Paraphrasing the great scientist Louis Pasteur, “Luck favors the prepared!” When an event occurs, there will be a response, and that response will begin locally and radiate. While most events are small and local, some are incidences of national significance. The collapse of the I-35 bridge in Minneapolis in 2007 is a great example of local tragedy with a well-executed local response. According to Director of Pharmacy, University of Minnesota Medical Center, Scott Knoer, “All of the disaster training really pays off.” “While this was a horrible tragedy for our city,” reflected Knoer, “it was rewarding to see such a well-orchestrated response as our community pulled together.”
It is the authors’ opinion that, as health care professionals, it is pharmacists’ ethical duty to assist during a disaster. Hospital pharmacists most likely have the easiest role to define because their participation in the hospital disaster plan should be clear. During a disaster, their service should be to their home institution. Pharmacists not associated with a health care facility will have to make their desire to volunteer known at the local or state level. Contacting your state’s department of health, pharmacy association, or department of emergency management would all be good places to start.
Organization at the local or state level will vary, but virtually all plans will be based on the National Incident Management System (NIMS). NIMS provides a systematic, proactive approach to guide departments and agencies at all levels of government, nongovernmental organizations, and the private sector. The guide allows agencies to work seamlessly to prevent, protect against, respond to, recover from, and mitigate the effects of incidents, regardless of cause, size, location, or complexity, in order to reduce the loss of life and property and harm to the environment. Preparedness is achieved and maintained through a continuous cycle of planning, organizing, training, equipping, exercising, evaluating, and taking corrective action.
The Strategic National Stockpile (SNS) Program provides pharmaceuticals and medical supplies to the public free of charge in the event of a disaster. The governor of the afflicted state must ask for the SNS. If the request is granted, the material will be on site within 12 hours, hence they are often referred to as 12-Hour Push Packs. It is the requesting states’ responsibility to manage the housing, dissemination, and administration of the material once it is received. However, this response time is inadequate for a nerve agent event, as treatment must be accomplished in <12 hours. The CHEMPACK container system is responsible for allowing storage of nerve agent antidote by various local and state agencies.
The pharmaceuticals initially found in the SNS were based on Category A threat agents. Presently, the pharmaceuticals are targeted for biologicals (smallpox, anthrax, botulism, viral hemorrhagic fevers, plague, and tularemia), chemical agents (nerve agents), radiologicals, and recently the pandemic influenza. Pediatric dosing cards have been developed for the majority of these threats and would be extremely useful in the field.
BIOLOGICAL CATEGORY A AGENTS