Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-25T21:39:41.105Z Has data issue: false hasContentIssue false
  • English
  • Français

Public Health Preparedness for Mass-Casualty Events: A 2002 State-by-State Assessment

Published online by Cambridge University Press:  28 June 2012

N. Clay Mann ,
Ellen MacKenzie  and
Cheryl Anderson
N. Clay Mann*
Affiliation:
Intermountain Injury Control Research, Center University of Utah School of Medicine, Salt Lake City, Utah, USA
Ellen MacKenzie
Affiliation:
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
Cheryl Anderson
Affiliation:
Trauma-EMS Systems Program, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, Maryland, USA
*
Intermountain Injury Control Research Center, 615 Arapeen Drive, Suite 202, Salt Lake City, UT 84108-1284USA E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

The ongoing threat of a terrorist attack places public agencies under increasing pressure to ensure readiness in the event of a disaster. Yet, little published information exists regarding the current state of readiness, which would allow local and regional organizations to develop disaster preparedness plans that would function seamlessly across service areas. The objective of this study is to characterize state-level disaster readiness soon after September 2001 and correlate readiness with existing programs providing an organized response to medical emergencies.

Methods:

During the first quarter of 2002, a cross-sectional survey assessing five components of disaster readiness was administered in all 50 states. The five components of disaster readiness included: (1) statewide disaster planning; (2) coordination; (3) training; (4) resource capacity; and (5) preparedness for biological/chemical terrorism.

Results:

Most states reported the presence of a statewide disaster plan (94%), but few are tested by activation, (48%) and still fewer contain a bioterrorism component (38%). All states have designated disaster operations centers (100%), but few states have an operating communications system linking health and medical resources (36%). Approximately half of states offer disaster training to medical professionals; about 10% of states require the training. Between 22–48% of states have various contingency plans to treat victims when service capacity is exceeded. Biochemical protective equipment for health professionals is lacking in all but one state, and only 10% of states indicate that all hospitals have decontamination capabilities. States with a functioning statewide trauma system were significantly more likely to possess key attributes of a functioning disaster readiness plan.

Conclusion:

These findings suggest that disaster plans are prevalent among states. However, key programs and policies were noticeably absent. Communication systems remain fragmented and adequate training programs and protective equipment for health personnel are markedly lacking. Statewide trauma systems may provide a framework upon which to build future medical disaster readiness capacity.

Keywords

bioterrorismdisastersdisaster planningterrorismviolence
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 19 , Issue 3 , September 2004 , pp. 245 - 255
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Slater, MS, Trunkey, DD: Terrorism in America. Arch Surg 1997;132: 1059–1066.CrossRefGoogle ScholarPubMed
2.Guidotti, TL: Bioterrorism and the public health response. Am J Prev Med 2000;18:178–180.CrossRefGoogle ScholarPubMed
3.Healthcare Advisory Board: Hospital preparing for bioterrorism can assess a wealth of planning resources [online]. Market and Planning Watch. 19 October 2001. Available at http://www.advisory.com. Accessed 30 October 2002.Google Scholar
4.Advisory Board. JCAHO releases hospital advisory for bioterrorism preparedness [online]. Cost Finance Watch. 19 November 2001. Available at http://www.advisory.com. Accessed 30 October 2002.Google Scholar
5.Macintyre, AG, Christopher, GW, Eitzen, E et al. :Weapons of mass destruction events with contaminated casualties. JAMA 2000;283:242–249.CrossRefGoogle ScholarPubMed
6.Wetter, DC, Daniell, WE, Treser, CD: Hospital prepardness for victims of chemical or biological terrorism. Am J Public Health 2001;91:710–715.Google ScholarPubMed
7.Nunn-Lugar-Domenici: Amendment to the FY 97 Defense Authorization Act, Pub L No. 104–201, Title XIV: Defense Against Weapons of Mass Destruction, Subtitle A; Domestic Preparedness. US Congress; 27 June 1996.Google Scholar
8.Office of Emergency Prepardness. Department of Health and Human Services. Metropolitan Medical Response System program. Available at http://www.mmrs.hhs.gov. Accessed 30 October 2002.Google Scholar
9.Fraser, MR, Brown, CK, Rauf, Z: Bioterrorism preparedness and local public health agencies. NACCHO White Paper Series. Washington: National Association of County and City Health Officials; 1999.Google Scholar
10.Hoard, LM, Williams, JM, Helmkamp, JC et al. : Preparing at the local level for events involving weapons of mass destruction. Emerging Infectious Diseases 2002;8:1006–1007.CrossRefGoogle ScholarPubMed
11.Wetter, DC, Daniel, WE, Treser, CD: Hospital preparedness for victims of chemical or biological terrorism. Am J Public Health 2001;91:710–16.Google ScholarPubMed
12.West, JG, Williams, MJ, Trunkey, DD, Wolferth, CC: Trauma systems: Current status–Future challenges. JAMA 1988;259:3597–3600.CrossRefGoogle ScholarPubMed
13.Fraser, MR, Brown, DL: Preparedness and local public health agencies: Building response capacity. Public Health Rep 2000;115:326–330.CrossRefGoogle ScholarPubMed
14.Falkenrath, RA: Problems of preparedness: US readiness for a domestic terrorist attack. International Security 2001;25:147–186.CrossRefGoogle Scholar
15. Executive Order 13228. Establishing the Office of Homeland Security and the Homeland Security Council. 08 October 2000. Available at http://www.fas.org/irp/offdocs/eo/eo-13228.htm. Accessed 30 October 2002.Google Scholar