by Kenneth Capek, MPA, RRT
The problem with disasters is that we can’t predict and sometimes not even imagine their detrimental impact on facility operations and patient care. I knew I wasn’t ready after reading Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital written by Sheri Fink. The writer describes in detail the tragedy that took place during Hurricane Katrina in New Orleans and how the lack of preparation cost many people their lives.
Hospital staff worked heroically in horrendous conditions caring for patients who were suffering and dying daily. Some patients were even euthanized by staff to end their suffering which later resulted in many legal and ethical hearings. I could not really imagine working days in a highly humid environment of over 100 degree heat, with and no running water or electricity. More recently, during Hurricane Sandy a couple New York hospitals were facing similar problems with the lack of emergency electrical power. Apparently people thought generators in basements weren’t a bad idea; until the flood came. In situations like this, it may come down to someone making a decision about who gets the last ventilator.
So imagine if you lost main and emergency back-up power at your hospital. How would you respond? No lights, no wall vacuum (with a limited number of battery-powered suction machines), no oxygen concentrators, and ventilators with a limited battery life. In the past I discussed emergencies with staff concerning running low on bulk oxygen but what about losing all electrical power for an extended period of time. I work in a long-term care facility with a dozen ventilators with extra external batteries. When asked, most staff thought we had 8 hours of back-up battery power. In actuality our ventilators have an internal battery life of about one hour and our specific external battery life is only 4 hours. So we only have a total of 5 hours, assuming these batteries were fully charged. After that we would be manually bagging all patients until power returned or transport arrived. Either of these remedies could take hours to days depending upon the problem. My house was without power for over a week during Superstorm Sandy. I can remember a few years back there was a widespread Flu outbreak and I was calling rental companies across the country to find out their availability to supply ventilators. We were down to our last ventilator at that point and local rental companies had none available. Nearby hospitals couldn’t help since they were in the same situation. Would you give away your last ventilator?
Today most of us have a disaster storage area or room in the hospital with emergency supplies. We have N-95 masks, oxygen cylinders and regulators (unfortunately not attached –where is that wrench?). I maintain 20 portable ventilators which run on 2 “D”; size batteries with circuits and other related supplies in my disaster room. It’s wise to in-service staff on their use before a disaster strikes and replace fresh batteries regularly.
So what emergency supplies do you have at your facility? What’s the forecast this winter? (Actually quite good, climate change)