Gist Ramon, Daniel Pia, Grock Andrew, Lin Chou-Jui, Bryant Clarence, Kohlhoff Stephan, Roblin Patricia, Arquilla Bonnie
1Department of Pediatrics,SUNY Downstate Medical Center,Brooklyn,New YorkUSA.
2Department of Emergency Medicine,SUNY Downstate Medical Center,Brooklyn,New YorkUSA.
Prehosp Disaster Med. 2016 Jun;31(3):259-62. doi: 10.1017/S1049023X16000297. Epub 2016 Apr 4.
Introduction The Medical Reserve Corps (MRC) is a national network of community-based volunteer groups created in 2002 by the Office of the United States Surgeon General (Rockville, Maryland USA) to augment the nation's ability to respond to medical and public health emergencies. However, there is little evidence-based literature available to guide hospitals on the optimal use of medical volunteers and hesitancy on the part of hospitals to use them. Hypothesis/Problem This study sought to determine how MRC volunteers can be used in hospital-based disasters through their participation in a full-scale exercise.
A full-scale exercise was designed as a "Disaster Olympics," in which the Emergency Medicine residents were divided into teams tasked with completing one of the following five challenges: victim decontamination, mass casualty/decontamination tent assembly, patient triage and registration during a disaster, point of distribution (POD) site set-up and operation, and infection control management. A surge of patients potentially exposed to avian influenza was the scenario created for the latter three challenges. Some MRC volunteers were assigned clinical roles. These roles included serving as members of the suit support team for victim decontamination, distributing medications at the POD, and managing infection control. Other MRC volunteers functioned as "victim evaluators," who portrayed the potential avian influenza victims while simultaneously evaluating various aspects of the disaster response. The MRC volunteers provided feedback on their experience and evaluators provided feedback on the performance of the MRC volunteers using evaluation tools.
Twenty-eight (90%) MRC volunteers reported that they worked well with the residents and hospital staff, felt the exercise was useful, and were assigned clearly defined roles. However, only 21 (67%) reported that their qualifications were assessed prior to role assignment. For those MRC members who functioned as "victim evaluators," nine identified errors in aspects of the care they received and the disaster response. Of those who evaluated the MRC, nine (90%) felt that the MRC worked well with the residents and hospital staff. Ten (100%) of these evaluators recommended that MRC volunteers participate in future disaster exercises.
Through use of a full-scale exercise, this study was able to identify roles for MRC volunteers in a hospital-based disaster. This study also found MRC volunteers to be uniquely qualified to serve as "victim evaluators" in a hospital-based disaster exercise. Gist R , Daniel P , Grock A , Lin C , Bryant C , Kohlhoff S , Roblin P , Arquilla B . Use of Medical Reserve Corps volunteers in a hospital-based disaster exercise. Prehosp Disaster Med. 2016;31(3):259-262.
引言 医疗预备队（MRC）是一个全国性的社区志愿者组织网络，由美国卫生局局长办公室（美国马里兰州罗克维尔）于2002年创建，旨在增强国家应对医疗和公共卫生紧急情况的能力。然而，几乎没有基于证据的文献可指导医院如何最佳利用医疗志愿者，且医院在使用他们方面也存在犹豫。假设/问题 本研究旨在确定如何通过让MRC志愿者参与全面演练，将他们用于医院灾难应对。
一场全面演练被设计成一场“灾难奥运会”，其中急诊医学住院医师被分成小组，负责完成以下五项挑战之一：受害者去污、大规模伤亡/去污帐篷搭建、灾难期间患者分诊与登记、分发点（POD）设置与运营以及感染控制管理。为后三项挑战设定的场景是大量可能接触禽流感的患者。一些MRC志愿者被分配了临床角色。这些角色包括担任受害者去污防护服支持团队成员、在分发点分发药物以及管理感染控制。其他MRC志愿者担任“受害者评估员”，扮演潜在的禽流感受害者，同时评估灾难应对的各个方面。MRC志愿者就他们的经历提供反馈，评估员使用评估工具就MRC志愿者的表现提供反馈。
28名（90%）MRC志愿者报告称他们与住院医师和医院工作人员合作良好，认为演练有用，且被分配了明确的角色。然而，只有21名（67%）报告称在分配角色之前对他们的资质进行了评估。对于那些担任“受害者评估员”的MRC成员，9人指出他们在接受的护理和灾难应对方面存在错误。在那些评估MRC的人中，9人（90%）认为MRC与住院医师和医院工作人员合作良好。这些评估员中有10人（100%）建议MRC志愿者参加未来的灾难演练。
通过全面演练的使用，本研究能够确定MRC志愿者在医院灾难中的角色。本研究还发现MRC志愿者在医院灾难演练中特别适合担任“受害者评估员”。吉斯特R、丹尼尔P、格罗克A、林C、布莱恩特C、科尔霍夫S、罗布林P、阿基利亚B。医疗预备队志愿者在医院灾难演练中的使用。院前灾难医学。2016；31(3):259 - 262。
