‘HazMat situations’ keep access employees on alert
HazMat situations’ keep access employees on alert
Phone tree’ keeps staff in reach
At Straub Clinic and Hospital in Honolulu, "we’ve had our fair share of HazMat situations," says Linda Dullin, RN, admitting director.
In little more than a week’s time, around the middle of October 2001, she says, the hospital was on alert to handle some six incidents involving hazardous materials, although not all resulted in victims being treated at Straub.
"Right at the time when there were a lot of things going on nationwide," Dullin says, "we had a situation in one of the hotels with a chemical exposure. We got nine people."
With nine patients to handle at once, only two computer terminals in the emergency department (ED), and "physicians calling for their information," she notes, staff recorded initial registration information by hand and entered it into the computer later. "We have clipboards ready and [disaster] logs available."
"Our procedure is that patients go through triage with the medical staff," Dullin explains. "Depending on the time of day, we have one of the access staff there. Otherwise, we do the best we can. We use the medical staff to gather the initial information."
In another incident, she says, a canister exploded in the back of a refuse truck, and the driver and two other people came in contact with a hazardous substance. "We treated one of the three men involved, and the HazMat team [for the city and county of Honolulu] provided us guidance."
Following the release of a potentially hazardous substance at a school, Dullin says, her staff prepared to receive some patients, but the HazMat team was able to handle that situation on the scene.
To respond to exposures to hazardous materials, Straub has a portable decontamination shower set up in the ED parking area, just off the ED entrance, she notes.
Tweaking the system
"One of the things we’ve identified on the admitting side," Dullin says, "is that we need to have preprinted stickers with the downtime visit numbers and downtime medical record numbers that we can use if the computer is down or if we need to register by hand." Those stickers, she explains, would be used to identify "lab work, blood tests, anything ordered for the patients. At the moment, we write the number on the requisition itself."
Normally, Dullin notes, staff would use an Addressograph to imprint such items with the patient’s name and other basic information, "but [in disaster situations], you don’t need a name as much as a visit number."
Even before the Sept. 11 attacks prompted a heightened sense of awareness, Dullin’s department had established an emergency prepared- ness phone tree, she says. "We made sure we had employees’ names, their emergency contact, phone numbers, where they lived, and any special considerations, such as whether they had children, only one car, or parents living with them."
On a second list, made after Sept. 11, the employee names were tiered, according to who lived closest to the hospital and how long it would take them to get to the hospital, Dullin adds. "We break [staff] up into three groups. The first group includes myself, the supervisors, and the leads on each shift, and the second and third groups are all frontline access staff."
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