Planning for large-scale disasters was under way at Stanford Hospital
before the events of Sept. 11, but doctors say they'll tweak their
plans in light of the terrorist attacks.

Stanford runs disaster drills twice a year, and a disaster-preparedness
committee meets monthly. All hospitals are required by the state
and federal governments to have disaster plans.

"We already had plans to deal with large influxes of patients
into the ER, and we practice the heck out of it twice a year," said
Per Schenck, the hospital's disaster-preparedness coordinator who
is also an ex-Navy corpsman.

If there is any difference after Sept. 11, Schenck said, it is
that "we have to be more vigilant in our planning and a little more
careful. We're looking now for weak points in our communications
system."

After Sept. 11, there have been news articles about the danger
of future terrorist attacks using biological, chemical or radioactive
weapons. But such apocalyptic scenarios aren't new to the disaster
planners.

"For the last two years now, we've been getting information from
the federal and state governments on the effects of weapons of mass
destruction," Schenck said.

One problem with biological or chemical weapons, he said, is that
the first indications "are so subtle that it sweeps over you before
you realize it," which makes the initial diagnosis so critical.
The first effects of some biological weapons, for instance, may
just show up as flu-like symptoms.

The hospital conducts emergency drills, such as one recent one
which had doctors and nurses using the large first-floor cafeteria
adjacent to the emergency room as a spillover area for treatment.

Stanford Hospital has a large emergency department, treating about
3,300 patients a month. The emergency room has the only Level One
trauma center, for treating victims of serious accidents, between
San Jose and San Francisco.

"We're looking at our plans and seeing how we can tweak them,"
Schenck said.