Will emergency health care providers respond to mass casualty incidents?

Unlabelled: Emergency response plans often call on health care providers to respond to the workplace outside of their normal working pattern.

Hypothesis: Providers will report to work during a mass casualty emergency regardless of family duties, type of incident, or availability of treatment.

Methods: Survey of emergency personnel needed to respond to a mass casualty incident. Two scenarios were presented: one involving the release of a non-transmissible biological agent with proven treatment and the other the release of a transmissible biological agent with no treatment. At critical time points, participants were asked whether they would report to work. Additional questions considered the effect of commonly used treatment dissemination methods.

Results: A total of 186 surveys were issued and returned. (45 physicians, 29 nurses, 86 EMS personnel, and 20 support staff); 6 were incomplete and excluded. Initial commitment rates were 78%. The highest commitment rate identified was 84% and the lowest was 18%. Any treatment dissemination method excluding providers' family members led to decreases in commitment rate, as did agents identified to be transmissible.

Conclusions: As an event develops, fewer health care providers will report to work and at no time will all providers report when asked. This conclusion may be generalizable to several types of incidents ranging from pandemic influenza to bioterrorism. Identification of the causative agent is a major decision point for providers to return to or stay away from work. Offering on-site treatment of providers' family increases commitment to work. These factors should be considered in emergency planning.