Catastrophic Events Preparing for Catastrophic

Catastrophic Events

Preparing for catastrophic events in hospital settings

As well as regularly treating potentially catastrophic illnesses, hospitals must also prepare for catastrophic events, including but not limited to natural catastrophes such as tsunamis, floods, earthquakes, tornadoes and hurricanes. Hospitals must also be able to cope with devastating human-generated catastrophes such as terrorist attacks. The need for emergency preparedness prior to a catastrophic event was strikingly and tragically manifest in the United States during and in the aftermath of Hurricane Katrina.

Disaster preparedness is also required for reasons of legal liability. Federal law demands that all healthcare institutions engage in disaster management exercises. Hospitals, even small ones, must be able to plan for the necessity of having to "provide care to large numbers of ill, injured, exposed, and concerned individuals" (Evaluation of hospital disaster drills: A module-based approach, 2011, AHRQ). Hospitals are also required to perform evacuation drills, "as a component of their emergency management plan according to regulations set by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)" (Evaluation of hospital disaster drills: A module-based approach, 2011, AHRQ).

To engage in more effective preparation exercises, studying hospitals that regularly cope with crisis situations can be useful. For example, one Canadian physician working in Kandahar, Afghanistan noted many valuable lessons could be learned by all healthcare providers, studying the facility where he worked. "Combat surgery has taught us to rapidly transport patients to [the] hospital resuscitating them along the way, to expedite life and limb-saving surgery, but then to send patients to the intensive care until their normal physiological status returns before attempting to complete surgery" (Wallis 2009). Unlike the United States, physicians and soldiers in Afghanistan must deal with extreme military situations every day. But all healthcare facilities must anticipate the worst in their contingency plans, should a terrorist action or other human-generated event occur, as transpired on September 11th in the United States.

Studying the aftermath of ineffective responses to cries is also essential. The failure to be able to deal with the fallout of Hurricane Katrina in New Orleans caused many overstressed hospital workers to respond in what would later be regarded as a horrific manner. Investigators "were stunned when health care workers charged that a well-regarded doctor and two respected nurses had hastened the deaths of some patients by injecting them with lethal doses of drugs" allegedly in an act of mercy due to the inability of rescue workers to evacuate the patients in an effective fashion" (Fink 2009:1). The New Orleans doctor implicated in the patients' deaths argued that "informed consent is impossible during disasters and that doctors need to be able to evacuate the sickest or most severely injured patients last -- along with those who have Do Not Resuscitate orders -- an approach that she and her colleagues used as conditions worsened after Katrina," given she believed that many patients could not survive an evacuation (Fink 2009:1).