Survey shows disturbing lack of preparedness
December 1, 2001
Survey shows disturbing lack of preparedness
Interviews with hospital personnel at 30 facilities located within the Federal Emergency Management Agency (FEMA) Region III paint a troubling picture of the state of preparedness for weapons of mass destruction (WMD) incidents. The survey, the results of which appeared in the November 2001 Annals of Emergency Medicine, found the following:
- No respondents believed their sites were fully prepared to handle a biologic incident.
- Seventy-three percent believed they were not prepared to manage a chemical weapons incident.
- Seventy-three percent believed they were unprepared to handle a nuclear event.
Further, the researchers found, "If a WMD incident were to occur, 73% of respondents stated a single-room decontamination process would be set up. Four of the hospitals [all rural] reported no decontamination plans. WMD preparedness had been incorporated into hospital disaster plans by 27% of facilities. Only one facility had stockpiled any medications for WMD treatment."1
Will the EDs be ready to respond?
In additional responses, 87% believed their emergency department could manage 10 to 50 casualties at once; nearly one-fourth said their hospital staff had some training in WMD event management; 77% had a facility security plan in place; and half were able to perform a hospital-wide lockdown.
While the manuscript was first submitted in early 2001, "The current situation [lack of hospital preparedness] is a sign of changing times," notes Janet M. Williams, MD, director of the Center for Rural Emergency Medicine, co-investigator of the Virtual Medical Campus at West Virginia University in Morgantown and one of the article’s co-authors. "Until 9/11, many did not believe that such terrorism would or could occur. Hospital preparedness was not on our radar screen as a need worthy of billions of dollars in our society — especially when there are so many other competing public health needs," he says.
What it means
The most important finding of the study, Williams asserts, is that the vast majority of hospital personnel surveyed believed that their facility would have difficulty managing a mass casualty incident involving a weapon of mass destruction. "Before Sept. 11, in my opinion, most medical and hospital personnel did not perceive a threat from terrorism using weapons of mass destruction," she says. "There was little federal funding specifically for hospital preparedness for training about weapons of mass destruction. Furthermore, prior to 9/11, there were few WMD-specific preparedness standards or requirements for hospitals."
Williams anticipates that the publication of this study will change things. "We are hoping that our study will help persuade policy-makers that funds are needed to support hospital preparedness planning," she says. "Our study describes specific preparedness topics that will be important to pursue, such as awareness training, developing the capability to perform mass decontamination, assuring facility security, protecting health care workers, as well as communication protocols," she adds. Hospital personnel are already aware of the issue, and at this time, I believe they would welcome initiatives related to WMD preparedness."
Williams is quick to point out that hospitals in no way bear the entire burden for disaster preparedness. "The hospital is only one spoke in the wheel of those who would be called upon to respond to a WMD event. "Critical to the response are law enforcement, the military, public health agencies and many other groups," she notes. "Some suggest that the other groups may be facing similar challenges related to WMD preparedness.
"[Nevertheless], the recent reports of anthrax as well as the multitude of false anthrax scares underscore the need for the medical community to be aware of how to handle these incidents," Williams adds. "The outbreaks only confirm the need for federal resources to be directed at improving the health care system’s capability to improve awareness, [and] detect, respond, and manage victims of possible bio/chemical terrorism," she says.
Reference
1. Treat KN, Williams JM, Furbee PM, et al. Hospital preparedness for weapons of mass destruction incidents: An initial assessment. Ann Emerg Med 2001; 38:5:562-565.
Need more information?
For more information, contact: Janet M. Williams, MD, P.O. Box 9151, West Virginia University, Morgantown, WV 26506-9151. Telephone: (304) 293-6682. E-mail: [email protected].
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