Report of the CIMERC/Drexel University Emergency Department Terrorism Preparedness Consensus Panel

This report describes the consensus recommendations of an expert panel convened to develop recommendations for a hospital-based emergency department (ED) to attain a minimal level of preparedness necessary to respond to mass casualty events derived from the use of weapons of mass destruction. The recommendations were created for use by hospital-based EDs of a variety of sizes and locations (urban, suburban, or rural). The disasters that were considered included those that are biological, chemical, or radiological. The panel focused on preparation for a single disaster that could generate 250-500 total patients in 24-48 hours. This number included asymptomatic, exposed, and symptomatic patients. The panel chose not to address circumstances where a small number of patients with an infectious disease are seen in one or a few hospitals. In addition, the panel believed that preparation of a single hospital for an overwhelming mass casualty situation (e.g., 10,000 patients) would not be broadly applicable and would not be required for an individual ED to "minimally prepared." Prior to the convening of this consensus panel, in June 2002, a search of all relevant agencies found no comprehensive, published, validated recommendations for preparedness for individual EDs. Although several agencies had released information on disaster management, clinical diagnosis and treatment tools, and training, no agency had produced a comprehensive list of items and issues that individual EDs must consider when preparing for a terrorist attack. The current report attempts to fill this void in information regarding ED preparedness.