LAS VEGAS – Physician assistants who receive emergency response training can improve their facilities’ ability to respond to disasters by devising response plans and developing timely surveillance systems, according to speaker at the 39th Annual American Academy of Physician Assistants Conference.
PAs who are better prepared themselves will respond better during medical emergencies that occur during disasters, according to James J. James, MD, DrPH, MHA, director of the American Medical Association Center for Public Health Preparedness and Disaster Response.
Although more clinicians said that they would feel obligated to help in the case of a disaster than those who said they would not (80 vs. 20), according to results of a small survey cited by James, many of those respondents felt that they would be unprepared to assist (20 out of 80).
“Responding to a disaster is only half the battle. Clinicians must also adequately prepare for it,” he said.
Being able to identify and clearly communicate injury severity, clinical features and patient risk factors are three simple ways that clinicians can improve their disaster preparedness and are key in any emergency response plan.
The DISASTER Paradigm – an acronym that stands for detection, incident management, safety and security, assessing hazards, support, triage and treatment, evacuation and recovery – serves as framework for clinicians to follow in the case of an emergency. Clinicians, especially PAs, can keep these guidelines in mind in the event of an emergency situation.
There are a number of factors that clinicians can use to determine the effects and severity of a disaster. Using the earthquake and tsunami that occurred in Japan this past April and the ensuing nuclear crisis at the Fukushima Daiichi nuclear power plant as an example, James explained that these would include factors such as: radiation dose; dose rat; the type and quality of radiation; radiation injury or illness; physical trauma and/or thermal burns; other unstable conditions; and individual susceptibility.
The presence of each of these factors will determine health care providers’ response in providing emergency medicine. Clinicians should be mindful of ethics and follow a particular triage when administering care. Under normal conditions, health care providers strive to treat the sickest people first, provide all medical care that is necessary to all patients and balance the proportion of benefit to risk on an individual basis.
But during a disaster the triage process changes, and clinicians must be prepared for this deviation. Clinicians must treat the salvageable first, use resources selectively and balance the benefit to risk considering the entire population.
Fortunately, new resources are available to help clinicians respond to emergencies more efficiently. For example, social media sites such as Facebook or Twitter enable health officials to send instant updates about disasters and allow health care providers to know a large quantity of information faster.
In the future, clinicians will have even more resources to help in emergency medical situations, according to James, including smartcards, a small electronic device that contains a patient’s history and next of kin information that can help identify a patient and personal susceptibilities with more ease.
James J. “The expanded role of physician assistants in disaster medicine and public health preparedness.” Presented at: 39th Annual American Academy of Physician Assistants Conference. 2011: Las Vegas, Nevada.