A school bus crash could easily swamp most emergency rooms.
Emergency departments in most parts of the country will be overwhelmed if any natural disaster, terrorist attack or other crisis hits, according to a report released Wednesday by the Institute of Medicine.
While there have been “islands of excellence” in providing quality care as emergency room demands have escalated in recent decades, the general picture is bleak, said Dr. Brent Eastman, chief medical officer of ScrippsHealth in California.
Baltimore has been spared the worst of this shortage because of the large number of hospitals serving the city, said Health Department Director Josh Sharfstein. “But we need to make some systemic changes before a health care crisis becomes a crisis for our patients.”
The solution here includes coordinating care regionally, imitating the practices of shock/trauma centers in handling patients, and providing clear accountability, including public statements of results for various treatments, officials said.
In a crisis, a lack of medical and emergency care specialists, increasing volume of emergency room visits, and inconsistent standards for evaluating and transporting critically ill or injured patients are common. In addition, a large-scale emergency is likely to overwhelm most health systems, especially if young children are the main victims.
“If our emergency departments are struggling to handle our daily needs, how in the world are they going to handle an emergency or national disaster?” said Dr. Benjamin Chu, president of Kaiser Foundation Hospitals for Southern California.
Nationally, visits to emergency rooms have grown at twice the rate of the population, with growing numbers of uninsured using emergency rooms as their first resort, according to the report. At the same time, the number of emergency departments has dropped 9 percent and hospitals are consolidating space, offering more private rooms and cutting beds.
“Hospitals must end the boarding of admitted patients” in exam rooms and hallways, Chu said. “We cannot let the most critical, time-sensitive medical care be paralyzed by gridlock.”
