A Point-Counterpoint discussion of California's new Hospital Incident Command System Guidebook, its strengths and weaknesses, its applicability to the "business" of medicine in the United States, and how it can be used to deal with real-life scenarios.
When medical protocols vary from state to state, the result - in a multi-state disaster - could be a towering Babel of confusion. The obvious solution - the writing and promulgation of national EMS guidelines.
The highly specialized skill sets of forensic epidemiologists are essential to deal effectively with bioterrorist attacks, but numerous structural and operational as well as bureaucratic obstacles are standing in the way.
EMS agencies have been assigned major new responsibilities under both the NIMS and the ICS. The key to "mission accomplished" will be the ability of agencies from adjoining states to submerge personal identities & work toward a common goal.
The world's largest international police organization has developed and is disseminating a new "how-to" manual to help member agencies cope with the increasingly lethal threat posed by transnational terrorist groups.
Very few U.S. hospitals have enough beds, operating rooms, or the medical staff & equipment needed to deal with a truly major disaster. Many warnings have been issued, but no plans are yet in place to deal with a worst-case scenario.
The administration's development and release of an "Implementation Plan" to deal with pandemic influenza is a helpful start - but no more than that. Few if any states or cities are taking the steps needed to protect their citizens.
The triage goal is to maximize the number of lives saved. But to do so requires some extremely difficult decisions from the EMT on the scene, particularly in mass-casualty incidents when time is limited and information is in short supply.
What are the best indicators of victim survivability? The RPMs provide a few clues that can be used to START processing. But continuing updates and additional analyses are needed to improve the decision-making process.