It’s Never Too Early to Prepare for an Emergency

Last month, I shared an up-close look at Puerto Rico and the challenges facing their health care system following two major hurricanes. Officials were working hard to put emergency protocols into place and restore regular delivery of care. As a follow-up this month, I’d like to focus on how every hospital can evaluate and prepare for disasters and emergencies.

Large-scale catastrophic events and infectious disease outbreaks require disaster planning at all community levels well in advance. An updated Committee Opinion, released last week, outlines the key components to preparation and communication for the successful management of obstetrical care during emergencies.

From the outset, preparing for disaster and emergency situations may feel overwhelming. Within the obstetrics unit alone, hospitals see many patients with health care needs that span a vast spectrum. In order to make planning more accessible and successful in application, collaboration across departments, hospitals and health care systems is vital.

A first step toward preparation is to form a standing committee, incorporating representatives from obstetrics, pediatrics and anesthesia, as well as any other departments deemed necessary. This committee can help the hospital to develop specific strategies for managing obstetrical issues that are likely to arise during an emergency, like stabilizing and transporting obstetric patients, managing surge capacity, limited resources, power outages, sheltering-in-place and incorporating regional facilities that do not provide maternity services.

While many hospitals may have already considered immediate concerns like those listed above, the Committee Opinion introduces two new recommendations to expand and improve preparation: adherence to ACOG and Society for Maternal-Fetal Medicine’s Levels of Maternal Care designations; and communication using a common terminology, like Obstetric Triage by Resource Allocation for Inpatient (OB-TRAIN). During an emergency, both systems enable quick categorization of patient needs and transport of obstetric patients to appropriate facilities, guaranteeing the right care at the right time for every woman.

As discussed last month, hospitals and health care systems must also consider how to reach women who are unable to access care facilities during or following a catastrophic event. When able, hospitals should consider using any existing telemedicine capabilities, including “distance prenatal care” or telephone triage, to reach patients remotely. Telemedicine can also facilitate consultation between smaller regional facilities and larger tertiary care facilities to share expertise, medical files and reach the maximum number of patients. Being flexible and creative with these resources is essential to making sure every woman receives the care she needs.

Of course, most importantly, hospitals must ensure that staff at every level are familiar with and understand when and how to implement disaster plans. Adequate review and training facilitates a safer and more efficient delivery of care during emergencies.

As years practicing obstetrics has taught me, even a hurricane won’t stop a baby from coming. It’s our job to be prepared, no matter the circumstances. ACOG colleagues in Texas, Florida and Puerto Rico know this all too well, and we commend them for their leadership, preparation and response at the local level during these most recent disasters. These efforts have no doubt saved the lives of many women and babies.

The full disaster preparedness guidelines are available here.

This entry was posted in Women's Health by Haywood L. Brown, MD. Bookmark the permalink.

About Haywood L. Brown, MD

Dr. Haywood L. Brown is Professor in the Department of Obstetrics and Gynecology at Duke University Medical Center in Durham, NC. He received his undergraduate degree from North Carolina Agricultural and Technical State University in Greensboro, NC and his Medical Degree from Wake Forest University School of Medicine in Winston-Salem, NC. He completed his residency training in Obstetrics and Gynecology at the University of Tennessee Center for Health Sciences in Knoxville, TN, followed by subspecialty fellowship training in Maternal and Fetal Medicine at Emory University School of Medicine/Grady Memorial Hospital in Atlanta, GA. Dr. Brown has participated in ACOG activities in District IV, V and VII over his 30-year career in Obstetrics and Gynecology. This includes being the Scientific Program Chair and General Chair (2001-2002) for the Annual Clinical Meeting. He chaired the steering committee for the District of Columbia National Institutes of Health Initiative on Infant Mortality Reduction, the Perinatal and Patient Safety Health Disparities Collaborative for HRSA and serves as the Chief Evaluator for Indianapolis Healthy Start. Dr. Brown is especially committed to the care of women at high risk for adverse pregnancy outcome, particularly those disadvantaged. Dr. Brown has served as Chair of CREOG and has been on the Board of Directors for the Society for Maternal Fetal Medicine and is past President of the Society. He is past President of the American Gynecological Obstetrical Society (AGOS) and Chair of the Ob-Gyn Section of the National Medical Association. He also served as a Director of the American Board of Obstetrics and Gynecology. Dr. Brown is past president of the North Carolina Obstetrical and Gynecological Society and is immediate Past District IV Chair of ACOG.

One thought on “It’s Never Too Early to Prepare for an Emergency

  1. Most physicians today are unable to imagine working with no electric power and no communication.This means no lights,heat or aircnditioning,no replacement of sterile supplies,no laundry,and perhaps contaminated water supply and a nonfunctioning sewage system.There is no computer network and no cell phones,and with no refigeration the blood bank and food supply is at risk. These are the condition that existed in Peuto Rico and in New Orleans after Katrina.Every emergency service is streached.Relience on outside reesources is vital,the military brings its own power,food , and lodging,plus ability to maintain public order: the looters are the first to arrive after a disaster.All of this is very sressful on a medical system trying ” to do every thing with nothing”. Do you remember how to set up a rotating water bottle system for suction?

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