Cole Leonard A, Scott Sandra R, Feravolo Michael, Lamba Sangeeta
Adjunct Professor, Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, New Jersey.
Assistant Professor, Department of Emergency Medicine, Rutgers New Jersey Medical School, University Hospital, Newark, New Jersey.
Am J Disaster Med. 2014 Winter;9(1):17-24. doi: 10.5055/ajdm.2014.0138.
The area between Newark and Elizabeth, NJ, contains major transportation hubs, chemical plants, and a dense population. This makes it "the most dangerous two miles in America," according to counterterrorism officials at the Federal Bureau of Investigation. This study compares medical response capabilities for terror and disaster in Newark, New Jersey's largest city, with those in Boston in view of that city's favorable response to the Marathon bombings in April 2013. Boston's numerous world-class medical facilities offer advantages unavailable in Newark and most other metropolitan locations. Thus, preparedness in Newark, despite its prime-danger designation, can also be instructive for many communities with similar medical resources.
Three categories of response capabilities are assessed: hospital resources, relevant personnel, and symposia/exercises. Data were derived from hospital Web sites, the New Jersey and Massachusetts Hospital Asso-ciations, communications with emergency response personnel, and interviews with spokespersons for hospitals.
Boston's population (618,000) is more than twice Newark's (278,000), and the number of hospitals and hospital beds in each city reflects that proportion. However, Boston's seven general adult hospitals include five level 1 trauma centers (which can provide comprehensive trauma care), whereas Newark's four hospitals include only one such center.Beds per 1,000 people are similarly disparate in those trauma centers: five in Boston, 1.5 in Newark. Emergency Medical Services (EMS) personnel based in Boston and Newark are comparable in numbers, though full-time hospital physicians/dentists and nurses are not. The number of doctors at Boston's five level 1 centers is more than triple that at all four of Newark's hospitals (5,284 vs 1,494). The disparity between nurses at the two sites is even greater (6,784 vs 1,566).There is greater equivalency between the two cities both in content and frequency of symposia/exercises. Hospitals in each city have conducted numerous tabletop and action exercises including on communications efficiency, power outages, and dealing with a bombing or active shooter. Hospitals in each city also have participated in citywide drills with EMS, police, fire, and other responders.
Commonalities in Newark and Boston's exercise approaches suggest that Boston's successful response at the Marathon might be replicated at least in part if the Newark area were similarly challenged. Whether Newark and similarly enabled communities would respond with comparable efficiency remains conjectural. Still, maintaining rigorous preparedness efforts seems a self-evident imperative, especially in an area deemed among the country's most inviting terrorist targets.
新泽西州纽瓦克市和伊丽莎白市之间的区域拥有主要交通枢纽、化工厂以及密集的人口。据美国联邦调查局的反恐官员称，这使其成为“美国最危险的两英里区域”。鉴于波士顿在2013年4月马拉松爆炸案中的良好应对表现，本研究将新泽西州最大城市纽瓦克市针对恐怖袭击和灾难的医疗应对能力与波士顿的进行了比较。波士顿众多世界级的医疗设施提供了纽瓦克市和其他大多数大都市地区所没有的优势。因此，尽管纽瓦克市被指定为高危地区，但其应急准备工作对许多拥有类似医疗资源的社区也具有借鉴意义。
评估三类应对能力：医院资源、相关人员以及研讨会/演习。数据来源于医院网站、新泽西州和马萨诸塞州医院协会、与应急响应人员的沟通以及对医院发言人的访谈。
波士顿的人口（61.8万）是纽瓦克市（27.8万）的两倍多，每个城市的医院数量和病床数量也反映了这一比例关系。然而，波士顿的七家普通成人医院中有五家是一级创伤中心（能够提供全面的创伤护理），而纽瓦克市的四家医院中只有一家这样的中心。这些创伤中心每千人口的病床数量也存在类似差异：波士顿为5张，纽瓦克市为1.5张。波士顿和纽瓦克市的紧急医疗服务（EMS）人员数量相当，但全职医院医生/牙医和护士数量并非如此。波士顿五家一级中心的医生数量是纽瓦克市所有四家医院医生数量的三倍多（5284人对1494人）。两地护士数量的差距更大（6784人对1566人）。两个城市在研讨会/演习的内容和频率方面更为相当。每个城市的医院都进行了多次桌面演练和实战演习，包括通信效率、停电以及应对爆炸或活跃枪手等方面。每个城市的医院还与EMS、警察、消防和其他应急响应部门参加了全市范围的演练。
纽瓦克市和波士顿市演习方法的共性表明，如果纽瓦克地区面临类似挑战，波士顿在马拉松爆炸案中的成功应对至少可以部分得以复制。纽瓦克市及类似条件的社区是否能以同样的效率做出反应仍不确定。不过，保持严格的应急准备工作似乎是不言而喻的必要之举，尤其是在一个被视为美国最吸引恐怖分子目标的地区。
