Very few Emergency Departments in U.S. hospitals can cope with a major outbreak of infectious diseases. But there is much that could & should be done before an outbreak occurs. Improved communications between and among all major medical facilities in the same geographic area should be the first priority, along with more and better training, and the elimination of current legal roadblocks jamming the system.
Most but not all HICS policy guidelines have been deemed by the nation's health-care community to be both reasonable and acceptable. And most but, again, not all are being incorporated into local emergency-response policies and guidelines as well. So the system is not yet perfect. It is headed in the right direction, though - but at much less than flank speed.
A possible nuclear attack against the U.S. homeland gets more attention, but homeland-security experts say an attack involving biological weapons could be much more devastating in its consequences. The warhead of such weapons would be pathogens - which, as this primer "for Knuckleheads" points out, are low in cost, easy to obtain, and already here, in galactic abundance.
EMTs and other responders face a host of dangers at the scene of a major accident. But the greatest danger, in many cases, is on the open highways and crowded streets that must be navigated, often at high speed, to and from a multi-vehicle collision or the sudden fire that broke out in a high-rise apartment building.
A plane crash, a toxic-chemical spill, and other "mass-casualty" incidents all represent just the beginning of an extremely complicated response and recovery process. One of the most important "collateral duties" will be the dissemination of timely information to the media, the general public, and the worried families of those dead, missing, or hospitalized. Here is how one major U.S. jurisdiction is handling that responsibility.
How does one define "critical"? Far too often in today's interconnected world, that important designation is awarded retrospectively - i.e., after a terroristic attack or major weather disaster. A credible case can be made, though, that major hospitals and other healthcare facilities deserve that description because of their intrinsic value to the entire community.
As this year's U.S. elections clearly demonstrate, there is a built-in conflict between voters' desire for more and improved services and the equally compelling requirement, at all levels of government, to reduce expenditures. In the field of emergency medical services, this problem is particularly difficult to resolve because not only dollars, but also human lives, are at stake.
Everyone in any given community throughout the world suffers when a hurricane, earthquake, or other disaster occurs. Those who suffer the most, though, are usually those already suffering from other problems, specifically including medical impairments that make it difficult to function on their own, or even with assistance. Fortunately, new government plans and policies are beginning to catch up with the "special needs" of these special citizens.
Surgeons, trauma specialists, and other doctors are in short supply in many areas of the United States and for that reason are usually not assigned to the emergency teams dispatched to an accident scene. On the other hand, a well trained physician may mean the difference between saving the life of a critically injured victim or letting that person die before he or she reaches the emergency room of the nearest hospital.
The risks may be theoretically "controlled" but they are still risks - and controls don't always work. Which is the reasoning behind the "two-in/two-out" rule, the need for an EMS specialist on scene, and the ethical imperative guiding the decisions of political leaders and emergency managers.
