NCJ Number
191796
Journal
American Journal of Public Health Volume: 91 Issue: 5 Dated: May 2001 Pages: 710-716
Date Published
2001
Length
7 pages
Annotation
This study examined hospital preparedness for incidents involving chemical or biological weapons.
Abstract
There is growing concern about possible terrorist use of chemical or biological weapons against civilian populations. Although such incidents have occurred rarely to date, the need for concern is illustrated graphically by the sarin nerve gas attack in a Tokyo subway and the bombings of the World Trade Center in New York and the Murrah Federal Building in Oklahoma. True preparedness to reduce loss of life from an incident involving a biological or chemical weapon is critically dependent on the availability of resources at the local level. A large proportion of hospitals probably are poorly prepared to handle victims of chemical or biological terrorism. Surveys of hospital emergency departments (EDs) have found broadly prevalent deficiencies in knowledge, plans, or resources for responding to hazardous materials or radiation incidents. By using a questionnaire survey of 224 hospital emergency departments in four northwestern States, this study examined administrative plans, training, physical resources, and representative inventories. Responses were received from 186 emergency departments (83 percent). Fewer than 20 percent of respondent hospitals had plans for biological or chemical weapons incidents. About half (45 percent) had an indoor or outdoor decontamination unit with isolated ventilation, shower, and water containment systems, but only 12 percent had one or more self-contained breathing apparatuses or supplied air-line respirators. Only 6 percent had the minimum recommended physical resources for a hypothetical sarin incident. Of the hospitals providing quantitative answers about medication inventories, 64 percent reported sufficient ciprofloxacin or doxycycline for 50 hypothetical anthrax victims, and only 29 percent reported sufficient atropine for 50 hypothetical sarin victims (none had enough pralidoxime). The current state of hospital preparedness in these four northwestern States for managing victims of chemical and biological terrorism is generally not adequate to support the present strategy of the Domestic Preparedness Program. Although efforts to improve national preparedness—such as the Centers for Disease Control and Prevention National Pharmaceutical Stockpile Program, which establishes a medication and resource cache for terrorist incidents—are under way, there is still a tremendous gap between Federal efforts and the current state of preparedness at the level of individual hospitals. The planned Federal efforts to improve domestic preparedness will require substantial additional resources at the local level to be truly effective. References