Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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In a disaster or mass casualty incident, health care resources may be exceeded and systems may be challenged by unusual requirements. These resources may include pharmaceuticals, supplies, and equipment as well as certain types of academic and administrative expertise. New agencies and decision makers may need to work together in an unfamiliar environment. ⋯ S. military may serve to educate colleagues who may be required to respond or react to an event that taxes the current health care system. This report presents concrete examples of surge capacity strategies used by both Israel and the U. S. military and provides solutions that may be applied to other health care systems when faced with similar situations.
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This breakout session at the Academic Emergency Medicine 2006 Consensus Conference examined how baseline overcrowding impedes the ability of emergency departments to respond to sudden, unexpected surges in demand for patient care. Differences between daily and catastrophic surge were discussed, and the need to invoke a hospital-wide response to surge was explored.
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The dramatic escalation of bioterrorism and public health emergencies in the United States in recent years unfortunately has coincided with an equally dramatic decline in the institutions and services we rely on for emergency preparedness. Hospitals in nearly every metropolitan area in the country have closed; those that remain open have reduced the number of available beds. "Just in time" supplies and health professional shortages have further compromised the nation's overall surge capacity. ⋯ The Agency for Healthcare Research and Quality and other government and private agencies have been rapidly widening the field of knowledge in this area in recent months and years. This report focuses primarily on the work of the Agency for Healthcare Research and Quality.
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In February 2003, many physicians in New Jersey participated in a work slowdown to publicize large increases in malpractice premiums and generate support for legislative reform. It was anticipated that the community physician slowdown (hereafter referred to as "slowdown") would increase emergency department (ED) visits. The authors' goal was to help others prepare for anticipated increases in ED volumes by describing the preparatory staffing changes made and quantifying increases in ED volume. ⋯ Emergency department visits, especially pediatric visits, increased markedly during the community physician slowdown. Anticipatory increases in staffing effectively prevented increased throughput times.
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This article discusses Taiwan's experience in managing surge needs based on recent events, including the 1999 earthquake, severe acute respiratory syndrome in 2003, airliner crashes in 1998 and 2001, and yearly typhoons and floods. Management techniques are compared and contrasted with U. S. approaches. ⋯ Several recent initiatives aimed at mitigating biothreats have begun in Taiwan, but their efficacy has not yet been tested. These include the integration of the emergency medical services and health-facility medical systems with other response systems; the use of the hospital emergency incident command system; crisis risk-communications approaches; and the use of practical, hands-on training programs. Other countries may gain valuable insights for mitigating and managing biothreats by studying Taiwan's experiences in augmenting surge capacity.