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Realities of Rural Emergency Medical Services Disaster Preparedness

Published online by Cambridge University Press:  28 June 2012

Paul M. Furbee ,
Jeffery H. Coben ,
Sharon K. Smyth ,
William G. Manley ,
Daniel E. Summers ,
Nels D. Sanddal ,
Teri L. Sanddal ,
James C. Helmkamp ,
Rodney L. Kimble  and
Ronald C. Althouse
...Show all authors
Paul M. Furbee*
Affiliation:
West Virginia University, Robert C. Byrd Health Sciences Center, School of Medicine, Center for Rural Emergency Medicine, Morgantown, West Virginia, USA West Virginia University, Robert C. Byrd Health Sciences Center, School of Medicine, Injury Control Research Center, Morgantown, West Virginia, USA
Jeffery H. Coben
Affiliation:
West Virginia University, Robert C. Byrd Health Sciences Center, School of Medicine, Center for Rural Emergency Medicine, Morgantown, West Virginia, USA West Virginia University, Robert C. Byrd Health Sciences Center, School of Medicine, Injury Control Research Center, Morgantown, West Virginia, USA
Sharon K. Smyth
Affiliation:
West Virginia University, Robert C. Byrd Health Sciences Center, School of Medicine, Center for Rural Emergency Medicine, Morgantown, West Virginia, USA West Virginia University, Robert C. Byrd Health Sciences Center, School of Medicine, Injury Control Research Center, Morgantown, West Virginia, USA
William G. Manley
Affiliation:
West Virginia University, Robert C. Byrd Health Sciences Center, School of Medicine, Center for Rural Emergency Medicine, Morgantown, West Virginia, USA West Virginia University, Robert C. Byrd Health Sciences Center, School of Medicine, Injury Control Research Center, Morgantown, West Virginia, USA West Virginia University Hospital, Trauma Services, Morgantown, West Virginia, USA
Daniel E. Summers
Affiliation:
West Virginia University, Robert C. Byrd Health Sciences Center, School of Medicine, Center for Rural Emergency Medicine, Morgantown, West Virginia, USA
Nels D. Sanddal
Affiliation:
West Virginia University Hospital, Trauma Services, Morgantown, West Virginia, USA
Teri L. Sanddal
Affiliation:
Critical Illness and Trauma Foundation, Bozeman, Montana, USA
James C. Helmkamp
Affiliation:
West Virginia University, Robert C. Byrd Health Sciences Center, School of Medicine, Center for Rural Emergency Medicine, Morgantown, West Virginia, USA West Virginia University, Robert C. Byrd Health Sciences Center, School of Medicine, Injury Control Research Center, Morgantown, West Virginia, USA
Rodney L. Kimble
Affiliation:
West Virginia University, Robert C. Byrd Health Sciences Center, School of Medicine, Center for Rural Emergency Medicine, Morgantown, West Virginia, USA
Ronald C. Althouse
Affiliation:
West Virginia University, Robert C. Byrd Health Sciences Center, School of Medicine, Injury Control Research Center, Morgantown, West Virginia, USA West Virginia University, Survey Research Center, Morgantown, West Virginia, USA
Aaron T. Kocsis
Affiliation:
West Virginia University Hospitals, Ruby Memorial, Morgantown, West Virginia, USA
*
West Virginia University Robert C. Byrd Health Sciences Center, School of Medicine Injury Control Research Center PO Box 9151 Morgantown, WV 26506-9151 USA E-mail:[email protected]
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Abstract

Introduction:

Disaster preparedness is an area of major concern for the medical community that has been reinforced by recent world events. The emergency healthcare system must respond to all types of disasters, whether the incidents occur in urban or rural settings. Although the barriers and challenges are different in the rural setting, common areas of preparedness must be explored.

Problem:

This study sought to answer several questions, including: (1) What are rural emergency medical services (EMS) organizations training for, compared to what they actually have seen during the last two years?; (2) What scale and types of events do they believe they are prepared to cope with?; and (3) What do they feel are priority areas for training and preparedness?

Methods:

Data were gathered through a multi-region survey of 1,801 EMS organizations in the US to describe EMS response experiences during specific incidents as well as the frequency with which these events occur. Respondents were asked a number of questions about local priorities.

Results:

A total of 768 completed surveys were returned (43%). Over the past few years, training for commonly occurring types of crises and emergencies has declined in favor of terrorism preparedness. Many rural EMS organizations reported that events with 10 or fewer victims would overload them. Low priority was placed on interacting with other non-EMS disaster response agencies, and high priority was placed on basic staff training and retention.

Conclusion:

Maintaining viable, rural, emergency response capabilities and developing a community-wide response to natural or man-made events is crucial to mitigate long-term effects of disasters on a local healthcare system. The assessment of preparedness activities accomplished in this study will help to identify common themes to better prioritize preparedness activities and maximize the response capabilities of an EMS organization.

Keywords

educationemergency medical services (EMS)preparednessruralsurge capacitytraining
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 21 , Issue 2 , April 2006 , pp. 64 - 70
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2006

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References

1.Lillibridge, S: New developments in health and medical preparedness related to the threat of terrorism. Prehosp Emerg Care 2003;7:56–58.CrossRefGoogle Scholar
2. Health Resources and Services Administration (HRSA): 2002 National Assessment of State Trauma System Development, Emergency Medical Services Resources, and Disaster Readiness for Mass Casualty Events. 2003. Available at ftp://ftp.hrsa.gov/hrsa/trauma/nationalassessment.pdf. Accessed 04 September 2003.Google Scholar
3. Emergency Medical and Public Health Response to Terrorism: Memorandum of Understanding. Available at http://www.naemsp.org/press1.pdf. Accessed 22 November 2001.Google Scholar
4. U.S. Department of Homeland Security: Fact Sheet: National Incident Management System (NIMS). Available at http://www.dhs.gov/dhspublic/display?theme=51&content=3423. Accessed 06 December 2004.Google Scholar
5.Waeckerle, JF, Seamans, S, Whiteside, M, et al. : Emergency medical services. Ann Emerg Med 2001;37:587–601.CrossRefGoogle Scholar
6.Moles, TM: Emergency medical services systems and HAZMAT major incidents. Resuscitation 1999;42:103–116.CrossRefGoogle ScholarPubMed
7.Maniscalco, PM, Christen, HT: EMS incident management: Emergency medical logistics. Emerg Med Serv 1999;28:49–52.Google ScholarPubMed
8. Testimony of Kenneth Burris, Acting Administrator United States Fire Administration, Federal Emergency Management Agency before the Subcommittee on Science, Technology and Space of the Senate Committee on Commerce, Science and Transportation. 11 October 2001.Google Scholar
9.Yackey, T, Arends, J, Davis, R: EMS Medical Preparedness for WIPP Accidents Responders Survey Results. (Presentation: Injury Prevention and Emergency Medical Services Bureau. New Mexico Department of Health, 22 May 2001.)Google Scholar
10.Peterson, DJ: RAND Study Finds Emergency Responders Believe They Have Inadequate Protection. In Fire Engineering's fire EMS. Available at http://fe.pennnet.com/Articles/Article_Display.cfm?Section=OnlineArticles &SubSection=HOME&PUBLICATION_ID=25&ARTICLE_ID=18527. Accessed 04 September 2003.Google Scholar
11.Erich, J: The expert take: Assessing the terrorism issues facing EMS. Emerg Med Serv 2002;31(1):67–70.Google Scholar
12. National Association of State Emergency Medical Services Directors (NASEMSD): Domestic Preparedness: Issues of Preparedness. Available at http://www.nasemsd.org/index.php?option=com_frontpage&Itemid=1. Accessed 06 December 2004.Google Scholar
13. US General Accounting Office: Bioterrorism: Preparedness Varied across State and Local Jurisdictions. GAO-03-373, 2003, i–48.Google Scholar
14.Hearne, SA, Davis, M, Segal, M, et al. : Trust for America's Health: Ready or Not? Protecting the Public's Health in the Age of Bioterrorism. Trust for America's Health Issue Reports Washington, DC, 2003.Google Scholar
15.Martchenke, J, Rusteen, J, Pointer, JE: Prehospital communications during the Loma Prieta earthquake. Prehosp Disast Med 1995;10:225–231.CrossRefGoogle ScholarPubMed
16.Chartoff, SE, Gren, JM: Survey of Iowa emergency medical services on the effects of the 1993 floods. Prehosp Disast Med 1997;12:210–214.CrossRefGoogle ScholarPubMed
17.Glick, J, Birnbaum, ML: Perceived preparedness for a mass casualty disaster in the United States: A survey. Prehosp Disast Med 1998;13:28–43.CrossRefGoogle ScholarPubMed
18.Perry, N: When disaster hits home. EMS agencies aren't immune to catastrophes. Emerg Med Serv 1996;25 24,26–29,41.Google ScholarPubMed
19.Denny, K: When terror fills the sky: Tornadoes, hurricanes, and EMS. Emerg Med Serv 1985;14:65–69.Google ScholarPubMed
20.Nordberg, M: A Matter of Time Part 1: Is EMS ready for domestic terrorism? Emerg Med Serv 2000;129(4):47–53.Google Scholar
21. Cornerstone Government Affairs for the National Association of State Emergency Medical Services Directors: Domestic Terrorism: Issues of Emergency Medical Services (EMS) Preparedness. Available at http://www.nasemsd.org/index.php?option=com_frontpage&Itemid=1. Accessed 15 July 2005.Google Scholar
22.Doyle, J: Under the Gun & Unprepared. Available at http://www.jems.com/homelandfirstresponse/point/08_03.html. Accessed 06 December 2004.Google Scholar
23.Hunt, DW: Rail rescue: Putting the multiple injury plan to the test. Emerg Med Serv 1994;23:58–67.Google ScholarPubMed
24.Key, KB: Operational issues in EMS. Emerg Med Clin North Am 2002;20:913–927.CrossRefGoogle ScholarPubMed
25. National Association of State EMS Directors (NASEMSD): NASEMSD Priorities. Available at http://www.nasemsd.org/index.php?option=com_front-page&Itemid=1. Accessed 06 December 2004.Google Scholar
26.United States Center for Disease Control and Prevention (CDC): Key Facts about Influenza and the Influenza Vaccine. Available at http://www.cdc.gov/flu/keyfacts.htm. Accessed 5 October 2005.Google Scholar
27.Chng, CL, Collins, J, Eaddy, S: A comparison of rural and urban emergency medical system (EMS) personnel: A Texas study. Prehosp Disast Med 2001;16(3):159–165.CrossRefGoogle Scholar
28. WV Title 64 Legislative Rule BPH Series 48 Emergency Medical Services. 64, 5.6.b.1–5.6.b.2. 2003. 64CSR48. Available at http://www.wvoems.org/Downloads/august2003/64csr48.pdf. Accessed 12 October 2004.Google Scholar
29.Lee, WH, Chiu, TF, Ng, CJ, Chen, JC: Emergency medical preparedness and response to a Singapore airliner crash. Acad Emerg Med 2002;9:194–198.CrossRefGoogle ScholarPubMed
30.Williams, K, Suner, S, Sullivan, F, Woolard, R: Rhode Island Disaster Initiative. Med Health R I 2003;86:207–210.Google ScholarPubMed
31.Asaeda, G: The day that the START triage system came to a STOP: Observations from the World Trade Center disaster. Acad Emerg Med 2002;9:255–256.CrossRefGoogle ScholarPubMed
32.Spivak, M: Bay Area blackout. EMS response to city-wide power outage. Emerg Med Serv 1999;28:68,72–73.Google ScholarPubMed
33.Okumura, T, Suzuki, K, Fukuda, A, et al. : The Tokyo subway sarin attack: disaster management, Part 1: Community emergency response. Acad Emerg Med 1998;5:613–617.CrossRefGoogle ScholarPubMed
34. Economic Research Service, United States Department of Agriculture (USDA): Measuring Rurality: New Definitions in 2003. Available at http://www.ers.usda.gov/Briefing/Rurality/WhatisRural. Accessed 12 October 2004.Google Scholar
35.Cohen, A: The Big Easy on the Brink. Time 2000;156:91.Google Scholar
36. Louisiana Water Resources Research Institute. Louisiana Water Resources Research Institute: NSEL Products 1998-2002. Available at http://www.lawater.lsu.edu. Accessed 04 October 2005.Google Scholar
37.Schur, CL, Berk, ML, Mueller, CD: Perspectives of Rural Hospitals on Bioterrorism Preparedness Planning. Policy Analysis Brief, W Serices, No. 4. Walsh Center for Rural Health Analysis. April 2004.Google Scholar
38.Barbera, J A, Macintyre, AG, DeAtley, C: Ambulances to Nowhere: America's Critical Shortfall in Medical Preparedness for Catastrophic Terrorism. BCSIA Discussion Paper 2001-15, ESDP Discussion Paper ESDP-2001-07. John F. Kennedy School of Government, Harvard University, October 2001.Google Scholar
39.Hoard, M, Homer, J, Manley, W, et al. : Systems modeling in support of evidence-based disaster planning for rural areas. Int J Hyg Environ Health 2005;208:117–125.CrossRefGoogle ScholarPubMed
40.Hirsch, GB: Modeling the consequences of major incidents for health care systems. 2005. 22nd International Systems Dynamics Conference. Oxford, England: Systems Dynamics Society; 2004.Google Scholar
41.Manley, W, Homer, J, Hoard, M, et al. : A Systems Dynamic Model to Support Surge Capacity Planning in a Rural Hospital. 23rd International Systems Dynamics Conference. Boston, MA. Systems Dynamics Society; 2005. Available at http://www.systemdynamics.org/conf2005/proceed/proceed.pdf. 04 October 2005.Google Scholar