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Use of Alternate Healthcare Facilities as Alternate Transport Destinations during a Mass-Casualty Incident

Published online by Cambridge University Press:  28 June 2012

Erik S. Glassman  and
Steven J. Parrillo
Erik S. Glassman*
Affiliation:
Disaster Medicine and Management Masters Program, Philadelphia University, Philadelphia, Pennsylvania USA
Steven J. Parrillo
Affiliation:
Associate Professor Jefferson Medical College and Philadelphia College of Osteopathic Medicine; Medical Director, Disaster Medicine and Management Masters, Philadelphia University, Philadelphia, Pennsylvania USA
*
1425 South Eads Street Apartment 1109 Arlington, Virginia 22202 USA E-mail: [email protected]
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Abstract

The purpose of this discussion is to review the use of destinations other than the hospital emergency department, to transport patients injured as a result of a mass-casualty incident (MCI). A MCI has the ability to overwhelm traditional hospital resources normally thought of as appropriate destinations for the transport of injured patients. As a result, those with less severe injuries often are required to wait before they can receive definitive treatment. This waiting period, either at the scene of the incident or in the emergency department, can increase morbidity and drain resources that can be better directed toward the transport and care of those more severely injured. Potential alternate transport destinations include physician office buildings, ambulatory care centers, ambulatory surgery centers, and urgent care centers. By allowing for transport to alternate locations, these less severely injured patients can be removed rapidly from the scene, treated, and potentially released. This effort can decrease the strain on traditional resources within the system, better allowing these resources to treat more seriously injured patients.

Keywords

alternate healthcare facilitiesmass-casualty incidentpreparednesssurge capacitytransport
Type
Research Article
Information
Prehospital and Disaster Medicine , Volume 25 , Issue 2 , April 2010 , pp. 178 - 182
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2010

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References

1. Carter, AJ, Chochinov, AH: A systematic review of the impact of nurse practitioners on cost, quality of care, satisfaction and wait times in the emergency department. CJEM 2007;9(4):297–299.CrossRefGoogle ScholarPubMed
2. Eastaugh, SR: Overcrowding and fiscal pressures in emergency medicine. Hosp Top 2002;80(1):7–11.CrossRefGoogle ScholarPubMed
3. Olshaker, JS, Rathlev, NK: Emergency department overcrowding and ambulance diversion: The impact and potential solutions of extended boarding of admitted patients in the emergency department. J Emerg Med 2006;30(3):351–356.CrossRefGoogle ScholarPubMed
4. Schaefer, RA, Rea, TD, Plorde, M, Peiguss, K, Goldberg, P, Murray, JA: An emergency medical services program of alternate destination of patient care. Prehosp Emerg Care 2002;6(3):309–314.CrossRefGoogle ScholarPubMed
5.DHS University Summit. Available at http://www.orau.gov/DHSRESummit08/presentations/Mar19/Kelen.pdf.Google Scholar
6. Kelen, GD, Kraus, CK, McCarthy, ML, Bass, E, Hsu, EB, Li, G, Scheulen, JJ, Shahan, JB, Brill, JD, Green, GB: Inpatient disposition classification for the creation of hospital surge capacity: A multiphase study. Lancet 2006;368(9551):1984–1990.CrossRefGoogle ScholarPubMed
7.CDC: Mass casualties—Mass casualties predictor. Available at http://www.bt.cdc.gov/masscasualties/predictor.asp. Accessed 13 January 2009.Google Scholar
8. Bloch, YH, Dagan Schwartz, D, Pinkert, M, Blumenfeld, A, Avinoam, S, Hevion, G, Oren, M, Goldber, A, Levi, Y, Bar-Dayan, Y: Distribution of casualties in a mass-casualty incident with three local hospitals in the periphery of a densely populated area: Lessons learned from the medical management of a terrorist attack. Prehosp Disaster Med 2007;22(3):186–192.10.1017/S1049023X00004635CrossRefGoogle Scholar
9. Schaefer, RA, Rea, TD, Plorde, M, Peiguss, K, Goldberg, P, Murray, JA: An emergency medical services program of alternate destination of patient care. Prehosp Emerg Care 2002;6(3):309–314.CrossRefGoogle ScholarPubMed
10. Hick, JL, Hanfling, D, Burstein, JL, DeAtley, C, Barbisch, D, Bogdan, GM, Cantrill, S: Health care facility and community strategies for patient care surge capacity. Ann Emerg Med 2004;44(3):253–261.CrossRefGoogle ScholarPubMed
11.United States Army: OST3C Plan. Available at http://www.ecbc.army.mil/down-loads/cwirp/ECBC_cwirp_concept_ops_ost3c.pdf Accessed 15 January 2009.Google Scholar
12. Leiba, A, Goldberg, A, Hourvitz, A, Weiss, G, Peres, M, Karskass, A, Schwartz, D, Levi, Y, Bar-Dayan, Y: Who should worry for the “worried well”? Analysis of mild casualties center drills in non-conventional scenarios. Prehosp Disaster Med 2006;21(6):441–444.10.1017/S1049023X00004179CrossRefGoogle ScholarPubMed
13.North Coast EMS: Multi-casualty Incident (MCI) Plan. Available at http://www.northcoastems.com/WhatsNew/MCIPlanFinal.pdf Accessed 15 January 2009.Google Scholar
14.Start Triage. Available at http://www.start-triage.com. Accessed 01 January 2010.Google Scholar
14. Blackwell, T, Bosse, M: Use of an innovative design mobile hospital in the medical response to Hurricane Katrina. Ann Emerg Med 2007;49(5):580–588.CrossRefGoogle ScholarPubMed
15. Bouman, JH, Schouwerwou, RJ, Van der Eijk, KJ, van Leusden, AJ, Savelkoul, TJ: Computerization of patient tracking and tracing during mass casualty incidents. Eur J Emerg Med 2000;7:211–216.CrossRefGoogle ScholarPubMed
16. Nates, JL: Combined external and internal hospital disaster: Impact and response in a Houston trauma center intensive care unit. Crit Care Med 2004;32:686–690.CrossRefGoogle Scholar
17. Schultz, CH, Koenig, KL, Lewis, RJ: Implications of hospital evacuation after the Northridge, California, earthquake N Engl J Med 2003;348:1349–1355.CrossRefGoogle ScholarPubMed