Blackout 2003: preparedness and lessons learned from the perspectives of four hospitals.
BACKGROUND
The blackout in North America of August 2003 was one of the worst on record. It affected eight US states and parts of Canada for >24 hours. Additionally, two large US cities, Detroit, Michigan and Cleveland, Ohio, suffered from a loss of water pressure and a subsequent ban on the use of public supplies of potable water that lasted four days. A literature review revealed a paucity of literature that describes blackouts and how they may affect the medical community.


METHODS
This paper includes a review of after-action reports from four inner-city, urban hospitals supplemented accounts from the authors' hospital's emergency operations center (EOC).


RESULTS
Some of the problems encountered, included: (1)lighting; (2) elevator operations; (3) supplies of water; (4) communication operations; (5) computer failure; (6) lack of adequate supplies of food; (7) mobility to obtain X-ray studies; (8) heating, air condition, and ventilation; (9) staffing; (10) pharmacy; (11) registration of patients; (12) hospital EOC; (13) loss of isolation facilities; (14) inadequate supplies of paper; (15) impaired ability to provide care for non-emergency patients; (16) sanitation; and (17) inadequate emergency power.


CONCLUSIONS
The blackout of 2003 uncovered problems within the US hospital system, ranging from staffing to generator coverage. This report is a review of the effects that the blackout and water ban of 2003 had on hospitals in a large inner-city area. Also discussed are solutions utilized at the time and recommendations for the future.


CONCLUSIONS
The blackout of 2003 was an excellent test of disaster/emergency planning, and produced many valuable lessons to be used in future events.
Klein
Kelly R
KR
Department of Emergency Medicine, Wayne State University, Detroit, Michigan 48235, USA.
Rosenthal
Marc S
MS
Klausner
Howard A
HA
D004189:Disaster Planning / Q000379:methods*; D011211:Electric Power Supplies; D004630:Emergencies; D004632:Emergency Medical Services / Q000458:organization & administration; D006739:Hospital Administration / Q000379:methods; D006801:Humans; D008284:Maintenance and Engineering, Hospital / Q000458:organization & administration*; D009511:New England; D011210:Power Plants; D011787:Quality of Health Care / Q000458:organization & administration; D014881:Water Supply