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Staying healthy in the trenches

Editor's note: A panel commissioned by the World Health Organization to investigate its handling of the swine flu pandemic has slammed mistakes made by the U.N. body and warned tens of millions could die if there is a severe flu outbreak in the future. Editorial Advisor Art Hsieh points out why this is relevant for responders.



You might wonder why this story is important to the typical EMS provider. In 2003 the Toronto, Canada EMS system was overwhelmed with calls for service during a major SARS outbreak in that city.

Out of the 850 paramedics, 436 were placed into quarantine after possible exposure to SARS-infected patients. As you can imagine, this created a tremendous challenge for the system's readiness to respond to calls for service. TEMS did a tremendous job adapting to the situation, and were able to implement a variety of actions that helped overcome the operational challenges.

Long scale events like SARS and flu pandemics can have significant effects on your ability to provide routine care. At the provider level, the need to remain vigilant for potential exposure is paramount. I know that the vast majority of patients with a cough are not contagious and represent little risk...but it's difficult to differentiate between the ones who aren't, and those who represent a true risk. No testing exists that allows us to tell the difference, so precautions are critical in these situations.

Mass events can and will affect systems. Check your operational readiness plans. Short term, single incident plans are probably fairly mature, containing a fair amount of detail and direction. Not surprising, since the potential for these incidents is fairly high and the frequency of actual events more common. But look further — what about events of longer duration? The Toronto event lasted more than three months. The resources necessary to support long-term operations are significant, having to feed, shelter and provide comfort facilities to rescue personnel in the initial phases, and reducing fatigue among staff.

While this story centers on the broad public health response, the issues that were discussed have real relevance to those of us working in the trenches.

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