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Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter Report (2009)
Board on Health Sciences Policy (HSP)

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. "C Crisis Standards of Care Implementation Guidance Scenarios." Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter Report. Washington, DC: The National Academies Press, 2009.

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Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter Report

33Legal Authority and Environment: Scope of practice

The State Health Department has also issued interim guidance33 for tetanus vaccine administration in response to this common complaint and is monitoring the daily conference calls and RMCC web-based messaging to identify other issues for the state DOH and the State Disaster Medical Advisory Committee. Fortunately, despite huge demands on the hospital, Hillendale was never forced to appoint a “triage team” or restrict access to critical care resources. Despite seeing 987 patients in the first 3 days, many of the injuries were minor. Although there were a number of severe trauma cases, the general surgery staff helped to augment34 the few trauma surgeons on staff in managing these patients. Twenty-one patients have been airlifted out, the rest remain hospitalized.

34Legal Authority and Environment: Scope of practice

35Clinical Process and Operations: Recognition of mental health needs

The staff are exhausted. Many have lost homes, as have many patients and their family members. Extended family and friends remain unaccounted for or are known to be injured or dead. Psychological first aid35 is provided to victims and staff by trained staff, and social workers try to assist with reunification. The road to recovery will be long and difficult, as the mental health and logistical challenges are just beginning, but Hillendale has played a key part in supporting the needs of the community during this major disaster.

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