title: Critical assessment of statewide hospital pharmaceutical surge capabilities for chemical, biological, radiological, nuclear, and explosive incidents.
abstract: 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.
authors: The Johns Hopkins Office of Critical Event Preparedness and Response, Baltimore, MD 21209, USA. edhsu@jhmi.edu
authors: Edbert B
authors: EB
authors: Hsu
authors: Julie A
authors: JA
authors: Casani
authors: Al
authors: A
authors: Romanosky
authors: Michael G
authors: MG
authors: Millin
authors: Christa M
authors: CM
authors: Singleton
authors: John
authors: J
authors: Donohue
authors: E Robert
authors: ER
authors: Feroli
authors: Melvin
authors: M
authors: Rubin
authors: Italo
authors: I
authors: Subbarao
authors: Dianne M
authors: DM
authors: Whyne
authors: Thomas D
authors: TD
authors: Snodgrass
authors: Gabor D
authors: GD
authors: Kelen
mesh_terms: 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
chemical_list: D004364:Pharmaceutical Preparations; D011847:Radioactive Fallout