Hospitals For Disaster

[Music] what is this one though doctor this one's in shock nurse let's get him to Ward right away blood pressure is low okay let's get him tagged into the ward all right let's get over to the next one where are we going to put them all over here take award B possible concussion factur tibia okay let's get him tagged into W SE let's [Music] move [Music] the hospital woran is a special one it was built in the day impossible not at all actually it was assembled in less than 12 hours and here's a fact that's equally possible your community hospital can be destroyed in a day even in one blinding flash have you ever stopped to think where you'd be without a hospital what would happen if some wiped out your hospital [Music] if this nation is successfully attacked with Thermon nuclear weapons it is possible that up to 70% of all hospital beds could be destroyed or their use temporarily denied due to damage or radioactive [Music] fallout and ironically this loss would come at a time when we would actually need more hospitals because of the mounting number of sick and injured people or if your community is hit by a calamitous natural disaster such as a flood or tornado again nearby hospitals may be destroyed certainly overloaded no hospital frightening thought isn't it to meet this threat the department of health education and Welfare Public Health Service administers a program to assure adequate hospital care after a disaster the packaged disaster Hospital a vital part of the nation's coordinated civil defense effort the package disaster hospitals or pdhs as they're often called are flexible they can be used to expand the capabilities of an existing hospital or or they can be set up rapidly in buildings such as community centers or schools classrooms become Wards separate Ward areas would be set up at the direction of the chief of staff according to the numbers and types of patients received other classrooms could become operating rooms the pdh is an AER but functional 200 bed medical and surgical hospital it contains a 30-day stock of medical supplies and equipment for emergency care sufficient to handle up to 1,000 patients without resupply here a gymnasium becomes the reception area where patients are sorted according to the doctor's diagnosis and sent to the proper Ward or other appropriate section of the hospital medical and administrative records are started here to assist the smooth efficient operation of the hospital still other areas of the school would be converted into a pharmacy a room with running water becomes a Clinical Laboratory capable of conducting basic diagnostic testing an effective x-ray department using radiographic paper that is processed in just 60 Seconds seconds or a fluoroscopic screen then there's a Central Supply area to store and dispense supplies and equipment in small quantities as needed by other sections of the hospital with a sterilization capability for items such as surgical instruments dressings and gowns in addition supplies include gasoline generators to take over if local electric services interrupted and a 1500g water tank cover and pumping unit to hold and dispense an emergency water supply a pdh is stored whenever possible in or near the building to be used as the Hospital operating site where it is becoming difficult for States and communities to obtain suitable space in existing buildings many communities are are building reasonably priced structures specifically for disaster Hospital storage supplies and equipment require about 7,000 grow cubic feet of space weighing almost 50,000 lb the material is stored in 660 CR rates to facilitate Transportation handling and long-term storage since some supplies are sensitive to temperature extremes both Heating and refrigerating facilities are necessary as well as protection for flammable materials regular quality control inspections ensure the up-to-date usability of sensitive supplies such as antibiotics x-ray film even flashh flight batteries the humidity indicator packed with the generators is periodically checked along with other equipment to ensure operational Readiness packaged disaster hospitals would be most needed in major population centers and in high density industrial areas but such places are as likely for attack as military installations and the pdhs stored too close to these probable attack areas would be lost along with all existing hospitals on the other hand positioning disaster hospitals too far from population centers would ensure their safety yes but would reduce their value to the community so federal state agreements on individual ual locations are worked out according to Federal location criteria taking any special circumstances and state emergency Readiness plans into consideration in an allout thermal nuclear attack on this country up to 1 million hospital beds could be destroyed or otherwise rendered useless how to replace these beds the obvious answer is packaged disaster hospitals staffed with available surviving medical personnel it is estimated that they could provide care for 10 million patients for the first month after the attack at the present time about 3,000 pdhs have already been pre-positioned in various communities or stored in Public Health Service emergency medical stock piles reassuring isn't it even in the face of a major disaster Hospital facilities will still be available but remember this the federal government stocks the pdh with only medical supplies and equipment and some simple tools and housekeeping materials it's up to the local community and hospitals to provide the rest a staff certain non-medical supplies Supportive Services and the vital pre-planning carefully select a one or twostory building with a minimum of 15,000 square ft of floor space prepare a floor plan to adapt the building for use as a package disaster Hospital prepare a detailed written plan describing how the hospital is to be set set up and operated when the hospital is not stored at the operating site Arrangements must be made to get it there what more ambulances and other vehicles will be needed to transport patients and to serve as utility vehicles for the hospital extra supplies that will be needed include gasoline for equipment such as generators and sterilizer burners motor oil for the generators bottled gas and electrical supplies such as extension cords and connections and then there are Narcotics vital to a hospital operation these drugs are not stored with the hospital but should be obtained from drug stores Physicians offices drug supply houses or veterinary hospitals in conformance with the procedure approved by the Bureau of narcotics but here again plans must be made to get them to the pdh after a disaster laundry services will be needed Linens operating room gowns and patient gowns will be in short supply patients will be moving through in hundreds another basic need is a food preparation capability a way to serve patients and the food itself providing all these Services requires careful planning and then people Personnel to use the equipment operate the disaster Hospital doctors nurses nurses AIDS Hospital administrators pharmacists laboratory technicians x-ray technicians the same type of medical personnel necessary for any Hospital the local community hospital is the best source for these people equally important are the supporting Personnel the people to keep the hospital functional electricians who know how to effectively use the emergency generator Carpenters plumbers people prepared to rig emergency heating an alternate water supply someone who understands methods of waste disposal should the sanitation facilities be disrupted and helpers people the local hospital staff and residents of the community it's up to them to plan and operate the hospital orientation and training are a must for all the people who have been given disaster Hospital assignments therefore special pdh units are available which permit medical personnel to familiarize themselves with equipment and the various components of the hospital pdh supporting Personnel also practice actually setting up the various functional units and operate the mechanical and electrical [Music] equipment for training specialized groups where handling of instruments and supplies is required special training materials are made available these supplies may be used in classroom situations for professionals such as nurses and technicians or for non-professionals such as AIDS and orderlies comprehensive training that's the way to be ready you may never experience a natural disaster or a man-made one but if you do a package disaster Hospital Hospital may become the most important thing in your life it may mean your life as soon as possible after the attack the hospital is loaded at the storage site for transport to the operational location this may be immediately after the attack or depending upon radiation levels a few days or even a couple of weeks later it is also possible that the hospital may be taken to a more distant location where the need is greater flexibility it's a must for this type of operation when the area is safe to move about in the hospital starts [Music] [Applause] rolling this is where training begins to pay off a quick efficient setup of the disaster Hospital the seriously sick and injured will start moving in at any time now and the hospital must be ready [Music] crates are placed in the area where the contents will be used and Personnel are careful to prevent damage to contents during opening Hospital activation it's all according to [Music] plan hello CD control center this is mnam disaster Hospital we're ready to receive patience over magnam pdh this is civil defense center Roger we'll begin routing patience to you right away first good Communications it's a necessity in any emergency [Music] situation as soon as radiation levels permit rescue workers go into damaged areas casualties who have not received self-help are given first aid and the seriously injured and Ill removed to the [Music] pdh [Music] let's see if we can expose more of this care with this one fractured vertebrae take her up to x-ray what's the BP that one's full put her into SE let's see probable concussion here get his BP and I'll be back in a minute ml I'm taking blood pressure it's all right it's all right it's all right nurse send under here [Music] please Marine lson lson are you from Brockton what's the reading 76 over 30 stretchers get him up to w b the admitting area a place where patients are sorted according to the urgency and type of injury or sickness it's the nerve center of the hospital and provides an even flow of casualties into the proper treatment area not only must the doctor be highly competent but he must be capable of quick sound decisions demonstrate mature judgment okay I think we better get you down to x-ray nurse will you redress this please over here take her down to x-ray Mr Roberts you have some rather extensive Burns there looks like you'll be with us for a while we'll get you back in Action again though don't you worry about that hey Dave stretcher all right let's get this man down to Ward B each casualty receives the best available treatment and care but always remember that the Paramount consideration is the greatest good for the greatest number in the shortest possible time within the means available it's a tough job and the effective operation of the hospital depends on effective sorting of patients [Music] X-ray equipment is especially suited for emergency conditions it can be operated either on the community Electric Supply or on power provided by the emergency [Music] generator [Music] the unit is designed primarily for examination of fractures and dislocations and for detection of foreign objects Wards are austere they don't have all the Comfort you'd find in a modern up-to-date hospital but they are functional reusable supplies such as syringes and needles are purposely selected for for disaster Hospital use a 30-day supply of disposable items would require far too much storage room and might be used up before replacement supplies became available she's doing surgery at 3 can we get the lab report right away the laboratory contains the equipment and supplies for normal basic clinical tests like every other department in the hospital it operates Around the Clock as long as the need continues and then there's the pharmacy with at least one medication for each essential therapeutic category and as with the other sections there's a 30-day Supply by the end of this period more supplies will become available from strategically placed protected federal stockpiles or possibly from commercial [Music] sources a well organized efficient Central Supply area is vital to the smooth operation of the hospital a place where supplies such as utensils basins package dressings towels and special sterile packs are drawn by other sections of the hospital with the large quantities of reusable supplies and equipment the Central Supply area sterilization facility gets very heavy usage an adequate supply of surgical materials must always be ready plus syringes needles catheters and all the other hospital equipment that must be sterile [Music] just a couple more [Music] chips and finally the operating room not exactly the most elaborate o in the city that comption to bring but it has all the equipment necessary Neary to do the job here again the equipment is designed for emergency conditions and to be reused time and [Music] again the pdh may have to stay in business for many months even a year or more while Community Hospitals are repaired or entirely rebuilt as the disaster victim are cared for and discharged the hospital settles down to a normal routine attention shift to more usual admissions accidental injuries heart attacks tonsilitis everyday [Music] illnesses what is it 1046 better get him upstairs for a blood count I'm pretty sure it's aute appendicitis if the uh blood count confirms the diagnosis do we have your permission to operate yes of course fine and would you mind stepping over here and giving the boys medical history for us would you take care of please oh how many dentaries today uh let's see two five only eight good looks like we may be over the hump at last huh he's a lucky boy it hasn't ruptured we can get it out without any drainage what would your community do if its Hospital were suddenly gone is there a pdh stored nearby if so is it receiving full community support your State Health Department can tell you where pdhs are stored in your state or whether your Community meets the location criteria for having its own disaster Hospital citizen action and interest before disaster strikes is vital to assure adequate hospital care after and earthquake tornado flood or thermonuclear attack if a packaged disaster hospital is to be ready when the need is greatest the time to prepare is [Music] now [Music]