Here's some food for thought. I have visited almost three dozen cities where we have instructed medical personnel of all persuasions (EMT, EMT-P, RN, MD) in regards to terrorist incidents involved CBR weapons (chem-bio-rad). The field providers are in fairly good shape. At least most of them have a clue as to the dangers of such a scene, and the requirements it will put on the system. Unfortunately, most hospital administrations will not spring for a decon facility, especially in private, for-profit hospitals. Guess who they are relying on. Fire department HAZ-MAT. Where will we be? At the scene halfway across town, doing our thing.
Many of you will say this is not our problem. The JCAHO requires each hospital to be able to decon one patient. I would guess less than 50% are capable. Is this our problem? You bet. What happens to the rig that pulls into an ED with 75 people beating on the locked ED doors?
I have seen some areas address this issue, but I am interested to see what methods anyone else has come up with.
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02-11-2000, 01:50 PM #1dousaemsFirehouse.com Guest
Hospital Response - How it Affects Us
02-15-2000, 05:20 PM #2anna millsFirehouse.com Guest
yes i agree with todd..the hosp and most people for that matter does not have a clue what we face and if and when it happens, boy i would even hate to think of that..we have drilled on that exact think and the drill was far from close with the hosp understanding.
they don't want to get involved. i run with a ems/rescue/fire co so we see and do it all but wait till several pt need to go to the hosp and they close and run after or during the one. but what do we do??? we have tried to drill with oem and the hosp togther gettting together but it worries me also..
worried in nj anna
02-16-2000, 12:42 AM #3mumedicFirehouse.com Guest
Here are some ideas to help solve your problems. I can tell you that Kansas City is in the process of getting its hospitals in the hazmat loop. They, through the auspices of the Metropolitan Medical Response System, have created a city-wide task force that has addressed the issues of training and equipment necessary to handle exposed patients.
They started by self-funding classes to get their personnel up to the operations level, a mandate of OSHA that is addressed in the March'99 Quips. This is a document you can use to strike interest in the administrators. They have now applied and received grants through the various county LEPC's to fund their classes. This took quite a lot of push to accomplish, as funding is usually directed towards Out-of Hospital personnel. We were able to prove to the LEPC that this was a necessary area of need and that the hospitals were part of "our team." You can use the Tokyo sarin release to better prove the need, as greater than 75% of the patients arrived at the hospitals by POV. My partners and I created a Hospital Operations class that takes all the mandated OPS info and adds some extra toxicology and treatment protocols, hits decon, IMS, and PPE hard, and has scenarios built into it. It's a 16hr. class that was created for the hospitals, which has gone over well with the attendees. The "Field" OPS classes don't fit into the hospital realm.
The issue of equipment necessary to have at the hospitals was addressed by a separate task force. The hospitals got together and purchased equipment in mass, getting theirselves a lower price by working together. We set the hospitals up with a hooded respirator system that met the need for a level B suit and didn't require the extensive training and fit testing of the SCBA system.
The best part of all this is that the hospitals are working together. We have taught over 15 classes so far, and each class has 2-3 hospitals personnel in it. They trade information, work with the same suits, and are now working on a plan that will call in surrounding hospitals staff to assist with a large hazmat incident. The IMS plans, training, and equipment are the same, leaving the door open for outside assistance.
As you can tell, the hospitals here are getting ready. EMS and Fire are close also. There is currently a plan in place that has the closest Hazmat team repond to the scene for mitigation, 2nd closest to the scene for decon, and 3rd closest to the primary receiving hospital for assistance with decon there.
Sleep calls for now. I'll be glad to answer any ?'s you may have. Respond here or E-mail me at HazmedConcepts@aol.com
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