As our hospital Safety Officer, I’m involved with disaster planning. This includes writing plans and planning for drills. Code Red, for example, is a fire emergency. While drills are regularly held by the maintenance crew, these involve checking the plant to make sure bells sound, doors close, the call system works, etc. and not primarily staff response.
To remedy this, for the last six months we’ve conducted weekly drills in staff fire response: how to handle the fire itself using a fire extinguisher, how to contain the fire, how to clear the hallways and report to the arriving emergency responders, etc. Luckily, I’ve had a fire fighter on staff who is willing to help.
Fire drills make good sense, since a fire emergency can create a chaotic and dangerous situation.
But what about the laboratory emergency response? Is everyone prepared for emergency release of uncrossmatched blood, massive transfusion, hemolytic transfusion reactions, workplace violence, and other life-threatening situations? Does everyone feel equally comfortable in their ability to respond?
Annual competency can include policy and procedure review, testing, and case histories. Live events can be critiqued. Periodic reminders and education at laboratory staff meetings work. But there’s no substitute for walking the walk, as I found in our fire drills. What looks good on paper or rationalized after the fact often looks different in a non-threatening, training atmosphere. And it is learned differently.
It would not be difficult to work with the ED, for example, to conduct a massive transfusion drill that would simulate an automobile accident multiple trauma situation where blood is needed. The laboratory could test its protocol, including calling additional help, checking the blood supply, and even throwing in variables such as telephone outages or positive antibody screens. This kind of drill can involve nursing minimally; all it takes is one staff nurse making a few scripted telephone calls.
Are any labs doing this? I wonder.