Principles of emergency department facility design for optimal management of mass-casualty incidents.

IntroductionThe Emergency Department (ED) is the triage, stabilization and disposition unit of the hospital during a mass-casualty incident (MCI). With most EDs already functioning at or over capacity, efficient management of an MCI requires optimization of all ED components. While the operational a...

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Publicado en:Prehospital & Disaster Medicine Vol. 27; no. 2; pp. 204 - 213
Autores principales: Halpern, Pinchas, Goldberg, Scott A, Keng, Jimmy G, Koenig, Kristi L
Formato: pictorial research tables/charts Journal Article
Publicado: Cambridge University Press 2012 Apr
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Principles of emergency department facility design for optimal management of mass-casualty incidents.
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        au:
          Halpern, Pinchas
          Goldberg, Scott A
          Keng, Jimmy G
          Koenig, Kristi L
        affil: 1Department of Emergency Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
      sug:
        subj:
          Emergency Service Evaluation
          Facility Design and Construction Evaluation
          After Care
          Ambulances
          Decontamination, Hazardous Materials
          Emergency Medical Services
          Human
          Mass Casualty Incidents
          Natural Disasters Prevention and Control
          Patient Isolation Methods
          Prehospital Care
          Safety
          Triage
      ab: IntroductionThe Emergency Department (ED) is the triage, stabilization and disposition unit of the hospital during a mass-casualty incident (MCI). With most EDs already functioning at or over capacity, efficient management of an MCI requires optimization of all ED components. While the operational aspects of MCI management have been well described, the architectural/structural principles have not. Further, there are limited reports of the testing of ED design components in actual MCI events. The objective of this study is to outline the important infrastructural design components for optimization of ED response to an MCI, as developed, implemented, and repeatedly tested in one urban medical center.ReportIn the authors' experience, the most important aspects of ED design for MCI have included external infrastructure and promoting rapid lockdown of the facility for security purposes; an ambulance bay permitting efficient vehicle flow and casualty discharge; strategic placement of the triage location; patient tracking techniques; planning adequate surge capacity for both patients and staff; sufficient command, control, communications, computers, and information; well-positioned and functional decontamination facilities; adequate, well-located and easily distributed medical supplies; and appropriately built and functioning essential services.DiscussionDesigning the ED to cope well with a large casualty surge during a disaster is not easy, and it may not be feasible for all EDs to implement all the necessary components. However, many of the components of an appropriate infrastructural design add minimal cost to the normal expenditures of building an ED.ConclusionThis study highlights the role of design and infrastructure in MCI preparedness in order to assist planners in improving their ED capabilities. Structural optimization calls for a paradigm shift in the concept of structural and operational ED design, but may be necessary in order to maximize surge capacity, department resilience, and patient and staff safety.Halpern P, Goldberg SA, Keng JG, Koenig KL. Principles of Emergency Department facility design for optimal management of mass-casualty incidents. Prehosp Disaster Med. 2012;27(2):1-9.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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