John Hick, M.D., an emergency medicine specialist at Hennepin County Medical Center in Minneapolis, identified five common myths that he often hears from hospitals preparing for a violent mass casualty incident. In his own words, those include:
- We’ll have adequate warning: Actually, with a lot of events, the only warning you get is a victim being brought in the door. Plan on making do with what you have in house for the first 30 minutes or so, and make sure that your callbacks are to the people you'll need need in the early aftermath — the trauma surgeons, emergency medicine and others.
- It won’t happen here: I think that’s been pretty well disproved. Whether you’re on a rural Native American reservation in northern Minnesota or in urban Orlando, the unfortunate truth is that you’re not immune to a mass shooting. You’re not immune to any of these events. Everyone has to be prepared, and just because you’re not a trauma center doesn’t mean it’s not going to happen near you or that victims of blast or severe penetrating trauma are not going to wind up on your doorstep.
- You can dictate the terms of the victims you receive: We hear frequently that trauma centers need to be prepared for children. That’s absolutely true. On the other hand, a lot of times, children’s hospitals are not prepared for adults and yet, especially in these types of instances, families are not going to want to be separated. In Aurora [Colo.], as an example, we saw situations where significantly injured adults requiring care stayed with their children and presented to children’s hospitals.
- We’re too competitive to do this together: The truth is that, with preparedness activities — whether it’s for Ebola, a mass casualty event or anything along those lines — there’s really no turf there. And so, there is great opportunity for hospitals to get together across system lines, engage, plan together and save each other a lot of work. If you can make up some protocols that apply 80 percent across all institutions, then you’ve got 20 percent of the work left to do. Versus, if you just go down in your hole in the basement and put the protocols together yourself, not only is that more work for you, but you don't have the benefit of the perspective of other institutions.
- We should have all the resources we need: With just-in-time inventory now, this is absolutely not true. You are likely to run out of the right pharmaceuticals, ventilators or any of the other basics that you may need to care for critically ill patients. Even if you’re a Level I trauma center, a lot of times hospitals are pretty thin on these materials and it’s not easy to get more, especially when the community’s in a disaster situation and other people may be calling for those same resources. You have to take a careful look because if you have a Lean team coming through optimizing your pharmacy resources, all of a sudden the disaster supplies that you thought you had are off the shelf again and you have to go back and make sure to reconstitute those supplies.