Today’s hospitals are challenged to become better prepared to manage large numbers of patients from mass casualty incidents (MCI), hazardous material incidents (HAZMAT), or in extreme cases, attacks using weapons of mass destruction (WMD). As reported in the April 2004 issue of the journal Disaster Management & Response (DMR), which is published by the
Emergency Nurses Association, Robert Wood Johnson University Hospital (RWJUH) in New Jersey initiated an emergency department based Special Operations Team to help prepare staff for these possible patient populations. Kathleen Zavotsky, MS, RN, CCRN, CNS, C, CS; Michael Valendo, BSN, RN; and Peter Torres, MSN, RN, authored the article. All serve on the staff of RWJUH.
RWJUH is an urban, Level I Trauma Center in central New Jersey. It is surrounded by chemical plants and industrial parks, and has a separate, fully equipped decontamination room with an outside entrance. Many local companies rely on RWJUH to treat employees exposed to hazardous materials. This reliance, coupled with a re-evaluation of disaster planning after September 11, 2001, prompted the hospital to expand its planning and response capabilities with the creation of an emergency department Special Operations Team (EDSOT). The function of EDSOT is to serve as a resource for the emergency department staff and help raise their awareness of HAZMAT/MCI/WMD events.
The EDSOT consists of registered nurses, pharmacists, security officers, technicians, and EMS personnel. Some of the group had experience as firefighters, pre-hospital providers, specialists in toxicology, and members of a federal disaster medical assistance team. The group found it helpful to collaborate with agencies outside the hospital (e.g., EMS, fire, police, and HAZMAT departments) to gain access to more resources.
Staff feedback improves operations. Staff suggested a warning sign outside the ED that directs exposed patients not to enter, but to instead use a telephone to communicate with ED staff. They also suggested a policy and procedures checklist, which can be used to document care and appropriate agency notifications.