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PPE, Decontamination, and Isolation Precautions for Bioterrorism Agents  

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PPE, Decontamination, and Isolation Precautions for Bioterrorism Agents  

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You are working in the emergency department (ED) of a community hospital. One evening, a radio call from EMS sends an alert that there is a possible multiple shooting at a restaurant a block away from the hospital. What are your priorities and first actions? What might be done to ensure safety of the ED staff and patients? How would you prepare for the arrival of patients who may have been injured from this event?

As a nurse, the priority intervention is safety. The safety of the patients in the hospital and the safety of the patients being admitted to the hospital. The victims of the shootings will be admitted through the emergency department therefore, a code should be called. Each hospital has their own code system but for example, a code "external triage" could be called and all the necessary personnel will be in the ED as soon as the patients arrive.

As stated earlier, safety is a priority. Units other than the ED should be placed on lock down, no visitors in, no visitors out. This is done because locations of high populations are at higher risk for shootings and attacks.

To ensure the safety of the ED staff, there should be more security present. The increased security presence can help to relieve some of the anxiety a high stress situation a shooting can cause. Local and state police can help with securing the hospital if available.

To prepare for the patients arriving, triage areas should be implemented. Individuals who are bleeding and experiencing respiratory distress are sent one direction to receive immediate help while other patients with less severe injuries are sent a different direction.

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Unfortunately in our society, terrorism, mass causalities, and disasters occur on a daily basis. To assure the safety of the patients and staff, all health care facilities are required to have and implement an Emergency Operation Plan.

Emergency Operation Plans (EOP) are a requirement of the Joint Commission after the terrorist attacks that occurred on September 11, 2001. The Emergency Operation Plans were implemented to help decrease the stress and anxiety, stressful situations can cause.

Plans are developed by the hospital safety and disaster management team which can consist of doctors, nurses, security, and administrated personal. The safety and disaster management team assess current treads nationwide and the community to create a unique EOP best suited for their community. Any location that involves a large amount of people is considered a high-risk area for potential shootings and terrorist attacks.

When developing the EOP, the hospital has to take into consideration their resources such as equipment, medications, and staffing. For example: How many ventilators does the hospital have? How will the staff triage patients in respiratory distress when there is a limited supply of ventilators? Will patients have to be transferred out to other facilities?

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Components of an Emergency Operation Plan 

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Components of an Emergency Operation Plan 

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Activation response: where, how, and when will the emergency response be initiated

Internal/external communication: communication during a disaster event is critical. How will individuals in the hospital be contacted along with those in the community be contacted?

Plan for coordinated patient care: the patients are the primary focus. In the event of an emergency, a response must be planned for organized patient care. Patients may have to be moved from one unit to another or may have to transferred from a hospital completely because of a disaster.

Security plans: security plans must be implemented to help control a chaotic situation.

Identification of external resources: resources outside the facility are identified, including local, state and federal resources.

Plan for people management and traffic flow: "people management" includes strategies to manage the patients, the public, the media, and personnel. Due to the chaotic situation, it is important to assign specific areas and assign a designated personnel to manage each of these groups.

Data management system: there must be a backup system in regards to documenting, tracking, and staffing employees in place to help save time and eliminate confusion

Demobilization response: deactivation of the response is as important as activation; resources should not be unnecessarily exhausted.

After- action report or corrective plan: facilities often see increased volumes of patients 3 months after an incident.

Plan for practice drills: the joint commission requires 2 practice drills to be completed each year.

Anticipated resources: food and water must be available for staff, families, and others who may be at the facility for an extended period of time.

MCI planning: Mass Casualty incidents (MCI) planning includes such issues as planning for mss fatalities and morgue readiness.

Education plan for all of the above: a strong education plan for all personal regarding each step of the plan.

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https://quizlet.com/_6dqypl

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Hinkle, J. L., Cheever, K. H.  (10/2017). Lippincott’s CoursePoint for Hinkle & Cheever: Brunner & Suddarth’s Textbook of Medical-Surgical Nursing, 14th Edition [VitalSource Bookshelf version].  Retrieved from vbk://9781496379054