Prepared for Trauma, Overwhelmed by Carnage

Hospitals' practice drills provide blueprint, but rapid response to Boston Marathon bombings shows how they really work

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Hospitals are required by their accrediting organization -- The Joint Commission -- to have a detailed emergency operations plan. They also must perform two drills a year, focusing on risks they believe are most likely to occur, based on their location, said George Mills, a director at The Joint Commission, which evaluates and accredits more than 10,300 hospitals in the United States.

A disaster like the Boston bombing is the hardest type of catastrophe to plan for, said James Romagnoli, vice president of emergency management at North Shore-LIJ Health System, in Great Neck, N.Y.

"You have no idea of the who, what or where. Even a plane crash is easier to prepare for, as unexpected as they are," he said. "But [Monday], you had no time. You have to be able to turn a switch, and instantly everyone has to know that you're going into incident command."

Romagnoli said he spent Monday monitoring the events in Boston and remained in contact with law enforcement officials in his area. "I had a real concern that [a bombing] was going to happen simultaneously in New York," he said. "We figured it could happen in Manhattan."

Still, no matter what's happening in New York or elsewhere, the emergency management staff at Romagnoli's network of 16 hospitals always knows how many beds are available.

"Just in case," he said.

More information

Learn more about community emergency response teams from the Federal Emergency Management Agency.

To learn how to help children cope with the emotional impact of the Boston bombings, click here.

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