32% of hospitals ill-equipped for mass-casualty disasters

Nearly a third of hospitals are unprepared for the six types of mass-casualty disasters that public health officials fear most, according to a report published in March by the Centers for Disease Control and Prevention.

All of the nearly 400 hospitals that responded to questions about emergency preparedness as part of the National Hospital Ambulatory Medical Care Survey had plans for at least one of the six types of disasters -- chemical, natural, epidemic, biological, nuclear-radiological and explosive-incendiary. The last two hazards were the ones for which hospitals were least likely to be prepared, with 20% lacking plans for either nuclear or explosive scenarios (link).

"There are things that hospitals do well -- planning for chemical releases, natural disasters, biological incidents," said Richard W. Niska, MD, MPH, co-author of the report and medical epidemiologist at the CDC's National Center for Health Statistics. "One of my concerns is that there is significantly less preparedness for explosive or fire-related incidents. Considering what happened in 2001, I would have expected more."

Despite the recent attention to radiological safety due to the crisis at Japan's Fukushima Dai-ichi nuclear power plant in the aftermath of the March earthquake and tsunami, Dr. Niska said it is understandable that hospital officials are preparing more for natural disasters common to their area.

"It's a matter of frequency, unless you're adjacent to a nuclear reactor and concerned about the prevention of mishaps from that," Dr. Niska said. "Even then, the risks of that -- because they are relatively small -- are nearly nonexistent."

As for the details of preparations, the vast majority of hospitals had agreements with other facilities in their area to transfer patients and could communicate with regional authorities about available beds. However, fewer than half of hospitals had plans for adjusting care standards for starting and stopping mechanical ventilation during an epidemic-driven surge in demand. The hospital survey was conducted in 2008.

The Dept. of Health and Human Services' Hospital Preparedness Program, launched in 2002, handed out nearly $400 million in grants last year to help hospitals improve communication systems, track available beds, register volunteer physicians and health professionals before disasters strike, plan evacuations and take part in regional and statewide emergency drills.