Rapid Medical Evaluation Tested by the Worried Well
Posted by Courtney Rice on Mon, Nov 30, 2009 @ 05:48 PM
By Wesley A. Curry, M.D.
As of this writing, the CDC reported 10,053 cases of documented H1N1 infections and 17 deaths likely related to this virus in the United States. As we all know, the emergence of the swine flu as an imminent pandemic has generated global concerns and issues which have brought the status of our preparation and ability to respond to mass casualties and bioterrorism into question.
Hospital emergency rooms are a key to our ability to respond, evaluate, and treat potentially millions of patients in a mass casualty event. The recent swine flu outbreak has been a test - a "dress rehearsal" - for how our emergency rooms will be able to cope with a sudden increase in patient volume. It's been reported that in many emergency rooms, patients are subjected to long waiting times and length of stays.
So what would happen in a scenario where the daily patient volume in our emergency rooms increased up to 60% or more in a major bioterrorism event?
The CDC designation of an imminent swine flu pandemic has recently increased emergency room visits to significant levels beyond the daily historical baseline with the worried well. Recently some CEP America sites topped over 500 patients per day in daily patient volumes. What is impressive was not how many patients arrived daily, but how few patients left without being seen, and how these sites were able to keep the time to provider close to historical levels.
We continue to study the impact of this recent surge in patients on our multiple emergency room practices. What is clear already is that rapid medical evaluation implementation (our version of provider at triage) has worked during this period because it's flexible enough to be modified to respond to surges in patient volume - even by 60% or more.
While this surge in patients did not result in many admissions or critical patients, it has given our hospitals a real time example from which to learn how best to cope with mass casualty or bioterrorism events in the future.
By instituting our provider triage system years ago, we've not only been preparing ourselves for every day patient care, but for situations like the recent events. In the end, preparation is what is needed to ensure a proper response in extreme times of need. But our emergency rooms can't wait until a catastrophe happens.