As the United States approaches the ten-year anniversary of the September 11 terrorist attacks this fall, much has changed in the way hospital systems have adapted and prepared for terrorist attacks or other mass casualty incidents.
During the response to the 9/11 attacks, trauma centers and hospitals were a vital part of the response, as administrators learned just how important it was to have communication centers and sites for families to gather, as well as a place to treat the first victims.
“Since the 2001 terrorist attacks on the United States, federal and state funding, primarily from the National Bioterrorism Hospital Preparedness Program, has resulted in a surge of hospital activity to prepare for future natural or human-caused catastrophes,” said Donald D. Trunkey in “U.S. Trauma Center Preparation for a Terrorist Attack in the Community,” published in the European Journal of Trauma and Emergency Surgery in 2009.
Paul Rosenzweig, former deputy assistant secretary for the Department of Homeland Security, agrees hospitals have adapted since 9/11.
“I think they now have better training for mass casualty events,” said Rosenzweig, a Carnegie Visiting Fellow at the Medill School of Journalism at Northwestern University. “There’s much better coordination between hospitals and police, fire, first responders. A better situational awareness of what else is going on around the country.”
Rush University Medical Center began training a decade ago for mass casualty disasters and has now incorporated the new training into its standardized staff training. The Rush medical staff has begun training on everything from hazmat suits to radiation safety.
When Rush opens the McCormick Foundation Center for Advanced Emergency Response in 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, according to Dr. Dino Rumoro, specialist in emergency medicine with clinical expertise in bioterrorism preparedness at Rush.
Many area hospitals have also received grants to better prepare for a major emergency or bioterrorism attack over the years. In 2005, Illinois received $13.5 million in emergency preparedness grants for Illinois hospitals and health organizations.
Advocate Illinois Masonic Medical Center in Chicago received $460,000, Children’s Memorial Hospital in Chicago received $27,000, Evanston Hospital received $54,000, Northwestern Memorial Hospital received $62,050, Rush North Shore Medical Center in Skokie received $54,000 and University of Chicago Hospitals in Chicago received $62,050.
Rosenzweig believes the biggest problem Chicago hospitals still face is capacity if there was to be a mass casualty incident or a terrorist attack.
“Our system is not designed for mass casualties,” Rosenzweig said. “When we’re overwhelmed, we ship people out. In terms of capacity, the real question is how we are doing in terms of [capacity in] places like DuPage County, Milwaukee. The answer is pretty good. It would take a pretty large disaster to overwhelm us. If we had a bio threat that overwhelmed them at the same time, then we could be in trouble.”
Hospitals are better prepared for outbreaks such as Avian flu, Rosenzweig said, as that is a far more likely threat than things such as a nuclear attack.
“To be prepared for a radiation attack, you need a whole lot of iodine, and you need to stockpile that,” Rosenzweig said. “We probably don’t have as much of that as we should have, but the threat is also not as high.”
Local hospitals continue to train and prepare for disasters through the years, however.
The University of Chicago Medical Center plays a role in the emergency health care system by serving as the “medical control” for the Chicago South EMS system, according to its website. It also acts as a Level 1 trauma center for injured children works to lead in the Chicago hospital system for mass casualty disaster and terrorism preparedness, according to its website. Designation as a Level 1 trauma center means it is responsible for coordinating and managing trauma care in the EMS Region.
Children’s Memorial Hospital is the leading hospital for training pediatric nurses in Chicago. Elisabeth Weber trains health care providers in emergency preparedness at Children’s, according to an article in Case Western Reserve University’s The Frances Payne Bolton School of Nursing alumni magazine in Fall 2007.
“So, for example, last year we used pediatric simulators and the strategic national stockpile ventilators to conduct scenarios based on biological and radiological events,” Weber said in the article.
She later added in the article, “Five years ago there was very little in the way of pediatric emergency planning. But 26 percent of our population are children, and 30 percent of ER visits in this country are pediatric visits.”
In addition, Advocate Illinois Masonic Medical Center has been designated as a level 1 trauma center, according to the hospital system website. The Advocate Health care system is recognized as the largest provider of trauma care in the state of Illinois, according to its site.
The system says on its website its vision is “to be a leader in the metropolitan Chicago area and the state of Illinois in the delivery of state-of-the-art trauma care and associated injury prevention, education and research program.”
In 2010 it held the 7th Annual Advocate Injury Institute Symposium, titled “Trauma 2010: Don’t Gamble With Your Life!”
Despite hospital efforts to train and prepare for disasters in the years since 9/11, there are still areas in which hospitals could improve.
“They could have better control of biological agents so that they’re not the source of leaking bad things that could be used for an attack,” Rosenzweig said. “A greater sensitivity to early identification of outbreaks—they tend to not be as sensitive as they might be to the idea. They tend to think it’s horses not zebras if they hear hooves. They begin by assuming it’s flu and don’t think it’s anthrax until later in the game.”
