By Suzi Birz, principal, HiQ Analytics, LLC
Disaster planning and response in the 21st century go beyond just planning for large numbers of persons seeking care for injuries related to the incident. The nature of disasters has changed, becoming highly complex events that can disrupt the normal functioning of any community for long periods of time. Effective planning is needed to address the problems posed by potential events ranging from motor vehicle incidents to acts of terrorism using weapons of mass destruction.
The quantity and severity of the casualties and the resources needed to care for the causalities vary widely based on the type and location of an event. The Electronic Mass Casualty Assessment & Planning Scenarios (EMCAPS) tool was developed to help emergency response planners in health and medical disciplines understand the nature and scope of the hazards for which they must prepare.
This standalone software program allows users to model the health and medical impact for 9 of the 15 Department of Homeland Security National Planning Scenarios for planning and education purposes.
EMCAPS was developed by The Johns Hopkins Office of Critical Event Preparedness and Response (CEPAR) and the Johns Hopkins University Applied Physics Laboratory (JHU/APL). Dianne Whyne, RN, MS, Administrator for Johns Hopkins Office of Critical Event Preparedness and Response in Baltimore, Maryland, served as the project manager.
EMCAPS Model estimates casualties arising from biological (Anthrax, Plague, Food Contamination), chemical (blister, nerve and toxic agents), radiological (dirty bomb) or explosive (IED) attacks.
How Does It Work?
“When you run the EMCAPS Model, you select one of the scenarios and adjust the various inputs,” explained Whyne.
First, you select the disaster scenario. There are nine scenarios in four disaster categories (radiological, biological, chemical and explosive), including RDD-Dirty Bomb, Inhalation Anthrax and Blister Agent – Mustard Gas.
The software presents some reference information for the user, including the scenario summary, Department of Homeland Security scenario executive summary, applicable target capabilities, assumptions and references.
The user enters answers related to outdoor temperature, wind speed, setting (urban, rural) and population density.
Next, the calculations are made and a report is produced. “For the selected scenario, EMCAPS will estimate casualties and the various levels of acuity,” said Whyne. The report presents the person count for each injury level (0-5) and a list of health considerations.
“These calculations allow you to examine what makes sense in your community,” explained Whyne. “It helps you determine what injuries you might expect and how that impacts staff, medications, beds and supplies.”
“The number and type of injuries varies widely between communities,” continued Whyne. “The number of people on the sidewalk in New York City is different than the number of people on the sidewalk in small town America.”
“The software is intended to allow plausible scenarios to be reasonably modeled to help planners better understand and assess preparedness and response capabilities needed,” noted Whyne. “It is not intended to precisely model the physical behavior of WMD threat agents or the outcomes of a specific threat condition.”
Role of Nurses
Under Whyne’s leadership, nurses served as subject matter experts. “The nurses provided the specifics for the data, including supplies, medications, and quantity of sick patients.”
“While the health care facility’s disaster planner might be the primary user of this software, the tool would be valuable to emergency department nurse managers, and other health and medical disaster planners” noted Whyne. “Planning for types of patients, required staff, and other resources would be enhanced with the data from the scenario calculations.”
“The supplies kept on hand to enable the facility to operate stand-alone for 96 hours will likely be insufficient in a disaster,” note Whyne. “Therefore, nurse managers will use the reports when working with hospital clinical staff, hospital finance staff and vendors on disaster planning.”
EMCAPS can also be used by state and local emergency officials when working with the health care organizations and emergency response units to help prepare for an emergency. “In addition to hospital facility planning, the report produced by the scenarios can help planners determine where to transfer certain injuries, requirements for communications systems, transport systems needs as well as the staffing of law enforcement agents and emergency personnel,” explained Whyne.
Whyne is hoping to develop the next version of the software. “We want to bring natural disasters such as hurricanes and earthquakes to the tool.”
Whyne emphasized, “Disasters have become an integral part of life for many Americans and nurses, as the largest sector of the health care workforce, will certainly be on front lines of any disaster response. There is no cure for disasters. The threats may change, but disasters are here to stay. It is important to be able to find answers before the scenario happens in your area.”
This project was developed via funding from the Maryland Special Project program under the Health Resources and Services Administration (HRSA) FY 2005 Bioterrorism Hospital Preparedness Program.
© 2007. AMN Healthcare, Inc. All Rights Reserved.