(P1-63) Post-Tsunami Hospital Evacuation Preparedness Improved by Development of Portable Medical Supply Caches

Abstract

Background

On September 29, 2009, an earthquake-caused tsunami struck American Samoa with only 20 minutes warning. Personnel successfully evacuated patients from the hospital within 20 minutes. The organization and transportation of medical supplies required for patient care took 90 minutes.

Objective

To describe a hospital evacuation exercise designed to identify critical medical supplies, and test their transport, and use in a field-hospital setting.

Methods

A retrospective review of hospital emergency preparedness and Boy Scout Eagle Project minutes, participant surveys, and key-informant interviews was performed. Descriptive statistics were used to evaluate data.

Results

Unit supervisors hospital-wide were tasked with designing portable supply caches for the care of typical unit patients for 72 hours. Nine hospital units participated (ED, Surgery, Medicine, Pediatrics, Labor & Delivery, Maternity, Nursery/NICU, ICU, Hemodialysis) in the exercise. Unit evacuation teams (1 physician & 2 nurses) carried caches by foot to a nearby field clinic site (1/4 mile). Cache transport times ranged from 3 minutes (maternity ward) to 15.5 minutes (hemodialysis), averaging 11.2 minutes. Hospital leadership arrived in 4 minutes, and maintenance staff with portable power and oxygen in 23 minutes. Fifty-seven community volunteers (age 9 months – 60 years) under Eagle Scout candidate leadership were prepared as moulaged mock patients. Unit teams used evacuated supplies to provide medical care for 6 mock patients each, listing missing or insufficient supplies at exercise end. Cache supply deficits noted by participating teams included: portable oxygen (66%), blood pressure cuffs (44%), thermometers (44%), select pharmaceuticals (44%), and others. Reported cache deficits and exercise lessons learned were reported hospital-wide for incorporation into preparedness planning.

Conclusion

The hospital unit medical supply cache exercise was effective in addressing prior evacuation deficits. Hospital collaboration with community service volunteers provides exercise realism for participants and increases community awareness for emergency preparedness.