Hospital Alerting and Internal Disaster Management

Given that hospitals began to receive casualties prior to LA EMSA setting up their EOC, hospitals were not uniformly alerted to prepare for the arrival of injured civil disturbance victims until late Wednesday night when LAEMSA made their first hospital call down. The Agency did not seem to be involved in civil disturbance preparations being made by law enforcement, fire or other County departments (these issues are more fully discussed in the LA EMSA section). Daniel Freeman Medical Center, Martin Luther King/Drew Medical Center, and Saint Francis ,N4edical Center activated based on what they were seeing in their emergency department, in their neighborhoods, or on the media. They organized their own resources by: arranging to move staff through the riot area, obtaining supplies, caring for the injured, and maintaining their operations. Hospital administrators demonstrated considerable creativity and initiative in handling the event. Two of the three hospitals visited for this study developed or implemented some sort of disaster management system. These efforts seem to incorporate elements of existing plans but did not appeal to draw upon plans specifically designed for civil disturbances. None used the Hospital Emergency Incident Command System (HEICS) (Russell, 1991). Daniel Freeman Medical Center established their disaster medical management system at 7:30 PM, Wednesday following a significant increase i ambulance and self transports to their emergency department. Martin Luther King JR./Drew Medic Center activated their Command Post and internal disaster plan at I 1:00 PM on Wednesday (Renfor 1992a), again after witnessing an increase in emergency department traffic. In contrast, Saint Francis did not implement an internal disaster plan or establish a special command post. Their contacts with the community had alerted them to the fact that a civil disturbance would probably occur. The hospital made necessary provisions to deal with the expected volume of patients on Wednesday. They also shifted staff from one ftinction to another to adjust for workers who could not come in. Employees living in dangerous areas did not have to report to work. Each hospital carefully tracked the status of their employees, medical supplies, patient load and other factors that could have negatively impacted the hospital's capability to provide care. Anticipated shortfalls were quickly corrected. The Kaiser Permanente Regional Emergency Operations Center was activated at 10 AM on Thursday April 30. Civil unrest and reports of a gas fire and bomb threat at two of their hospitals led to the activation. (The earlier was not civil disturbance related and the latter was dealt with using standard procedures.) A portion of the Incident Command System (Operations/Planning) was established. Staffing was drawn from other regional administration offices. They monitored the situation by making calls to ten medical service and mental health services areas and key regional facilities (Kaiser Permanente, 1992). Cedars -Sinai Medical Center did implement its disaster plan early in the crisis. "Department head discussed how to fortify the hospital for what might lie ahead and how to feed, sleep, transport, an provide security for a staff that would have to work around the clock to provide patient care and staff support throughout the conflict" (Stein, 1992).

Medical Care for the Injured

Continue to Pattern of Hospital Assistance needs

Return to the Table of Contents