Chemical exposure preparedness for emergency departments in a Midwestern city.

Objective: To determine if each hospital in a large Midwestern city has the resources to treat 50 patients exposed to terrorist chemical agents and/or industrial chemicals. Design: Surveys specific to each department were sent to emergency department (ED) nursing supervisors, safety officers, and pharmacy directors of each hospital. Setting: The survey was performed in a large Midwestern city (metropolitan population of 1,500,000). Participants: Nine hospitals. Main Outcome Measures: The survey measured the presence of written materials, amount of equipment, quantities of pharmaceuticals, and number of staff available in each hospital. Hospital staff also rated the preparedness of their hospital. Results: Twelve of the 27 respondents returned the survey for a response rate of 44 percent. None of the EDs had a known cooperative written plan with the police or fire departments. Three safety officers reported limited numbers of hospital security personnel and a total of 35 ventilators for respiratory failure. The four pharmacy directors reported limited sum doses of atropine (315), cyanide antidote (10 complete kits), and succimer (100). Respondents who felt qualified to evaluate the ED gave a mean score of 5.4 on a scale of 1-10 when asked how prepared they felt their ED was to treat 50 chemical exposure patients. Conclusions: Despite hospital staff rating chemical exposure preparedness as 5.4, it is unlikely that each hospital could handle 50 patients exposed to some chemicals due to lack of prearranged coordination, security, antidotes, and ventilators.