Who Will Provide Medical Care In A Disaster?

My wallet contains two unusual cards. One, which bears a picture of me at an earlier stage in my medical career, identifies me as a California Disaster Service Worker. The second, titled "Medical Volunteers for Disaster Response," identifies me as a physician specialising in internal medicine and hematology affiliated with the County of Santa Clara Public Health Department, Office of Disaster Medical Services.

It was in the context of the second card that I recently attended a three hour meeting of the Medical Volunteers. I learned that the system of federally recognized organized medical and public health professionals with which I am affiliated as a "sworn" volunteer is the 9th largest such emergency system in the nation, serves as daily population of about two million, covers more than 1300 square miles which includes 15 municipalities, and is headquartered in Silicon Valley. We are volunteering to respond to natural disasters and emergencies.

Santa Clara County's medical health system includes public and private elements, The County has 3 trauma centers, 11 emergency departments, 12 hospitals, a public health laboratory and disease outbreak teams. There are 12 fire service providers, 7 private ambulance service providers (with far more ambulances than the nearby City/County of San Francisco), and 14 public safety answering points. The medical health system is a major employer, with 1300 emergency medical technicians, 700 paramedics, 50 critical care transport nurses, 40 mobile intensive care nurses and more than 350 medical volunteers.

Medical health resources includes strategically placed chemical packs, elements of the strategic national stockpile, caches of personal protective equipment, stockpiled local pharmaceuticals, a biodetection system, environmental monitoring systems, hospital data systems, and field treatment site trailers. There is the capacity to electronically track patients, which experience in other catastrophes has proved to be essential.

Before an emergency, identification of the critical emergency players, facilities, equipment, resources, and system strengths and weaknesses, is essential. Santa Clara County has stepped up to the plate. In following blogs I will report my impressions of our readiness.