Introduction
In this thread, we will be discussing the four points of emergency management health preparedness which includes, (a) triage and pre-hospital treatment, (b) medical surge, (c) medical supplies and distribution, and lastly, (d) mass prophylaxis. Next we will discuss personal views on how the United States might increase preparedness if it were to ever face a second 1918 Great Pandemic situation. In conclusion, changes that may remain a issue will be explored.
Discussion
Since the horrendous events of 9/11, the medical preparedness efforts have developed methods to provide care in a high risk, chaotic environment. Planning for such events were accelerated when President Bill Clinton published the 1995 U.S. Policy on Counterterrorism during his time in office. This caused The Department of Health and Human Service to established what are known today as the Medical Response System (MRS). (Barbisch, Koenig, 2006) There are four points to the MRS, (a) triage and pre-hospital treatment, (b) medical surge, (c) medical supplies and distribution and lastly, (d) mass prophylaxis.
Triage
Triage and pre-hospital treatment is initially set up on site, for example, during the Boston Marathon Bombing of 2013, two homemade pressure-cooker bombs, denoted at 2:49 p.m. April 15, 2013. Of the 23,000 participants in addition to the spectators, approximately 264 people were injured, 16 individuals lost their limbs, and 3 lost their lives. (History.com Staff, 2014) As media outlets began to capture the brutal moments, all the world could see was uttered chaos, however once dispatched to the incident, medical response teams began setting up triage to treat those injured. To effectively treat individuals, the injured are assessed in less than one minute and tagged to fall under four categories. (1) Red, indicating the injured is in need of immediate care with life threatening injuries. (2) Yellow, indicating the injured is in need of urgent care that can be delayed for up to an hour. (3) Green, indicating the injured is in need of delayed care that can be delayed for up to three hours. Lastly, (4) Black, which indicated that the individual is deceased and no further care is needed. This allows individuals to be prioritized and accounted for during an extremely chaotic time, as-well-as well set priority once the individuals are transported to a hospital. (Gilboy, et. Al, 2011)
Medical Surge and Medical Supplies
Medical surge falls under the concept of prepared planning in efforts to accept a high volume of patients during major medical incidents. Medical surge can be described as, “the ability to provide adequate medical evaluation and care during events that exceed the limits of the normal medical infrastructure of an affected community.” (U.S. Department of Health & Human Services, 2012) Referring to the Boston Bombing, due to the number of injured individuals, hospitals began to implement their medical surge strategies. (FEMA, 2014) Under this category, hospitals must ensure that their medical supplies and distribution methods are up to par in preparation for future major incidents.
The 1918 Great Pandemic also known as “Spanish Flue” or “La Grippe” was a influenza pandemic that lasted approximately a year, 1918-1919. The death toll was approximately between 20 to 40 million people worldwide by the end of the year, classifying it as “the most devastating epidemic in recorded world history.” (Billings, 2005, para. 1) The pandemic was also responsible for killing more people in a year than the Black Death Bubonic Plague did from 1347 to 1351. (Billings, 2005)
Mass Prophylaxis
Mass prophylaxis can be defined as, “the capability to protect the health of the population through the administration of critical interventions […] in order to prevent the development of disease among those who are exposed or are potentially exposed to public health threats.” (Ohio Emergency Management Agency, 2008) An example of mass prophylaxis is the seasonal flu (influenza) shots. During the annual flu seasons, media outlets are continuously emphasizing the need to get the flu vaccination. While vaccinations many times has a low percentage of working due to the various influenza strains; it is a form of intervention to protect the health of the population. During critical interventions, an example may include the quarantine of certain individuals possessing dangerous strains to prevent and epidemic or pandemic from occurring.
United States in Preparation and Challenges that Remain
The United States might be better prepared to address an event like the 1918 Great Pandemic by raising funding to equip hospitals and medical response teams with the proper resources and staff to execute their jobs thoroughly. In comparison the 1918 Great Pandemic, the United States has come a long way in vaccinations, however, vaccines today have a low percentage of fully functioning due to the various strains as mention in the previous paragraph. While the low percentage may be affective, if the United States where to face another pandemic, I believe it would not be better prepared to address such an event.
Conclusion
In overview, the United States has advanced in their efforts of emergency management. This thread explored the different points of emergency management health preparedness, personal views on how the United States might increase preparedness if it were to ever face a second 1918 Great Pandemic situation. Lastly challenges that remain in today’s society that would affect the United States if it were to face another pandemic. The emergency management efforts have advanced significantly over the century that I believe the battle against a future pandemic would be quite different that written in history.
References
Barbisch, D. F., & Koenig, K. L. (2006). Understanding Surge Capacity: Essential Elements. Academic Emergency Medicine, 13(11), 1098-1102. doi:10.1197/j.aem.2006.06.041
Billings, M. (2005, February). The Influenza Pandemic of 1918. Retrieved April 06, 2018, from https://virus.stanford.edu/uda/
Boston Marathon Bombings: Hospital Readiness and Response. (2013). Retrieved April 06, 2018, from https://www.hsdl.org/?view&did=744165
Gilboy, N., Tanabe, P., Travers, D., & Rosenau, A. M. (2013, February 01). Emergency Severity Index (ESI): A Triage Tool for Emergency Department. Retrieved April 07, 2018, from https://www.ahrq.gov/professionals/systems/hospital/esi/index.html
History.com Staff. (2014). Boston Marathon Bombing. Retrieved April 05, 2018, from https://www.history.com/topics/boston-marathon-bombings
Influenza. (n.d.). Retrieved April 05, 2018, from https://www.historyofvaccines.org/content/articles/influenza
What is Medical Surge? (n.d.). Retrieved April 05, 2018, from https://www.phe.gov/Preparedness/planning/mscc/handbook/chapter1/Pages/whatismedicalsurge.aspx#fn01_05_001