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Radiology specialists are calling for a greater role in decision-making, as well as pre-established guidelines, communication, and protection for healthcare workers. These concerns were highlighted during a session “Disasters and Radiology: Can We Prepare?” held as part of the 38th National Congress of the Spanish Society of Medical Radiology in Valencia, Spain. The session moderated by Ana Blanco Barrio and Ane Ugarte Nuño, brought together specialists from several hospitals to discuss lessons learned from floods and other disasters.

The experience of radiology departments in the Valencian Community during the cold snap of November 2024 has highlighted the need to strengthen hospital planning for weather emergencies and to integrate radiology into strategic decision-making during mass casualty incidents. Following the cold snap, various healthcare professionals have mentioned that hospital departments still lack protocols for dealing with disasters.

Eva Llopis San Juan, MD, chief of the Department of Radiology at La Ribera University Hospital, Valencia, Spain, explained that the priority of patient care during an emergency cannot be separated from the care of healthcare professionals. If we don’t take care of the people who keep the hospital running, we can’t take care of the patients either, she stated.

The floods directly affected numerous healthcare workers, many of whom were unable to reach their workplaces in the days following the flooding. As Llopis recounted, road closures and mobility issues forced the hospital to reorganize its operations in real time and without pre-established guidelines.

Team-Based Organization and Communication

The key was team-based organization and communication, noted Llopis. Professionals used tools already in place in daily clinical practice, such as instant messaging groups. In the radiology field, hospitals combined in-person care with teleradiology systems, which allowed for the remote organization of diagnostic tests based on specialist availability.

The speaker acknowledged that one of the main problems during the first hours of the emergency was the lack of standardized instructions. We were receiving conflicting orders, she explained. Some workers were sent home while others were instructed to remain at the hospital. Faced with this situation, several departments opted to call in staff on a voluntary basis, depending on each professional’s availability and ability to commute.

Protocols for Dealing With Disasters

Llopis warned that protocols for dealing with disasters must be designed before an emergency occurs. When they don’t exist or are insufficient, teams must organize on the fly, take the lead, show empathy, and use available resources, she noted.

The specialist also highlighted the emotional and organizational impact of the crisis. Technology helped, but what really sustained the system were the people. In this regard, she emphasized the resilience of healthcare professionals and the importance of maintaining a collaborative attitude in contexts of extreme uncertainty.

During the session, the experts agreed that climate change will increase the frequency of extreme weather events. Flood-prone areas will continue to flood more frequently, warned Llopis, which is why she advocated for the need to adapt hospital plans to this scenario.

Conventional Guidelines Are Not Enough

For his part, Luis Martí-Bonmatí , director of the Clinical Medical Imaging Department at La Fe University and Polytechnic Hospital in Valencia, noted that one of the main difficulties during a disaster lies in the impossibility of strictly applying conventional protocols. Disasters place professionals in unusual situations, marked by chaos, nervousness, and a lack of information, he explained.

The specialist noted that the cold drop affected nearly 300,000 people and caused significant personal injury and property damage in various Valencian municipalities. However, operational confusion prevailed during the initial hours. To address this situation, the radiology and nuclear medicine department at La Fe organized brief daily follow-up meetings to assess staff availability and prioritize urgent care.

Leadership Model

It is essential to redirect resources toward the most severe cases, Martí-Bonmatí noted. He also advocated for a leadership model based on empathy and closeness to the affected professionals.

The specialist also noted that some hospitals faced an atypical care situation: There was a shortage of both staff and patients. Many chronically ill patients living in affected areas were unable to travel to receive essential treatments such as dialysis, radiation therapy, or chemotherapy. This circumstance necessitated the coordination of resources among centers and reinforced the role of regional healthcare management.

Strategic Plans

The second part of the session focused on the specific preparedness of radiology services for mass casualty incidents. Milagros Martí de Gracia , president of the Spanish Society of Medical Radiology and head of the Emergency Radiology Section at La Paz University Hospital, Madrid, Spain, argued that imaging services must be part of hospital emergency strategic plans.

The specialist explained that the arrival of patients following a disaster typically occurs in three waves: patients who arrive on their own, nonurgent cases, and critically ill patients requiring immediate care. This pattern necessitates organizing diagnostic and human resources in a phased manner.

Among the measures considered a priority, Martí de Gracia highlighted the implementation of unique identifiers to ensure patient traceability and the performance of secondary triage, understood as a clinical reevaluation aimed at confirming the initial care priority.

Radiology in Decision-Making

Radiology, she stated, plays a key role both in patient screening and in correcting initial diagnoses that influence treatment decisions. In this context, the availability of streamlined imaging workflows can reduce diagnostic delays and prevent care bottlenecks.

Martí de Gracia emphasized that hospitals must have integrated, well-known, and pre-tested plans. Among the proposed measures is the automated activation of human resources. Thus, the progressive redeployment of staff should be based on patient severity. Mild cases must be placed in specific areas under clinical supervision.

She also advocated for the immediate issuance of preliminary verbal reports and the use of checklists to maintain continuity of care during high-pressure situations.

Martí-Bonmatí reported serving as a biomedical research advisor to Quirónsalud Valencia and as co-founder of QUIBIM. He reported being the director of the Medical Imaging Clinical Area at La Fe University and Polytechnic Hospital, professor of radiology at the University of Valencia, founder and director of the Biomedical Imaging Research Group (GIBI230) at La Fe Health Research Institute, a member of the Royal National Academy of Medicine of Spain, vice president of the Federation of European Academies of Medicine, scientific director of the European Federation for Cancer Images, director of the Imaging La Fe node in the Distributed Network for Biomedical Imaging, and president of the IMAGING Foundation. He reported being a former president of SERAM, SEDIA, ESMRMB, and ESGAR, and receiving honorary doctorates from the National University of Tucumán and the University of Coimbra. The other speakers declared having no relevant financial relationships.

This story was translated from El Medico Interactivo, part of the Medscape Professional Network.