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Committee on Homeland Security Approves Hospital Preparedness Standard

ASTM International Committee E54 on Homeland Security has approved its first standard, E 2413, Guide for Hospital Preparedness and Response. The purpose of the guide is to answer questions regarding the minimal levels of preparedness needed for hospitals to deal with a large-scale terrorist attack or other serious emergency. Guide E 2413 is under the jurisdiction of Subcommittee E54.02 on Emergency Preparedness, Training, and Procedures.

James Augustine, M.D., an emergency physician in Atlanta, Ga., and chair of the task group that developed the new guide, says that vast amounts of knowledge are available to assist healthcare facilities in preparing for and responding to large-scale emergencies. “However, despite all this information, a medically and environmentally driven definition of ‘minimal levels’ of preparedness has been lacking. E 2413 addresses this need,” says Augustine.

According to Augustine, the new guide deals with the following issues:

• The process for preparedness and mitigation;
• The process of organizing and planning a hospital response plan;
• The nature of supplies that hospitals need to make available;
• The application of existing regulations and guidelines; and,
• An acceptable means to protect the facilities for usual operation, patients, and staff while still providing an effective level of response.

In addition to suggested minimum levels of preparedness for acute care hospitals, E 2413 places emphasis on the coordination of operations with community assets, including local emergency planning committees, and emphasizes the effective development and utilization of a hospital vulnerability analysis. In addition, the standard encourages the use of a hospital incident command system for organizing human resources and mandates communications and infrastructure systems to integrate the response.

Provisions for dealing with contaminated patients, including the number of patients to prepare for, what type of facilities to use, the level of protective equipment needed and necessary protocols involved with decontamination procedures, are also included in E 2413.

“We believe that this standard will improve patient care in major and minor incidents by making the planning process more efficient,” says Augustine, who notes that the standard emphasizes the need for education, drills and exercises. He also says that Committee E54 hopes that hospitals will use the standard to focus their preparedness activities, and that funding and regulatory agencies will utilize the guide to assist hospitals in obtaining and maximizing physical resources for patient care and facility management. “Communities will benefit when hospital planning is integrated with community planning,” Augustine says.

Kathleen Higgins, chair of Committee E54 and director, office of law enforcement standards at the National Institute of Standards and Technology, feels that E 2413 is an important standard. “E 2413 is a milestone for both the homeland security and public safety communities,” says Higgins. “It gives hospitals uniform guidelines for preparing facilities and personnel to handle casualties from a large-scale terrorist attack and coordinating their preparations with other organizations in their communities. That’s a major step toward domestic preparedness.”

For further technical information, contact James J. Augustine, M.D., Emory University, Atlanta, Ga. (phone: 404/486-1157). Committee E54 meets Jan. 24-26, 2005, during the January Committee Week in Atlanta, Ga. For membership or meeting details, contact Pat Picariello, ASTM International (phone: 610/832-9720). //

Copyright 2004, ASTM Internationa