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The current crisis in emergency care and the impact on disaster preparedness.

Cherry RA, Trainer M - BMC Emerg Med (2008)

Bottom Line: This constant acute overcrowding, felt in communities all across the country, indicates a nation at risk.Currently, the nation is unable to meet presidential preparedness mandates for emergency and disaster care.Federal funding strategies must therefore be re-prioritized and targeted in a way that reasonably and consistently follows need.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Section of Trauma and Surgical Critical Care, Penn State College of Medicine, Hershey, Pennsylvania, USA. rcherry@psu.edu

ABSTRACT

Background: The Homeland Security Act (HSA) of 2002 provided for the designation of a critical infrastructure protection program. This ultimately led to the designation of emergency services as a targeted critical infrastructure. In the context of an evolving crisis in hospital-based emergency care, the extent to which federal funding has addressed disaster preparedness will be examined.

Discussion: After 9/11, federal plans, procedures and benchmarks were mandated to assure a unified, comprehensive disaster response, ranging from local to federal activation of resources. Nevertheless, insufficient federal funding has contributed to a long-standing counter-trend which has eroded emergency medical care. The causes are complex and multifactorial, but they have converged to present a severely overburdened system that regularly exceeds emergency capacity and capabilities. This constant acute overcrowding, felt in communities all across the country, indicates a nation at risk. Federal funding has not sufficiently prioritized the improvements necessary for an emergency care infrastructure that is critical for an all hazards response to disaster and terrorist emergencies.

Summary: Currently, the nation is unable to meet presidential preparedness mandates for emergency and disaster care. Federal funding strategies must therefore be re-prioritized and targeted in a way that reasonably and consistently follows need.

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Related in: MedlinePlus

History of federal funding for trauma EMS [24, 25].
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Figure 1: History of federal funding for trauma EMS [24, 25].

Mentions: Trauma centers are expensive to maintain. They must operate 24 hours a day, 7 days a week, and provide highly trained trauma teams for critical and highly complex injuries. These trauma response teams are comprised of specially trained nurses; up to 16 physicians who specialize in a wide range of fields including trauma surgery, emergency medicine, neurosurgery, orthopedic surgery, anesthesiology, critical care medicine, and radiology. These response teams are also composed of nurses, respiratory therapists, radiology technicians, blood bank personnel, and operating roomstaff [12]. The expense and complexity of this level of readiness is effective and is appreciated by all public agencies in all states and at all levels [21]. A trauma team response is also expected by the clear majority of America's public. A recent study showed that 61% of the public was confident that they would receive the best trauma care, and would feel extremely concerned if that were not the case [22]. Federal funding for HRSA's trauma-EMS program was funded post-9/11 at $3.5 million for 2002, 2003, 2004, and 2005, but cut altogether for fiscal years (FY) 2006 and 2007 [23,24] (See Figure 1).


The current crisis in emergency care and the impact on disaster preparedness.

Cherry RA, Trainer M - BMC Emerg Med (2008)

History of federal funding for trauma EMS [24, 25].
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2386501&req=5

Figure 1: History of federal funding for trauma EMS [24, 25].
Mentions: Trauma centers are expensive to maintain. They must operate 24 hours a day, 7 days a week, and provide highly trained trauma teams for critical and highly complex injuries. These trauma response teams are comprised of specially trained nurses; up to 16 physicians who specialize in a wide range of fields including trauma surgery, emergency medicine, neurosurgery, orthopedic surgery, anesthesiology, critical care medicine, and radiology. These response teams are also composed of nurses, respiratory therapists, radiology technicians, blood bank personnel, and operating roomstaff [12]. The expense and complexity of this level of readiness is effective and is appreciated by all public agencies in all states and at all levels [21]. A trauma team response is also expected by the clear majority of America's public. A recent study showed that 61% of the public was confident that they would receive the best trauma care, and would feel extremely concerned if that were not the case [22]. Federal funding for HRSA's trauma-EMS program was funded post-9/11 at $3.5 million for 2002, 2003, 2004, and 2005, but cut altogether for fiscal years (FY) 2006 and 2007 [23,24] (See Figure 1).

Bottom Line: This constant acute overcrowding, felt in communities all across the country, indicates a nation at risk.Currently, the nation is unable to meet presidential preparedness mandates for emergency and disaster care.Federal funding strategies must therefore be re-prioritized and targeted in a way that reasonably and consistently follows need.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Section of Trauma and Surgical Critical Care, Penn State College of Medicine, Hershey, Pennsylvania, USA. rcherry@psu.edu

ABSTRACT

Background: The Homeland Security Act (HSA) of 2002 provided for the designation of a critical infrastructure protection program. This ultimately led to the designation of emergency services as a targeted critical infrastructure. In the context of an evolving crisis in hospital-based emergency care, the extent to which federal funding has addressed disaster preparedness will be examined.

Discussion: After 9/11, federal plans, procedures and benchmarks were mandated to assure a unified, comprehensive disaster response, ranging from local to federal activation of resources. Nevertheless, insufficient federal funding has contributed to a long-standing counter-trend which has eroded emergency medical care. The causes are complex and multifactorial, but they have converged to present a severely overburdened system that regularly exceeds emergency capacity and capabilities. This constant acute overcrowding, felt in communities all across the country, indicates a nation at risk. Federal funding has not sufficiently prioritized the improvements necessary for an emergency care infrastructure that is critical for an all hazards response to disaster and terrorist emergencies.

Summary: Currently, the nation is unable to meet presidential preparedness mandates for emergency and disaster care. Federal funding strategies must therefore be re-prioritized and targeted in a way that reasonably and consistently follows need.

Show MeSH
Related in: MedlinePlus