Emergency Management

Behind The Scenes Of A Medical Emergency During Natural Disasters

Last few weeks proved to be a catastrophic experience for the United States as it reeled under two major hurricanes – hurricane Harvey that hit the coast of Texas on 25th August, and hurricane Irma that hit the Virgin Islands and Puerto Rica and was poised to move towards US Mainland in early September.

But FEMA along with other federal partners, hospitals, fire department and other emergency responders have been working tirelessly to control the havoc created in the affected areas.

In case of hurricane Harvey, the Emergency Command Centre in Texas had prepared itself days before the hurricane hit the coast of Texas. They had prepared themselves to be fully functional on the day of the storm and were expected to remain open around the clock until the storm passes

Everybody right from the fire department to EMS was notified to be prepared for the impending storm. Twenty-five EMTs and paramedics from Gold Cross – an ambulance service in Texas, underwent a specialized training from FEMA that prepared them for disasters. They were already on the ground to help the stranded victims.

Similarly, the emergency operations centers such as Miami-Dade County Emergency Operations Center had braced itself for hurricane Irma as they prepared themselves a week before the hurricane hit the US, which gave the emergency response team more time to plan rescue operations.

In fact, according to Scott Wiley, emergency director of NCH, the emergency preparedness was flawless as the staff in Downtown Baker hospital in Florida helped in relocating the emergency room, pharmacy, laboratory and other rooms situated on the ground floor to the upper floors within 12 hours to accommodate the patients.

It will take several weeks to understand the aftermath of these hurricanes. But as on last week, the damage estimate is over $100 billion. Over 1 million people do not have power and in areas affected by hurricane Harvey, the infrastructure recovery work has just begun.

However, one must recognize the contribution of emergency responders who have learned few lessons from hurricane Katrina and have worked towards minimizing the damages in the recent disasters.

Some of the lessons learned by the responders include better planning and training for responders, the advance arrangement of emergency supplies, seeking help from locals and federal and local responders working off the same playbook.

According to the Urban Institute, after the excruciating experience of hurricane Katrina, wildfires and floods, the state government and federal government have prepared better processes. One of the remarkable changes noticed during these hurricanes was better medical emergency preparedness.

Behind the scenes work of Emergency Medical Technicians

The Emergency Medical Technicians (EMT) faced major problems during hurricane Katrina and Hurricane Gustav. From lack of medical bays, basic medicines to lack of generators during power cuts, medical technicians faced multiple issues in safeguarding the lives of the victims. The lack of proper medical care was equally responsible for the loss of lives.

This led the EMTs to learn few lessons in emergency preparedness. They are now better equipped to handle emergencies such as natural disasters.

Let us look at the behind the scenes preparation of Emergency Medical Technicians during such disasters.

In the earlier disasters, EMTs did not have access to basic data, such as the number of empty beds in hospitals, the availability of oxygen cylinders, and list of hospitals having generators and so on. This led to confusion when a hurricane struck, as the EMTs were unable to decide on the hospitals that had facilities to accommodate patients requiring immediate oxygen supply or dialysis. The indecisiveness on the part of EMTs led to the death of more than 950 people.

This led to the development of ESF8 Portal that contains information about the number of beds and patients in each hospital, availability of power supply and generators in the hospitals and availability of basic medical needs such as oxygen cylinders, dialysis units, and ventilators.

The data is collected much before a natural disaster hits the region. Hospitals conduct Hazard Vulnerability Analysis (HVA) and review it annually to recognize hazards that could affect the demand for hospital services or its ability to provide the services. Hazard Vulnerability Analysis helps in prioritizing planning, mitigation and response and recovery activities during emergencies.

ESF8 Portal offers Hazard Vulnerability Analysis service that provides regional reports containing data on a regional level, custom risk formulas that address all the needs of the hospitals, and the option to share documents among all the medical facilities and emergency responders in the region.

So when a disaster strikes, the EMTs access the ESF8 Portal to get details about the number of beds available in a hospital, determine if the hospital has the power supply and generator as the backup and if it has oxygen supply and dialysis units. For example, if a patient requires dialysis during a natural disaster, the ESF8 Portal helps the EMTs to locate a hospital that has an empty bed, power supply, and a dialysis unit, to enable them to take the patient to that hospital.

However, EMTs cannot manage the rescue operation alone. It requires support from hospitals and nursing homes. Besides the annual Hazard Vulnerability Analysis, hospitals and nursing homes are expected to update the status of power supply and generators, empty beds and medical equipment on the ESF8 Portal regularly.

This is a critical step because EMTs and other emergency responders having access to the portal refer to the data available on the portal to take a decision. For example, if a hospital having beds, a power supply, and dialysis unit does not update its status on the portal, the EMT will not be able to locate the hospital and will have to look for other hospitals even if the said hospital is closer to the patient’s area.

Hence, hospitals and nursing homes must update the information constantly especially during a natural disaster. For example, if the power goes off and a generator is switched on in a hospital, the hospital staff must update this information on the ESF8 Portal to enable the EMTs to take a decision on admitting the patient to that hospital.

To ensure timely and real-time updates, ESF8 Portal is also available as a mobile app. So, the hospitals, nursing homes, EMTs and other emergency responders have access to all the information entered in the app on the go! This comes handy especially when the power goes out and the emergency responders lose access to the information.