Managing change and risk is an ongoing challenge for emergency medical services managers. One growing concern is whether, before transporting patients to the hospital, paramedics should be providing more care than is now required.
Hospitals and other medical facilities are rapidly evolving into a true national healthcare system that can more effectively meet the 21st-century threats posed by terrorist acts and infectious diseases. Fortunately, systems and technological capabilities needed to cope with such threats, particularly those involving infectious agents, is already available.
As the threat of a biological attack against the United States increases, the nation's public health sector faces many hurdles, including funding cuts and difficulties in integrating the plans and policies of various levels of government - and with the private sector. Since the 9/11 attacks, greater focus has been placed on both biodefense and biosurveillance, but much more is needed.
During and after a known or suspected biological attack, most events initially play out in local hospitals where the first symptoms caused by a toxic agent are recognized. Raising awareness among medical staff and expanding current training programs will help healthcare providers respond to a possible biological event both more quickly and more effectively.
To help ensure that hospital staff and their families receive much needed medications during a biological incident, healthcare facilities in the Nation's Capital are coordinating with the D.C. Department of Health (DCDOH) to establish closed points of distribution. By doing so, staff responsibilities and capabilities can be optimized and lines for general public distribution can be reduced.
A "system" of any type consists of numerous vulnerable as well as valuable components, thus the entire system faces possible failure if a single component is removed or not working as it should. In the field of emergency medical services, all personnel must be fully prepared to prevent service lapses when a key component is removed.
A biological agent is released, samples are collected, and then the diagnostic process begins. Laboratories within a national (and international) network screen for potential threats and determine the level of exposure and treatment required for each response. Such diagnostics provide the guidelines necessary for using and distributing medical countermeasures.
By using mHealth technologies, local health departments can improve their efficiency and effectiveness not only in communicating with the public but also in dispensing medical countermeasures during large-scale pandemics. Current initiatives can offer a starting point on how to integrate mobile technology into local preparedness planning efforts.
Current plans for combatting the effects of an anthrax attack at the local level include the use of antibiotics. Although federal agencies recommend - and the Strategic National Stockpile provides - anthrax vaccine adsorbed as a medical countermeasure against such attacks, the vaccine currently is not included in the preparedness plans of many local health departments.
An emerging infectious disease or a bioterrorism attack must be prevented from spreading globally even when the effectiveness of predictive measures and detection programs is in question. In addition to current medical countermeasures, defending against biological threats may require the enforcement of control measures that rely on non-medical public health interventions.