For most hospitals, emergency preparedness means being ready to treat a surge of patients from natural disasters or terror attacks that occur outside hospital walls.
Hospitals rarely need to evacuate patients from their own facilities, but when they are forced to due to fire, riot, earthquake, internal flooding or hazardous material spill, getting non-ambulatory patients out of multilevel facilities presents major logistical challenges.
For disaster planners, vertical evacuation of high-rise hospitals down darkened stairwells that are possibly full of smoke or debris represents either an insurmountable obstacle or an element left to local fire departments.
Patients must be carried if power is out to elevators. Even if power is on, elevator equipment may be unsafe to use following explosions or earthquakes. In many cases, elevators are just too slow.
A recent suggestion describes a clever way of using common evacuation resources found on every hospital ward to achieve a rapid, safe vertical hospital evacuation: wrap patients in double sheets, line the stairwell with mattresses, and guide patients down in a controlled slide using three-person teams.
“I believe in achieving results in as elegant a manner as is possible, and not depending on fancy, expensive equipment or old-fashioned plans that don’t do the job,” said Kenneth Iserson, MD, University of Arizona emeritus professor of emergency medicine.
Iserson told Homeland1 his proposed evacuation remedy uses readily available resources to accomplish the type of critical evacuation that is often prepared for inadequately.
Iserson describes his evacuation method, including the best way to grip patients wrapped in the sheets, in a chapter on patient transport/evacuation in his recent book “Improvised Medicine” (2012 McGraw Hill).
Hospital evacuation has traditionally been a slow process, involving fire department stretchers and teams of firefighters. Iserson, however, said his method is faster and can be used in nearly any situation, with or without firefighters.
“It’s much faster, and takes only a few people of normal strength and requires no special equipment,” he said.
The Iserson method has been tested successfully. In 2008, its effectiveness was illustrated by evacuating volunteer patients from the top floor of a five-story hospital in Tucson, AZ. Results showed it took less than one minute per floor elapsed for a slow, controlled descent using disaster staff with no prior experience with the technique.
In comparison, a similar drill using a Stokes basket demonstrated that four firefighter extraction teams along with an accompanying nurse and respiratory therapist took nearly four-times as long per floor (3.75 min.) to evacuate one patient.
Iserson admits, however, this method is not nearly as fast and easy in an ascent evacuation, such as to a helipad on the roof.