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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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References

1.Centers for Disease Control and Prevention (CDC): Strategic National Stockpile. Available at http://www.bt.cdc.gov/stockpile/#deploy. Accessed 04 August 2006.Google Scholar
2.US Code Collection, Title 42, Chapter 6A, Subchapter XXVI, Part B, Number 300hh-12, Strategic National Stockpile. Available at http://www4.law.cornell. edu/uscode/htmluscode42. Accessed 04 April 2006.Google Scholar
3.CDC: Strategic National Stockpile.Available at http://www.bt.cdc.gov/stockpile/#transport. Accessed 04 August 2006.Google Scholar
4. Pharmaceutical Response Project (PRP) Expert Panel: Health Resources and Services Administration (HRSA) Special Projects Report, July 2005.Google Scholar
5. US Census: Maryland Population. Available at http://factfinder.census.gov/servlet/SAFFPopulation. Accessed 14 February 2006.Google Scholar
6.Office of Public Health Preparedness and Response: Maryland Bioterrorism Hospital Preparedness Program Report, April 2005.Google Scholar
7.Hsu, EB, Casani, JA, Romanosky, A, et al. : Are regional hospital pharmacies prepared for public health emergencies? Biosecur Bioter 2006;4(3):£237-43.CrossRefGoogle ScholarPubMed
8. List of Hospitals in the State of Maryland, September 2004. Available at http://www.mdhospitals.org/mha/MarylandHospitals/index.html. Accessed 05 January 2005.Google Scholar
9.CDC: Bioterrorism agents/diseases By category. Available at http://www.bt.cdc.gov/agentlist-category.asp. Accessed 28 April 2005.Google Scholar
10.US Army Medical Research Institute of Infectious Diseases: Medical Management of Biological Casualties Handbook. Frederick, MD: US Army Medical Research Institute of Infectious Diseases, 2001.Google Scholar
11.Henderson, DA, Ingelsby, TV, O'Toole, T (eds): Bioterrorism: Guidelines for Medical and Public Health Management. Chicago: AMA Press, 2002.Google Scholar
12.CDC: Fact sheet: Anthrax information for health care providers. Available at http://www.bt.cdc.gov/agentlist-category.asp. Accessed 28 April 2005.Google Scholar
13.CDC: Frequently asked questions about plague. Available at http://www.bt.cdc.gov/agentlist-category.asp.Accessed 28 April 2005.Google Scholar
14.CDC: Key facts about tularemia. Available at http://www.bt.cdc.gov/agentlistcategory. asp Accessed 28 April 2005.Google Scholar
15.Bartlet, JG: PDR Guide to Biological and Chemical Warfare Response. Montvale, NJ: Thompson PDR, 2002.Google Scholar
16.CDC: Update: Investigation of bioterrorism-related anthrax and interim fuidelines for exposure management and antimicrobial therapy, October 2001. MMWR 2001;50(42):909–919.Google Scholar
17.CDC: Frequently Asked Questions About Plague.Atlanta: US Centers for Disease Control and Prevention, 2005.Google Scholar
18.Inglesby, TV, Dennis, DT, Henderson, DA, et al. : Plague as a biological weapon: Medical and public health management. Working Group on Civilian Biodefense. JAMA 2000;283(17):2281–2290.Google ScholarPubMed
19.CDC: Key Facts About Tularemia. Atlanta: US Centers for Disease Control and Prevention, 2003.Google Scholar
20.Dennis, DT, Inglesby, TV, Henderson, DA, et al. : Tularemia as a biological weapon: Medical and public health management. JAMAGoogle Scholar