Major Concern: Cost - @

Major Concern: Cost

Fire division considering mobile hospital for disasters


Suzanne Hoholik | | Thursday, August 21, 2008

COLUMBUS, Ohio -- Columbus fire officials want to buy a $5.5 million mobile emergency hospital that could treat overflow patients during a disaster.

Right now, central Ohio emergency officials have plans in place to use area hospital beds and medical staff to treat people during a natural disaster or pandemic.

But if the hospitals fill up or if, for example, the O'Shaughnessy Dam breaks and floods the emergency departments of three Franklin County hospitals, patients would have to be moved to medical centers across 15 counties.

It's that kind of scenario that has Columbus Division of Fire officials saying the city needs a mobile hospital unit that could be set up in about 19 minutes to treat emergency patients.

Fire officials say they plan to apply to the U.S. Department of Homeland Security to pay for the two tractor-trailers -- one to house a 14-bed hospital and the other to carry supplies.

Dr. David Keseg, medical director for the Fire Division, said he surveyed a number of large cities to gauge what they would do in similar disaster situations. Plans varied from tent hospitals in Chicago to a tractor-trailer hospital in Memphis.

The tractor-trailers cost an estimated $200,000 a year to operate.

"I don't know if we need something like this, but I don't want Columbus to fall behind in emergency preparedness," Columbus Fire Chief Ned Pettus said. "I have a vested interest in keeping in pace with the rest of the country."

Pettus said he plans to have a similar set-up from North Carolina brought to Columbus next month so city officials can tour it.

He said he plans to talk to Franklin County hospitals about staffing or possibly being joint owners.

"I don't see us being able to do any of this without a partner hospital," Pettus said.

The mobile hospital Columbus is considering would be the model developed by Carolinas Medical Center in Charlotte, N.C. The mobile unit was sent to Mississippi after Hurricane Katrina, to New Orleans during Mardi Gras in 2006 and to Columbus, Ind., last month when the Columbus Regional Hospital emergency department flooded, said Dr. Tom Blackwell, emergency medicine specialist at the Carolinas hospital.

Pettus said a mobile hospital also could be used at Ohio State University home football games and Red, White & Boom.

"Say we had a bomb blow up at OSU during a football game -- EMS would respond to that but would they have the resources to take care of all those patients?" Keseg said. "And hospitals would be overtaxed."

He said the mobile hospital would be a temporary place where patients could be triaged and receive immediate care.

"If we got one in Columbus, it would be the only one in the state, probably the only one in the Midwest," Keseg said. Federal emergency management officials said grants paid for the Carolinas mobile unit as well as one in Los Angeles County in California.

Local emergency response experts say they understand the value of mobile hospital units, but question the price tag.

"It's not just looking at the initial cost of the system but the long term costs of the piece of equipment," said Jim Leonard, deputy director of Franklin County Office of Emergency Management and Homeland Security.

Retired U.S. Air Force Maj. Gen. Todd Stewart, director of Ohio State's national security research and education programs, said a mobile hospital would have to be on the move to be worth the cost.

"For a high value item like that, you have to have a plan to get high use out of it day to day," he said. "The best way is to move it around a state or region to meet the needs of an area needing medical attention."

He suggests the state or federal government operate the mobile hospital so it can be moved to any region.

Pettus, however, said he believes such a mobile hospital should stay close to Columbus.

"I just want my paramedics to have the resources and tools available if anything ever happened."

Mobile hospital

The Columbus Division of Fire wants to apply for federal Homeland Security money to buy a mobile hospital. There are several mobile hospitals across the country, including units in Charlotte, N.C., Los Angeles County and Memphis, Tenn. The Columbus unit could include:

* Two operating beds, four critical-care beds, seven emergency beds and a bed for dental/ear, nose and throat patients

* Full trauma and anesthetic capabilities

* A full laboratory and pharmacy and radiology areas

* An outdoor tent/awning system that can add 200 beds

Source: Carolinas Medical Center, Columbus Division of Fire

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