Thoughts About Sandy with a Katrina Twist

So we are moments away from Hurricane Sandy making landfall in Cape May, NJ and I cannot help but be reminded of Katrina. That disaster sits in all of our minds, but it was especially important to me as my first ever response to a true Type I Catastrophic incident.  I am not recollecting that time in 2005 because of comparisons of NOLA and NYC or because of the storm of the century titling’s but because I can’t help but wonder if we have learned from the many lessons Katrina taught us.  

Now, I am not calling to question government response because I have a tremendous amount of respect of Craig Fugate and his team.  I am concerned by those that did not heed the warnings of true experts that did not evacuate or take the appropriate actions.  James Lee Witt did a good job of placing the focus on the individual to prepare for disasters and Craig Fugate has returned to that mantra.  I am just not sure if it has worked.

As an emergency manager it is a struggle to convince individuals to invest the time and resources to prepare.  People truly believe that it will not happen to them.  Katrina served as a wake-up call for our nation but the blessing that was a problem in disguise was that we have not had a catastrophic incident since.  The nation has fallen back asleep and it looks like Sandy is our new wake-up call. 

My thoughts and prayers are with those that are in the path of Sandy and my colleagues that will serve them.   I hope Sandy will silence the critics that want to eliminate disaster response funding or those that think their local emergency manager is nicety not a necessity.

I would love to hear your thoughts, so leave me a comment.

Multi-Patient Disasters and the Need for Analysis: As influenced by the Aurora Theater Shooting

First, along with the rest of the nation and the entire public safety and health care community, my thoughts and prayers are with the survivors and victims of the shooting in Aurora.  I also send support and praise to all of the PD, EMS, Fire, and Hospital personnel that were affected and will continue to be affected.

Posting on my original planned topic (SCOTUS Health Care Ruling) would be disrespectful. Instead I provide this short post on two topics; one a health care disaster response to something like this and two why we start to analyze the next day.

Health Care Response

I saw a post on Twitter the other day that said hospitals throughout the United States have disaster plans.   For those of you not familiar, hospitals are obligated by regulators to have disaster plans.  They are required to test their plans twice a year.  Watching the information coming from Aurora you can see that they have been preparing for worse case scenarios.  When hospital staff members were interviewed they all said something similar to ‘We were notified of multiple patients and we activated our disaster plan.’  These plans are what allowed those hospitals to respond capably to this disaster.  The regulatory standards around EM have supported organizations that have to be very cost conscious to focus on disaster preparedness.  Friday morning, that level of focus paid dividends as Incident Command was initiated and staff were called in to augment the response.  Dr. Sasson at UCH actually said they were able to open virtually every OR needed, a true testament to planning and preparedness.

Now, as the focus rightly shifts to the victims, there are additional survivors that weren’t in the theater when the shooting occurred.  All of the public safety workers involved and hospital staff are indirect survivors are strongly affected.  In the first day of a hospital stay victims of a multiple shooting at a trauma center can interact with 100+ staff members.  Those indiviuals are impacted by their experience and suffer an extension of the trauma and their exposure will not end when the crime scene tape comes down or the news cycle fades.  It is up to their employer to ensure that they have the plans in place for a delayed recovery.  Critical Incident Stress Management (CISM) must be a core part of it so that they support the indirect survivor.

The Need for Immediate Analysis

When something like this happens there is always someone that becomes a Monday morning quarterback.  That is not what I am advocating.  To use another analogy I encourage individuals to strike while the iron is hot.  As any seasoned Emergency Manager will tell you, you get more buy-in to an initiative such as Active Shooter response planning or the need for a disaster drill when there is desire for change generated from an event such as the Aurora Theater Shooting.  The ultimate goal is to protect and/or save lives in the future.

If you agree or disagree, please comment and let me know below.

I will blog more in the coming weeks on the concept of indirect survivors and CISM in the hospital setting.