Background: To assure hospital emergency preparedness, the Office of Emergency Management at the Johns Hopkins Hospital (JHH) requires each department tests hospital emergency plans. Respiratory Care Services (RCS) held a drill to assess current pandemic influenza plan.

Methods: Using Electronic Mass Casualty Assessment and Planning Scenarios (EMCAPS) software and 2000 Census ata for Baltimore City, RCS executed a tabletop drill to identify RT responsibilities and actions. We included local RT staffing agency and equipment rental companies to help assess key equipment and personnel availability. Goals were: assure RCS is prepared to follow JHH's framework; identify areas where additional direction is needed for division and staff function; and recognize key system issues affecting patient care. JHH's Epidemic/Pandemic Respiratory Illness (EPRI) Surveillance and Response Plan lists the following RT responsibilities:

1. Assess ventilator use and redistribute as directed
2. Obtain number and availability of additional mechanical ventilators (MV) ready for use
3. Assess staffing to determine need for non-RT patient ventilator management
4. Support emergency rooms, cohorted areas and other inpatient units

Results: RCS owns 80 critical care MVs, 30% available for use daily. EMCAPS projection indicated JHH will exhaust current MV resources by EPRI week 3. Projected needs could be met by reallocating adult-capable MVs from neonatal ICU and activating rental resources. RCS also purchased 20 AutoVent 3000s to meet basic disaster MV needs. Anesthesia ventilators used in ICUs will be managed by trained OR personnel. JHH's goal is to meet equipment needs internally without relying on Strategic National Stockpile MVs. We will need an additional 4 RTs per shift for safe patient care during EPRI. Local RT staffing agency offered 5-7 staff per shift to fill needs. RCS priority during EPRI will be to maintain adequate levels of care for critically ill patients. Triage of non-critical respiratory care will allow for RT management of acute care patients.

Conclusion: RCS is prepared to follow the JHH EPRI Surveillance and Response Plan. Additions to departmental policies were necessary to document specific RCS actions. RT staff training is ongoing to assure competency in EPRI process and equipment management. We will continue testing emergency plans to assure preparedness.