home > by publication type > backgrounders > Responding to a Terrorist Attack: Hospital Emergency Rooms
Email
| Author: | cfr.org editorial staff |
|---|
Updated: January 2006
Emergency room teams treat those injured in conventional terrorist attacks—such as a car bomb—in much the same way they treat victims of car accidents. Emergency rooms would also be on the front lines after terrorist attacks involving weapons of mass destruction. After an attack with a biological weapon such as anthrax or smallpox, emergency room physicians and nurses would likely be the first to detect exposure, identify the agent used, and treat the victims. Most victims of chemical or radiation attacks would be decontaminated by firefighters and emergency medical services ( EMS ) workers at the scene and then be rushed to local emergency rooms. But U.S. emergency room teams don’t have much experience in handling large terrorist attacks and don’t always know what to expect.
Perhaps. Hospitals could probably handle many types of smaller-scale attacks such as bus bombings, but experts say most U.S. emergency medical personnel aren’t properly trained or equipped to deal with a large number of victims of a chemical, biological, or radiation attack. Even a “Level-1” trauma center like Boston Medical Center, which is certified to treat the most serious injuries around the clock, can only decontaminate about twenty patients at a time.
Moreover, after a biological, chemical, or radiation attack in a U.S. city, thousands of people—both actual victims and panicked bystanders—would flood local emergency rooms for testing, decontamination, and treatment. In the 1995 sarin gas attack on the Tokyo subway system by the doomsday cult Aum Shinrikyo, about 4,000 people who were not affected by the gas rushed to nearby hospitals, overwhelming staff and facilities.
To test hospital and emergency room capabilities, the Department of Homeland Security held the largest ever nationwide anti-terrorism drill in April 2005 to expose weak spots in the U.S.’s emergency response. Hospitals and law enforcement officials took part in the $16 million, five-day exercise, which involved simulated biological and chemical attacks, and required emergency responders to treat and assess mock patients.
Not exactly. The federal government requires every U.S. hospital to have an “all-hazards plan”—a flexible set of procedures to follow in case of a disaster. A recent study done by the Centers for Disease Control, found that 97 percent of hospitals have plans for natural disasters; about 85 percent have plans for responding the chemical and biological attacks and 77 percent have plans for responding to nuclear or radiological attacks and explosive incidents.
In 2002, the Department of Health and Human Services created the National Bioterrorism Hospital Preparedness Program (NBHPP) to “prepare hospitals and supporting healthcare systems to deliver coordinated and effective care to victims of terrorism and other public health emergencies.” Since 2003, the program’s budget has been a nearly half a billion dollars, but the money has been slow to reach individual hospitals.
Yes. One of the best prepared is St. Vincent’s Medical Center in Manhattan, which treated victims of the 1993 and 2001 attacks on the World Trade Center and has had a committee devoted to nuclear, biological, and chemical threats since 1997. (In fact, after the September 11 attacks on the World Trade Center, doctors at St. Vincent ’s and other nearby trauma centers treated far fewer patients than they had anticipated because of the high percentage of fatalities.) Small-town facilities tend to be less prepared, with the odd exception: the only hospital emergency room in the country dedicated to treating patients for radiation exposure is located in Oak Ridge, Tennessee (population 26,700), near a major nuclear facility.
Weigh in on this issue by emailing CFR.org.
To order Task Force reports, Council Special Reports, and Critical Policy Choices, please call, fax, or order online from our distributor, the Brookings Institution Press: phone +1.800.537.5487, fax +1.410.516.6998.
For information on other reports that are not for sale, or for general publications information, please call +1.212.434.9516 or email publications@cfr.org.
Start-Up Nation addresses the trillion-dollar question: How is it that Israel—a country of 7.1 million, only sixty years old, surrounded by enemies— produces more start-up companies than large, peaceful, and stable nations like Japan, China, India, Korea, Canada, and the UK? With the insights of geopolitical experts and investors, the authors examine this nation’s adversity-driven culture to answer this question and offer prescriptions for a global economy on the rebound.
In Forces of Fortune, Vali Nasr presents a paradigm-changing revelation that will transform the understanding of the Muslim world at large. He reveals that there is a vital but unseen rising force in the Islamic world—a new business-minded middle class—that is building a vibrant new Muslim world economy and that holds the key to winning the cold war against Iran and extremists.
In Cuba: What Everyone Needs to Know, Julia E. Sweig presents a remarkably accessible portrait of Cuba's unique place on the world stage over the past fifty years, including its internal politics, its often fraught relationship with the United States, and its shifting relationship with the global community.
Complete list of CFR Books
The report of this bipartisan Task Force of distinguished leaders and experts represents a strong consensus on the importance of repairing America's immigration policy. It makes the case that maintaining America's political and economic leadership depends on attracting talented and hard-working immigrants, and on securing the country's borders in a smart, effective, and humane way.
This report finds that nuclear weapons will remain a fundamental element of U.S. national security in the near term, and makes recommendations on how to ensure the safety, security, and reliability of the U.S. deterrent nuclear force, prevent nuclear terrorism, and strengthen the nuclear nonproliferation regime.
About Independent Task Forces at CFR
Complete list of Task Force reports
Identifying international threats and acting on them may be the most difficult job for U.S. policymakers. This report
provides an actionable road map for managing international threats before they erupt into crises and makes a strong case that preventive action is not a luxury but a necessity.
For more than a decade, the United States has mostly watched from the sidelines as Asian countries organize themselves into an alphabet soup of new multilateral groups. In this report, the authors review the relationship between pan-Asian and trans-Pacific institutions and suggest policy guidelines for a new U.S. approach to this new Asian landscape.
Complete list of Council Special Reports
To request permission to reprint or reuse CFR material, please fill out this permissions request form (PDF), referring to the instructions on page 1.
Copyright 2009 by the Council on Foreign Relations. All Rights Reserved.