Terror Australis 2004: preparedness of Australian hospitals for disasters and incidents involving chemical, biological and radiological agents.

OBJECTIVE: To assess the level of preparedness of Australian hospitals, as perceived by senior emergency department physicians, for chemical, biological and radiological (CBR) incidents, as well as the resources and training available to their departments.

METHODS: Detailed questionnaires were mailed to the directors of the 86 hospital emergency departments (EDs) in Australia accredited by the Australasian College for Emergency Medicine. Questions covered hospital planning, available resources and training, and perceived preparedness.

RESULTS: Responses were received from 76 departments (88%): 73 reported that their ED had a disaster plan, with 60 (79%) having a contingency plan for chemical, 57 (75%) for biological, and 53 (70%) for radiological incidents. Specific staff training for managing patients from a conventional mass casualty incident was given in 83% of EDs, falling to 66% for a CBR incident. Forty-three per cent reported that their plan involved staff managing contaminated patients, but availability of personal protective equipment and decontamination facilities varied widely. Although 41% believed their ED could cope with a maximum of 20 patients in the first 2 hours after a conventional incident, this increased to 71% for a CBR incident. Staff training was considered the main funding priority (59%).

CONCLUSIONS: This survey raises significant questions about the level of preparedness of Australian EDs for dealing with patients from both conventional and CBR incidents. Hospitals need to review their plans and functionality openly and objectively to ensure that their perceived preparedness is consistent with reality. In addition, they urgently require guidance as to reasonable expectations of their capacity. To that end, we recommend further development of national standards in hospital disaster planning and preparedness.