Without notice emergency physicians at even the smallest EDs can be thrust into the limelight. Beyond dealing with the medical needs of the patients which is the first priority, as a physician leader you will also have public relations responsibilities during this time of crisis. Today we will review some Dos and Don’ts of dealing with the press after a mass casualty situation.


1. A truckload of cows broadsides a school bus and 30 children are brought to your emergency department. 4 are critically injured (children, not cows) and about 10 have sustained moderate injuries, the remaining 10 have minor injuries. Several other victims were taken to a local Children’s Hospital. You have expertly managed the initial portion of the event and the critical patients are admitted or off to the operating room. What are the next priorities?
A. Make sure a list of the involved patients is being put together.
B. Perform hand hygiene.
C. Check your hair for the cameras at the press conference.
D. Restock the pediatric disaster boxes.

Answer: A

One of the biggest challenges after an mass causality incident is getting families back together. This is a particular challenge with pediatric events. Children may be able to provide limited information to providers, even as simple as their name. Especially when victims go to more than one hospital, rapidly getting an accurate victim and disposition list together is critical to avoid having parents going to or repetitively calling the wrong hospital. The school system has policies for these events and also we have MnTrac, our electronic incident and patient tracking software that can be used to provide information about where victims went.

2. Public Relations has arranged for you to speak to the press, who are clamoring for information. What should you tell them?
A. No comment
B. Patient names
C. General information about the numbers of victims, condition, and overview of the types of injuries
D. That you have always wanted to be on TV

Answer: C

It is best to provide general information about actions the hospital has taken in response to the incident, the rough numbers of victims, range of conditions, and general comments about the types of injuries. The key here is to not get specific enough that individual victims can be identified (for example, we had one pregnant patient that delivered after the bridge collapse – not appropriate to comment on her injuries – but with many patients with spinal column injuries it’s ok to share that information in general terms). Do not use patient names of course, and do not ever say ‘no comment’ as it always looks like you’re hiding something. Give them the ‘what’ (what happened, what are we doing), ‘when’ and ‘why’ without being too specific about the ‘who’. Be honest and open about what you don’t know – e.g. ‘I don’t have an accurate count of patients right now, we are working on putting that together and should have that available within the hour’ rather than speculating. Also, be careful about what you say and how you act – for example smiling and laughing even when you don’t think you’re being filmed and are talking about something else could wind up making it on TV (as happened to one of our staff in the past). If there’s a camera or a reporter around, everything is fair game.

3. How much do we have to worry about HIPAA during a disaster?
A. A lot
B. A little
C. Depends on what is being shared and with whom
D. What’s HIPAA?

Answer: C

Significant exceptions are made under HIPAA during disasters, particularly when the information is being shared to facilitate reunification of families. Most of the time, agencies want injury information, or patient lists (remember that the patient’s name, age, and general condition unless prior restricted are NOT protected information) but not specifics on individual patients. The exception to this is MDH in infectious disease cases, and since it’s a state agency that has to investigate outbreaks, it’s not a problem in that case. Usually, we don’t wind up on the receiving end of these requests, but if there’s a question, engage PR or our liaison officer in the Hospital Command Center and let them work on the request.

Dr. Michael McGonigal has written about HIPAA and Trauma care on his blog.

For some good, brief tips on talking with the press that everyone should read see:

Compiled by Dr. John Hick, Medical Director for the Office of Emergency Preparedness with the Minnesota Department of Health.