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	STAFF PREPAREDNESS

	The medical needs of the unaffected community must be considered since these requirements will not diminish in the event of an MCI or NBC event. Plans must include provisions for diverting the normal number of trauma and medical emergency patients to other facilities, possibly in neighboring communities. These surrounding hospitals must be consulted during the planning phase, so they in turn can make realistic plans regarding the most efficient use of resources after a major terrorist event.

	Terrorist use of NBC agents could result in large numbers of dead victims who require special handling procedures. These victims may be contaminated, and their clothing along with any embedded foreign material will be needed as evidence. Disposition of bodies may require specific decontamination procedures. Temporary morgues may be required.

	In addition to planning and training, hospital staff will need to be “mentally” prepared to deal with the ramifications of a large scale terrorist incident. If a disaster does occur in the community, staff members will want to remain at the hospital for the duration of the crisis to offer assistance. Although their desires are admirable, some of these individuals will need to return home so personnel can be rotated effectively to prevent staffing congestion and help minimize fatigue. This is particularly important for decontamination or treatment personnel who will be in PPE; they could be subject to heat stress, and will not be able to function as long as those not burdened with protective equipment.

	Train with crisis intervention teams for psychological assessment of the patients and support of the hospital providers.