Disaster preparation is an enormous undertaking for any hospital, but for small or rural hospitals, this challenge is amplified. Geographical separation, budget and staffing shortages, as well as limited bed availability can cause a rural hospital to be quickly overwhelmed when disaster strikes.
To better handle a patient surge, rural hospitals should keep the following disaster preparedness items in stock:
1. Cots
With a sudden large influx of patients, rural hospitals need a plan to open up bed spaces by:
- Cancelling any non-urgent procedures
- Determining if current patients can be discharged
This may still not be enough, and extra patient care spaces will need to be created. Stock a large number of cots that can be placed in hallways or used to double-up in trauma rooms to help accommodate the sick or injured during patient surge events.
2. Portable Airway Management Equipment
In patient care, we often refer to the ABC’s – Airway, Breathing and Circulation – as the most important things to establish. Since in a disaster patients may need to be treated in areas that are not fully equipped, it is important to have the supplies needed to establish and maintain a patent airway. This includes portable suction machines, portable oxygen tanks, and portable ventilators. When possible, equipment that can also run on batteries should be stocked. This maximizes the usability of portable equipment in any location.
3. Personal Protective Equipment
Disasters occur in many forms, from a mass shooting, to a bioterrorist attack, to an influenza pandemic. Healthcare workers must be protected while doing their jobs, and it is a hospital’s responsibility to provide the necessary equipment.
This includes the standard gown, gloves, and respirators that are often used in hospitals. However, rural hospitals also need to be prepared to treat patients that may have been exposed to unidentified hazardous materials that need to be decontaminated. Employees working in the decontamination zone should also have air-purifying respirators, chemical resistant suits that are sealed with tape at the openings, head and face coverings, and protective boots.
4. Stockpiled Medications
Rural hospitals should maintain a cache of medications that are most likely necessary during a disaster. Every hospital should assess its own needs and the most likely disaster scenarios to determine what medications to stockpile should supply lines be interrupted. The CDC offers a wealth of information to help develop an initial list. Common therapeutic categories include antibiotics, IV fluids, analgesics, antiemetics, burn care agents, intubation medications, respiratory treatments, and vaccines.
5. Alternate Means of Communication
In a disaster, communication can be challenging if power is lost or cell towers are not functioning. Yet maintaining communication with state and local authorities is essential for rural hospitals during these times. Hospitals also need to be able to contact employees, as well as outside vendors or mutual aid hospitals to maintain the supply chain. For this reason, every rural hospital should establish secondary methods of communication such as satellite phones, or a citizens band (ham) radio.
Despite the additional challenges, rural hospitals are still obligated to provide continuous patient care during a disaster. By keeping a healthy supply of these necessary items, rural hospitals will be better prepared to overcome potential obstacles to emergency preparedness.
Editor's note: This blog was originally from January 2016. It has been re-published with additional up to date content.
