Hazardous materials readiness of United States level 1 trauma centers

Injuries caused by hazardous materials (hazmat) accidents are common in the United States, and emergency departments should be capable of decontaminating these patients. There are, however, no national studies that assess emergency department preparedness. The purpose of this survey was to assess the hazmat readiness of US Level 1 trauma centers (TCs). All 1996 Hospital Blue Book TCs (256) were queried by anonymous survey; 61% (156) responded to the survey. The TCs treated 43,046 +/- 28,455 patients (median, 40,500; range, 600 to 220,000); 15 +/- 29 (median, 6; range, 0 to 200) were hazmat-contaminated. Only 6% acknowledged having all necessary equipment required for safe decontamination. Many (83%) had hazmat response plans, but few (30%) of these plans were complete. Approximately 36% of the staff had received training. Thirteen staff required medical attention themselves after rendering care to a contaminated patient. Only 58% of the TCs performed a single drill. The preparedness of US Level 1 TCs to safely decontaminate hazmat patients seems to be inadequate.