Disaster PreparationPhysician Roles And Responsibilities In Disasters And EmergenciesJeffrey Goldhagen, M.D., MPH and Patricia Frank R.N.All physicians, hospitals and other health care providers and facilities will play critical roles in our community's response to natural and manmade disasters. As such, they are fully integrated into our County's disaster plans. Different types of disasters will require differing responses. It is important to understand the spectrum of physician roles and functions to ensure we work together efficiently and effectively as a community to minimize the loss of life and impact of a disaster. Patient IssuesPhysicians need to consider the health and medical needs of their patients as they relate to their preparations for emergencies.
Special Needs SheltersIn the event of an emergency that requires evacuation, people with special health and medical needs will require placement in Special Needs shelters. Nine thousand people are currently registered in a Special Needs database. In the event of a major disaster, approximately 1500 to 2000 people will need to be triaged with respect to their health care needs into 7 Special Needs shelters. In order to ensure all medical personnel and resources are available to open and staff Special Needs shelters, each hospital in the city has adopted a shelter. In conjunction with the Health Department and EOC, hospitals will include their Special Needs shelter in their institutional emergency plans and identify the medical, nursing and ancillary staff required to support their institution and the Special Needs shelter. Each hospital will implement their own procedure to notify these staff of their placement and responsibilities. Physician RolesIf physicians are not notified of the requirement for their participation in a hospital and/or other institutional emergency plan, it will be assumed they are available to support other aspects of the community's health and medical emergency response. Depending on the severity of the disaster, physicians may be required to staff first aid stations, answer phone calls, participate in triage activities, participate in a DMAT (Disaster Medical Assistance Team), etc. All physicians in Duval County have been requested to complete a postcard survey of their preferences for involvement in disaster and emergency response activities. Information as to the availability of nursing and other office staff is also requested in the survey. Based on these responses, physicians will be contacted to determine their availability and define their assignments. For those requesting to support shelter activities, their families will be invited to be with them at the shelter. As part of the Statewide plan, physicians may also be required to help support other communities throughout the State. Terrorist EventsBiomedical, chemical and radiation related terrorist events will require varied involvement of physicians. First and foremost, physicians need to be vigilant and report unusual patterns and/or frequency of symptoms and/or diseases encountered in their offices, emergency departments and inpatient facilities to the Health Department. These reports may be the first indication that a terrorist event has occurred. If an event has occurred, physicians will need to participate in a community wide response that will: a) protect them, their staff and families from contamination, b) prevent further contamination and spread of disease, c) respond to the medical needs of their patients, d) deal with the "worried well," e) answer patient and community questions, f) participate in mass casualty responses, and g) staff shelters, first aid stations and other community sites as noted above. It is important for us all to understand and accept that we have a joint responsibility to respond to emergencies and disasters. Toward this end, the Duval County Medical Society has taken a lead role in planning and ensuring the medical community is ready to respond. It is critical that all physicians complete the Society's postcard survey. In conjunction with the Health Department, an email listserve of physicians is being developed to ensure rapid communication with all physicians. For those with email, we encourage you to check your email frequently. For those not yet on email, we urge you to "log on" and tune in. Rapid and accurate communication will be key to all emergency responses. Thank you in advance for your participation. Consultation and support to help you, your staff and family prepare for disasters is available through the County EOC (630-2472 or their website) and Health Department. Please call the Health Department's Emergency Response and Preparedness Division (630-3254) with any questions. July, 2000/ Jacksonville MedicineWhat's New
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