Answers to these questions will reveal facility’s readiness

The Association for Professionals in Infection Control and Epidemiology in Washington, DC, has issued a bioterrorism/disaster preparedness checklist for infection control professionals to assess their facility’s readiness. The checklist includes the following key questions:

Identification of authorized personnel

A. Is there an individual designated as a disaster coordinator on a 24-hour-per-day basis?

B. Has the hospital/health care facility designated a medical commander who will be responsible for the hospital’s medical responses during the time the plan is activated?

C. Have other key position holders who have a role in disaster management been identified?

Response

A. Has the hospital/health care facility developed internal plans for internal emergencies?

B. Has the hospital/health care facility developed internal plans to respond to an external disaster? Does this plan indicate how the hospital will respond to an abnormally large influx of patients?

C. Has the hospital/health care facility developed plans indicating how the hospital will be able to supply resources and personnel in response to an external disaster?

D. Have provisions been made for activating a hospital disaster medical team in response to both internal and external disasters?

E. Does the plan include procedures for incorporating and managing volunteers and unexpected medical services responders who want to help?

F. Has each department developed standard operating procedures to reflect how the department will continue to provide services in a timely and 24-hour manner?

G. In the Emergency Department (ED) section of the plan, are the following detailed?

  1. Is there a separate entry to the ED for contaminated patients?
  2. Is there a dedicated facility, area, or portable device for decontamination?
  3. Is there a hot and cold water supply to the decontamination area?
  4. Can water runoff from the decontamination area be contained?
  5. Can the ventilation system in the ED be isolated from the rest of the facility?
  6. Is a communication method established within the ED so communication can be established and maintained with the local emergency medical services agencies, Emergency Management Agency, Federal Bureau of Investigation, and the local health department?

Reception of casualties and victims

A. Is there a precise plan of action whereby at short notice, multiple casualties can be received and: identified; triaged; registered; treated in designated treatment areas; admitted or transferred; transported as needed

B. In the confirmation notification of a disaster, does the plan provide for:

  1. Clearance of all nonemergency patients and visitors from the ED
  2. Cancellation of all elective admissions and elective surgery
  3. Determination of rapidly available or open beds
  4. Determination of space that can be converted to patient care areas
  5. Determination of number of patients who can be transferred or discharged

C. Has provision been made to secure traffic access to the ED and control the access to allow timely ambulance turnaround?

D. Is the receiving and sorting area accessible and in close proximity to the areas of the hospital in which definitive care will be given?

E. Is the reception area equipped with portable auxiliary power for illumination and other electrical equipment, or can power be supplied from hospital emergency power (generator) circuits?

F. Does the reception area allow for retention, segregation, and processing of incoming casualties?

G. Are sufficient equipment, supplies, and apparatus available, in an organized manner, to permit prompt and efficient casualty movement?

H. Can radiological monitors and radiation detection instruments be assigned to the area, if required?

I. Has provision been made for a large influx of casualties to include such factors as:

  1. Bed arrangements
  2. Personnel requirements
  3. Extra resources such as interpretive services, linen, pharmaceutical needs, dressings, etc.

J. Are the medical records and admission departments organized to handle an influx of casualties?

K. Is there a system for retention and safekeeping of personal items removed from casualties?

L. Is there a plan to segregate/isolate disaster victims from the rest of the hospital if those victims are contaminated (e.g. hazardous materials)?

(Editor’s note: The complete APIC checklist and other bioterrorism materials are available at www.apic.org/bioterror/.)