Nurses say in Vegas that trauma centers not ready for terrorism

LAS VEGAS -- America's trauma centers are ill-prepared to face a biological or chemical terrorist attack, a panel of medical professionals warns.

Heightened awareness of threats should mean more emphasis on preparing hospitals and emergency rooms as first responders, members of the Society of Trauma Nurses said before beginning a two-day conference Monday.

Dr. John Fildes, trauma medical director at University Medical Center in Las Vegas, said during a Sunday news conference that staffing and funding shortages and a malpractice insurance crisis have left the Las Vegas-area's critical care network vulnerable.

"We will have serious difficulty dealing with mass casualties if trauma doctors continue to leave our community," he said.

A 10-day shutdown of the UMC trauma center after surgeons balked last summer at working without county medical malpractice insurance protection highlighted the risks, Fildes said.

The trauma center, which serves Nevada and parts of Arizona, California and Utah, reopened after Clark County guaranteed emergency malpractice insurance coverage as part of the county hospital's insurance plan.

Dr. Kenneth Maddox, vice chairman of the surgery department at Baylor College of Medicine in Houston, cited the current Asian mystery illness that has sickened hundreds in several countries as another example of the need for preparedness.

He noted that the federal Centers for Disease Control and Prevention in Atlanta has been circulating drafts of a Health Powers Act proposal since the Sept. 11, 2001, terrorist attacks.

But doctors cannot quarantine patients suspected of harboring infectious diseases such as smallpox, he said.

"If a patient comes to me and I think they have this Hong Kong virus, I can't make them stay in the hospital," Maddox said. "They can walk out anytime they want."

Maddox said that if a patient leaves against medical advice and then coughs on 150 people, health care officials could be faced with 150 more infected patients.

Maddox said there may be 20 cases of the illness in Houston.

Mary Kate FitzPatrick, Society of Trauma Nurses president-elect, said the Santa Fe, N.M.-based organization maintains an Internet Website to help nurses protect themselves and their families while treating potential bioterrorism victims.

"The Internet board has been an important way for our members to talk about their feelings, share solutions and find out what's being done," she said.

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On the Net:

Society of Trauma Nurses: http://www.traumanursesoc.org