Biomedical Engineering Reference
In-Depth Information
hospitals, the providers who work there, and the
patients who are already under care) at the time
a mass-casualty event occurs. The protection of
alternate care sites created in response to a mass
casualty event would also be important. A plan to
protect health care facilities might include steps to
ensure the following:
personnel be trained in pediatric triage stan-
dards and other pediatric assessment protocols
(e.g., JumpSTART); family care and adult care
be available in pediatric settings; appropriately-
sized supplies, equipment and medication doses
be available; and safe use of decontamination
procedures be ensured. Provisions for treating
children whose parents are not present and for
treating parents who will not leave their chil-
dren are important considerations.
•
Current patients and facility staff do not become
secondary victims.
•
Contaminated victims are not permitted to enter
“clean” treatment areas.
•
Persons with physical or cognitive disabilities
.
As under normal standards of care, provisions
to accommodate the special disability-related
needs of some persons are important aspects
of the organization of care. These are likely to
include issues of physical access to and within
care sites, alternative and safe decontamina-
tion procedures, enhanced communication, and
issues involving informed consent.
•
Facilities may utilize temporary security proce-
dures, such as lockdowns, to enforce safety.
•
Decontamination processes in all care settings
are adequate.
•
Noncritically ill patients are safely relocated to
other facilities, if needed.
•
Persons with preexisting mental health and/or
substance abuse problems
. Preexisting mental
health and substance abuse conditions are
known to exacerbate an individual's ability
to cope with physical and emotional trauma.
Provisions should be made for screening and
direction to appropriate services as part of triage
or other assessment protocols.
Caring for Populations with Special
Needs
It is essential that plans for the delivery of health
and medical care in a mass casualty event address
how the special needs of several groups within
the general population can be met. These needs
may vary from providing for alternate means of
decontamination for babies and other nonambu-
latory persons, to having translators available at
intake centers, to providing mental health assess-
ment resources within the health care setting.
Involving organizations and services designed to
serve groups with special needs under normal
conditions may be a successful approach. As
mentioned earlier, a victim's underlying medical
condition may affect their survivability, and there-
fore may be considered negatively in triage. In
some cases resources may be diverted away from
adults to children because of their greater life
expectancy.
Populations recognized as having special needs
in a mass casualty event include but may not be
limited to the following:
•
Frail or immunocompromised adults and chil-
dren
. Individuals in these groups who are
victims may require adjustments in treatment
regimens and special monitoring, but these
adjustments will be made within the context
of any overriding goal
to maximize lives
saved.
•
Non-English speakers
. Local and regional plan-
ning may have to take into account the need
for communication tools in languages other
than English. Although printed materials of a
general nature may be prepared in advance,
printed materials and signs will not be an
adequate response for those who cannot read
any language. An additional challenge may
be present if undocumented individuals fear
discovery and reprisal if they come forward
for health care in a mass casualty event.
Involvement of formal and informal networks,
•
Children
. The unique physiology and wide vari-
ation in physical and cognitive development
by age within childhood requires that triage
