The terror attacks of September 11, 2001, changed many things. The notion of honor in conflict was lost forever, as was the separation of targeting military and civilian assets and people. On that day, terror became the weapon of choice of radical regimes and movements. And our thinking toward emergency preparation changed forever, as well.

Nowhere is the new emergency preparation paradigm more evident than in the Kaiser Permanente hospital and emergency facility in Walnut Creek, Calif. A $25-million, 32,000-square foot expansion and renovation of the facility’s emergency room was completed several months ago.

Featuring the latest in high-tech equipment, including decontamination units for a major chemical spill or bioterrorist attack, the new emergency room is noticeably different than such facilities. And, at least to a point, it offers a view of the future of industrial emergency preparation.

State of the art

The new facility offers 52 patient rooms, each separated by solid walls and doors, as opposed to the curtains used in the past. The idea was to provide greater privacy and comfort, as well as more direct care. All 52 beds have cardiac monitoring.

An on-site lab drawing station and digital imaging are available, which allows for emergency room patients to remain in the ER. This minimizes the need to move possibly contaminated or contagious patients to other departments.

A total of 140 computer monitors are located throughout the ER, facilitating rapid access to medical records and test results. Traditional X-ray equipment has been replaced with Digital Radiography — DR technology — that allows digital images to be viewed by any Kaiser facility in Northern California for consultation purposes.

Perhaps the most telling feature of the Walnut Creek facility is outside the ER entrance. Subtly tucked in next to the main emergency room pedestrian entrance is a gated triage/prep area for victims requiring drench shower and/or eyewash treatment prior to administering emergency care. A row of six combination shower/eyewash units, including hand-held sprayers, stands ready for large-scale emergencies.

Contamination barrier

In discussions with Richard West, of Kaiser’s National Facilities Services group, we were advised that the outdoor location was chosen based on the desire to: 1) Provide immediate showering and irrigation to mitigate further injury from contact with hazardous substances; and 2) Assure that those hazardous substances remain outside of the emergency room facility to the greatest degree possible, in order to protect staff and other patients. In effect, the shower/eyewash configuration allows the main entrance to act as a contamination barrier of sorts. The facility also features a single additional outdoor shower located right next to the ambulance entrance for use prior to entering the facility with the more critically injured.

The facility has three negative-pressure isolation rooms for cases involving highly contagious diseases or contamination cases. The main isolation room, also located right next to the ambulance entrance, has a built-in shower, in addition to an impressive array of high-tech cardiac care and computerized diagnostic equipment.

Transferable technology

Kaiser’s Walnut Creek facility is a case study in state-of-the-art emergency hospital design — but many of the strategies employed can be transferred to the industrial sector. On-site plant emergency treatment facilities may be expected to handle an entirely new set of circumstances today — circumstances that include the potential for intentional damage and injury, as well as the use of biological and chemical agents that never before factored into emergency planning.

Until now, we’ve addressed mostly accidental injuries in an open and direct manner. Today, we need to consider containment of the situation, due to the greater potential for the incident to still be in progress when emergency treatment enters into the picture.

Bottom line: The rules have changed and we need to review and possibly change our approach to guarding the welfare of employees and others.