, NY at 4:30am on
September 12, 2001 and was on the ground in the
city later that day.[1]
9.7 Additional Preparation
Retrieving and organizing the hospital's disaster
cache is another activity that needs to be performed
at this time. Equipment technicians, nurse's aides
or PCAs can do this and distribute it as needed.
The contents of the cache should be established
according to local need and as part of the hospital
disaster plan. Additional beds may need to be
retrieved at this time as well.
If staffing allows, a physician, senior resident
or nurse may quickly gather information regarding
the type of incident and the appropriate treatment.
Likely symptoms can also be researched. If time
allows, a quick briefing of this information can
be relayed to senior medical leaders for further
