Final Module Discussion

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    Busayo Asebioyo
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    1) I think she learn proper planning for the disaster situation will help them navigate the dilemma of the six power outlets. Once the hospital realized the situation they will face during the disaster, they started strategize and put a plan in place to manage the situation. They single out a well protected fuel pump generator they could used to power six outlets in the ICU, but Choices had to be made about which patients would have access to the six power outlets that might keep working even if every other outlet died. Setting out guidelines in advance of a crisis was a way to avoid putting exhausted, stressed front-line health professionals in the position of having to come up with criteria for making tough decisions in the midst of a crisis. Evans requested for the list of patients and pulled together an ad hoc committee to decide how the six outlets in the ICU will be fairly allocated to patients. They also make arrangement to squeeze oxygen into patients’ lungs manually with flexible Ambu-bags and planned for old school method and give vasopressors by drops per minute. Unfortunately, with these good plans they have in place, patients or their family choices were not included.They did not even think about asking whether any of the selected patients or their families might wish to volunteer to give up a power outlet so that it could be provided to someone else.

    2) I think the changes that took place in disaster planning post Hurricane Katrina were early evacuation of the critical ill patients and they put in place early strategies to deal with the situation when it occurred. According the book, doctors took to a whiteboard to sketch out priorities: “Establish clinical command structure”; “triage.” One of the hospitals’ local command center in the region was proactive and had strong assistance ready for the hospitals in that region. However there were still no critical and well defined plan for a worst situation, some hospital staff members still don’t know what to do in case of a failure to the backup plan, if there is a complete loss of power. I think American Medical Association should have work with states and federal governments to put forward a well defined guidelines that capture everything that need to be done in a disaster situation and make sure the medical staff are protected.

    3) In addition to experts’ ideas, citizens opinion were included in Maryland’s approach to disaster planning and this help them to considered various possible factors needed before completing the disaster plan. Involving public ideas make the medical decision more transparent and eliminate or reduce the discriminating factor.I think one of the limitation of the Maryland plan is the fact that is not scientifically oriented or proved. Also difficulty in coming to an agreement in the high range of public ideas. The medical choices made on how limited resources are located during disaster with intention of saving more lives,fairness and others are moral decision made by small group of medical professionals, public opinion may be different from the professional ideas.

    4) I think AMA tried to help after the Hurricane Katrina disaster, AMA delegates voted to create model legislation to shield disaster doctors from civil and criminal prosecution and also strengthen existing efforts to oppose criminal prosecution of doctors by adding an emphasis on doctors in emergencies. Anyway, in my opinion AMA should be a champion in layout a comprehensive disaster plan, they should work with appropriate government authorities with the plan and make sure medical staff were covered in the disaster approach. I think US justice system is good, but sometimes justice department misplace priority to achieve political point just like what Attorney General Foti did to Dr. Pou and the two nurses in this book.

    5) Yes, I strongly agreed with Roger Bernier. Our policy makers don’t genuinely engaging or seeking people opinions before making decision, they use their own believes or their own perception of people opinions in decision making. They don’t make good efforts of getting people ideas on public policy decisions.

    6) Education is very important because medical and disaster training knowledge will help in making right decision and utilize the available resources appropriately in a disaster situation. Even if you have adequate equipment during disaster and don’t know how to use them effectively, they will be useless.
    The book revealed a lot of things that could go wrong during disaster and what can be done to mitigate the effect of the disaster such as proper preparation, staff disaster training and having well developed guidelines ready for the situation. Based on the knowledge gained by reading this book most especially the stories of those who have experienced disasters, I think my decision making in a disaster situation like Hurricane Katrina will be effective.

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