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Testing Emergency Medical Personnel Response to Patients with Suspected Infectious Disease

Published online by Cambridge University Press:  28 June 2012

Kelly R. Klein ,
Jenny G. Atas  and
Jerry Collins
Kelly R. Klein*
Affiliation:
Weapons of Mass Destruction/Disaster Medicine/EMS Fellow, Department of Emergency Medicine, Wayne State University/MichiganDepartment of Community Health, Detroit, Michigan, USA
Jenny G. Atas
Affiliation:
Clinical Associate Professor, Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
Jerry Collins
Affiliation:
Director of Public Safety, Detroit Receiving Hospital, Detroit, Michigan, USA
*
WMD/Disaster Medicine/EMS Fellow, Wayne State University, 4160 John R, Suite 616, Detroit, MI 48201USA E-mail: KleinKR@mindspring.com or KKlein@dmc.org
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Abstract

Objectives:

In the United States (US), hospitals are required to have disaster plans and stage drills to test these plans in order to satisfy the Joint Accreditation Commission of Healthcare Organizations. The focus of this drill was to test if emergency response personnel, both prehospital and hospital, would identify a patient with a potentially communicable infectious disease, and activate their respective disaster plan.

Methods:

Twelve urban/suburban emergency departments (ED) received patients via car and ambulance. Patients were moulaged to imitate a smallpox infection. Observers with checklists recorded what happened. The drill's endpoints were: (1) predetermined end time; (2) identification of the patient and hospital “lock-down”; and (3) breach of drill protocol.

Results:

None of the ambulance personnel correctly identified their patients. Of the total 13 mock patients assessed in the ED, seven (54%) were identified by the ED staff as possibly being infected with a highly contagious agent and, in turn, the hospital's bio-agent protocol was initiated. Of the correctly identified patients, five (71%) were placed in isolation, and the remaining two (29%), although not isolated, were identified prior to their ED discharge and the appropriate protocol was activated. The six remaining mock patients (46%) were incorrectly diagnosed and discharged. Of the hospitals that had correctly identified their “infected” patients, only two (29%) followed their notification protocol and contacted the local health department.

Conclusion:

This drill was successful in identifying this area's shortcomings, highlighted positive reactions, and raised some interesting questions about the ability to detect a patient with a possibly highly contagious disease.

Keywords

bioterrorismdisaster plandrillinfectious diseasemoulageprehospital drillsmallpox
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 19 , Issue 3 , September 2004 , pp. 256 - 265
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2004

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