PBHE413 Week 3 Forum – Medical Disaster Response

The following was written in response to a classroom forum:

There are many reasons as to why anyone classified amongst the “worried well” might seek care during a disaster situation; the most common reasons likely being connected to some incarnation of fear, misinformation, ignorance, or a combination of these elements. If we were to take an individual off the street and poll them on how they would respond to a given scenario, we might find that their response is one that differs from what we—varying members of the emergency community—would necessarily expect or recommend; this is simple ignorance of the proper methods, procedures or actions. The individual would, however, likely supply some sort of response based on the level of knowledge they possess of the given scenario, or some similar situation, referring to their simplest and most basic training in life—which, in this case, would likely be to seek immediate assistance from a professional.

To the medical professionals in this course—you have likely seen, responded, or worked on cases where a patient did not need treatment—or if they did, it could have came from a first-aid kit or a trip to the corner drugstore. Many of these patients may have been ignorant to the simplicity of their injury/ailment; some may have been knowledgeable—or would have been—had they not been influenced by the situation in some manner, triggering a flash of fear and confusion.

[Fear, confusion and other emotional responses can come at odd times and have quite an effect on our behavior. I had known a person that had broken their arm, and responded to it with an “Awe, cool!” mentality, chasing their siblings with a wildly flailing arm. Later in life, that very same person fainted from the sight of the pinkish skin he revealed on a finger after pulling back and ripping off a nail-cuticle. An odd tale–but one that shows how an individual can react differently to varying stimuli. In this tale, we can see how a single person may calmly respond and await treatment—arm flailing—or seek immediate treatment—cuticle—based upon their reaction to the event.]

To the parents of multiple children in this course—how many times did you rush your first-born infant or toddler to the hospital? Did you transport the child in your personal vehicle or await an ambulance? Did your next child make as many trips to the ER, or had you changed your perception of an emergency? Initial responses to a new situation, such as the care of a child are heightened, where there may not be a base of comparison or a personal knowledge-bank.

[Picture this one—your first-born infant is spiking a nice temperature. You do have knowledge that Tylenol can bring it down; you even have a bottle or two in the medicine cabinet; yet the sight and sounds of the baby in discomfort wipes your memory of this information. What do you do?—you likely respond by seeking a professional, either through calling a doctor, a family member, or by loading the babe in the car and driving to the hospital—and if you drove, it’s because you ‘knew’ that an ambulance wouldn’t come fast enough. Now, with the third or fourth kid, you simply mutter to yourself, grab a doser, and sigh when that sticky pink fluid drips down junior’s chin and all over that clean Onesie…]

With these examples of everyday possibilities to facing the “worried well”, we can understand how the numbers may grow in disaster situations—when people may be relatively fine or unharmed. Facilities must expect that there will be a greater influx of these patients as well as patients in true dire need of assistance. In order to prepare for these scenarios, the involved organizations must work to establish a triage system in which all patients can be evaluated and prioritized according to medical condition. Unfortunately, these efforts are only as effective in relation to the numbers of staff and personnel available, the size of any facilities involved, and the number of patients that arrive. Additionally, efforts will be affected by the communication between any agencies involved, whether any plans laid out are followed, and the unknowns involving the patients/public themselves/itself.

In communities where more than one hospital or medical center exist, multiple locations can be coordinated and organized for the receipt of the varying levels of trauma; clinics and related facilities may be used for low-priority trauma and first-aid, while larger hospitals are reserved for high-priority cases. Organizing, designating and publicizing such locations in such a manner would greatly reduce some of the headaches associated with a massive event; however, there would still be issues related to members of the public incorrectly identifying their injuries to either extreme, or bypassing a designated location out of personal preference. Staffing requirements and transportation may become an issue as well.

With regard to those persons who are more-or-less in a state of shock, suffering little to no injury at all, medical centers would need to respond with staffing persons able to handle the psychological aspects of disaster. Supplying a psychological support staff might be easier than it seems—as many of the patients are in a shock state and not necessarily psychotic, it would be possible to train additional staff in disaster psychology—support staff such as secretaries, housekeeping and maintenance, as well as staff from other supporting emergency services could be utilized to calm and speak with the patients.

In every aspect of the disaster situation, the medical community might benefit from establishing a medical reserve corps or nurses auxiliary; keeping in good contact with such reserves and inclusion of these additional resources in planning and exercises would be mandatory for successful operation and organization, however.