Critical assessment of statewide hospital pharmaceutical surge capabilities for chemical, biological, radiological, nuclear, and explosive incidents.
BACKGROUND
In recent years, government and hospital disaster planners have recognized the increasing importance of pharmaceutical preparedness for chemical, biological, radiological, nuclear, and explosive (CBRNE) events, as well as other public health emergencies. The development of pharmaceutical surge capacity for immediate use before support from the (US) Strategic National Stockpile (SNS) becomes available is integral to strengthening the preparedness of local healthcare networks.


METHODS
The Pharmaceutical Response Project served as an independent, multidisciplinary collaboration to assess statewide hospital pharmaceutical response capabilities. Surveys of hospital pharmacy directors were conducted to determine pharmaceutical response preparedness to CBRNE threats.


RESULTS
All 45 acute care hospitals in Maryland were surveyed, and responses were collected from 80% (36/45). Ninety-two percent (33/36) of hospitals had assessed pharmaceutical inventory with respect to biological agents, 92% (33/36) for chemical agents, and 67% (24/36) for radiological agents. However, only 64% (23/36) of hospitals reported an additional dedicated reserve supply for biological events, 67% (24/36) for chemical events, and 50% (18/36) for radiological events. More than 60% of the hospitals expected to receive assistance from the SNS within < or = 48 hours.


CONCLUSIONS
From a pharmaceutical perspective, hospitals generally remain under-prepared for CBRNE threats and many expect SNS support before it realistically would be available. Collectively, limited antibiotics and other supplies are available to offer prophylaxis or treatment, suggesting that hospitals may have insufficient pharmaceutical surge supplies for a large-scale event. Although most state hospitals are improving pharmaceutical surge capabilities, further efforts are needed.
Hsu
Edbert B
EB
The Johns Hopkins Office of Critical Event Preparedness and Response, Baltimore, MD 21209, USA. edhsu@jhmi.edu
Casani
Julie A
JA
Romanosky
Al
A
Millin
Michael G
MG
Singleton
Christa M
CM
Donohue
John
J
Feroli
E Robert
ER
Rubin
Melvin
M
Subbarao
Italo
I
Whyne
Dianne M
DM
Snodgrass
Thomas D
TD
Kelen
Gabor D
GD
D023482:Bioterrorism; D051337:Chemical Terrorism; D004189:Disaster Planning / Q000379:methods*; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000592:standards; D005107:Explosions; D019538:Health Care Surveys; D006752:Hospital Planning / Q000379:methods; D006801:Humans; D008396:Maryland; D020380:Needs Assessment; D004364:Pharmaceutical Preparations / Q000600:supply & distribution*; D010607:Pharmacy Service, Hospital / Q000458:organization & administration* / Q000592:standards; D011832:Radiation Injuries; D011847:Radioactive Fallout
D004364:Pharmaceutical Preparations; D011847:Radioactive Fallout