Administration and Leadership, Columns, Major Incidents, Mass Casualty Incidents, Patient Care

Will Emergency Health Care Providers Respond To MCIs?

Review of: Syrett J, Benitez J, Livingston W, et al: “Will emergency health care providers respond to mass casualty incidents?” Prehosptial Emergency Care. 11(1):49-54, 2007.

The Science
This study was conducted in a medical center in upstate New York that was designated as a major receiving center in the event of a major biological terrorist event. The study was conducted through random anonymous surveys of healthcare professionals, which included emergency medicine physicians, nurses and EMS personnel.

Surveys offered two scenarios. Both scenarios started out with the report of a flu-like infection that caused some healthcare workers to become ill. At some point, the participants were made aware that this was terrorist event. The two scenarios then differed. In the first case, the agent was determined to be non-transmissible and had an effective treatment and/or prophylaxis. In the second scenario, the agent was determined to be transmissible with only an experimental treatment. The participants were asked at various points in the survey if they would respond to work if called.

The researchers discovered that initially almost 80% of the survey takers would respond to work. However, when it was determined that the agent was transmissible with no proven treatment, the response dropped to 18%. The most significant factor that influenced their decision was the availability for treating their family members if they were to report to work. This resulted in a doubling of response to work in both scenarios.

The Street
We have spent the past several years developing federal and state plans to deal with biological events such as anthrax, smallpox and even avian and pandemic flu. The majority of this planning has concentrated on the availability of material resources such as hospital beds, ventilators, medications and ambulances. However, what use will these resources be if there is no one to care for the patients?

This study confirms what we have seen during natural disasters, such as Katrina, where public safety and healthcare personnel either did not report to work or even left work to care for their loved ones. Unless we address this human resource issue, all of our planning will be for naught. It appears that we need to be more creative in our planning by providing for the safety and welfare of our rescuers families.

Without doing so, the fear of terrorism will create more death and destruction than the terrorist act itself.