Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-25T01:58:11.677Z Has data issue: false hasContentIssue false
  • English
  • Français

Recommended Modifications and Applications of the Hospital Emergency Incident Command System for Hospital Emergency Management

Published online by Cambridge University Press:  28 June 2012

Jeffrey L. Arnold ,
Louise-Marie Dembry ,
Ming-Che Tsai ,
Nicholas Dainiak ,
Ülküen Rodoplu ,
David J. Schonfeld ,
Vivek Parwani ,
James Paturas ,
Christopher Cannon  and
Scott Selig
Jeffrey L. Arnold*
Affiliation:
Yale University School of Medicine, New Haven, Connecticut, USA
Louise-Marie Dembry
Affiliation:
Yale University School of Medicine, New Haven, Connecticut, USA
Ming-Che Tsai
Affiliation:
Department of Emergency Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, ROC
Nicholas Dainiak
Affiliation:
Yale University School of Medicine, New Haven, Connecticut, USA
Ülküen Rodoplu
Affiliation:
Department of Emergency Medicine, Alsancak State Hospital, Izmir, Turkey
David J. Schonfeld
Affiliation:
Yale University School of Medicine, New Haven, Connecticut, USA
Vivek Parwani
Affiliation:
Yale University School of Medicine, New Haven, Connecticut, USA
James Paturas
Affiliation:
Yale-New Haven Center for Emergency Preparedness and Disaster Response, Yale New Haven Health System, New Haven, Connecticut, USA
Christopher Cannon
Affiliation:
Yale-New Haven Center for Emergency Preparedness and Disaster Response, Yale New Haven Health System, New Haven, Connecticut, USA
Scott Selig
Affiliation:
Yale-New Haven Center for Emergency Preparedness and Disaster Response, Yale New Haven Health System, New Haven, Connecticut, USA
*
Yale-New Haven Center for Emergency Preparedness and Disaster Response, 1 Church Street, 5th Floor New Haven, CT 06510USA E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

The Hospital Emergency Incident Command System (Hospital Emergency Incident Command System), nowin its third edition, has emerged asa popular incident command system model for hospital emergency response in the United States and other countries. Since the inception of the Hospital Emergency Incident Command System in 1991, several events have transformed the requirements of hospital emergency management, including the 1995 Tokyo Subway sarin attack, the 2001 US anthrax letter attacks, and the 2003 Severe Acute Respiratory Syndrome (Severe Acute Respiratory Syndrome) outbreaks in eastern Asia and Toronto, Canada.

Several modifications of the Hospital Emergency Incident Command System are suggested to match the needs of hospital emergency management today, including: (1) an Incident Consultant in the Administrative Section of the Hospital Emergency Incident Command System to provide expert advice directly to the Incident Commander in chemical, biological, radiological, nuclear (CBRN) emergencies as needed, as well as consultation on mental health needs; (2) new unit leaders in the Operations Section to coordinate the management of contaminated or infectious patients in chemical, biological, radiological, nuclear emergencies; (3) new unit leaders in theOperations Section to coordinate mental health support for patients, guests, healthcare workers, volunteers, anddependents in terrorismrelated emergencies or events that produce significant mental health needs; (4) a new Decedent/Expectant Unit Leader in the Operations Section to coordinate the management of both types ofpatients together; and (5) a new Information Technology Unit Leader in the Logistics Section to coordinate the management of information technology and systems.

New uses of the Hospital Emergency Incident Command System in hospital emergency management also are recommended, including: (1) the adoption of the Hospital Emergency Incident Command System as the conceptual framework for organizing all phases of hospital emergency management, including mitigation, preparedness, response, and recovery; and (2) the application of the Hospital Emergency Incident Command System not only to healthcare facilities, but also to healthcare systems.

Finally, three levels of healthcare worker competencies in the Hospital Emergency Incident Command Systemare suggested: (1) basic understanding of the Hospital Emergency Incident Command System for all hospital healthcare workers; (2) advanced understanding and proficiency in the Hospital Emergency Incident Command Systemfor hospital healthcare workers likely to assume leadership roles in hospital emergency response; and (3) special proficiency in constituting the Hospital Emergency Incident Command System ad hoc from existing healthcare workers in resource-deficient settings. The Hospital Emergency Incident Command System should be viewed asa work in progress that will mature as additional challenges arise and ashospitals gain further experience with its use.

Keywords

biologicalchemicalconsultanthospitalhospital emergency incident command system (HEICS)informationmanagementmental healthmitigationnuclearpreparednessradiologicalrecoveryresponseterrorism
Type
Theoretical Discussion
Information
Prehospital and Disaster Medicine , Volume 20 , Issue 5 , October 2005 , pp. 290 - 300
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2005

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.Emergency Medical Services Authority. Hospital Emergency Incident Command System: The Hospital Emergency Incident Command System. EmergencyMedical Services Authority Web site. Available at www.emsa.ca.gov/dms2/heics_main.asp. Accessed 20 December 2004.Google Scholar
2.Zane, RD, Prestipino AL: Implementing the Hospital Emergency Incident Command System: An integrated system's experience. Prehosp Disast Med 2004;19:311–317.CrossRefGoogle ScholarPubMed
3.Debacker, M: Hospital preparedness for incidents with chemical agents. International Journal of Disaster Medicine 2003;1:42–50.CrossRefGoogle Scholar
4.Macintyre, AG, Christopher, GW, Eitzen, E et al. : Weapons of mass destruction events with contaminated casualties.Effective planning for health care facilities.JAMA 2000;283:242–249.CrossRefGoogle ScholarPubMed
5.O'Neill, K: The Nuclear Terrorist Threat. Washington, DC: Institutefor Science and International Security; 1997. Available at www.isis-online.org/publications/terrorism/threat.pdf. Accessed 04 February 2005.Google Scholar
6.Jernigan, DB, Raghunathan, PL, Bell, BP et al. : Investigationof bioterrorismrelated anthrax, United States, 2001: Epidemiologic findings. Emerg Infect Dis 2002;8:1019–1028.CrossRefGoogle Scholar
7.Okumura, T, Nakasu, N, Ishimatsu, S et al. : Report on 640 victims of the Tokyo Subway Sarin Attack. Ann Emerg Med 1996;28:129–135.Google Scholar
8.Okumura, T, Suzuki, K, Fukuda, A et al. : The Tokyo subway sarin attack: Disaster management, Part 1: Community emergency response. Acad Emerg Med 1998;5:613–617.Google Scholar
9.Okumura, T, Suzuki, K, Fukuda, A et al. : The Tokyo subway sarin attack: Disaster management, Part 1: Hospitalresponse. Acad Emerg Med 1998;5: 618–624.CrossRefGoogle Scholar
10.Chen, Y-C, Huang, L-M, Chan, C-C et al. : Severe Acute Respiratory Syndrome in hospital emergency room. Emerg Infect Dis 2004;10:782–788.CrossRefGoogle ScholarPubMed
11.Lim, S, Clooson, T, Howard, G, Gardam, M: Collateral damage: The unforeseen effects of emergency outbreak policies. Lancet Infect Dis 2004;4:697–703.CrossRefGoogle ScholarPubMed
12.Lateef, F: Severe Acute Respiratory Syndrome changes the ED paradigm. Am J EmergMed 2004;22:483–487.Google Scholar
13.Loufty, MR, Wallington, M, Rutledge, T et al. : Hospital preparedness and Severe Acute Respiratory Syndrome. Emerg Infect Dis 2004;10:771–776.Google Scholar
14.McDonald, LC, Simor, AE, Su, I-J et al. : Severe Acute Respiratory Syndrome in healthcare faciliteis, Toronto and Taiwan. Emerg Infect Dis 2004;10:777–781.Google Scholar
15.Tsai, M-C, Arnold, JL, Chuang, C-C et al. : Impact of an outbreak of severe acute respiratory syndrome on a hospital in Taiwan, ROC. Emerg Med J 2004;21:311–316.CrossRefGoogle ScholarPubMed
16.Tsai, M-C, Arnold, JL, Chuang, C-C et al. : Implementation ofthe Hospital Emergency Incident Command System during an outbreak of severe acute respiratory syndrome (Severe Acute Respiratory Syndrome) at a hospital in Taiwan, ROC. J Emerg Med 2005;28(2):185–196.Google Scholar
17.Arnold, JL: Disaster medicine in the 21st Century: Future hazards, vulnerabilities, and risks. Prehosp Disast Med 2002;17:3–11.CrossRefGoogle Scholar
18.DiGiovanni, C: The spectrum of human reactions to terrorist attacks with weapons of mass destruction: Early management considerations. Prehosp Disast Med 2003;18:253–257.Google Scholar
19.Holmes, A: System issues for psychiatrists responding to disasters. Psych Clin NAm 2004;27:541–548.Google Scholar
20.Arnold, J, O'Brien, D, Walsh, D et al. : The perceived usefulness of the Hospital Emergency Incident Command System and an assessment tool for hospital disaster response capabilities and needs in hospital disaster planning in Turkey (abstract). Prehosp Disast Med 2001;16(2):s12.Google Scholar
21.Wang, T-L, Chang, H: Appraisal of disaster response plan of hospitals in Taipei judged by Hospital Emergency Incident Command System (Hospital Emergency Incident Command System). Ann Disast Med (Taiwan, ROC) 2003;1(2):104–111.Google Scholar
22.Keim, M: Key topics for emergency health education in the Pacific. Pac Health Dialog 2003;(9)1:104–108.Google Scholar
23.Nozaki, H, Hori, S, Shinozawa, Y et al. : Secondary exposure of medical staff to sarin vapor in the emergency room. Intensive Care Med 1995;21:1032–1035.CrossRefGoogle ScholarPubMed
24.Burkle, FM: Mass casualty management of a large-scale bioterrorist event: An epidemiological approach that shapes triage decisions. Emerg Med Clin N Am 2002;20:409–436.CrossRefGoogle ScholarPubMed
25.Kennedy, K, Aghababian, RV, Gans, L, Lewis, CP: Triage: Techniques and applications in decision-making. Ann Emerg Med 1996;28:136–144.CrossRefGoogle Scholar
26.Super, G. Simple Triage and Rapid Treatment Triage System: A training module. Newport Beach, CA: Hoag Memorial Hospital Presbyterian, 1984.Google Scholar
27.Schultz, CH, Mothershead, JL, Field, M: Bioterrorism preparedness: I: The emergency department and hospital. Emerg Clin N Am 2002;20:437–455.Google Scholar
28.Dainiak, N, Waselenko, JK, Armitage, JO et al. : The hematologist and radiation casualties. Hematology 2003 2003:473–496.CrossRefGoogle Scholar
29.Waselenko, JK, MacVittie, TJ, Blakely, WF et al. : Medical management of the acute radiation syndrome: Recommendations of the Strategic National Stockpile Radiation Working Group. Ann Intern Med 2004;140:1037–1051.Google Scholar
30.Srinivasan, A, McDonald, LC, Jernigan, D et al. : Foundationsfor the Severe Acute Respiratory Syndrome Preparedness and Response Plan for Healthcare Facilities. Infect Control Hosp Epidemiol 2004;25:1020–1025.Google Scholar
31.Arnold, JL, Levine, BN, Manmatha, A et al. : Information-sharing in out-ofhospital disaster response: The future role of information technology. Prehosp Disast Med 2004;19:3:201–207.CrossRefGoogle Scholar
32.Chan, TC, Killeen, J, Griswold, W, Lenert, L: Information technology and emergency medical care during disasters. Acad Emerg Med 2004;11:1229–1236.Google Scholar
33. American Medical Association: Advanced Disaster Life Support Provider Manual. Version 2.0. Chicago, IL: American Medical Association, 2004.Google Scholar