OCEANSIDE, N.Y. — American Medical Alert Corp. (NASDAQ:AMAC) a developer and provider of healthcare communication services and advanced home health monitoring technologies, announced today that it has increased the size of its Board of Directors from seven to eight members. Concurrently, the Board has appointed Greg Fortunoff to fill the newly created position.

Howard M. Siegel, Chief Executive Officer commented, “Mr. Fortunoff has more than a decade of investment management experience with a specific focus on small cap healthcare and biotech companies. Mr. Fortunoff is a significant shareholder and over the years has demonstrated a strong interest in working with management. We believe as a Board member, Mr. Fortunoff will be able to provide additional expertise to assist the Company with its relations with the investment community.”

Mr. Fortunoff commented, “I have been a long time investor in AMAC and believe that now is the time for me to work with the Company in order to help them build on the significant value they have created. AMAC management has put the Company in a strong position to capitalize on major trends in the healthcare industry, particularly the movement to augment healthcare facility communication capabilities and the increasing reliance on disease management and remote patient monitoring as a more cost effective treatment modality. I would like to thank the Board for inviting me to join them and look forward to working together to enhance the value of our company for all stakeholders.”

About American Medical Alert Corp.

AMAC is a healthcare communications company dedicated to the provision of support services to the healthcare community. AMAC’s product and service portfolio includes Personal Emergency Response Systems (PERS) and emergency response monitoring, electronic medication reminder devices, disease management monitoring appliances and healthcare communication solutions services. AMAC operates seven communication centers under local trade names: HLINK OnCall, Long Island City, NY, North Shore TAS, Port Jefferson, NY, Live Message America, Audubon, NJ, Answer Connecticut, Newington, CT and Springfield, MA, MD OnCall, Cranston RI and Capitol Medical Bureau Rockville, MD to support the delivery of high quality, healthcare communications.

This press release contains forward-looking statements that involve a number of risks and uncertainties. Forward-looking statements may be identified by the use of forward-looking terminology such as “may,” “will,” “expect,” “believe,” “estimate,” “anticipate,” “continue,” or similar terms, variations of those terms or the negative of those terms. Important factors that could cause actual results to differ materially from those indicated by such forward-looking statements are set forth in the Company’s filings with the Securities and Exchange Commission (SEC), including the Company’s Annual Report on Form 10-KSB, the Company’s Quarterly Reports on Forms 10-QSB, and other filings and releases. These include uncertainties relating to government regulation, technological changes, costs relating to ongoing FCC remediation efforts, our expansion plans, our contract with the City of New York and product liability risks.

“My brother-in-law Tex has been told he has, maybe, one week to live with Stage IV liver cancer. Do you have any suggestions?” The question was posed in late November, 2002, to an American who has established an expertise in tracking down breakthrough medical technologies, and then getting them to doctors who want to use them. The American replied: “There’s just one chance. You need to get Tex to Hermosillo, Mexico, today and take him to Dr. Hector Romero.” The brother-in-law rented a plane in his Texas city and flew Tex that very day to Hermosillo. When Tex got to Dr. Romero’s, he could not hold down even a glass of water. Immediately upon arrival at the clinic, that afternoon, there were two treatment sessions that ran until about midnight. The next morning, before 10 am, he ate a boiled egg and potato, and held it down! Within two days, he was up and walking, as this starved and dehydrated man regained energy. Within 3 weeks, he was walking a mile per day. On 11 January, he went home, via commercial airliner, his liver tumor reduced by over 50%! You can contact Tex by telephone at: 512-556-3424 and he can tell you the details of his experience.

What’s going on? How could this happen? That’s what I wanted to know when I traveled to Hermosillo the week of February 16-22 to attend a small Congress put on by Dr. Romero for people interested in his cases.

Hermosillo, capital of the Mexican state of Sonora, bordering the Gulf of California, is a city of 800,000 about 250 miles south of Tucson, Arizona, Pleasantly modern, it has a handsome, well-preserved 400-year-old cathedral downtown.

There are always lots of little events that lead up to any story. This one started a few years ago when Dean Graves, a big-hearted Arizona businessman, founded an organization called Amigos de las Americas, dedicated to helping where help is needed. The next winter, learning that an’Indian tribe in northern Mexico was near starvation after their crops had failed because of no rain, he and his group loaded up a semi with wheat, corn and beans, which was distributed to the Indian tribes in the mountains.

Dean Graves got acquainted with Dr. Hector Romero, a doctor assigned to work with small town medical groups. Dean learned that Dr. Romero was buying medicine for the poor people, who had no money, but his pay was low, and sometimes he ran out of money. One day, he told Graves: “I won’t have enough medicine to treat all of these children, so I’m only going to be able to treat some of them.” A few days later, Dean learned one of the children who didn’t get treated had died. The news “hit me like a ton of bricks,” he says, and from then on, his Amigos tried to assist Dr. Romero in his needs to take care of his patients.

That is how a remarkable American met a remarkable Mexican doctor, who would buy medicine for his poor patients until his own funds ran out.

Fast forward to January 2002, when Dean Graves met the American who tracks down new medical technologies, who quickly put an end to his wife’s migraines and her need to take half-dozen prescription drugs every day. He did this with just one treatment of the Rife “Blue Light” device, so-called because its bulb glows blue while it dispenses healing frequencies. “Now,” jokes Dean, “it’s an open question which my wife would be most willing to give up: me or the Blue Light.” The American had another device, the Quantum or QXI, which has the capability of diagnosing and then treating to reverse whatever condition it finds. Graves told the American: “I want you to drive down to Hermosillo with me to meet Dr. Hector Romero,” and so the contact was made.

The American wasn’t salesman but just someone who wanted to help others, so he offered to leave with Dr. Romero on indefinite loan: 1) the Rife Blue Light device, 2) a Plexus Venus Pulsar, which stimulates the lymph system and the flow of venous blood and 3) the Quantum QXI. The latter is a very complicated computerized device, but Dr. Romero’s bright, bilingual, 22-year-old son, Hector Jr., quickly learned how to operate it, and taught his father.

That is the background of how a small group of people were invited to spend February 16-22 in Hermosillo to learn what results Dr. Romero had achieved with these technologies, all forbidden in the US, where we have the benefit of being “protected” from such breakthroughs, by the FDA.

While there, I asked the American who had brought the technologies if he knew of something that would help a brain tumor. “The Blue Light,” he replied, “has already reversed 5 brain tumors.” He added that two years ago, an asthmatic ten-year-old who was treated just once with the Blue Light became asthma free, and remains so two years later. This, of course, is the Rife device, discovered in the 1920’s and 30’s in San Diego by the brilliant scientist Royal Rife. Chapter four of Politics in Healing tells of its suppression in the US.

Everyone wanted to know how Dr. Romero had treated the by-now famous Tex. The first thing he did, he explained, was simple, down-to-earth, old fashioned doctoring: he had his nurse give Tex an enema. He followed that with two hour treatments with the Blue Light, then two hours of the Quantum, and an hour on the Venus Pulsar. Two treatments the first day, then next day the same protocol was followed. Eating and being able to hold down food quickly increased his energy, and within less than twelve days he was off all drug medications, without negative consequence. A pleasant house in a fine neighborhood was found for the 80 year-old Tex and his wife and son, who had accompanied him. Remember, when he arrived, he had been given up for dead by American doctors, who had declared he had not more than one week to live. He went home the end of January, well.

Manual provider credentials processing can create hours of data entry work and build mountains of paperwork. An Arkansas medical group learned that lesson quickly–and responded by implementing a credentialing software program that has helped staff save both time and money.

Scaling Paper Mountains

Cooper Clinic is a large multispecialty medical group headquartered in Fort Smith, Ark. The clinic employs 830 workers, including 130 physicians. Debbie Heimark, assistant director of human resources, heads the clinic’s provider enrollment and credentials verification process.

When Heimark joined Cooper Clinic five years ago, there was no credentialing software in place. When a new provider came on board, she had to manually complete as many as 13 different enrollment forms, get the provider’s signature and then mail the completed documents to each insurance carrier. She followed a similar process each time a staff provider’s license or credentialing information needed to be updated. The process amounted to hours of data entry work and piles of paper. Filling out forms by hand was not complicated, she says, but the process was redundant and left room for errors.

“I knew there had to be a better way to do provider enrollment,” Heimark says. About a year later, the medical group bought its first credentialing software. But she felt the headaches soon afterward. Within months, the software was obsolete, Heimark says. Vendor staff lacked medical background and failed to understand end-user needs. “The only thing that system did was warehouse information for us,” Heimark says. “We still had to manually complete many provider forms for various insurance companies.”

Heimark needed to find a more efficient option–and fast. As a member of the human resources department, she could not dedicate the majority of her time to provider credentials. After considering several vendors, Cooper Clinic focused on Brentwood, Tenn.-based Sy.Med Development Inc. and its OneApp healthcare credentialing software.

The software offered Cooper Clinic a user-friendly provider database, a one-click electronic application completion process, data tracking and reporting, and the ability to scan and store images of virtually any license, certificate or other paper document. It also gave Heimark the capability to electronically scan and update provider applications and forms in-house–Heimark’s “biggest must-have.” Sy.Med’s staff possessed a medical background and a solid understanding of Cooper Clinic’s needs. Additionally, OneApp allowed Cooper Clinic to import provider data it had warehoused in the old credentialing software, eliminating the need for hours’ worth of data re-entry.

Automated Credentialing

The medical group went live with OneApp in January 2002. The vendor assisted Cooper Clinic’s in-house IT staff with loading the software onto the clinic’s mainframe and converting provider information to the OneApp database. A Sy.Med representative conducted a typical single-day training, spending time one-on-one with Heimark to train her how to use OneApp’s database to populate required credentialing applications and forms. By the time the vendor staff left, Heimark had most of her provider forms loaded into OneApp and could navigate through the program easily.

Now, instead of filling out each form manually, Heimark needs only to enter a provider’s information once, and OneApp automatically completes subsequent credentialing applications. The completed applications and all required attachments are then printed and sent to the provider for approval and signature in a process that takes hours rather than days; often, forms are ready for provider signature the same day the information is entered. The printed documents are then forwarded to the appropriate healthcare organization for verification and acceptance. Why the hurry? The faster a provider is enrolled, the faster he or she receives his Medicare, Medicaid and other insurance reimbursements–and the faster that funds are brought into the clinic, Heimark says.

The most labor-intensive part of the process was bringing a new provider on board, Heimark says. “I would cringe,” she recalls. “For one provider to get all of his or her initial provider credentialing paperwork done took at least three days. It was worse when several providers started at the same time.”

Now, if Heimark receives the provider’s file in the morning, she uses OneApp to scan all appropriate documents and enters the provider’s personal and educational information only once. She can automatically complete and print all of the necessary applications and forms, flag them for signature and get them into the provider’s hands by that afternoon.

When Heimark needs to confirm an individual provider number to a hospital, radiology department or group insurance plan, she can do so with a few keystrokes, obtaining all the information she needs at the desktop. If an insurance carrier or a hospital needs verification of a provider’s education or certification, Cooper Clinic staff can print out a copy of the scanned document and fax it, or attach it to an e-mail, rather than run to the file cabinet to retrieve another piece of paper.

Singapore’s Health Ministry is on the alert after three people in the city state had to be hospitalized for pneumonia after returning from Hong Kong recently.

”The Ministry of Health is closely monitoring the situation,” the ministry said in a statement Thursday.

A ministry spokeswoman said the Health Ministry is still investigating if the three cases have any link to the outbreaks of chronic pneumonia in Hong Kong, Vietnam and China’s Guangdong Province. So far there has been no indication of such a link, she said.

The three, who had traveled to Hong Kong at the end of February, were admitted to hospital for pneumonia after they returned to Singapore recently, the ministry statement said. Two of them have recovered and have been discharged from hospital while a third is recovering in hospital.

”Investigations suggest a viral origin, however no causative organism has been identified,” the statement said.

The ministry has ordered all medical practitioners in the city state to be vigilant and to look out for similar cases. It has also issued an advisory for those who recently traveled overseas, particularly to Hong Kong, Vietnam or Guangdong Province to seek medical attention early if they experience flu-like symptoms.

”Our surveillance has shown that there has not been any increase in the number of cases of acute respiratory infections” in Singapore,” it said.

The World Health Organization has issued a global alert on the outbreaks of cases of a severe form of pneumonia in Hong Kong, Vietnam and Guangdong Province. Guangdong Province has been worst hit with about 300 cases of pneumonia, of which five have been fatal.

OCEANSIDE, N.Y. — American Medical Alert Corporation (NASDAQ: AMAC), a provider of healthcare communication services and advanced home health monitoring technologies, announced today that Cynthia L. Scollins has joined the Company as Managing Director, Health Management and Monitoring Division. In this pivotal role, Ms. Scollins will provide strategic direction and management to enhance AMAC’s telehealth monitoring capabilities with clinical support services to create a specialized health care management organization for high-risk populations.

Jack Rhian, President and Chief Operating Officer, speaking on behalf of AMAC, commented, “Ms. Scollins’ proven track record and operational expertise in the development of disease management programs for health plans, employers and provider groups makes her uniquely qualified to assist AMAC in creating new services that integrate telehealth monitoring technology with comprehensive care management activities.”

Cynthia Scollins possesses over 15 years experience developing and implementing proactive health management programs. In addition to her tenure at Americhoice, a division of United Healthcare, Sunrise Fl, Scollins held the position of Vice President Health Services for WellPoint Health Networks and Director of Disease Management, Case Management and Utilization Management for Harvard Pilgrim Healthcare in Quincy, MA. She holds a Master of Public Health from Boston University School of Public Health, a Bachelor of Science Management from Lesley University MA and received her Diploma in Nursing from Brigham and Women’s Hospital School of Nursing.

About American Medical Alert Corp.

AMAC is a healthcare communications company dedicated to the provision of support services to the healthcare community. AMAC’s product and service portfolio includes Personal Emergency Response Systems (PERS) and emergency response monitoring, electronic medication reminder devices, disease management monitoring appliances and healthcare communication and solutions services. AMAC operates several 24/7 Emergency Response and Telephone Answering Service (TAS) Communication Centers to support the delivery of high quality, healthcare communications.

This press release contains forward-looking statements that involve a number of risks and uncertainties. Forward-looking statements may be identified by the use of forward-looking terminology such as “may,” “will,” “expect,” “believe,” “estimate,” “anticipate,” “continue,” or similar terms, variations of those terms or the negative of those terms. Important factors that could cause actual results to differ materially from those indicated by such forward-looking statements are set forth in the Company’s filings with the Securities and Exchange Commission (SEC), including the Company’s Annual Report on Form 10-KSB, the Company’s Quarterly Reports on Forms 10-QSB, and other filings and releases. These include uncertainties relating to government regulation, technological changes, our expansion plans and product liability risks.

Epinephrine and phenylephrine previously have been identified as high-alert medications, a designation that results from the narrow margin of safety associated with their use. (1) The Joint Commission on Accreditation of Healthcare Organizations (JCAHO), AORN, the United States Pharmacopeia (USP), and the Institute for Safe Medication Practices all have received reports of adverse events involving epinephrine and phenylephrine in the OR and other surgical settings. These adverse events most frequently were related to solutions being diluted incorrectly or the wrong concentration being used.

A case involving mislabeled epinephrine 1:1,000 that resulted in the death of a seven-year-old child in a Florida OR was reported widely in both the professional and consumer media. The Joint Commission has received sentinel event reports for occurrences in the OR in which side effects from nasally applied phenylephrine resulted in death, as well as reports in which the use of epinephrine in the OR resulted in adverse events or death. The USP, through its Medmarx medication error reporting program, has received multiple reports of epinephrine medication errors in the OR. One resulted in a patient’s death, another in cardiac arrest, and several others placed patients at risk of injury. None of the adverse events reported to Medmarx also were reported to JCAHO. Medmarx also contains medication error reports of multiple mishaps with epinephrine in day surgery settings and postanesthesia care units.

In addition to the errors reported to Medmarx and JCAHO, there are a number of documented cases of intraoperative cardiac complications resulting from the use of one of these medications, alone or in combination with other medications (eg, cocaine), during otorhinolaryngologic procedures. (2) Other case reports (n = 12) of severe hypertension have been documented after the intraoperative use of topical phenylephrine, submucosal epinephrine, or both during nasal surgery, for intubation purposes, or when injected into the submucosal area of the palate. (3) Epinephrine when combined with cocaine during septoplasty also has been associated with myocardial ischemia in unsuspected coronary artery disease. (4)

WHAT IS EPINEPHRINE?

Epinephrine (ie, adrenaline) stimulates alpha, beta-one, and beta-two sympathetic effector cells in a dose-related fashion. Its most prominent actions are on the beta receptors of the heart, vascular muscles, and other smooth muscles (Table 1). The dose, strength, and concentration of epinephrine all are related closely to the purpose of its use and a patient’s general condition and age. (5)

Epinephrine is supplied and used in various concentrations (Table 2). Clinicians handling and administering epinephrine must verify both the dose form and concentration. Clinicians need to understand that 1:1,000 is the most concentrated form of epinephrine when compared to 1:100,000 or 1:200,000, which are much less concentrated forms of the medication in solution. Epinephrine can be used for a variety of purposes in the perioperative setting, including

* relieving bronchospasm,

* treating sensitivity reactions,

* restoring cardiac rhythm during cardiac arrest,

* treating cardiac arrhythmias,

* prolonging action of local and regional anesthetics,

* providing local vasoconstriction,

* reducing conjunctival congestion, or

* treating mucosal congestion.

Bronchospasm or hypersensitivity reactions. For severe anaphylaxis or asthma, the usual initial dose is 0.1 mg to 0.5 mg (ie, 0.1 mL to 0.5 mL of a 1:1,000 injection) given subcutaneously or intramuscularly. If given via the intramuscular (IM) route, the buttocks should be avoided.

Cardiac arrest and cardiac arrhythmia. During cardiopulmonary resuscitation and when treating certain cardiac arrhythmias, epinephrine generally is administered by IV, but it also can be instilled directly into the tracheobronchial tree via an endotracheal tube, intraosseous infusion, or intracardiac injection. During cardiopulmonary resuscitation, the usual adult dose is 0.5 mg to 1 mg (ie, usually as 5 mL to 10 mL of a dose of a 1:10,000 injection). (6)

Anesthesia and local vasoconstriction. One common use of epinephrine in the OR involves its topical administration via cotton or gauze to mucous membranes or other tissues. In this instance, concentrations used can vary from 1:1,000 to 1:50,000. In combination with local anesthetics, epinephrine may be used in concentrations of 1:50,000 to 1:500,000. The most frequently used concentration in local anesthetics is 1:200,000. (7) When used for intranasal procedures, there may be unpredictable medication absorption. (8)

For vasoconstriction, epinephrine often is diluted with varying amounts of normal saline or other solution for use as an irrigating solution. For example, a solution for a hip or shoulder arthroscopy may consist of epinephrine 1 mg (ie, 1 mL of a 1:1,000 solution) in 3 L of normal saline. Tumescent solution, which is used during plastic surgery, may include epinephrine 1 mg (ie, 1 mL of a 1:1,000 solution) in 1,000 mL of normal saline along with 500 mg or 1,000 mg of lidocaine and 12.5 mEq of sodium bicarbonate. (9)

IF YOU SUFFER FROM HAY fever, you could exacerbate your allergies by eating certain foods. Research shows that bananas, cantaloupes, cucumbers, honeydew, watermelon, and zucchini, as well as chamomile and echinacea, contain proteins in their pollen that resemble the pollen found in ragweed. So if you react to ragweed, you could very well react to these foods and herbs.

Hay fever sufferers should avoid these foods during ragweed season, which lasts from mid-August to the first frost, when their reaction would be most severe, says Leonard Bielory, M.D., director of the Asthma and Allergy Research Center at the New Jersey Medical School in Newark, N.J. But if you get hay fever, you may react to these foods any time of year. So if you notice that your mouth itches or tingles when you eat a food on this list, stop eating it immediately and contact your allergist.

In July 2005, Sue A. Blevins, president of the Institute for Health Freedom, wrote an essay as editor of its Health Freedom Watch: “For the first time in our nation’s history, a local health department has proposed compelling medical laboratories to report blood-sugar-test results. The New York City Department of Health and Mental Hygiene floated the proposal in early July. The New York Times says that although medical laboratories have been mandated to report information about infectious diseases (such as hepatitis), they have never been ordered to pass along information about chronic diseases.

“According to the Times, the rationale for mandatory reporting of blood-sugar-test (A1c) results is to exercise ’surveillance’ of diabetes and employ ‘more aggressive intervention.’ City health officials are hoping to collect data on at least 90% of those with diabetes–meaning the government would obtain and analyze millions of test results. It is estimated that the New York City government would keep information on approximately 500,000 citizens, including their names.”

Blevins pointed out that in proposing mandatory reporting, health officials noted that at least seven other registries are already in operation in New York and at the national Veterans Administration. She informed her readers of an August public hearing on the issue, encouraging them to become informed about the role and responsibilities of their local boards of health. “After all,” Blevins wrote, “tax dollars support them, and health officials are working for the citizenry …. Whether you live in New York City or not, you should consider how such a trend could affect your health privacy and freedom. In a free society, government serves the citizens–it is not the master, not even when it comes to public-health activities.”

Reason for worry

The Association of American Physicians and Surgeons, the National Lawyers Guild, and the National Libertarian Party all saw the plan as an invasion of patient privacy and physicians’ prerogatives. In several recent newspaper articles, however, the fact that the government has a long history of tracking infectious diseases to protect the public was noted. New York health officials claimed that tracking diabetes–which has become a crisis due to the American obesity epidemic–is no different than the government’s ongoing tracking of lead poisoning, cancer clusters, and low birth weights.

In the past, they say, public health officials have also quarantined travelers, confined tuberculosis patients, and notified STD patients’ sex partners. But the New York plan is the first instance of required routine reporting of lab test results for a major chronic, non-infectious disease so that government officials can scrutinize how well doctors and patients are treating it.

Despite the argument from many health experts that this is a gallant effort to improve diabetes treatment, ethicists and privacy advocates are alarmed at this type of intrusion into medical care. Some critics indicate that such a registry could also lead to higher insurance premiums for patients or denial of life, health, or car insurance coverage. Officials at the American Diabetes Association, however, say the plan has merit as long as confidentiality is protected.

A new twist on ‘intervention’

So, on January 15, 2006, New York City started monitoring the blood-sugar levels of some 500,000 diabetic residents and creating a database. (In 2007, their initial plan will be expanded with a pilot treatment program in the Bronx.) Since diabetics undergo an annual A1c blood test to provide a long-term measurement of how well they are controlling their condition, the city now requires all 120 New York medical laboratories with electronic data transmission ability to report results of these tests within 24 hours. A laboratory failing to report would be in violation of the city’s health code and could face warnings and possible fines, according to the NYC Health Department’s counsel.

The data compiled based on those medical laboratory reports will then be used to directly intervene in individual patient’s care. Not only will city officials alert patients whose blood-sugar levels are not being well controlled, but they will also contact doctors about those patients and will offer advice.

Lawrence O. Gostin, director of the Center for Law and the Public’s Health at Georgetown and Johns Hopkins universities, says, “There are lots of good reasons to do this kind of thing, but … should the government be collecting this kind of information? Should it be intervening like this? You can imagine it getting to the point where you have a public health worker showing up at your door and asking, ‘Did you remember to exercise, eat right, and take your medication today?’”

JCAHO Recommends Reconciling Patient Medications. To help prevent medication errors, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) encourages healthcare organizations to reconcile a patient’s medications as the patient transitions from one care setting, service, practitioner or level of care to another.

“Emergency preparedness” can mean any number of things. In the context of hospitals, it may refer to the ability to manage a sudden influx of patients, contain a fire, deal with a power outage, or handle numerous other events that overload the system or disrupt the usual flow of activity. The Joint Commission for the Accreditation of Hospital Organizations (JCAHO) mandates periodic institutional disaster drills to ensure preparedness for such occurrences. The terrorist attacks of September 11, 2001, and subsequent anthrax scare focused attention on the preparedness of the health care system to respond to mass casualties. The public - and consequently the federal government - has a keen interest in the preparedness of not just individual institutions, but of cities and states, to manage disasters. This has translated into a tremendous financial appropriation to states: the Department of Health and Human Services committed $3.5 billion in funding for bioterrorism preparedness, with over $1.3 billion committed to support states, hospitals and public health agencies in preparedness planning. Rhode Island’s share, $9.75 million, compares to a total of just over $300,000 in federal funding received by the State through the Trauma/Emergency Medical Services (EMS) Systems program since 1992. Clearly this money will be best spent if we can critically analyze our preparedness and identify those areas most in need of improvement. Unfortunately, as others have found, it is often only in retrospect that we can truly assess our readiness.1,2 In the aftermath of a mass casualty incident in Rhode Island, we analyzed the event to assess our performance and our needs for future preparedness.

On Thursday, February 20, 2003, a fire broke out at The Station, a nightclub in West Warwick, during a performance by the rock and roll band Great White. Toxic smoke immediately filled the club and the flames rapidly spread, engulfing the building within minutes. Ninety-six persons unable to escape perished at the scene.

THE RESPONSE

The West Warwick Fire Department was the first to arrive on the scene, and quickly called for backup. Dozens of fire and rescue units arrived shortly thereafter. A medical triage station was established at the Cowesett Inn, across the street from the nightclub. Rescue units were held in a staging area and sent in small groups to the triage station as patients were identified for transport. Many victims fled the scene in privately-owned vehicles, seemingly headed for either the nearest hospital, or the hospital nearest their homes. In all, 186 patients were initially treated at eleven regional hospitals.

Individual hospitals activated their internal disaster plans. At Rhode Island Hospital (RIH), this involved activating our Hospital Emergency Incident Command System (HEICS). This establishes an incident command center and triage center, and mobilizes dozens of individuals to organize and oversee the response. Anticipating the arrival of as many as 150 victims, the emergency department was emptied, with all patients rapidly admitted to ward beds. A single floor in the main hospital- normally containing a 10-bed trauma/burn intensive care unit (ICU), an 11-bed intermediate-care unit, and a 24-bed ward, was transformed into one large burn unit. Fortuitously the incident occurred around the change of nursing shift, resulting in a larger-than-usual complement of nursing staff in the hospital.

Ten attending surgeons were called in from home, along with six emergency physicians and approximately 30 surgical residents. Together with the usual in-house physicians, these doctors worked to stabilize patients and get them either admitted or discharged as quickly as possible. The event occurred at approximately 11:00 p.m. Two hours later the scene was cleared of patients, and by 3:00 a.m. the RIH emergency department was empty. In all, 68 patients were treated at RIH, with 43 admitted. Ofthose, 22 were mechanically ventilated.

For days, teams of surgeons worked around the clock to stabilize the patients. Patients with inhalation injuries required high levels of ventilatory support, and some required multiple bronchoscopies daily to clear their airways of soot and secretions. It took weeks to get all of the patients’ burn wounds excised and grafted. Ultimately, however, all of the patients were discharged with their wounds covered.