Lessons from Recent Disasters and the Development of Disaster Medical Assistance Teams in Taiwan

Disaster is anything that can occur causing damages, an ecological disruption and deterioration of health and the health services. Disaster can be manmade or natural disasters such as floods. When disasters like flooding or tornadoes that may be accompanied by floods occur, the public health personnel and public health nurses are normally the first people who respond to the emergency, given that they are the people who understand and know the available resources used in providing first aids to the affected victims.

Memorial Hospital did not have suffice evacuation guidelines for a disaster, let alone one of this magnitude. The hospital staff developed their own triage system to evacuate patients, and as a result the LifeCare and other critically ill patients were neglected. Memorial Hospital had a vast variety of departments at the hospital including: neonatal intensive care, dialysis, oncology,

In day to day operations, uncertainties do occur. Henceforth it would be important to have a contingent and well detailed disaster preparedness plan and procedures. Healthcare systems, on a day to day basis, are faced with emergencies in form of disasters. As a result, majority of medical centers have well-structured exit plans in the event of a disaster occurring("Hospital Disaster Preparedness: Your Guide to Getting Started - Emergency Preparedness", 2011). However, this essay will aim at interviewing one of the top disaster preparedness staffat the Houston Methodist Hospital. In the interview, I will seek to identify the top three disasters that the Houston Methodist Hospital is prepared for. Similarly, in the interview, I would seek to identify the top lessons learnt from disaster preparedness at the hospitals.As it concludes it would summarize the findings with regards to the interview stated below. Below is an excerpt from the interview to answer the two aforementioned questions.

Effective disaster management is highly important when it comes to assisting in rescue and relief to affected. This does not only include post disaster rescue efforts but these disaster management activities should be proactive. They start right from taking preventive measures before the disaster actually occurs and goes on till the effected people are resettled back in their lives. This disaster management pertaining to human life is not only associated with physical well being but also focuses on psychological, emotional, and spiritual rehabilitation.

Natural and man-made disasters have increased in the past decade, and due to these changes, Emergency Managers had to make drastic changes in order to improve the way first responders operate in a disaster area.

Medical, trauma, and emergency knowledge was needed in assessing victims of the attacks, in deciding who needed or did not need medical care and in which order was most beneficial to the time and for the greatest use of supplies available. The days, weeks, months, and years required to recover from these incidents not just in the hot zone, but medically and mentally have set forth implementation of how we focus our efforts before, during, and after hazards strike. The affects of September eleventh, have taught us as first responders and government officials valuable information on disaster response and recovery efforts.

Using proper sanitation techniques and having sanitizer stations throughout the facility can help in the management of disease control within a LTCF. Maintaining the facility and making sure it is up to date on county facility codes and regulations. Having a safe and sound facility structure can ensure safety and reduce potential risk of structure damage. The facility should also keep all medical equipment up to date on maintenance. The facility may also choose to have a backup power system to prevent power failure during a disaster. Facilities will need to have staff members trained in emergency response, possibly use intercom for emergency color code system like hospital use to increase response time. With LTCF’s being populated with the more vulnerable and fail group of patients it is essential to the staff and facility to take extra preventative steps to decrease the risks towards these patients associated with any disaster that may arise.

The currently evolving H1N1 influenza and Severe Acute Respiratory Syndrome (SARS) emphasize the concerning threat of naturally occurring contagion. The recent experience from hurricanes and extreme weather along with the attacks of September 11th 2001 have confirmed that the United States faces a true threat of mass casualty incidents. These threats have brought to light that U.S. Healthcare organizations must be prepared, resourced and organized to respond to hazard impacts. Hospital administration must ensure that their facilities are prepared to handle hazard impacts, an examination of healthcare system response has shown that when there is a disaster the initial response to any medical need will always be based upon locally available health organizations and that effective healthcare response during a disaster is complex (Emergency Management Principles and Practices for Healthcare Systems, Second Edition, 2010).

“In recent years with an increased emphasis on non-routine incidents such as hazardous materials, and now terrorist events, other methods have been developed to address new aspects related to non-routine situations” (FEMA, 1999). Command structure will encourage the delegation of workload to more manageable levels. Panic and chaos are not conducive to emergency responder productivity in a disaster. Managed response is a “force multiplier”, meaning that responders can accomplish their mission with less personnel or fewer resources if they work within a well- developed and planned system of

During a declared disaster, the State Medical Assistance Teams (SMAT) are coordinated by the SMRS. They are requested and activated as an ESF-8 resource. These teams may be requested by other states across the nation to respond to major events through a mutual aid system between states (Mississippi State Medical Assistance Team, 2008). The SMAT concept was again modeled after the North Carolina SMRS SMAT, allowing for enhanced interoperability between the two states. One SMAT is up to a fifty-bed mobile field hospital designed to support impacted healthcare systems in a disaster. Mississippi has three SMAT units that may be deployed separately or combined. These teams provide the state of Mississippi an effective, all-hazards solution to support various missions. These mission profiles include disaster field medical care, alternate care site, weapons of mass destruction response, hazardous material response, contingency management, pharmaceutical point of distribution, and/or event medical support (Mississippi MED-1, 2009). The SMAT staff are both non-clinical and clinical providers from around Mississippi that undergo advanced disaster training and orientation to the mobile field hospital setting. Each of the SMAT mobile field hospitals provides a full array of clinical services that include cardiac telemetry, digital x-ray, ultrasound, ventilators, and intravenous pumps. Combining the efforts of the advanced trained staff with the

The capacity of any health care organization to endure a particular hazard and to respond and recover rapidly from any compromised medical services is crucial. Giving attention to this area will ensure that stable platforms are in place to counter any emerging medical surge needs.

A study was carried out to assess the required knowledge, skills and competencies to deal medical emergency incidents successfully. Study finding showed that there is superficial knowledge on medical emergencies, drug and equipments among health professionals working emergency unit (McGaghie.et al, 2010).

Gebbie, K., & Qureshi, K. (2002). Emergency and Disaster Preparedness: Core Competencies for Nurses: What every nurse should but may not know. American Journal of Nursing, 102(1), 46-51. Retrieved from

The EMS Department showed great enthusiasm and desire to develop a rescue task force, in addition to working and training with the various other emergency services departments. Sustainable medical training for EMS and other first responders was analyzed, selected, scheduled, and carried out. Requirements for RTF and support positions were developed and approved as part of the project development.

In a disaster where healthcare facilities are face with a large number casualties, mass casualty triage is use to allocate the facilities resources to do the greatest good for the most people. Mass casualty is a four colored coded tag system, starting with red tags; immediate, these are life or limb threatening, but are survivable. Followed by yellow tags; delayed, which are injuries that are significant and require medical treatment; however, they are non-life or limb threatening and can wait for hours. Next are green tags; minimal injuries that are minor and can wait for hours or days be for receiving treatment. Lastly is the black tags; expectant, which are injuries that are extensive and chances for survival is unlikely (Hinkle & Cheever,