Emergency doctors are warning that hospitals aren't ready for disasters or mass casualty incidents, especially because of ongoing shortages of crucial drugs and supplies.
The American College of Emergency Physicians surveyed 1,328 emergency doctors and found that 93% do not believe their emergency rooms are "fully prepared" for the surge of patients that follows a disaster or mass casualty incident. Fewer than half (49%) said they their ERs were "somewhat prepared."
Among the top issues identified: A lack of critical medicines, with 90% of those surveyed saying they faced either a shortage or the total absence of such supplies in their ERs.
Jim Augustine, M.D., a clinical professor of emergency medicine at Wright State University in Dayton, Ohio, and a member of ACEP's board of directors, told FierceHealthcare in an interview that these results were hardly surprising, as he's tracked drug shortages in the ER since 2011.
"I've been following this issue for a long time, and [the survey] frankly shows less paranoia than what I see in my own practice," Augustine said. "This is a huge concern for the day-to-day ... scaling up to any kind of a big incident."
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Nearly 90% of the survey respondents said that exploring alternative treatments and medications took them away from patient care, and close 70% said they've seen drug shortages "increase a lot" over the past year.
URGENT: Many hospitals lack critical medicines, aren't fully prepared for disasters & mass casualty incidents.
— ACEP - Members (@ACEPNow) May 22, 2018
Congress must recognize that current shortages are a substantial threat to our nation's preparedness & response capabilities. #LAC18
More here: https://t.co/282sGKo6Zm pic.twitter.com/fxuVHjfYFQ
Augustine said that in his time monitoring this problem he's only seen it get worse and said there's no end in sight. He pointed to severe hurricane damage to facilities in Puerto Rico last fall, which exacerbated shortages of supplies such as saline.
Hospitals can mitigate some of these issues, and some have taken the step of producing saline and other supplies in-house, but there is still plenty of uncertainty about when the supply of these products will grow to meet the need, Augustine said.
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In preparing for emergencies amid these shortages, it's crucial for hospitals to determine how to best structure their finances to get what they need. That can extend to ditching some expensive products, such as certain chemicals, altogether, he said.
Education is another crucial piece of addressing the problem, Augustine said. At WSU, for example, there is a focus on educating providers and paramedics about alternative products.
"When other things go into shortage, we're already prepped for it," he said.
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ACEP President Paul Kivela, M.D., said in the announcement that the survey results should spur Congress to adopt a "regionalized" approach to emergency preparedness, as outlined in the pending Pandemic and All-Hazards Preparedness and Advancing Innovation Act.
The legislation includes several provisions that could boost hospitals' preparedness, such as:
- Improved coordination between local public health agencies, first responders, trauma centers and other hospitals.
- Better tracking of hospital resources before a disaster.
- Consistent and interoperable data systems for local providers to access.
"Congress must recognize that current shortages of essential emergency medications are a substantial threat to our nation's preparedness and response capabilities," Kivela said.