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Hospitals Ill-Prepared, Survey Says

Story Filed: Monday, October 15, 2001 6:40 PM EDT

CHICAGO (AP) -- A survey of 30 hospitals in four states and Washington, D.C., found them ill-equipped to handle a widespread biological disaster, researchers reported Monday.

Emergency room workers at just one of the hospitals said they had stockpiled medicines for a bioterrorism attack, such as an anthrax poisoning, and 26 hospitals reported they could handle only 10 to 15 victims at once.

The study was done last year and released at the American College of Emergency Physicians' annual meeting here, where experts said the results probably apply to hospitals nationwide.

Twenty-two hospitals said they were not prepared to handle a chemical weapons or nuclear attack, and only seven said their staff had some training in managing casualties from an attack involving weapons of mass destruction.

``If fully prepared means you can handle 10 times your normal load, we'll never be fully prepared,'' said Dr. Stephen Cantrill, associate director of emergency medicine at Denver Health Medical Center.

But Cantrill said hospitals' quick response to the isolated anthrax cases shows ``a great deal of heightened awareness'' prompted by the Sept. 11 terrorist attacks.

That awareness suggests preparedness is improving, Cantrill said at the convention, where the agenda was revised after the attacks on the World Trade Center and the Pentagon to include extra sessions on dealing with terrorism.

The study by Dr. Janet Williams and colleagues at West Virginia University sampled 22 rural hospitals and eight urban hospitals in Washington, D.C., Pennsylvania, Maryland, Virginia and West Virginia. The hospitals were not identified. Results also will be published in the November issue of group's medical journal, Annals of Emergency Medicine.

``It's evident that hospital personnel keenly recognize a need for training,'' though a lack of time, available courses and funding were cited as obstacles to improving training, Williams said.

While ACEP scrambled to add special terrorism-related courses this year, it's not the first time the meeting has addressed the issue. The group represents more than 20,000 doctors who specialize in emergency medicine and who consider themselves ``the front line'' in treating victims of a mass attack.

Doctors who came for the four-day event said they used to feel like Chicken Little, calling for better preparations for disaster. Not anymore.

``We've been talking about this for years and people in general have not been interested,'' said Dr. Jonathan Burstein of Harvard Medical School, a member of the college's task force on weapons of mass destruction. ``Now, of course, everyone's coming to us and saying, 'Well, gee, we understand this is a problem.'''

Dr. Michael Carius, ACEP's president, said that since Sept. 11, most hospitals nationwide have begun improving their ability to quickly diagnose anthrax. One test merely involves swabbing fluid or discharge from the nose and examining it under the microscope. But in many cases, health care workers need to be trained to identify magnified anthrax spores, he said.

``It's something that obviously we weren't testing for on a regular basis'' before Sept. 11, Carius said in an interview.

More than 250 people crowded a room at the meeting Monday for a slide show on how to identify skin rashes from anthrax and other potential biological and chemical weapons.

One graphic photograph showed a patient's forearm with a large, black ulcerated sore -- typical of cutaneous anthrax poisoning, instructor Dr. Kristi Koenig told the audience.

Anthrax means ``coal'' in Greek, and refers to the telltale color of such lesions, said Koenig, national director of an emergency management group at the Veterans Health Administration in Washington, D.C.

Dr. Eric Mailman, an emergency room physician at Swedish Hospital in Seattle, called the presentation an excellent crash-course.

Already, Mailman said, worried patients are showing up in his emergency room with colds and the flu, concerned they might have anthrax ``and we're not even deep into the cold and flu season.''

On the Web:

ACEP: http://www.acep.org

-- Anonymous, October 15, 2001