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Critical Assessment of Statewide Hospital Pharmaceutical Surge Capabilities for Chemical, Biological, Radiological, Nuclear, and Explosive Incidents

Published online by Cambridge University Press:  28 June 2012

Edbert B. Hsu ,
Julie A. Casani ,
Al Romanosky ,
Michael G. Millin ,
Christa M. Singleton ,
John Donohue ,
E. Robert Feroli ,
Melvin Rubin ,
Italo Subbarao  and
Dianne M. Whyne
...Show all authors
Edbert B. Hsu*
Affiliation:
The Johns Hopkins Office of Critical Event Preparedness and Response, Baltimore, Maryland, USA The Johns Hopkins UniversityDepartment of Emergency Medicine, Baltimore, Maryland, USA
Julie A. Casani
Affiliation:
Maryland Department of Health and Mental Hygiene, Office of Emergency Preparedness and Response, Baltimore, Maryland, USA
Al Romanosky
Affiliation:
Maryland Department of Health and Mental Hygiene, Office of Emergency Preparedness and Response, Baltimore, Maryland, USA
Michael G. Millin
Affiliation:
The Johns Hopkins Office of Critical Event Preparedness and Response, Baltimore, Maryland, USA
Christa M. Singleton
Affiliation:
Baltimore City Health Department, Office of Public Health Preparedness and Response, Baltimore, Maryland, USA
John Donohue
Affiliation:
Maryland Institute for Emergency Medical Services Systems, Weapons of Mass Destruction and Counterterrorism, Baltimore, Maryland, USA
E. Robert Feroli
Affiliation:
The Johns Hopkins Hospital, Department of Pharmacy, Baltimore, Maryland, USA
Melvin Rubin
Affiliation:
Maryland Department of Health and Mental Hygiene, Board of Pharmacy, Baltimore, Maryland, USA
Italo Subbarao
Affiliation:
The Johns Hopkins Office of Critical Event Preparedness and Response, Baltimore, Maryland, USA The Johns Hopkins UniversityDepartment of Emergency Medicine, Baltimore, Maryland, USA
Dianne M. Whyne
Affiliation:
The Johns Hopkins Office of Critical Event Preparedness and Response, Baltimore, Maryland, USA The Johns Hopkins UniversityDepartment of Emergency Medicine, Baltimore, Maryland, USA
Thomas D. Snodgrass
Affiliation:
The Johns Hopkins Office of Critical Event Preparedness and Response, Baltimore, Maryland, USA
Gabor D. Kelen
Affiliation:
The Johns Hopkins Office of Critical Event Preparedness and Response, Baltimore, Maryland, USA The Johns Hopkins UniversityDepartment of Emergency Medicine, Baltimore, Maryland, USA
*
Edbert Hsu, MD, MPH, The Johns Hopkins Office of Critical Event Preparedness and Response, 5801 Smith Ave., Davis Building, Suite 3220, Baltimore, MD 21209USA E-mail: edhsu@jhmi.edu
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Abstract

Introduction:

In recent years, government and hospital disaster planners have recognized the increasing importance of pharmaceutical preparedness for chemical, biological, radiological, nuclear, and explosive (CBRNE) events, as well as other public health emergencies. The development of pharmaceutical surge capacity for immediate use before support from the (US) Strategic National Stockpile (SNS) becomes available is integral to strengthening the preparedness of local healthcare networks.

Methods:

The Pharmaceutical Response Project served as an independent, multidisciplinary collaboration to assess statewide hospital pharmaceutical response capabilities. Surveys of hospital pharmacy directors were conducted to determine pharmaceutical response preparedness to CBRNE threats.

Results:

All 45 acute care hospitals in Maryland were surveyed, and responses were collected from 80% (36/45). Ninety-two percent (33/36) of hospitals had assessed pharmaceutical inventory with respect to biological agents, 92% (33/36) for chemical agents, and 67% (24/36) for radiological agents. However, only 64% (23/36) of hospitals reported an additional dedicated reserve supply for biological events, 67% (24/36) for chemical events, and 50% (18/36) for radiological events. More than 60% of the hospitals expected to receive assistance from the SNS within ≤48 hours.

Conclusions:

From a pharmaceutical perspective, hospitals generally remain under-prepared for CBRNE threats and many expect SNS support before it realistically would be available. Collectively, limited antibiotics and other supplies are available to offer prophylaxis or treatment, suggesting that hospitals may have insufficient pharmaceutical surge supplies for a large-scale event. Although most state hospitals are improving pharmaceutical surge capabilities, further efforts are needed.

Keywords

chemicalbiologicalradiologicalnuclearexplosivehospitalpharmaceuticalpreparedness
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 22 , Issue 3 , June 2007 , pp. 214 - 218
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2007

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