EMERGENCY MEDICAL OPERATIONS

	At first glance, it might appear that the Galaxy class USS Enterprise is 
overequipped for medical support. While the nominal mission of the medical 
department is to provide health care for the shipÕs crew and attached 
personnel, this is a relatively small task considering the standard long-term 
crew complement of about a thousand individuals. However, the Medical 
department must also be capable of responding to a wide range of medical 
and emergency situations. These scenarios include emergencies on other 
spacecraft, planetary disasters, and bacteriologic and other exobiological 
threats, as well as crises involving nonhumanoid patients.

	One of the key provisions for emergency preparedness is the 
requirement that at least 40% of crew and attached personnel be cross-
trained for various secondary assignments including emergency medical, 
triage, and other disaster response functions. (Other nonmedical support 
secondary assignments include Engineering and Security duties.) Yellow and 
Red Alert protocols call for cross-trained personnel with noncritical primary 
assignments to be available for their secondary assignments as necessary.

	Emergency medical facilities are designed to significantly increase 
the patient-load capacity of the Enterprise sickbay. Depending on the 
severity and patient load, different options are available.

	Large numbers of patients can be handled by emergency conversion 
of one or more shuttlebays into triage and treatment centers. The main 
shuttlebay is equipped with five portable emergency hospital modules, which 
can be set up in the flight deck area, providing up to five triage and surgery 
wards. Three additional emergency patient care modules can provide up to 
seventy-five intensive-care beds and 530 medium-care beds. Shuttlebays 2 
and 3 are each equipped with one hospital and one emergency patient care 
module. These emergency care facilities are equipped for full biohazard 
protocol, minimizing exposure risk to Enterprise personnel.

	Additionally, Shuttlebay 3 includes hardware for short-term 
conversion to Class H, K, or L environmental conditions, intended for 
nonhumanoid populations. Note that the use of shuttlebay facilities for 
medical service will necessarily impact shuttlecraft launch and recovery 
operations, a factor that can be significant during evacuation scenarios. For 
this reason, large-scale evacuation involving shuttlecraft support will 
generally make use of sickbay and other facilities first, before shuttlebay 
conversion procedures are invoked.

	Fewer numbers of patients can be handled by conversion of other 
facilities. Guest quarters on Decks 5 and 6 are convertible to medical 
intensive-care use, and utility hookups to those compartments include 
biomedical telemetry links and medical gas connections. The shipÕs cargo 
bays, gymnasium, and other recreational facilities can also be converted to 
emergency medical use. All of these compartments are stocked with medical 
conversion kits, which provide necessary hardware and standard medical 
supplies. Additionally, during noncrisis situations, one or more Holodecks 
can be converted to patient care use. While this is a very convenient 
procedure, it is also very energy-intensive and is not normally employed for 
long-term care or during alert situations.

	Supplementing emergency medical supplies, contingency 
preparedness scenarios include provisions for large-scale replication of 
supplies and hardware. Nevertheless, because energy availability for 
replication may be severely limited during crisis situations, emergency plans 
are designed to depend primarily upon the use of stored supplies.

	A typical emergency situation might be a case where a severe 
explosion has injured 150 crew members on a starship. The Enterprise 
medical department response might be as follows:

	After the determination of the existence of the emergency situation, 
the Chief Medical Officer would receive a report from the Main Bridge. The 
CMO would consult with the Commanding Officer as well as the Security 
Officer to determine that the accident site is sufficiently safe for Enterprise 
personnel to transport over. Such determination would generally be based 
on sensor scans of the accident site.

	A survey and triage team would then be transported to the accident 
site. The CMO would normally lead this team, evaluating the extent of 
casualties and on-site requirements. Simultaneously, the medical staff on the 
Enterprise would be preparing sickbay and secondary treatment areas for 
the imminent arrival of patients.

	At the accident site, the triage team would separate patients into one 
of three categories:

	1. Individuals whose injuries are not immediately life-threatening and 
do not require immediate transport to the ship;

	2. Individuals whose injuries are severe enough to require immediate 
attention but can be successfully treated; and

	3. Individuals whose injuries are so severe that they are beyond help.

	Individuals in the second category are prioritized for transport to the 
ship. The triage team does not administer any actual patient care (except for 
airway management) because to do so would slow triage processing to an 
unacceptable rate. The CMO may opt to supplement the on-site triage team 
with an on-site treatment team, although treatment in a controlled on-ship 
environment is usually preferred.

	Using all personnel transporters aboard the Enterprise, a maximum of 
approximately one thousand individuals per hour can be evacuated to the 
ship. If the number of casualties is relatively small, site-to-site transport can 
be used to beam the patients directly to the on-board treatment area. 
Otherwise, patients are beamed only to the transporter rooms and then 
shuttled to the treatment area by gurney. This is because site-to-site 
transport effectively halves the capacity of the transporter system.

	While on-site triage is underway, conversion of secondary treatment 
areas would be prepared, using medical conversion kits. For major disasters, 
hospital and emergency patient care modules can be deployed, providing 
full-scale surgical and intensive-care facilities. If necessary, these 
conversions can include complete biohazard protocols.

	Once patients are received onboard, treatment teams would include 
all available medical staff. The medical staff would be supplemented as 
needed by additional cross-trained personnel from other departments.  Æ