Letter to the Editor

Emergency Medicine (1999) 11, 119

Will emergency medicine be ready

for the year 2000?

On 31 December 1999 Australia will be among the firstcountries to experience the start of a series of potentialequipment failures due to software and hardwareproblems which include the ‘millennium bug’.1,2

Doctors must ensure the potential impact of theseevents upon their patients is minimized. One Britishmedical protection society has indicated that thosemembers who fail to take steps to prevent problemsdeveloping as a result of date-sensitive computerhardware and software failures cannot expect supportwith advice, assistance or indemnity if a patient isharmed as a result.3

Documents regarding New South Wales publichospital Y2K (year 2000) compliance are classed asconfidential by the NSW Health Department. Ifgovernment and area health authorities cannotguarantee the safety of patients threatened bypotential hospital equipment or system failures,including hospital backup systems, then steps shouldbe taken to reduce the hospital’s patient census to aminimum before 31 December 1999. Reducing thenumber of hospital in-patients minimizes the numberof vulnerable individuals who could be threatened bythe millennium bug in hospitals while the extent ofcomputing and equipment failures can be determined.The unique nature of 31 December 1999 also meansthat hospitals, especially those institutions that aredependent on locum medical staff, nurse bank andagency staff, are likely to be confronted with staffingproblems due to a combination of staff absenteeismand reduced availability of nurse agency and locummedical staff on that night.

Hospitals could face stock and warehouse problemsdue to hoarding of supplies and pharmaceuticals in

anticipation of the disruption the new millennium willcause. Hospital emergency departments are likely toexperience increased workloads, due to alcohol anddrug-related events, and increased parasuicidal activityby at-risk individuals who feel an increased sense ofsocial isolation.4 This will be in addition to dealingwith the impact of the millennium bug, related mediaenquiries and possible switchboard failures. Anycritical functional loss of infrastructure on the night of31 December 1999 will be a unique disaster, especiallygiven that the onset of the event has been predictedaccurately down to the split second, several years inadvance.

An on-site emergency physician represents thesingle most important asset for hospitals that areattempting to deal with a disaster. It’s time theAustralasian College for Emergency Medicine developspolicy that is a positive affirmation of the value ofstaffing hospital emergency departments with Fellowson site 24 hours a day, at least for designated traumacentres that will bear the brunt of casualty load inmost incidents.

References

1. Reicha J. Millennium bug set to bite. Aust. Med. 1998; 10: 8–9.

2. Institution of Electrical Engineers. Embedded Systems and theYear 2000 Problem Guidance Notes. Stevenage: Institution ofElectrical Engineers, 1998.

3. Anthony S. Vaccinate yourself against the millennium bug.MPS Casebook 1998; 11: 7–9.

4. Wenz FV. Seasonal suicide attempts and forms of loneliness.Psychol. Rep. 1977; 40: 807–10.

Dr Antony Nocera FACEM

7/44 Bennet Street,

Cremorne, NSW, Australia