Biomedical Engineering Reference
In-Depth Information
conditions, it is not possible to provide a complete
picture of what is available and effective. General
principles that might guide the development and
identification of effective training include the
following:
•
Legal and ethical basis for allocating scarce
resources in a mass casualty event.
•
Orientation on how an incident management
system would work in a mass casualty event.
•
How to treat populations with special needs
(e.g., children and elderly persons).
•
Training should be competency based.
•
How to recognize the signs and symptoms of
specific hazards and a trend of similar types of
signs and symptoms.
•
Training should be ongoing.
•
Training should be provided to all responders,
including nonmedical personnel and potential
community volunteer responders, as well as
primary care providers in office and clinic
settings.
•
How to treat specific conditions.
•
How to recognize and manage of the effects of
stress on themselves and their patients.
•
Training should be based on the doctrine of
daily routine, which assumes that providers will
do best what they do most often, but anticipate
extension and expansion of provider roles.
Finally, as components of preparedness training
are defined, they should be incorporated into the
original training for each provider group. For
example, if paramedics are expected to partici-
pate in mass immunizations or assist in emergency
departments, it would be desirable that they get
basics on immunization and sterile technique in
their original training.
•
Training should be provided on a just-in-time
basis only where appropriate, especially if it
differs from daily routine.
•
Training should be specific to the role a person
is likely to play in a mass casualty event (e.g.,
clinic nurses and nurse aides may need training
in burn care).
Protection of Health Care Providers and
Facilities
It is important for planners to consider the
following to ensure the protection of health care
providers:
•
Training should be specific to the conditions
of performance (type of hazard, type of site)
and involve opportunities to practice new skills
through simulation and other mechanisms.
•
Personal protective equipment, prophylaxis,
and other protections that enable them to work
safely.
•
Training should be effective, as demonstrated
by evaluations and trainee performance.
•
Training should be made available to all poten-
tial traditional and non-traditional providers,
including veterinarians, dentists and dental
auxiliary providers, pharmacists and health
professional students.
•
Training specific to provider responsibilities
and to the nature of the event.
•
Adequate rotation of staff to prevent burnout
and errors due to fatigue.
•
Freedom from threats of malpractice (see earlier
discussion of legal issues).
A beginning list of the types of training needed
by all responders and providers in pre-hospital,
hospital, and alternate care sites includes but is not
limited to the following:
•
Mental health support during and following
stressful situations (e.g., Critical Incident Stress
Management).
•
General disaster response, including an intro-
duction to altered standards of care and how
the move to such standards may affect triage
and treatment decisions as well as facility
conditions.
•
Care and support for health care providers'
families.
A related concern is to protect the integrity
and safety of existing health care facilities (e.g.,
