Southland VA Hospitals Gear Up to Treat Desert War Casualties : Readiness: Most would go to military centers. If the VA is used, it might transfer patients to civilian facilities.

As prospects grow for bloody desert clashes in the war with Iraq, Southern California Veterans Administration hospitals are gearing up to be among the first in the United States to receive war casualties if the nation’s military hospitals fill up.

Most of the wounded transferred to stateside hospitals would be recovering from injuries, having received treatment in battlefield hospitals and military facilities in Europe. Upon arrival in the United States, casualties would be sent to military hospitals first, then to Veterans Administration medical centers if the military hospitals fill up. Civilian hospitals would back up the VA facilities.

The hospitals involved belong to the National Disaster Medical System, a network mandated by the Health Resources Sharing and Emergency Operations Act of 1982 in the event of a national emergency. Heavy casualties in the Persian Gulf would be its first test.

Local civilian hospital officials, meanwhile, said they do not expect normal patient services to be disrupted, barring massive casualties. Some VA patients in Southern California might be transferred to other hospitals.

“It’s largely because we have so many empty hospital beds in Los Angeles County,” explained David Langness, spokesman for the Hospital Council of Southern California, which is coordinating war preparations at the civilian hospitals. “It would take enormous casualty levels to push the private sector here to the point where we were turning away patients.”

The main Los Angeles-area hospitals in the network are the Long Beach Naval Hospital, a military facility for active-duty personnel, and the VA hospitals at West Los Angeles, Long Beach, Sepulveda and Loma Linda. In addition, about half of the general hospitals in Los Angeles County are standing by to take care of patients normally treated at VA hospitals in order to free VA beds for war casualties.

The network was created for natural disasters as well as man-made ones such as war. During World War II, military hospitals handled most of the wounded, having about 500,000 beds in facilities around the country. Today, however, there are only 16,000 military hospital beds, necessitating backup from the emergency network.

Under the 1982 law, VA hospitals nationally must make 9,000 beds available for military use within 24 hours of a request from the Department of Defense. Within 30 days, the VA is obligated to provide 25,000 beds, Brown said.

The VA system has 80,000 staffed beds in 172 facilities around the country. Most of these beds, however, are occupied by ill veterans, making backup from civilian hospitals necessary. In Los Angeles County, there are 74 National Disaster Medical System hospitals, for a total of 6,300 beds.

The veterans most likely to be transferred to civilian hospitals are those with less serious medical problems. VA hospitals also have plans to restrict admissions to emergency cases and divert others to private hospitals should the number of military casualties exceed bed vacancies.

Plans for the shuttling of military and veteran patients between airports and hospitals also have been worked out. According to officials, routes from airports to local hospitals have been plotted and timed. A remote corner of Los Angeles International Airport has been tentatively designated to assess soldiers’ medical needs and assign them to military, veterans or civilian hospitals.

LAX officials have pledged to give military transports priority in landing and to provide computer lines so that medical teams at the airport can transmit information on the soldiers to receiving hospitals, said Kathrene Hanson, spokeswoman for the VA hospital in West Los Angeles.

Hospitals, meanwhile, have been briefing staff and attending to such details as updating home phone lists of staff and scheduling review courses on the treatment of chemical burns and other potential battlefield injuries.

Assistance has been offered by doctors at civilian hospitals with expertise in surgery, trauma and other specialties relevant to war injuries. The dean of the UCLA School of Medicine this month told medical staff chiefs of the West Los Angeles and Sepulveda VAs that his faculty doctors were on call to them. UCLA’s surgery chairman, Dr. Michael J. Zinner, has reassigned staff to make as many doctors as possible available to help out at the VAs.

Also involved in the planning are officials of the Los Angeles County Medical Alert Center based at County-USC Medical Center. The Medical Alert Center normally tells ambulances where to take trauma patients and monitors the availability of beds in county hospitals. If casualties begin to arrive in Southern California, the center will undertake that function for all of the hospitals standing by to receive casualties, said Langness of the hospital council.

Melvin Gordon, liaison with military officials for the VA Medical Center in Sepulveda, said even though the number of casualties may be too few to fully test the system, the spirit of cooperation evident in all of the planning meetings has been reassuring.

“The thing that was really neat to see was the military, the VA, the county and the airport work so well together,” Gordon said. “That doesn’t happen very often.”

There are still details to be worked out. Traffic control is one concern, particularly if LAX is used. Freeways are often congested in the airport area. One possible solution under study is to close certain surface streets to all but ambulances, Hanson said.

Concern about terrorists has made military and veterans officials far more secretive about their plans for dealing with casualties than before the fighting started.

It is an area no one has much experience with, concedes Dr. Raymond Bonnabeau, the VA’s national director of emergency medical preparedness.

Nevertheless, he said the network is “as ready as we can be.” The questions that remain--how many wounded, what kind of wounds, will they overwhelm the resources of the network--no one can answer.

Times staff writer Josh Meyer contributed to this report.

MAKING WAY FOR THE WOUNDED

Under a tentative local plan for receiving injured from the gulf, casualties would be directed first to military hospitals. Overflow patients would be sent to Veterans Administration medical centers and, if necessary, to civilian hospitals. * First tier in Southern California:

March Air Force Base

Long Beach Naval Hospital

Camp Pendleton Naval Hospital

San Diego Naval Hospital

* Second tier in California, VA Centers:

West Los Angeles

Loma Linda

Long Beach

Sepulveda

San Francisco

San Diego

Palo Alto

Martinez

Fresno (after primary VA hospitals are full)

Livermore (after primary VA hospitals are full)

* Third tier

Civilian hospitals that belong to the National Disaster Medical System; 74 member hospitals in Los Angeles.

Source: Department of Veterans Affairs and local hospital officials