Though hospitals are required to have emergency preparedness plans in place, many facilities are not prepared for the worst: a potential mass casualty incident, which pushes emergency physicians and trauma teams to the limits.
Dan Birbeck, a captain with the Dallas County Hospital District Police Department, the police force at Parkland Health and Hospital System, told Hospitals & Health Networks that many providers fail to recognize that large-scale emergencies are possible. Parkland treated the victims of a sniper shooting at police officers last July.
“You would be surprised by how many have the mentality of ‘it won’t happen here,’ or people who truly underestimate the threat of what is capable of happening in their own community or, for that matter, at their facility,” Birbeck said.
Large hospitals like Massachusetts General Hospital, which treated victims of the Boston Marathon bombing in 2013, and Orlando Regional Medical Center, which treated victims of the Pulse shooting in June, the deadliest in U.S. history, emphasize the importance of practice drills that simulate such emergencies.
Mark Jones, senior vice president for Orlando Health and president of ORMC, said that frequent drills, especially at times when it’s inconvenient, are necessary. Nighttime drills, or drills during busy hours, for instance, will better identify gaps in response, he told H&HN.
John Hick, M.D., an emergency medicine physician at Hennepin County Medical Center in Minneapolis, said hospitals may miss three important points when developing emergency preparedness plans:
- There must be a plan in place for heightened security in the event that a shooting or other mass trauma incident occurs in the hospital itself.
- Victims of gunshot wounds or other penetrative trauma injuries will require a more complex surgical plan, so have a strategy for rounding up needed staff.
- Ensure that a large blood bank is available so that patients can get timely blood transfusions.
Healthcare leaders must also be prepared to offer emotional support as needed to staff members, according to a second article from H&HN. Don’t immediately expect the employees who were involved in a trauma response to be back to business as usual.
Staff at Loma Linda University Health, which treated victims of the San Bernardino shooting in December 2015, huddled shortly after the shooting to debrief, and decided to channel their emotions into a group activity: baking cookies for people outside the hospital who felt the impact of the shooting.
Connie Cunningham, R.N., the hospital’s executive director of emergency services, said the experience was “therapeutic” for all involved. Staff members who are feeling emotionally drained should engage in self-care instead of burying the stress, she said.
Paul Bissinger, M.D., vice chairman for emergency preparedness in the department of emergency medicine at Mass General, said a solution to minimize emotional harm to clinicians is to practice “micro zoning,” where a nurse and doctor wait in an ER room for a patient to arrive instead of watching patient after injured patient go past in the hospital hallways.