Designed for disaster: Planners of innovative ED want it to be ready for anything

Washington Hospital Center has a plan to build the nation's first all-risks-ready emergency department. But it needs $75 million from the federal government to get the job done.

By David Glendinning, AMNews staff. March 5, 2007.

Imagine this scenario:

Terrorists attack Washington, D.C., with a combination of conventional explosives and a biological agent, killing hundreds of people while injuring and infecting thousands more. Soon emergency departments across the area are receiving more patients than they can possibly handle. Long lines of ambulances with no space to offload patients form at hospital entrances. Patients are stuck in waiting rooms and hallways when all available beds are taken. EDs become overtaxed and inaccessible.

By the time doctors realize the assault exposed some victims to a deadly communicable disease, hundreds more patients and medical personnel have been infected. Entire hospitals are declared quarantine zones.

Just when physicians think the situation couldn't possibly get worse, the terrorists launch their second wave of attacks. Using truck bombs to target emergency departments, the assailants push several facilities past the point of total loss and ensure the system's complete breakdown.

Such a situation might seem hopeless, but some physicians think at least one of the D.C. area's EDs can be modernized so it remains functional and helps hold the system together amid any disaster -- natural or man-made.

ER One would be the nation's first civilian "all-risks-ready" emergency department. Washington Hospital Center, with the leadership of its emergency department chair, Mark S. Smith, MD, is planning to build the facility on its campus about two miles from the U.S. Capitol.