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Full-scale regional exercises: closing the gaps in disaster preparedness
David A Klima1, Sarah H Seiler, Jeff B Peterson
1FH Sammy Ross, Jr, Trauma Center, Department of Surgery, Carolinas Medical Center, Charlotte, North Carolina 28203, USA.
The Journal of Trauma and Acute Care Surgery
|August 30, 2012
Summary
Full-scale disaster drills reveal critical gaps in hospital preparedness for mass casualty incidents. Communication and decontamination remain significant challenges, highlighting the need for regular, realistic exercises to ensure effective emergency response.
Area of Science:
- Disaster Medicine
- Emergency Preparedness
- Healthcare Operations
Background:
- Major disasters underscore the need for robust medical disaster preparedness.
- Hospitals must establish protocols for mass casualty incidents per Joint Commission requirements.
- This study evaluated a full-scale regional exercise to identify logistical and operational gaps.
Purpose of the Study:
- To identify deficiencies in logistics and operations during a simulated mass casualty incident.
- To assess hospital compliance with disaster response protocols.
- To evaluate the effectiveness of full-scale regional exercises in revealing preparedness gaps.
Main Methods:
- A multiagency, multidisciplinary full-scale regional exercise (FSRE) simulated a train derailment and chemical spill.
- Sixteen hospitals and one Level I trauma center participated, with 281 moulaged volunteers.
- Evaluators assessed five key areas: communications, command structure, decontamination, staffing, and patient tracking.
Main Results:
- No hospital achieved full compliance in all five assessed areas; mean compliance was 1.9 areas.
- The most frequent deficiencies were in communications (94%) and decontamination (75%).
- Other significant issues included inadequate staffing (63%), suboptimal command structure (56%), and patient tracking (31%).
Conclusions:
- Communication remains a critical vulnerability in mass casualty preparedness.
- Tabletop exercises are insufficient for identifying operational and logistical gaps.
- Routine full-scale regional exercises are essential for adequate preparation for catastrophic events.
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