American Journal of Public Health, Vol 91, Issue 5 710-716, Copyright © 2001 by American Public Health Association
Hospital preparedness for victims of chemical or biological terrorism
DC Wetter, WE Daniell and CD Treser
OBJECTIVES: This study examined hospital preparedness for incidents
involving chemical or biological weapons. METHODS: By using a questionnaire
survey of 224 hospital emergency departments in 4 northwestern states, we
examined administrative plans, training, physical resources, and
representative medication inventories. RESULTS: Responses were received
from 186 emergency departments (83%). Fewer than 20% of respondent
hospitals had plans for biological or chemical weapons incidents. About
half (45%) had an indoor or outdoor decontamination unit with isolated
ventilation, shower, and water containment systems, but only 12% had 1 or
more self-contained breathing apparatuses or supplied air-line respirators.
Only 6% had the minimum recommended physical resources for a hypothetical
sarin incident. Of the hospitals providing quantitative answers about
medication inventories, 64% reported sufficient ciprofloxacin or
doxycycline for 50 hypothetical anthrax victims, and only 29% reported
sufficient atropine for 50 hypothetical sarin victims (none had enough
pralidoxime). CONCLUSIONS: Hospital emergency departments generally are not
prepared in an organized fashion to treat victims of chemical or biological
terrorism. The planned federal efforts to improve domestic preparedness
will require substantial additional resources at the local level to be
truly effective.