For most U.S. hospitals, planning for a mass-casualty disaster is an administrative afterthought. The result, frequently, is a counterproductive "game plan" based on rosy optimism and unproven assumptions.
Preparing for an emergency is like packing for a long trip: Focus on the essentials first, and always consider the possibility of a worst-case scenario. Unfortunately, some communities and hospitals are making cost reductions their highest priority.
Three modes of operation, two of which might strain the trained EMS personnel resources immediately available but would not overwhelm them. Preparing for the third mode, a sudden mass-casualty scenario, must be done carefully and thoughtfully.
Defeating the threat posed by biological weapons requires a mountain of relevant information, collated and translated into actionable data, and distributed to a broad spectrum of potential users.
When it seems likely that explosives have been used in a mass-casualty incident or "event," the personnel responding must remember that additional, and bigger, explosions might soon follow and that they, the first responders, may be the target.
The setting of national standards for the personal protective equipment worn and training received by first responders working in a hazardous-materials environment is a positive step forward.
The era of "us versus them" is over. In times of disasters affecting the entire local population, all private-sector as well as public agencies must pool their resources in a common effort.
Several years have passed since the first H5N1 outbreak and there have been speeches, studies, and statistics galore - but few if any nations are even half-prepared to deal with the consequences of a major pandemic.
The U.S. private-sector health care system is probably the best in the world. But it is not prepared to deal with mass-casualty incidents, lacks the funding needed to expand beyond current capacity, and suffers from certain shortages.
A high-efficiency mask, a procedure mask, an SCBA, or a PAPR - which shall it be? The correct answer determines whether the wearer is part of the solution, or becomes another part of the problem.
