Hostname: page-component-848d4c4894-p2v8j Total loading time: 0 Render date: 2024-05-01T05:28:59.387Z Has data issue: false hasContentIssue false
  • English
  • Français

Y2K Medical Disaster Preparedness in New York City: Confidence of Emergency Department Directors in their Ability to Respond

Published online by Cambridge University Press:  28 June 2012

Steven H. Silber ,
Neill Oster ,
Bonnie Simmons  and
Christopher Garrett
Steven H. Silber*
Affiliation:
Department of Emergency Medicine, New York Methodist Hospital, New York City, New York, USA
Neill Oster
Affiliation:
Department of Emergency Medicine, Elmhurst Hospital Center, New York City, New York, USA
Bonnie Simmons
Affiliation:
Department of Emergency Medicine, Cabrini Medical Center, New York City, New York, USA
Christopher Garrett
Affiliation:
Department of Emergency Medicine, New York Methodist Hospital, New York City, New York, USA
*
Department of Emergency Medicine, New York Methodist Hospital, 506 Sixth Street, Brooklyn, New York 11215, E-mail: sts9005@nyp.org
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To study the preparedness New York City for large scale medical disasters using the Year 2000 (Y2K) New Years Eve weekend as a model.

Methods:

Surveys were sent to the directors of 51 of the 9-1-1-receiving hospitals in New York City before and after the Y2K weekend. Inquiries were made regarding hospital activities, contingencies, protocols, and confidence levels in the ability to manage critical incidents, including weapons of mass destruction (WMD) events. Additional information was collected from New York City governmental agencies regarding their coordination and preparedness.

Results:

The pre-Y2K survey identified that 97.8% had contingencies for loss of essential services, 87.0% instituted their disaster plan in advance, 90.0% utilized an Incident Command System, and 73.9% had a live, mock Y2K drill. Potential terrorism influenced Y2K preparedness in 84.8%. The post-Y2K survey indicated that the threat of terrorism influenced future preparedness in 73.3%; 73.3% had specific protocols for chemical; 62.2% for biological events; 51.1% were not or only slightly confident in their ability to manage any potential WMD incidents; and 62.2% felt very or moderately confident in their ability to manage victims of a chemical event, but only 35.6% felt similarly about victims of a biological incident. Moreover, 80% felt there should be government standards for hospital preparedness for events involving WMD, and 84% felt there should be government standards for personal protective and DECON equipment. In addition, 82.2% would require a moderate to significant amount of funding to effect the standards. Citywide disaster management was coordinated through the Mayor's Office of Emergency Management.

Conclusions:

Although hospitals were on a heightened state of alert, emergency department directors were not confident in their ability to evaluate and manage victims of WMD incidents, especially biological exposures. The New York City experience is an example for the rest of the nation to underscore the need for further training and education of preparedness plans for WMD events. Federally supported education and training is available and is essential to improve the response to WMD threats.

Resumen

Introduccón:

Estudiar la preparación de la ciudad de Nueva York para desastres médicos de gran escala utilizando el fin de semana de fin de año del 2000 como modelo. Métodos: Se enviaron encuestas a los directores de 51 hospitales de la ciudad de Nueva York que reciben emergencias 911antes y después del fin de semana de fin de año. Se preguntó sobre actividades hospitalarias, planes de contingencia, protocolos y niveles de confianza en la capacidad para manejar incidentes críticos incluyendo eventos Desastres Médicos Asociados a la Guerra. Información adicional fue recolectada de agendas gubernamentales de la ciudad de Nueva York en relación a su coordinación y preparativos.

Resultados:

La encuesta Pre fin de año 2000 reveló que 97.8% tenían planes de contingencia para la pérdida de servicios esenciales, 87.0% practicaron su plan de desastres por adelantado, 90.0% utilizó Comando de Incidentes y 73.9% efectuaron un simulacro en vivo del fin de año 2000. El terrorismo potential influyó en los preparativos de un 84.8% de fin de año 2000. La encuesta post fin de año 2000 reveló que la amenaza de terrorismo influyó los preparativos futures en un 73.3%. 73.3% tenían protocolos específicos para eventos químicos y 62.2% para eventos biológicos. 51.1% no tenían o tenían solamente una mínima confirnaza en su capacidad para manejar incidentes potenciales Desastres Médicos Asociados a la Guerra 62.2 tenían mucha o moderada confianza en su habilidad para manejar víctimas de un evento químico, pero solo un 35.6% tenían semejante confianza acerca de víctimas de incidentes biológicos. 80% sintieron que debería haber estándares gubernamentales para preparativos para eventos Desastres Médicos Asociados a la Guerra y 84% sintieron que debería haber estándares gubernamentales para el equipo de protección personal y de decontaminación. 82.2% requeriría una cantidad moderada a significativa de financiamiento para alcanzar los estándares. El manejo de desastres en la ciudad se coordinó a través de la oficina del Alcalde para manejo de emergencias.

Conclusiones:

A pesar de que los hospitales estaban en un estado de alerta, los directores de departamentos de emergencias no tenían confianza en su habilidad para evaluar y manejar víctimas de incidentes Desastres Médicos Asociados a la Guerra, especialmente exposición biológica. La experiencia de la ciudad de Nueva York es un ejemplo para el resto de la nación para subrayar la necesidad de mayor capacitación y educación en planes de preparación para eventos Desastres Médicos Asociados a la Guerra Hay disponibilidad de educación y capacitación apoyada federalmente y es esencial para mejorar la respuesta a amenazas Desastres Médicos Asociados a la Guerra.

Keywords

decontaminationdisaster preparednessexerciseshospitalsincident command systemNew York Cityplanningterrorismweapons of mass destruction
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 16 , Issue 2: T. Michael Moles Memorial Issue , June 2001 , pp. 88 - 95
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2001

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. Gannon, J: Chairman of the CIA's National Intelligence Council. Speech, The Hoover Institution, November 16, 1998. Available at: http://usinfo.stste.gov/topical/pol/armsctrl/gannon.htm. Accessed 08 April 2000.Google Scholar
2. Stein, J: The Billion-Dollar Rumor. Salon Newsreal Website. Available at http://www.salon.com.news.1998/10/8newsa2.html. Accessed 08 April 2000.Google Scholar
3. 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. U.S. Congress; 27 June 1996.Google Scholar
4. New York City Office of Emergency Management Press Release #679-97. 09 November 1997.Google Scholar
5. Hauer, JM: Preparing for terrorism involving weapons of mass destruction. U.S. Capital Police Board. February 26, 1998.Google Scholar
6. Joint Commission for Accreditation of Healthcare Organization: 1996 Comprehensive Accreditation Manual for Hospitals, Section 2, Management the environment of care. Standard EC. 1.5. 347–349. Joint Commission for Accreditation of Healthcare Organization: Oakbrook Terrace, Illinois.Google Scholar
7. Joint Commission for Accreditation of Healthcare Organization: 1996 Comprehensive Accreditation Manual for Hospitals, Section 2, Management o the Environment of Care. Standard EC. 1.6. 349–350. Oakbrook Terrace, Illinois.Google Scholar
8. OSHA Regulations (Standards – 29 CFR), Part 1910, Occupational Safety and Health Standards. Subpart H: 1910.120 Hazardous Materials - Hazardous Waste Operations and Emergency Response. Occupational Safety and Health administration. Government Printing Office. Washington DCGoogle Scholar
9. OSHA Regulations (Standards – 29 CFR), Part 1910, Occupational Safety and Health Standards. Subpart I - Personal Protective Equipment. Occupational Safety and Health Administration. Government Printing Office. Washington DCGoogle Scholar
10. De Lorenzo, RA: Mass gathering medicine: A Review. Prekosp Disas Med 1997;12:68–72.Google Scholar
11. Hogan, DE, Waeckerle, JF, Dire, DJ, Lillibridge, SR: Emergency department impact of the Oklahoma City terrorist bombing. Ann Emerg Med 1999;34:160–167.Google Scholar
12. Brennan, RJ, Waeckerle, JF, Sharp, TW, Lillibridge, SR: Chemical warfare agents: Emergency medical and emergency public health issues. Ann Emerg Med 1999;34:191–204.CrossRefGoogle ScholarPubMed
13. Okumura, T, Takasu, N, Ishimatsu, S et al. : Report on 640 Victims of the Tokyo subway sarin Attack. Ann Emerg Med 1996;28:129–135.Google Scholar
14. Okumura, T, Suzuki, K, Fukuda, A et al. : The Tokyo subway sarin attack: Disaster management, Part 2: Hospital response. Acad Emerg Med 1998;5:618–624.Google Scholar
15. Sharp, TW, Brennan, RJ, Keim, M, Williams, RJ, Eitzen, E, Lillibridge, SR: Medical preparedness for a terrorist incident involving chemical or biological agents during the 1996 Atlanta Olympic Games. Ann Emerg Med 1998;32:214–223.CrossRefGoogle ScholarPubMed
16. Keim, M, Kaufmann, AF: Principles for emergency response to bioterrorism. Ann Emerg Med 1999;34:177–182.Google Scholar
17. CDC: Bioterrorism alleging use of anthrax and interim guidelines for management-United States, 1998. MMWR Morb Mortal Wkly Rep 1999;48:69–74.Google Scholar
18. Richards, CF, Burstein, JL, Waeckerle, JF, Hutson, HR: emergency physicians and biological terrorism. Ann Emerg Med 1999;34:183–190.Google Scholar
19. English, JU, Cundiff, M, Malone, J, Pfeiffer, J: Bioterrorism readiness plan—A template for healthcare faculties. Association for Professionals in Infection Control and Epidemiology (APIC) and Centers for Disease Control and Prevention (CDC). ED Manag 1999;11:suppl 1–16.Google Scholar
20. Torok, TJ, Tauxe, RV, Wise, RP et al. : A large community outbreak of salmonellosis caused by intentional contamination of restaurant salad bars. JAMA 1997;278:389–395.CrossRefGoogle ScholarPubMed
21. MacIntyre, AG, Christopher, GW, Eitzen, E Jr, Gum, R, Weir, S, DeAteley, C et al. : Weapons of mass destruction events with contaminated casualties: Effective planning for health care facilities. JAMA 2000;283:242–249.Google Scholar
22. Waeckerle, JF. Domestic preparedness for events involving weapons of mass destruction. JAMA 2000;283:252–254.Google Scholar
23. Domestic Preparedness: Expert Assistance: Compendium of Weapons of Mass Destruction Courses Sponsored by the Federal Government. January 2000. Available at http://www.usfa.fema.gov/pdf/cwmdc.pdf. Accessed 16 March 2001.Google Scholar