scholarly journals Surge Capacity and Capability. A Review of the History and Where the Science is Today Regarding Surge Capacity during a Mass Casualty Disaster

2014 ◽  
Vol 2 ◽  
Author(s):  
Randy D. Kearns ◽  
Bruce A. Cairns ◽  
Charles B. Cairns
Keyword(s):  
Author(s):  
Terri Rebmann ◽  
Rachel L. Charney ◽  
Rebecca L. Eschmann ◽  
M. Colleen Fitzpatrick

Abstract Objective: To assess non-pediatric nurses’ willingness to provide care to pediatric patients during a mass casualty event (MCE). Methods: Nurses from 4 non-pediatric hospitals in a major metropolitan Midwestern region were surveyed in the fall of 2018. Participants were asked about their willingness to provide MCE pediatric care. Hierarchical logistical regression was used to describe factors associated with nurses’ willingness to provide MCE pediatric care. Results: In total, 313 nurses were approached and 289 completed a survey (response rate = 92%). A quarter (25.3%, n = 73) would be willing to provide MCE care to a child of any age; 12% (n = 35) would provide care only to newborns in the labor and delivery area, and 16.6% (n = 48) would only provide care to adults. Predictors of willingness to provide care to a patient of any age during an MCE included providing care to the youngest-age children during routine duties, reporting confidence in calculating doses and administering pediatric medications, working in the emergency department, being currently or previously certified in PALS, and having access to pediatric-sized equipment in the unit or hospital. Conclusion: Pediatric surge capacity is lacking among nurses. Increasing nurses’ pediatric care self-efficacy could improve pediatric surge capacity and minimize morbidity and mortality during MCEs.


2017 ◽  
Vol 11 (4) ◽  
pp. 473-478 ◽  
Author(s):  
Michael Frogel ◽  
Avram Flamm ◽  
Mayer Sagy ◽  
Katharine Uraneck ◽  
Edward Conway ◽  
...  

AbstractA mass casualty event can result in an overwhelming number of critically injured pediatric victims that exceeds the available capacity of pediatric critical care (PCC) units, both locally and regionally. To address these gaps, the New York City (NYC) Pediatric Disaster Coalition (PDC) was established. The PDC includes experts in emergency preparedness, critical care, surgery, and emergency medicine from 18 of 25 major NYC PCC-capable hospitals. A PCC surge committee created recommendations for making additional PCC beds available with an emphasis on space, staff, stuff (equipment), and systems. The PDC assisted 15 hospitals in creating PCC surge plans by utilizing template plans and site visits. These plans created an additional 153 potential PCC surge beds. Seven hospitals tested their plans through drills. The purpose of this article was to demonstrate the need for planning for disasters involving children and to provide a stepwise, replicable model for establishing a PDC, with one of its primary goals focused on facilitating PCC surge planning. The process we describe for developing a PDC can be replicated to communities of any size, setting, or location. We offer our model as an example for other cities. (Disaster Med Public Health Preparedness. 2017;11:473–478)


2008 ◽  
Vol 23 (2) ◽  
pp. 121-127 ◽  
Author(s):  
Richard D. Zane ◽  
Paul Biddinger ◽  
Lyndsley Ide ◽  
Sally Phillips ◽  
Donna Hurd ◽  
...  

AbstractIntroduction:With limited available hospital beds in most urban areas, there are very few options when trying to relocate patients already within the hospital to make room for incoming patients from a mass-casualty incident (MCI) or epidemic (a patient surge). This study investigates the possibility and process for utilizing shuttered (closed or former) hospitals to accept medically stable, ambulatory patients transferred from a tertiary medical facility.Methods:Two recently closed, acute care hospitals were evaluated critically to determine if they could be made ready to accept inpatients within 3–7 days of a MCI. This surge facility ideally would be able to support 200–300 patients/beds. Two generic scenarios were used for planning: (1) a patient surge (including one caused by conventional war or terrorism, weapons of mass destruction, or a disaster caused by natural hazards) requiring transfer of ambulatory, medically-stable inpatients to another facility in an effort to increase capacity at existing hospitals; and (2) a bio-event or epidemic where a shuttered hospital could be used as an isolation facility.Results:Both recently closed hospitals had significant, but different challenges to reopening, although with careful planning and resource allocation it would be possible to reopen them within 3–7 days. Planning was the most conclusive recommendation. It does not appear possible to reopen shuttered hospitals with major structural deterioration or a complete lack of current mission (i.e., no current utilities). Staffing would represent the most challenging issue as a surge facility would represent an incremental additional need for existing and scarce human resources.Conclusions:With careful planning, a shuttered hospital could be reopened and ready to accept patients within 3–7 days of a MCI or epidemic.


Author(s):  
Magnus Blimark ◽  
Per Örtenwall ◽  
Hans Lönroth ◽  
Peter Mattsson ◽  
Kenneth D. Boffard ◽  
...  

Abstract Background In Sweden the surgical surge capacity for mass casualty incidents (MCI) is managed by county councils within their dedicated budget. It is unclear whether healthcare budget constraints have affected the regional MCI preparedness. This study was designed to investigate the current surgical MCI preparedness at Swedish emergency hospitals. Methods Surveys were distributed in 2015 to department heads of intensive care units (ICU) and surgery at 54 Swedish emergency hospitals. The survey contained quantitative measures as the number of (1) surgical trauma teams in hospital and available after activating the disaster plan, (2) surgical theatres suitable for multi-trauma care, and (3) surgical ICU beds. The survey was also distributed to the Armed Forces Centre for Defence Medicine. Results 53 hospitals responded to the survey (98%). Included were 10 university hospitals (19%), 42 county hospitals (79%), and 1 private hospital (2%). Within 8 h the surgical capacity could be increased from 105 to 399 surgical teams, while 433 surgical theatres and 480 ICU beds were made available. The surgical surge capacity differed between university hospitals and county hospitals, and regional differences were identified regarding the availability of surgical theatres and ICU beds. Conclusions The MCI preparedness of Swedish emergency care hospitals needs further attention. To improve Swedish surgical MCI preparedness a national strategy for trauma care in disaster management is necessary.


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