Biomedical Engineering Reference
In-Depth Information
exposed to the biological weapon to remote facili-
ties to provide area hospital space.
The ACC provides inpatient medical services to
those exposed to a biological weapon but do not
require mechanical ventilation and/or those who
are likely to die. Patients requiring higher standard
of care will be admitted to a hospital until capacity
is reached. In that event, patients will receive as
much care as the ACC can provide. Restricting care
at an ACC ensures that an efficient approach to
patient care is delivered. Most patients will require
similar treatment following pre-established clinical
practice guidelines. This system also allows for
grouping patients with similar symptoms following
exposure thereby eliminating potential exposure
to non-infected persons. Again, as with the triage
process, healthcare practices will have to be
reassessed regularly to effectively apply available
resources to provide care for the greatest number
of casualties. Patient care would be prioritorized
to provide the best care available under existing
conditions.
Respondingmedical personnel must be cognizant
and understand that to deliver the necessary patient
care for each patient is not optimal and may
be hazardous. The rationale for limiting the care
provided at the ACC is based on the following [6]:
not provide oxygen. They would however offer
space to provide needed agent-specific therapy
and basic supportive care).
Pre-designated practice guidelines will allow
healthcare clinicians of various backgrounds to
provide care in a streamlined manner. The orga-
nization of the command of the ACC will de
designed to compliment the existing local emer-
gency command structure. The medical command
center (MCC) will determine whether patients need
to be admitted to a hospital or should be triaged to
an ACC.
The ACC is physically designed into five 50-bed
nursing subunits (or a 250 bed “pod”). The pod can
admit patients when it is ready and fully staffed.
When the current pod is at 70-80% capacity
the next pod should be nearing completion and
preparing to accepts patients. Upon arrival, patients
are registered and evaluated for placement. The
ACC is not designed to provide assessments in the
registration area, but to log patients into an internal
tracking system and assign a bed.
Suggested staffing requirements per 12-hour
shift for a 50-bed nursing unit is a follows [6]:
one physician
•
one physician's assistant or nurse practitioner
•
six RNs (or a mix of RNs and LPNs)
Hospitals are better equipped to treat critically
ill patients and have more resources.
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•
•
four nursing assistants
Hospitals have better access to trained staff and it
is more efficient to treat patients in one location.
•
•
two clerical personnel
•
one respiratory therapist
The ACC is designed for situations where
the demand for healthcare exceeds existing
resources. The ACC must be set up quickly and
streamline its level of care to provide maximum
good to the most people.
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•
one case manager
•
one social worker
•
two housekeepers
two patient transporters
•
•
Providing a designated level of care minimizes
ethical decisions healthcare providers will need
to make when limited resources are available.
Creative planning may be necessary and mutual
aid resources may be necessary to augment
available staff. The local office of emer-
gency medical services (OEMS) and metropolitan
medical response system (MMRS) could fulfill
personnel needs while awaiting outside assistance.
Division of responsibility for different aspect of
patient care will be based on the knowledge and
skills of available staff members.
•
A designated level of treatment eliminates the
healthcare professional's dependence on tech-
nology to provide mass care.
An ACC may face logistical issues that affect
the level of care that can be provided (e.g.,
an ACC set up in a school gymnasium could
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