The important on-scene roles played by emergency medical technicians (EMTs) may soon be shifting both upward and outward. Moreover, as various jurisdictions allow EMTs to carry out more life-saving interventions, paramedics will be able to expand their individual and collective capabilities to include the use of such new technologies as portable imaging devices.
Regardless of what many experts perceive as the likelihood of a biological attack, continuing improvements in U.S. public health preparedness programs are necessary to ensure more effective response operations and save countless lives. A cooperative approach to biodefense planning should include an expansion of the nation's existing arsenal of medical countermeasures and the development and production of additional vaccines.
The first step in preparing for a "Black Swan" event is to confirm that it actually exists. Once that is done, it is important to recognize its potential impact, implement the plans and strategies needed, and understand the roles played by all stakeholders involved.
Public health is a concern for all citizens, but the preparedness efforts for public health emergencies provide information primarily to that sector. Members of the private sector and/or other "non-public health organizations" should take the additional steps needed to help ensure that continuity of operations plans are in place before a major health emergency develops.
The huge workload that public health agencies manage on a "typical" day can push resources to the limit. However, when a pandemic or other public health emergency arises and health professionals are unable - or simply refuse - to respond, the responsibilities of the professionals who do respond become that much more demanding and more difficult to sustain.
As the nation's circumstances change, unexpected events unfold, and funding shifts, the priorities of the U.S. healthcare system must change with them. The location and timing of the bomb attacks at the Boston Marathon this year helped reduce the number of lives lost, but that incident still raised new concerns about healthcare preparedness efforts and funding priorities.
Natural disasters such as floods and forest fires can have a crippling effect on communities large and small when they damage the critical infrastructure and, at times, literally change the local landscape. However, advance planning for a total and possibly prolonged separation from the outside world can significantly improve the response and recovery operations.
The U.S. public health community is tasked with more roles and responsibilities than ever before in the nation's history. That community may soon have to take on even more responsibilities during a radiological emergency. Uncovering the gaps and challenges involved may help in moving toward realistic operational planning without continuing to stress current public health programs.
When patients are admitted to a healthcare facility after being exposed to hazardous materials, the decontamination location and process may differ significantly from one facility to another. Each decision made will affect the total cost. And that cost must be weighed against the need for the services rendered.
By examining the successes and challenges of national preparedness efforts each year, the nation is steadily raising the bar for protecting its residents. The unresolved question remains, though, about how to sustain efforts on a decreasing budget - especially when the health of the American people depends on it.
