February's devastating earthquake has highlighted a need for hospitals to do more planning on how they would cope with mass casualty events, says senior Christchurch orthopaedic surgeon John McKie.
He is presenting a paper on disaster management and the lessons that can be learned from February's quake to an international gathering of orthopaedic surgeons in Rotorua later this week and believes hospitals need to put more emphasis on disaster preparedness.
McKie led the surgical team at Christchurch Hospital that performed about 130 orthopaedic operations in the week immediately after the February 22 quake, mainly to fix broken hips, arms and shoulders.
He told the Star-Times that no drills or paper exercises could adequately prepare hospitals for the reality of a mass casualty event like the Christchurch quake and it was important that lessons learnt from the experience were passed on.
"There are things we have learnt from our experience that hopefully we won't have to put into practice again in our lifetime, but the reality is, with the geography and topography of this country, natural disasters are an expected phenomenon," McKie said.
The Christchurch experience had highlighted the need for clinically led rapid decision-making in emergency situations and the need for comprehensive disaster planning that covered all eventualities, including the loss of key personnel and power.
Christchurch Hospital had to use its emergency generators after the quake, but the violent shaking had caused blockages in the fuel supply to the generators and they were unreliable: "If you've got no power, you've got no computers which means you can't log in patients, it makes it difficult for x-rays and imaging, you can't use lifts so it's difficult to move patients up and down stairs, which causes real problems if your operating theatre is on a different floor from your emergency department. It raises lots of issues about hospital design," McKie said.
The quake had also highlighted the importance of decision-making being driven at a local level rather than from a national level.
"One of the issues we had was that there were things happening at ministry [of health] level... and instructions coming down that weren't that practical or helpful and just wasted a lot of time," McKie said.
Around 500 surgeons from as far afield as the United Kingdom, the United States and South Africa will be Rotorua for the orthopaedic surgeons' conference.