In Your Neighborhood, a Medical Emergency : Life in quake zone requires decentralized treatment system

From a health care standpoint, we were lucky on Jan. 17, 1994, and that’s the frightening part.

Recall the major medical statistics from the Northridge earthquake, and a few that have received far less attention: 61 dead, another 1,600 hospitalized, a total of 10,200 people treated at hospitals and then released, a total of 27,539 around the area who received medical intervention from the federal government.

Eleven hospitals were completely or partially closed due to quake damage and their patients evacuated, but that was only part of the story. On the grounds of 23 hospitals and skilled nursing facilities, 82 buildings were forced to evacuate many or all of their patients and personnel. Even medical buildings that escaped major structural damage still had to close because of collapsed ceilings and ruined heating, ventilation and sprinkler systems.

The Los Angeles Department of Water and Power briefly lost all electrical control to its service area, and 100,000 people were immediately without water. Nearly one-quarter of the Southern California Edison Co.’s 4.2 million customers briefly lost power. It might be longer next time, and the medical infrastructure relies on Edison and DWP too.

So how in blazes were we fortunate?

Well, Times reporter Jon D. Markman points out that the county came within just 70 critical-care beds of being overwhelmed. According to David Langness, spokesman for the Healthcare Assn. of Southern California, “A quake just a point or two higher (in intensity) would have overtaxed our capacity.”

True, but the experts who are now thinking of ways to prepare for a series of 7.0 quakes or higher, or the long-fabled Big One, ought to realize that we don’t need a temblor larger than Northridge to be faced with a medical emergency of nightmarish proportions.

All that is required is a Northridge at 4:31 p.m., in the middle of rush hour or a few hours earlier, when 1 million or more students throughout the area are in school. Think of the damage that occurred at the Northridge Fashion Center and imagine it packed with shoppers instead of closed to everyone but security guards. Consider all those things, and you’ll understand what we mean about luck.

Now, some folks are rightly thinking about worst-case medical scenarios and what to do about them. One of them is Dr. Arnold Bresky of Calabasas, who argues that supplies should be stashed in various locations throughout the region and that volunteers should be trained and at the ready to use those supplies in communities that might be isolated in the next quake. He’s already gotten 40 physicians to volunteer to serve.

At the hospital level, a Northridge anesthesiologist is urging the county medical association to adopt a satellite-linked identification system that could quickly verify medical credentials and grant hospital working privileges to outside doctors.

Most authorities seem to think that a community-based network of the type envisioned by Bresky would be painfully inadequate. Maybe so, but they also have to consider the possibility of much more widespread damage to highways and roads, impassable routes and traffic jams envisioned only in the nightmares of Caltrans workers.

Simply put, people might not be able to get away from where they are at the moment such an earthquake hits. Entire communities could be cut off from one another for hours or days, with no access to crowded hospitals.

Any serious preparation plan must acknowledge such problems. Training and preparing communities to treat illnesses and injuries on their own during the initial phases of a less timely disaster would be time well spent. Thousands of lives could ultimately depend on it.