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Local hospitals are the next, and usually last, level of emergency preparation. "The biggest key is having proper emergency response codes, like active shooter, system utility disruption, amber alert, facility alert, mass casualty, hazardous materials – this way staff can respond in the appropriate way," said Judith Wheeler, Royal Oak Beaumont Health System emergency management specialist. "The key is having education and training."
Beaumont sends people down to the Center of Domestic Preparedness in Anestan, Alabama, where a hospital on an old Army base now offers one week health care leadership classes for mass casualties.
"They throw every possible scenario at you, knowing you're going to be overwhelmed and still can run your emergency room and manage your patients. They make it so real you're prepared for anything from a drug overdose to a 9/11 situation. It's a phenomenal training opportunity," Wheeler said, where they use lifelike mannequins that can spit and take medicine as well as actors, who are often veterans, playing casualty victims.
She said they have revised their whole decontamination process for patients for hazmat, as well as if there were a horrific mass casualty event along the lines of the Boston Marathon situation. Communications are foremost, with coordinations with Oakland County and Royal Oak fire and police.
Glenn Garwood, administrator, emergency and radiological services, Ascension Crittenton Hospital in Rochester, said they have an emergency management committee which meets every other month, as well as representatives that sit on various Oakland County committees, "so we can be collaborative on health care specific needs."
He said they regularly conduct drills to be prepared for any and every contingency of influx of patients, "whether it's an active shooter, decontamination of patients, communicative diseases, mass casualty incident planning, or other things on the horizon we will look at in the future. Ever facility has to have a hazard vulnerability analysis, to see where are the gaps, where are the weaknesses. That's where we train and put resources toward. It's good for everyone.
"We like to think we're prepared," Garwood continued. "We could spend all day, every day preparing. We take emergency management very seriously, as we see it all around the globe, whether it's weather, violent acts, computer scenarios – we have to be prepared."
"A terrorist is a terrorist. Just like nature – there's nothing we can do to compare with nature," said Birmingham's Donohue. "If the system is hacked because of terrorism, well, nature's done that many times. We're ready. FEMA, the Red Cross, and larger agencies are put into place so people are cared for and shelters are available and set up in case of a longer term power outable. They would (take over) and coordinate regionally."