Mass casualty lessons for hospitals from Iraq and Afghanistan

Hospitals can take lessons from war for ways to deal with potential mass casualty incidents (MCIs), according to Hospitals & Health Networks.

MCIs, such as the 9/11 attacks and the Boston Marathon bombing, put extreme strain on medical resources and can overwhelm their care capabilities, writes Alisa Gean, M.D., professor of neuroradiology and adjunct professor of neurology and neurological surgery at the University of California at San Francisco and San Francisco General Hospital.

And despite wider awareness of the dangers of such incidents, only two-thirds of hospitals in the U.S. have comprehensive plans in place for terrorist attacks, nuclear-radiological hazards, power outages, fires and natural disasters, she says.

To stengthen their preparedness efforts, healthcare systems should look to the wars in Afghanistan and Iraq for inspiration, according to Gean, who cites five lessons from the wars for hospitals during MCIs:

  • Establish a clear emergency hierarchy: Healthcare providers should ensure all personnel are familiar with the National Response Framework and the local incident command system, as well as having "a dedicated command center with restricted access to a defined set of leaders," Gean writes.

  • Improve triage: Emergency department (ED) overcrowding is a problem even without a disaster, writes Gean, so hospitals must prepare not only for an influx of ED patients but of CT scan patients, as well as a second wave of patients improperly sent to hospitals without trauma facilities.

  • Maintain functions: Hospitals must develop contingency plans to avoid suspending vital services, such as one New Orleans facility's plan to house its utilities and ED on the upper levels.

  • Improve communication: "Hospital information systems are more complex than ever, and reliance on information technology is firmly entrenched in organizational success," Gean writes. "Hospitals should conduct a detailed evaluation of the emergency power system that includes all system-related components."

  • Practice for the unexpected: "The unpredictable nature of terrorism and MCIs makes preparation key. Nothing teaches disaster preparedness like experience," Gean writes. Indeed, incidents like the 2014 Ft. Hood shooting and the Boston bombing have inspired revitalized drilling procedures for such scenarios.

To learn more:
- read the article

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