The Challenge of the Hospitals and Health Care Systems in Preparation for Biological and Chemical Terrorism Attack

Abstract

In the present study a few aspects of planning for terrorism events that expose large numbers of people to contamination are discussed. Many issues were considered as an absolute requirement for implementation of NBC response: 1) policy, 2) plan and 3) emergency department response to surge capacity. Key elements of the healthcare facility response plan include prompt recognition of the incident, staff and facility protection, patient decontamination and triage, medical therapy and coordination with external emergency response and public health agencies. Controversial aspects include the optimal choice of personnel protective equipment, establishment of patient decontamination procedures, the role of chemical and biological agent detectors and potential environment packs and water treatment systems. Bioterrorism is an event in a civil setting that is equivalent to an epidemic in a medical setting. This incident usually results in a direct challenge to the medical community. The medical profession must assume a central role and participate actively in the discussion and planning of strategies in order to influence formulation of policies that will be activated in response to bioterrorism events

The Quality of Homeland Security and Health Care Systems: The Texas Rangers Initiative

“…It is a significant challenge to prepare for an event without a clear-cut indication of whom to protect, when to protect them, and from whom to protect them. In our previous report [2] we reported the problems with healthcare and the need for active plans and policies to apply to healthcare, which includes the Emergency Medical system (EMS) response to the full treatment and decontamination in emergency rooms and hospitals.…”

“…Controversial aspects include the optimal choice of personnel protective equipment, establishment of patient decontamination procedures, the role of chemical and biological agent detectors and potential environment packs and water treatment systems [4] .This all needs to be done to improve our response strategies.…”

“…Clinicians must maintain a high index of suspicion for use of bioterrorism agents, be able to make a rapid diagnosis and probably initiate empirical treatment. However, the personnel, fellow administration, security, public relations, laboratory, pharmacy and facility management should be familiar with the plan and know when to activate it [4] . A recognized incident command system should be used.…”

“…In general, the absolute requirement for implementation of WMD response: 1) policy, 2) plan, 3) emergency department response to surge capacity, including design of emergency department, equipment required, personnel required, education and training, occupational health and safety issues, and surveillance system in details. WMD policies and plans were described by our group in an earlier publication [4] . …”

An Engineer’s Mathematical Approach to Designing an Emergency Room Decontamination Area for Weapons of Mass Destruction Casualties

“…Therefore, they will not be able to alert medical professionals. If the hospital allows any of these patients inside, the staff may be exposed to the toxin and the facility may require closure for decontamination [3][4] . The risk is universal.…”