Emergency preparedness—Is your OR ready?

AORN Journal,  June, 2004  by John E. Eiland,  Donna A. Pritchard,  Darlena A. Stevens

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INDIVIDUAL ROLES

Duties should be assigned according to an individual's position and skills. Key roles include the following.

* Perioperative lead--This generally is the perioperative manager or designee, who is responsible for communicating with the command center and coordinating the perioperative services response.

* Scribe--Assign an individual to keep track manually of all communications and events, including names of individuals and times of events.

* Specialty coordinators--Specific staff members may be assigned to coordinate the activities and needs of certain specialties (eg, neurosurgery, orthopedic, burn, pediatrics) related to the situation. These individuals may be responsible for obtaining specific supplies, calling in specialty physicians, and assisting staff members who may not be familiar with specific service needs.

* Staff coordinator--Assign a qualified individual to keep track of staff members and their assignments. This person also would stay in contact with members of the hospital staffing pool in case the perioperative area needs additional staff members or has additional staff members who can assist in other areas of the facility. The perioperative staff coordinator also could be responsible for coordinating break periods for staff members, obtaining food and water for them, and watching them for signs of stress and fatigue.

* Anesthesia lead--This typically is the chief of anesthesia. This anesthesia care provider would assist in triaging patients and coordinating the flow of patients throughout the perioperative area.

* Surgeon lead--This typically is the chief of surgery. This surgeon works in conjunction with the perioperative manager and anesthesia lead and is a key in coordinating the assignment of surgeons, triaging patients, and keeping communication flowing among medical staff members.

SUPPLIES

An initial assessment of the supplies on hand should be performed by staff members who are familiar with the area and its supplies. Additional supplies can be requested from vendors based on the type of emergency. For example, a multivehicle accident may require additional orthopedic fixation systems or wound irrigation sets. The ED may quickly deplete the hospital's supply of suture sets, and the perioperative area may need to supplement the ED with additional supplies. The just-in-time resupply programs currently used by most health care facilities cannot be expected to sustain perioperative departments when disasters occur.

Having a procedure in place whereby suppliers automatically bring specified supplies to the facility in the event of a major disaster could address an immediate supply need until a more thorough review of needed supplies can take place. Traditional methods of placing orders may not be possible if computers and telephone lines are down.

The perioperative department must keep its vendor list, including representatives' names and telephone numbers, current. It may be difficult to get supply trucks into a disaster area; therefore, a hospital staff member should be assigned the responsibility of maintaining good communication with local authorities to ensure that supply trucks will have access to the facility. It is important to establish these arrangements before a disaster occurs. (4) To minimize access problems, some facilities provide high-volume vendor representatives who serve the perioperative area with hospital identification badges noting their vendor status.