Biomedical Engineering Reference
In-Depth Information
To decrease the likelihood of contaminating other
parts of the hospital, it is probably better to bring
food to the department rather than send the staff to
the cafeteria.
There will also be a need for staff rest and
sleeping quarters as the event progresses. The
longer a staff member goes without sleep, the
greater the possibility for errors and poor judge-
ment. Many hospitals have dormitories and call
rooms that can be used for this purpose. Staff
shower and lavatory facilities will also be required,
separate from the general public (to decrease the
possibility of contamination).
Terrorism does not only affect the hospital,
it has an impact on the entire community. As
such it should be planned as a community event
with leaders from outside of the hospital. Staff
will work more diligently if they do not have to
worry about their children and families. Child-
care can help alleviate some of this worry for
the staff. Some hospitals have childcare facili-
ties in house, others do not. A relationship with
the local school system and churches may be
helpful.
As an example, the CT-1 DMAT team actu-
ally has a formal arrangement where members
who are not deployed on missions will look
out for the family members of those who are
deployed. This may be as simple as a phone
call or two, to as complex as making childcare
or eldercare arrangements. It has had a reas-
suring effect on the team members who are out
on deployments, unable to fulfill obligations at
home and on their family members as well. This
could be a role for a social worker or mental
health professional, hospital volunteers or the Red
Cross.
The CISD should be required of all personnel
prior to their being allowed to return to normal
operations / shift work. Early integration of mental
health teams can head off feelings of guilt, help-
lessness, frustration, and anxiety by emergency
providers after a terrorist event.
The CISD defusings can be career and life-
saving for the providers involved. Providers
needing professional follow-up care can be identi-
fied at an early stage and be assisted with putting
their lives back into perspective and order after
these events.
During CISDs, emergency providers are given
the opportunity to discuss the events that they
were involved in, including areas that did not go
as planned or that did not end with good results.
The environment is one of support and no assig-
nation of blame is placed on any provider. A
responsible director will arrange for shift coverage
while he stands his crew down for debriefing
(both for CISD and normal debriefing) and rest
and relaxation. For many small departments this
may be accomplished in as little as a single day
or two. For larger departments a more thought
out and organized approach may be needed. This
process can be planned, just like the rest of the
disaster plan.
Long term psychological evaluation need to
be made available; many times the effects of
a terrorist attack do not manifest until days or
weeks after the event. Some of these manifesta-
tions may need long term psychological care and
this should be provided to any EMS provider who
needs it.
Lastly, a final event debriefing should occur,
separate from the CISD debriefing. This should
include reviewing lessons learned from the event
and the plan for applying those lessons to future ED
responses and into the overall emergency response
plan. By reflecting on all the information gathered
at an incident, from patients, providers, depart-
ment heads and municipal leaders, we can learn
about areas of the response that went well and
areas that did not. From that knowledge, changes
can be made to address the shortcomings of the
original plan. This is not done to assign blame,
9.10 Post Incident Return to Normal
Operations
Once a terrorist event is contained and the response
phase for ED staff has been completed, the process
of taking the system out of emergency response
mode and putting it back into day to day opera-
tions starts.
