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      Hospital Disaster Preparedness in Los Angeles County

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      Academic Emergency Medicine
      Wiley

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          A medical disaster response to reduce immediate mortality after an earthquake.

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            Implications of hospital evacuation after the Northridge, California, earthquake.

            On January 17, 1994, an earthquake with a moment magnitude (total energy release) of 6.7 occurred in Northridge, California, leading to the evacuation of patients from several hospitals. We examined the reasons for and methods of evacuation and the emergency-management strategies used. The experience in California may have implications for hospital strategies for responding to any major disaster, including an act of terrorism. From September 1995 to September 1996, we surveyed all acute care hospitals in Los Angeles County that reported having evacuated patients after the Northridge earthquake. Physicians, nurses, hospital administrators, and staff on duty at the hospitals during the evacuation responded to a 58-item structured questionnaire. Eight of 91 acute care hospitals (9 percent) were evacuated. Six hospitals evacuated patients within 24 hours (the immediate-evacuation group), four completely and two partially. All six cited nonstructural damage such as water damage and loss of electrical power as a major reason for evacuation. Five hospitals evacuated the most seriously ill patients first, and one hospital evacuated the healthiest patients first. All hospitals used available equipment to transport patients (blankets, backboards, and gurneys) rather than specialized devices. No deaths resulted from evacuation. One hospital evacuated patients after 3 days and another after 14 days because of structural damage, even though initial inspections had shown no damage (the delayed-evacuation group). Both hospitals required demolition. Some hospitals identified destinations for their evacuated patients independently, whereas others sought the assistance of the Los Angeles County Emergency Operations Center; the two strategies were equally effective. After even a moderate earthquake, hospitals are at risk for both immediate nonstructural damage that may force them to evacuate patients and the delayed discovery of structural damage resulting in permanent closure. Evacuation of large numbers of inpatients from multiple hospitals can be accomplished quickly and safely with the use of available resources and personnel. Copyright 2003 Massachusetts Medical Society
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              Assessing hospital preparedness using an instrument based on the Mass Casualty Disaster Plan Checklist: Results of a statewide survey

              Background Hospitals would play a critical role in a weapon of mass destruction (WMD) event. The purpose of this study is to assess preparedness for mass casualty events in short-term and long-term hospitals in Kentucky. Methods All short-term and long-term hospitals in Kentucky were surveyed using an instrument based on the Mass Casualty Disaster Plan Checklist and a brief supplemental bioterrorism preparedness questionnaire based on a checklist developed for the Agency for Healthcare Research and Quality. Results Responses were received from 116 of the 118 (98%) hospitals surveyed. Hospitals reported surge capacity equal to 27% of licensed beds, and virtually all respondents were engaged in planning for weapons of mass destruction events. However, advanced planning and preparation were less common. Large regional differences were observed, especially in the area of pharmaceutical planning. Preparedness planning in general and pharmaceutical management planning in particular were more advanced in counties participating in the Metropolitan Medical Response System Program (MMRS). Conclusions Hospital mass casualty preparedness efforts were in an early stage of development at the time of this survey, and some critical capabilities, such as isolation, decontamination, and syndromic surveillance were clearly underdeveloped. Preparedness planning was more advanced among hospitals located in MMRS counties.
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                Author and article information

                Journal
                Academic Emergency Medicine
                Acad Emergency Med
                Wiley
                1069-6563
                1553-2712
                November 2006
                November 2006
                : 13
                : 11
                : 1198-1203
                Article
                10.1111/j.1553-2712.2006.tb01648.x
                79f6aa22-1e39-4c55-ac9a-fe7ec40413a3
                © 2006

                http://doi.wiley.com/10.1002/tdm_license_1

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