Irvine, Calif., April 7, 2003 -- In the event of a significant threat to their buildings and facilities, hospitals can successfully evacuate patients and staff without relying on outside assistance, a UC Irvine study found.
The study, which appears in the April 3 issue of the New England Journal of Medicine, also suggests that in the aftermath of a severely damaging earthquake or similarly devastating terrorist event, the biggest risk to hospitals isn't structural integrity, but non-structural damage like water leaks and electrical outages. The findings include basic steps for responding to a bioterrorist attack on a medical facility.
Dr. Carl Schultz, professor of emergency medicine, and his colleagues reached their conclusion after surveying Los Angeles County hospital reactions to the 1994 Northridge earthquake -- a moderate but very damaging earthquake. In the Los Angeles area, about 12,500 structures suffered significant damage. Of the 66,546 buildings inspected, 6 percent were severely damaged and 17 percent were moderately damaged.
"We conducted this study in 1996, shortly after the earthquake, to see how hospitals responded to the temblor," said Schultz, who was at UCLA at the time of the survey. Schultz found that of the eight hospitals that had to evacuate, most did so because of water leaks and electrical problems and not because of imminent collapse. "Each of these hospitals evacuated their facility safely and quickly," he said. "Facilities around the country can use this to help prepare for other types of disasters, such as terrorism."
Schultz and his colleagues found that of the hospitals in Los Angeles County that evacuated staff and patients, none had adverse problems with patients due to the move. In addition, Schultz' team found that hospitals could evacuate large numbers of patients without assistance from a county or state emergency operations center, other than providing vehicles for patient transport. While some hospitals did rely on the emergency operations center to coordinate evacuation, others functioned independently. There was no difference in outcomes for hospitals using either strategy.
"Sometimes these centers can get overwhelmed, especially in the minutes or hours after disaster strikes," Schultz said. "At least temporarily, the hospitals can work without them, but only as long as they have a backup plan for treating patients outside a hospital setting -- sometimes, literally outside. Obviously, it is best to try and coordinate the evacuation process with the emergency operations center. But sometimes this is not possible or practical. Our study demonstrated hospitals can evacuate their patients safely without assistance from the center."
Schultz, an emergency room physician and disaster medicine specialist at UCI Medical Center in Orange, is an internationally recognized authority in medical responses to disasters, including earthquakes and acts of terrorism.
Journal
New England Journal of Medicine