A robust and extensive guide describes mass casualty planning in the essential areas of emergency medical services, hospital/acute care, alternative care settings, palliative care, and legal/ethical issues. A pandemic influenza case study is included to assist planners in preparing for a pandemic event.
Health Care System Preparedness
The capacity and capability of healthcare institutions to respond to an increased number of patients and/or an increased level of serious injury or illness. Activities may include the ability to respond to a mass casualty situation, in which emergency and healthcare personnel may otherwise be overwhelmed by the number and/or severity of people injured or killed, or the ability to provide mass care for increased numbers of injured or ill people. Examples of events that require healthcare system preparedness and mass casualty/mass care planning include bombings, firearm attacks, and mass transportation accidents. For more information, please visit the CDC page on mass casualty event preparedness and response.
Background
The importance of caring for children plays a significant role in emergency planning; however, children's medical needs are often drastically different than the needs of adults. Children have different vital sign norms and anatomical/physiological characteristics that require a specific age-appropriate approach to emergency care. Children also have mental health and communication needs that correspond to their level of development, and they depend on adults for basic necessities.
Recent public health emergencies in the United States, such as the H1N1 outbreak and Hurricane Katrina, highlighted the important role pharmacists and pharmacies can play in reaching medically at-risk populations. Pharmacists bring a unique set of skills to all-hazards preparedness activities, including accessibility within communities, extended hours of availability, and the ability to identify high-risk patients based on their medication history. Pharmacists are seen as trustworthy health professionals, said Mitchel C.
Background
More than half the US population lives in cities and metropolitan areas. If a public health emergency, such as a bioterrorist attack or a disease epidemic, were to affect one of these areas, a significant number of people would require treatment and/or prophylaxis. CDC’s Cities Readiness Initiative (CRI) funds 72 metro areas to develop plans for providing antibiotics or antivirals to their entire population in the event of a large-scale emergency.
Specific issues
The North Carolina Division of Public Health (NC DPH) developed a program to increase surveillance for potential bioterrorist or infectious disease events by placing public health epidemiologists in 10 of the state's largest hospital systems. Increased partnerships between public health and hospitals, along with the enhanced surveillance skills epidemiologists bring to large healthcare systems, led to a program with great potential for responding quickly to an emerging health crisis.
This city-wide planning document provides detailed information on varied aspects of fatality management during a pandemic and other mass fatality events. Specifically, it defines the local and state jurisdictional responsibilities and identifies key assumptions for handling pandemic influenza-related deaths. The guidance discusses several features of mass fatality planning in seven Attachments, which address issues such as establishment of a temporary morgue, identification and tracking of remains, coordination of planning with local laws, and standards of death scene investigation.
A shortage of healthcare workers is a constant challenge for rural areas of the United States, yet it also may hinder the level of care hospitals and clinics can provide during an emergency. While retired health professionals and other volunteers may be available to augment a healthcare system response, barriers to implementing a volunteer program often include liability concerns and hospitals' ability to meet training requirements.
Many of the events and responses involved in this practice are still undergoing investigation, so the description below pertains only to local mitigation efforts.
On November 5, 2009, an active shooter at the Fort Hood military base endangered the lives of both military personnel and civilians. During approximately 45 minutes, 26 people were wounded, and 13 people were killed. Some of the injured were treated at a nearby Level 1 trauma center, while others were cared for at local hospitals.
On May 10, 2010, a massive tornado outbreak occurred in Oklahoma. Over 50 tornadoes touched down within a 36-hour period, and more than 200 homes were destroyed in Pottawattomie County alone. Evening storms and tornadoes resulted in significant human injury, damage to property, and 3 deaths. More than 1,000 people were affected by these storms, including those who lost their homes or sources of income.
In 2010, Tennessee experienced the worst flooding emergency since 1937. Floods had dramatic effects on Tennessean communities, considering that 52 counties were declared disaster areas. Homes and businesses were damaged or destroyed, and 24 citizens lost their lives.
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