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Prepare for the Worst, Hope for the Best

Nurses and other staff at Washington, D.C.-area hospitals, who had hoped for the best and prepared for the worst on Inauguration Day, got what they hoped for.

Traffic was smooth, staff arrived on time (or in some cases spent the night), extra supplies were not needed, and hospital visits were mostly for minor injuries, despite the influx of nearly 2 million people who gathered to celebrate President Barack Obama’s inauguration Jan. 20.

“Everything went extremely well,” said Michelle M. Allen, senior media relations specialist for the Washington Hospital Center, which is 4 miles from the Capitol. “There was a lot of preparation, but it all paid off.”

The George Washington University Hospital about 1.5 miles from the National Mall had fewer patients than it does on a normal weekday because it canceled elective surgeries for Inauguration Day and the day prior, said Heather Oldham, hospital communications manager. On Jan. 20, the hospital’s emergency department helped 64 people who said they attended the inauguration, she said.

Before the inauguration, various agencies said they expected 100 to 700 extra visits for every million people who attended, said Susan Eckert, RN, MSN, a lead coordinator of inaugural planning at Washington Hospital Center. Only 55 patients presented at the hospital’s ED with inauguration-related complaints and only 13 were admitted, Allen said. They made up about 27% of all ED patients that day, she said.

One of those was Sen. Edward Kennedy, who suffered a seizure at the inaugural lunch. Kennedy, who was diagnosed with an aggressive brain tumor in May 2008, was discharged the next day. Most people who came to the hospitals complained of dizziness, shortness of breath, anxiety, chest pain, sprains and fractures, and problems stemming from pre-existing conditions, such as diabetes. Another 750 were treated for minor ailments at aid stations along the Mall, according to news reports.

Cold weather, standing for hours, and delays in taking medications can result in increased complaints of chest pain and shortness of breath, said Elizabeth Wykpisz, RN, MS, MBA, CNAA, C, CHE, Washington Hospital Center’s chief nursing officer. These are the most common reasons for hospital visits during large events, she said.

Before the inauguration, area hospitals spent many hours reviewing emergency drills, setting up communication centers, and stocking disaster supplies. Many increased staff, especially in the ED.

One of the hospitals’ greatest concerns — crush-related injuries from a stampede — never occurred, in part because of tight crowd control, hyper-vigilant security, and the general good behavior of the crowds themselves. No arrests were reported during the inaugural swearing in and parade, security officials said.

Even hypothermia, another concern the hospitals prepared and trained for, was not seen at Washington Hospital Center, Allen said, though other hospitals reported cases of people with cold-related complaints. Many stood for hours in freezing weather.

One of the greatest concerns of emergency planners had been getting people to work the day of the swearing-in ceremony because road and bridge closures in Virginia restricted commuter traffic into the city. But all the warnings and suggestions of alternative routes paid off, Allen said.

Visitors heeded advice to take public transportation, and traffic from Maryland and the city flowed smoothly, she said. Hospitals reported almost all staff arrived on time.

Most hospitals also offered staff the option of sleeping over, and some took them up on it. About 80 people checked out cots at The George Washington University Hospital, Oldham said.

Northern Virginia Teams Up

Outside the city, the Northern Virginia Hospital Alliance, a group of 12 hospitals surrounding the Capitol, coordinated care from a command center near Inova Fairfax Hospital and increased hospital staff by 10%.

The hospitals communicated by radio through the command center, which acted as central dispatch, and also through an emergency online system. They were prepared for anything from an influx of people with minor injuries to a disaster with mass casualties, but only received a few patients from D.C. hospitals.

Hospitals near the Capitol have experience in disaster preparedness. For example, the facilities treated President Ronald Reagan after an assassination attempt in 1981 and those wounded during the 9/11 terrorist attacks on the Pentagon.

The record-breaking crowds at the Obama inauguration were lower than expected — earlier predictions estimated up to 4 million.

Despite the calm event, no one thought the work was a wasted effort. “We didn’t want it to be the other way around,” Oldham said.

By | 2009-01-23T00:00:00-05:00 January 23rd, 2009|Categories: National|0 Comments

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