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Helping Residents Prepare for Emergencies

Mar 28, 2011

Managing the chaos of an evolving emergency requires a trained multidisciplinary team.

THERE HAS BEEN A PLANE CRASH NEARBY, a train car containing chlorine gas has just spilled, we need to evacuate the third floor of the hospital within the hour, and a terrorist bomb just exploded downtown.

Luckily, the confluence of these events is unlikely. They are all separate training scenarios in which our hospital has participated to test our emergency response capabilities over the past few years. Pharmacy residents from the Baptist Medical Center Downtown and Wolfson Children’s Hospital in Jacksonville, Fla., have assisted and learned during these drills, adding a unique experience to their training.

The pharmacy residency program is in its fifth year of training post-graduate doctors of pharmacy with two tracks, including a PGY-1 and a PGY-1 with pediatric emphasis. The program provides 12 months of training to residents and includes opportunities to accelerate their professional growth, practice direct patient care, and to learn the art and science of clinical pharmacy practice.

Emergency preparedness and disaster medicine topics are not typical curricula taught in schools or during residency, making this training a unique opportunity.

The residents learn that disaster preparedness involves preparing for and responding to a multitude of low-probability situations that have the potential to disrupt normal day-to-day hospital operations. It may involve something as small and local as a multi-vehicle accident on the interstate or a large-scale event like Hurricane Katrina that potentially affects multiple regions.

The Cycle of Emergency Prep

Preparing and responding is not the only function residents learn about during these drills… they also learn the art of sustaining pharmacy operations as a health system and recovery afterward. Disaster preparedness encompasses the cycle of preparing, responding, sustaining, and recovering.

During training, residents participate in lectures and exercises. At times, our residents participate as healthcare providers during mock mass casualty incidents; at other times, they are paired with senior leaders and administrators to learn the finer points of evaluating how the staff responds to various events.

Some of our more motivated residents even volunteered to be “patients” during an evacuation training scenario. They were strapped to transport “sleds” and safely lowered, multiple times, down the hospital tower stairwell.

Showcasing Pharmacists’ Skills

Placing residents in these roles allows them to gain an appreciation for the amount of work and coordination it takes to respond to various situations and learn the importance of their roles in a disaster situation. It also allows them to network with leaders from other departments and areas across the health system and showcases the strength of pharmacy residents to people who might not ordinarily work directly with a pharmacist.

We find that often the fresh eyes of a young pharmacy resident can provide a unique view, solution, or critique that often leads to improvements during after-action reviews.

All disciplines within the hospital should be involved in drills, training, and planning. An article in The Journal of Rescue and Disaster Medicine states, “…hospital disaster preparedness can only be achieved with active participation of all key medical service providers within a multidisciplinary team.” The importance of training pharmacists and residents in this field is important as “…pharmaceutical services represent one of the most important and yet under-recognized services in mass casualty care.”1

The ICU pharmacist and nursing team follow hospital protocols during a mock bomb threat.

The largest value in participating in drills and training within the hospital is the recognition of services that everyone is able to provide and the reinforcement of relationships between the various components that make up our system.

Pharmacists have been involved with disaster medicine and provided expertise on the ground in situations such as the earthquake in Haiti, after Hurricane Katrina, and post 9-11. During the 2009 H1N1 influenza outbreak pharmacists assisted not only with vaccine procurement and distribution, but also with education and administration. The pharmacy residents at Wolfson and Baptist Downtown have learned that pharmacists can play a vital role during times of stress and they stand ready to assist when the next situation arises.

By Matthew J. Geraci, Pharm.D., EOD, clinical pharmacist in emergency medicine, Baptist Medical Center Downtown, Jacksonville, Fla.

1. Hospital Disaster Preparedness in the United States: New Issues, New Challenges. Journal of Rescue and Disaster Medicine. 2005: 5(2).


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