Survey: Do you feel your hospital is prepared to handle a major disaster?

prn nurse · Oct 17, 2001

My hospital is not. I live in a city of about 200,000 people. I work in the 2nd largest hospital of 4. Today , at our hospital, we realized the words..anthrax, smallpox, etc. are not even on the computer. The Infectious Disease doc's...have nothing about bio-warfare...to access...the E.R. > da nada. On several of the anthrax threads I have read, it said the bodies of an infected anthrax person should not be embalmed, but quickly taken to a cemetery and buried....How many morticians are going to be standing around waiting to bury these folks if we ever have a MAJOR outbreak with hundreds or thousands of deaths? How many ER docs will be available? In my hospital, I think they would split. No, my hospital is not ready and could not handle more than a dozen. I think we need more education. I think the staff would justifiably panic. Look at what happened in D.C. this week. They have closed down the entire House "until at least Tuesday," and everyone WENT HOME...What do they think doctors and nurses would do with a dozen contaminated anthrax patients in the E.R. or anywhere in the hospital? I don't know about you all, but at my hospital, I am betting the staff will do the same thing the House staffers did, they will go home. And guess what?,... these people were already taking Cipro before the first envelope was found in D.C., it is on AOL news today.

jayna, RN · Oct 18, 2001

The hospital in my country is a biggest NO!...You know developing country and so forth..but when disaster strikes the good neighbour country helps..if not we'll be all death...hahahaha:D

six feet underground or in few inches deep graves... :D

jayna, RN · Oct 18, 2001

Well, US nurses.... be prepared...i will be praying for you....

Hope there's not going to be a big disaster...take care

mattcastens · Oct 18, 2001

I guess it depends on the type of disaster. If it's the standard major pileup on the freeway, or an explosion downtown, then as a Level I trauma center, I would say yes. Also, since our facility works with the local power company to prepare for radiation disaster at the local nuclear power plant, then we're prepared for that as well. In terms of biological disaster, we are unprepared, but another Level I center and the local children's hospitals have protocols and drills for that circumstance.

debbyed · Oct 18, 2001

The Maryland Department of Health and Human Services has been very good at sending out timely fax's to our ER with updated information on Anthrax. Basically what to do, who to call, when to test, when to treat.

Heard nothing about smallpox.

As far as nuclear disaster, concidering where we are, it really don't matter much. We'll hear the sirens, but by the time it hits we'll be toast.

krisfroggie · Oct 18, 2001

Well, I feel this is not a simple yes/no question. I feel our nurses are well educated and devoted:D But unfortunately, it is difficult to adaquately staff the Childrens Hospital where I work at times. We have closed our PICU even recently due to not having enough nurses to handle more admissions. I do not believe we have enough nurses to handle the staffing needs of even a minor disaster. If we can't find enough nurses to handle normal flow...AND IT IS NOT EVEN WINTEER YET!!!!!!!!!!!!!!!!!

sarjeetgill · Nov 3, 2001

Yes, my hospital is able to deal with a major disaster. However, I must qualify my answer because the definition of a major disaster is unclear.

No hospital can cope with a major disaster of epic

proportions, like the World Trade Centre Disaster.

However, my hospital is perfectly capable of local

disasters.

Planning for disasters, could be like bridges. Bridges are built to handle 10 yr. floods, 50yr. floods etc. Some are built to handle 100yr. floods. My hospital will not be able to handle a

100 yr disaster. :rolleyes:

RNPD · Nov 3, 2001

Why on earth would hospital staff go home if they get anthrax patients? Anthrax isn't contagious from human hosts. Only the spores cause morbidity; once they are in a host environment-i.e. the human body-they become active bacteria. These patients don't need isolation but of course follow standard precautions. I am curious as to the source of the info that anthax infected bodies shouldn't be embalmed. What is the rational for this? Morticians embalm people with other bacterial or viral illnessess all the time. They just take adequate precautions. What is so special about anthrax-which is found in the soil quite regularly, BTW. But when naturally occurring, it needs certain conditions to cause infection and these aren't often present. It would be difficult to cause a major outbreak with 100s of thousands of cases, especially inhalation anthrax. It just isn't that easy to spread and would need to be obtained in extremely large amounts for that to occur.

Smallpox is droplet precautions-and if you are exposed you can receive the vaccine 3-5 days afterward and still be 100% protected.

You really need to go to the CDC website and educate youself. It reflects poorly on the profession to have nurses spreading rumors and incorrect info. And if the House staffers on Capital Hill were taking Cipro before the fact, it is because they are uneducated, non-professionals who don't know any better. And we all know plenty of docs who have no trouble writing any script their patient dictates.

As far as my community hospital-I believe we are as well prepared as possible. We know what to do and have the resources to do it-unless of course sheer numbers overwhelm the system. But of course, no one can be prepared for THAT!

prn nurse · Nov 9, 2001

I take my responsibility to this BB very seriously and would never post anything I had not researched and verified, certainly would never post irresponsible rumors. I respect the CDC site, but just this week the CDC admitted they had not warned the postal workers about the risks of inhalation anthrax "because we did not know the (microscopic) spores could fall out of envelopes." The information I posted was from the New York Times. If you go to their site and check their library and research ,you will find more comprehensive information. You asked, "What is so special about anthrax?, it is found in the soil anyway." It is true, anthrax has been in the soil for thousands of years, and farmers all over the world have tilled the soil behind a cow, ox, mule, horse,human, and never come down with anthrax. Why not? Have you not read any reports that the biological strains used for terrorism are altered from those found in nature? And that if you are plowing behind a mule and turn up a few spores you are unlikely to catch anthrax? It takes 8,000-10,000 inhaled spores to cause inhalation anthrax. This number is not inhaled "naturally, " behind a mule. Why would the nurses go home? For the same reason the senators and representatives went home. Fear. If a person has been exposed to and contaminated by the anthrax spores in the thousands, they must be decontaminated in a room where the vent system has been shut down, the room sealed and placed under negative pressure, and one that is equipped with a special filtering system to filter the anthrax spores from the envoirment. Is your emergency room set up for this? The same requirements for funeral directors. So far , the dead have been decontaminated prior to being taken for embalming. In a contaminated building, the spores can lodge in the air conditioning system, ducts, behind the walls, etc. I do not know how to make this clearer. Anthrax contamination is to be considered different and therefore worthy of special consideration. One last thought to consider, it is the spraying of the spores in the envoirment that makes them so hazardous. A patient presenting to the E.R. is considered contaminated, not because of the spores is his/her intravascular system or lungs, but because of the spores free floating on their clothes, hair, skin, shoes, etc. The causative organisms of HIV, TB, Hepatitis, etc. do not fall off the patients and contaminate the envoirment/health care workers. I hope this clarifies the concept for you.

RNPD · Nov 9, 2001

I still disagree because a patient presenting to the ER with inhalation anthrax would not be carrying a concentrated amount of spores on his person. Also the spores need a way to be inhaled, such as with the postal workers. Are you aware that the post office cleans the mail sorting machines daily with a powerful air blower to blow out paper particles from the machines? It is similar to a leaf blower and this is what caused the spores to become concentrated as well as airborne with enough force to be inhaled at the needed numbers to cause disease. This is why the CDC at first didn't realize the danger; they were unaware of the cleaning procedures. This would not be the case with a patient, even if several thousand spores were clinging to their person-highly unlikely. Also once inside the body the spores germinate and are no longer infective as active bacteria, as anthax is spread thru spores, not the bacteria. So standard precautions are sufficient, and funeral home workers should not have a problem. As you stated, it is the spraying of the spores that causes infection. Merely falling off the clothes of the patient would not cause inhalation anthrax (possibly cutaneous though)-and certainly by the time it was recognized that the patient indeed has inhalation anthrax, any possible exposure would already have occurred and the patient would have been disrobed. So unless all ER personnel decide to stay at home indefinitely, there would be no reason to run once a case was diagnosed. And since it mimics the flu until xrays and lymph node exams are made, the ER people would be running ewith every fever, chills and body aches patient they see. Now if you were to talk about chemical warfare that is a totally different scenario and proper decon is vital to the survival of the patient as well as the safety of the healthcare workers.

nurseybikerchic · Nov 10, 2001

My hospital in theUK has had all kinds of briefings against the threat of chemical warfare and I think we are all pretty well clued up as to what actions would take place in that eventuality. What really scares me is what would happen if we were subject to a terrorist strike. The building is 19 floors high, we already know the fire service can only reach the 6th floor by ladder so how the hell do all the rest get out in a hurry?. We have a system for evacuating bed bound paitients in the event of a fire, but that only allows for 1 or 2 wards to be cleared at any one time. Srikes me that if we needed to evacuate the entire building we would be pretty well stuffed!. Even more bizarre, ICU is on the top floor. All I can say is god help us all!!