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Recent natural and infrastructural disasters, such as Hurricanes Sandy (2012) and Katrina (2005) and the Northeastern power outage of 2003, have emphasized the need for hospital staff to be trained in disaster management and response. Even an internal hospital disaster may require the safe and efficient evacuation and transfer of patients with varying medical conditions and complications. A notably susceptible population is renal transplant patients, including those with post-transplant complications.
Hypothesis
This descriptive study evaluated staff performance of a vertical evacuation drill of renal transplant patients at State University of New York (SUNY) Downstate Medical Center – University Hospital Brooklyn (UHB; Brooklyn, New York USA).
Methods
Thirteen standardized patients, 12 of whom received a renal transplant, with varying medical histories, ambulatory ability, and mental status were vertically evacuated by the transplant staff from the eighth floor to the ambulance entrance on the ground floor. Non-ambulatory patients were transported on portable evacuation sleds.
Results
All patients were evacuated successfully within 3.5 hours. On a post-drill evaluation form, drill participants self-reported largely positive results concerning their own role in the drill and the evacuation drill itself. Drill evaluators observed very different results, including staff reticence, poor training retention, and lack of leadership.
Conclusion
Despite encouraging post-drill evaluation results from the participants, the evacuation drill highlighted several immediate deficiencies. It also demonstrated a significant discrepancy in performance perception between the drill participants and the drill evaluators.
SalwayRJ, AdlerZ, WilliamsT, NwokeF, RoblinP, ArquillaB. The Challenges of a Vertical Evacuation Drill. Prehosp Disaster Med. 2019;34(1):25–29.
This chapter discusses the problems winter storms pose, and how they fit into the continuum from minor annoyance to major disaster. It explores what can be done to prepare for future events that threaten the welfare of those in their paths. Understanding the human impact of catastrophic events, so that society can be better prepared for future challenges, is the primary mission in the fields of emergency management and disaster medicine. Establishing an incident command structure, regardless of size, should bring together the resources officials need to determine the security and safety of affected areas, identify hazards to responders, and coordinate the support necessary to begin rescue and recovery efforts. Rapid assessments for identifying immediate challenges created by a winter storm and determining potential resources required to mount an effective response are necessary to avoid a dysfunctional approach.
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