Tragic events such as the May 12th Amtrak derailment in Philadelphia don’t happen as frequently as depicted on most prime-time hospital dramas. In the real world, these events fortunately occur much less frequently. When disasters strike, hospital preparedness becomes a crucial factor in successful treatment of the injured. Whether it is a deficit in resources, training, or both, a lack of preparedness for disasters can have a significant effect on patient outcomes. Handling the majority of the injured – 54 patients – Temple University Hospital stated that routinely practiced disaster drills were a major contributing factor to the smooth process of treating the injured following the train crash.
Beginning with an announcement that the derailment was a Level 4 Emergency (the highest level), Temple called in reinforcements from key departments of the hospital. This extended beyond doctors and nurses – lab staff, cafeteria workers, and security personnel were contacted to report in as well. Having support staff is crucial to patient management in situations where the trauma level is high.
All local hospitals involved (7 including Temple) stayed in constant communication with each other to keep ahead of volume and severity. The most difficult part of managing the disaster was remaining in contact with first responders. Communication with the field frequently can be difficult when the nature of the disaster scene is chaotic.
Those arriving with injuries were triaged in the emergency department. Emergency department physicians who were on duty that night at Temple explained that previously practiced drills created fluidity to processes. Time is saved when there is a plan to follow and employees know what they are expected to do. Time is one of the most crucial elements in successful outcomes in the treatment of patients injured in disasters. When all the moving parts are working in coordination and there is no ambiguity, staff efficiency increases and consequently, patients are better served.
Following the 9/11 terrorist attacks, many hospitals and health systems became keenly aware that they were not fully prepared to handle disasters. Progress in preparedness has come a long way since then. Prior to 2001, no integrated communication systems equipped to respond to large-scale disasters were in existence. Today, every state public health department has established relationships, developed protocols, and practiced exercises among different medical and emergency management players. Fifteen years ago there was no national stockpile of medical supplies or written plans on how to disperse these to disaster sites. Today, the CDC maintains the Strategic National Stockpile to ensure that medical supplies are available and every state has an individualized, structured plan on how to receive and distribute these materials during a disaster.
Disasters can strike at any time and in any place. Preparation and practice are essential ingredients to reduce mortality and morbidity among the injured. When hospitals, health systems, and individuals prepare and practice for emergencies before they happen, immediate and informed action can be delivered when it matters most.