When Rush University Medical Center opens its new emergency department next January, it will be the first Chicago-area hospital to be prepared for an outbreak of an infectious disease, a bioterrorism attack and even a chemical or nuclear attack.
The McCormick Foundation Center for Advanced Emergency Response, part of the Medical Center’s new hospital building, aims to do what hospitals all over the country have been trying to do for years: give patients a place to go in a large-scale emergency.
“The concept is not that novel, but putting it all together is novel,” said Dr. Dino Rumoro, specialist in emergency medicine with clinical expertise in bioterrorism preparedness at Rush. “I would like to see this take off. I envision that these centers will be scattered throughout every state. Illinois should have one in Rockford, Springfield, Peoria.”
With the center constructed into three different pods, all capable of isolation, preventing the spread of disease or radioactive material is crucial. Patient rooms within the pods can also be isolated, and air flow controlled, according to Rumoro. The hospital also has the ability to deal with large numbers of burn patients at once.
While traditional emergency rooms have decontamination areas and showers to serve about one to six patients, Rush’s emergency response will be able to serve and decontaminate several hundred patients at once, according to Rumoro. The center is being built with fire hydrants across the entrance of the ambulance bay. To avoid contamination in a bioterrorism attack, a water “curtain” can be created with the hydrants, washing off patients before they enter the facility. The curtain also serves as a crowd control mechanism in an emergency. Additional decontamination equipment is built into the walls of the ambulance bay, according to Rumoro.
“Since we’re a state disaster center and have an affiliation with the military, being able to do large-scale decontamination inside and outside the hospital is a big deal as well,” said Louis Hondros, director of emergency medical systems at Rush, in a hospital statement. “It’ll definitely make Rush a major player in emergency medical services and disaster centers.”
Located downtown, the $40-50 million response center received a $7.5 million grant from the McCormick Foundation, as well as grants from other agencies such as the Department of Energy and the Department of Defense, Rumoro said. The hospital also conducted a private capital campaign initiative from private donors. The center will also rely on operations for funding.
The idea behind the new emergency response center goes back to the terrorist attacks on 9/11, when doctors and emergency responders were forced to change the definition of a mass casualty, Rumoro said.
Mass casualties have traditionally been defined as traumas like gunshot wounds, vehicle accident injuries and stab wounds, according to Rumoro. After 9/11, the definition of a mass casualty has been expanded to such things as inhalation problems, burns, and a body being crushed. Rumoro said the anthrax attacks in 2001 also changed the way emergency medicine is now viewed here.
“There was a period of time where people came in because they were worried they were exposed,” Rumoro said. “Suddenly everyone saw white powder everywhere, and we had to handle that influx of people.”
After 9/11, emergency departments became frontline responders to large-scale incidents, and emergency room locations become overwhelmed almost immediately by patients, Rumoro said. The idea of an emergency room designed to handle large-scale incidents, leaving other emergency rooms to handle traditional blunt traumas like gunshots, was created.
The new center will measure 40,000 square feet on the ground floor of the new hospital building. According to the Rumoro, last fiscal year the emergency department received about 49,500 patient visits. Rumoro expects emergency room visits to reach 65,000 annually by January 2015.
On a daily basis the new facility will stand as a traditional emergency room. The new center will have 70 treatment beds, Rumoro said. Larger patient rooms have also been designed to give caregivers more room, as well as the capacity to divide the room into two rooms to accommodate an increase in patients in a disaster without compromising supplies or equipment.
The facility can transform to serve another 30 patients, with the center’s lobby converting into a treatment area complete with oxygen lines built into the lobby’s support columns. Rumoro estimates the facility could manage 200 patients at a time in an emergency.
The hospital took additional precautions to ensure it can stand during an emergency. As one example, the loading dock for the hospital is not located near the emergency room, helping to stop truck bombs from exploding near the emergency room.
In addition to creating a new facility, hospital staff members are planning to anticipate and respond to health problems before they become emergencies or epidemics. According to a hospital statement, the emergency center will utilize a computer program that analyzes patient data continuously from other area hospitals to identify potential health threats and to notify health officials.
