Hospital preparedness for victims of chemical or biological terrorism

Objectives. This study examined hospital preparedness for incidents involvi ng chemical or biological weapons. Methods. By using a questionnaire survey of 224 hospital emergency departme nts in 4 northwestern states, we examined administrative plans, training, p hysical resources, and representative medication inventories. Results. Responses were received from 186 emergency departments (83%). Fewe r than 20% of respondent hospitals had plans for biological or chemical wea pons incidents. About half (450/'o) had an indoor or outdoor decontaminatio n unit with isolated ventilation, shower, and water containment systems, bu t only 12% had 1 or more self-contained breathing apparatuses or supplied a ir-line respirators. Only 6% had the minimum recommended physical resources for a hypothetical satin incident. Of the hospitals providing quantitative answers about medication inventories, 64% reported sufficient ciprofloxaci n or doxycycline for 50 hypothetical anthrax victims, and only 29% reported sufficient atropine for 50 hypothetical sarin victims (none had enough pra lidoxime). Conclusions. Hospital emergency departments generally are not prepared in a n organized fashion to treat victims of chemical or biological terrorism. T he planned federal efforts to improve domestic preparedness will require su bstantial additional resources at the local level to be truly effective.