As has happened before, I was struck dumb as I was sitting in front of my computer, looking at the live scenes of destruction in the wake of the Oklahoma City tornado last week. It makes perfect sense to feel helpless hundreds or thousands of miles away, but what about those in and around Oklahoma City? What about our imaging colleagues? Should they (or could they) prepare for events like this tornado?
The fact is that imaging is an essential part of modern medicine and questions about emergency preparedness ought to be asked of most imaging services. No, it’s probably not critical to restore service to a bone-densitometry service within 24 hours of a natural disaster, but in a busy trauma unit, 24 hours without a CT may feel like an eternity.
An important first step is to establish the criticality of each imaging service. Stated another way, how will patient diagnosis and treatment be impaired if each modality is unavailable? If everything was down, how would we triage our imaging services? Which modalities would we choose to restore first? If we can’t restore in-house service, can we send patients elsewhere, or bring the imaging resource to us?
Once the criticality of each modality/service has been ranked, then we need to identify what infrastructure and services are needed to support that device. For example, if the IT network is catastrophically damaged, how much benefit will a working MRI be if there’s nowhere to display the image other than at the console? Each modality will likely require combinations of electricity, enclosure, shielding, equipment cooling, lighting, and data/telecommunications. Electronics will need to be protected from the elements. Each equipment’s infrastructural needs should be prospectively identified.
The tornado in Oklahoma City developed so quickly that it only afforded the Moore Medical Center a few minutes of advance warning from the National Weather Service. Fortunately, however, many disasters come with hours or even days of forewarning. An important part of emergency preparedness is in minimizing damage from the disaster that is approaching. For much of radiology, that may mean getting electronics and cables up off of the floor to protect against water damage, securing backup power sources for imaging equipment or essential peripherals, even having service contract personnel forewarned and on speed-dial to help with the restoration as soon as the coast is clear.
Whether it is a tornado, or hurricanes, wildfires, flooding, blizzards/ice storms, or even regional power outages, there is no such thing as a disaster-immune area. It is essential that every clinical provider – including imaging services – anticipate the necessity of their services, and prospectively plan for the prioritization, protection, and restoration of essential radiology services.
About the author: Tobias Gilk, M. Arch, with RAD-Planning is one of the foremost design consultants for radiology facilities. His body of work includes beam therapy, simulation suites, CT examination rooms, interventional radiology, MRI, PET/CT, gamma camera and ultrasound.