Editorial on preparedness

We Need to Do a Better Job of Preparing for the Next Big Disaster

Posted 08/25/2006

Margaret A. Clark, RN, RRT-NPS, MS

Since Hurricane Katrina, numerous reports and recommendations have been developed to incorporate lessons learned, and assess our readiness to respond to the next big disaster. While well intentioned, many of these reports are of little use. They tell us what we should do, but give little guidance on implementing the recommendations -- let alone funding them.

For example, some reports confirm that the nation's hospitals would not have enough mechanical ventilators should a pandemic flu or mass casualty situation occur.^[1,2] An estimated 105,000 ICU ventilators are currently available.^[3] According to the National Preparedness Plan issued by President Bush in November of 2005, we would need over 700,000 in the event of an influenza pandemic.^[4]

It's been estimated that the Strategic National Stockpile, created in 1999 by the federal government for just such emergencies, has only 4000-5000 ventilators.^[5] With the cost of a typical ICU ventilator around $30,000, stockpiling enough ventilators for a pandemic would seem cost-prohibitive at an $18 billion price tag.^[3]

September is National Preparedness Month. The Federal Government through the Department of Homeland Security is encouraging individuals, business, and especially state and local healthcare authorities and hospitals to review and update their plans. This year we should inject a heavy dose of practical reality into that review rather than following some meaningless pro forma checklist.

That's my opinion. I'm Margaret Clark, Editorial Director, Pulmonary Medicine, Medscape.