PBHE413 Week 6 Forum – Natural Disasters

The following post was originally written in response to a classroom forum:

For what natural disaster is your local community at highest risk? Considering this information, answer these questions: what are the triage, mass casualty care and public health challenges involved in a response to this disaster? 

If you have had experience in natural disaster response, please share your stories and insights with the class.

It would seem that Harrison County, her two cities, and sparsely distributed communities are at greater risk of flooding events, with other meteorological events following close in ranking. Frequently our communities are faced with flooding events, with the areas of primary concern being Cynthiana, the county seat.  At least once a year Cynthiana is faced with waters rising near, if not above, flood-stage. Often-times the rising waters become more of a hindrance and nuisance rather than a disaster; the closing of one commonly traveled roadway is practically guaranteed, and the potential of damages to structures and land alongside said road is equally frequent.

Floodwaters also provide the potential of rising higher with decent frequency, and causing problems with the lower west-side of Cynthiana, commonly overtaking storm sewers and backfilling into intersections and roadways a few blocks away that lie at a lower elevation than the river banks. At times, this backfill enters into basements, creeps toward homes on the surface, and reduces/removes street access to certain residential areas; similar situations occur in rural areas of the county. Fifteen years ago, however, flood waters challenged the boundaries of the 100-year floodplain, and created quite a bit of trouble for the entire county and her emergency services.

With the threats of flooding—and most natural disasters—there generally occurs issues with transportation; heavily traveled roads may become more congested due to the closing of secondary routes, or vice-versa. In flooding events that are “normal” for this area, congestion is seen on our main highways due to the closing of some secondary streets; during the extraordinary flooding event of 1997, congestion was seen on many single-lane, two-way roads outside of the city limits, due to the closure of two main highways. The blockage of these roadways made travel difficult for emergency vehicles and increased response time. Since that event, measures are taken to stage a temporary “station” for fire and ambulance on the opposing side of the river; both the city fire department and ambulance service take extra precautions to verify that they are equipped and stocked slightly above normal capacity when operating out of this satellite location. Additionally, crews sent to operate in this area are familiarized with alternate routes back to the city and hospital, so as to limit the needs of asking dispatch for directions.

When the potential threat of flooding exists, plans are made in advance—typically two days, up to one week—for the coordinating, opening and operations of shelters for potential victims; these efforts are another example of lessons learned from 1997. Voluntary evacuation of the potentially affected areas occurs 4-12 hours before the expected flood-crest. During these planning and preparation phases all emergency and medical services are notified of the potential risks. Further medical response and preparation for these events has not been tested—to my knowledge—as none of the events since 1997 have caused issues that would specifically impact the local hospital, outside of their concerns of staffing.

Another potential disaster concern for the entire community is that of winter storms bringing large amounts of snow and/or ice. Similar to the effects of flooding, snow/ice have the potential of closing roadways. Again, this issue does not seem to cause the local hospital much concern, other than the potential impact on staffing. Frequently, members of the emergency community volunteer to aid in the transport of nursing staff to the hospital—typically transport is volunteered by the members of Harrison County’s volunteer fire department and the Harrison County Sheriff. As I understand it, the hospital encourages employees to find a location in town to spend the night, or find alternate transportation methods; no other efforts or accommodations are made by the hospital for their staff.

Finally, the most common potential for disaster lies in damages associated with thunderstorm activity. Any thunderstorm may potentially bring damaging winds or tornadic activity, which would again cause issues with transportation and utilities. Similar to the other previously mentioned events, all emergency services plan accordingly.

I realize that I have failed to discuss the challenges associated with a mass casualty event during these potential disasters; I’ve done so, in part, due to the ignorance of the local medical community. To the best of my knowledge, the local hospital has never truly planned for any potential for a disaster beyond the concerns of whether there will be enough staff on hand, “just-in-case”. In my experience of observing a number of disaster exercises—all dealing with other extraordinary hazards outside the norms mentioned—the hospital has never exercised anything other than processing the list of staff and calling off-duty personnel to see if they would be able to give an ETA for response. Not once have I seen or heard of an instance where the hospital has truly tested their abilities beyond their routine operations.

In reality, even the more mundane of events—such as the norms I have listed—have the potential of creating a mass-casualty event. Every disaster mentioned has an effect on transportation to some degree; every transportation issue has the potential of creating any number of traffic accidents. During any one of these events, the potential exists for a traffic accident to involve any number of victims with a variety of injuries and the potential involvement of any chemical; one fully occupied mini-van could potentially inundate our hospital’s emergency room. Unfortunately, it seems that our medical community—save those that respond on-scene—is ignorant of these possibilities, and takes for granted the time for transport locally and involvement of flight-crews from regional hospitals; time associated with ambulance response and transport allows for calling additional staff, while patients being air-lifted are the responsibility of another hospital.

Not meaning to sound grim, or wanting to wish ill upon others, but I would thoroughly enjoy seeing a true mass-casualty event befall our community, just so that the local hospital could see how idiotic and dangerous their smugness truly is.

…cross-posted auto-magically via Being Jeremiah Palmer https://kg4vma.duckdns.org/2012/11/07/pbhe413-week-6-forum-natural-disasters/ using IFTTT.com