Preparing for a mass-casualty disaster can be something of a science.
Parker Adventist Hospital was among 20 organizations that took part in a large-scale drill in which 150 mock patients were transported to metro-area medical centers June 5. The Federal Coordinating Center Denver Reception exercise was meant to test 11 hospitals on their ability to handle multiple patients at one time.
The drill brought together some of the local, regional and federal authorities and agencies charged with caring for victims of a disaster. Among the top priorities for officials was the testing of communications systems and procedures.
Parker Adventist’s emergency department was filled with the sound of tones and calmly-spoken alerts over handheld radios, as well as discussions about the duties of hospital staff members when a “code grey” is issued. It announces the implementation of the disaster plan.
The scenario acted out June 5 was a frightening one: it was based on an EF-5 tornado striking Wyoming’s two primary medical centers, leaving them unable to care for current patients or take in new patients. Patient transports went through Denver International Airport, and volunteer victims were taken by eight ambulances and 10 helicopters to various hospitals. The hospitals were notified about the number of patients en route and the severity of their injuries. Parker Adventist received about 15 mock patients.
Molly Duffy, safety and emergency preparedness specialist for Parker Adventist, spent six weeks planning for the drill with department heads. It was one of two disaster drills that take place each year, and the objective is to identify and fix any flaws in the system before the hospital is faced with a real mass-casualty event. It was tested last July after the Aurora theater shooting.
Duffy’s own 3-year-daughter, Lyndy, was among the mock patients treated at Children’s Hospital Colorado at Parker Adventist Hospital as part of an exercise that helps doctors and nurses work on their communication skills with children. At the urging of her mother, Lyndy, shares the well-rehearsed line she is supposed to say to the medical staff: “Ow, my shoulder hurts.”
The most seriously-injured patients are instructed to scream and pretend to writhe in pain to make things realistic and to test the medical teams’ ability to identify injuries and operate in a stressful environment.
“If we don’t make it as real as possible, we’re not going to learn anything,” said Lisa Woltering, the emergency department’s charge nurse and disaster preparedness specialist.
A unified response is perhaps the most critical component of successfully processing a large number of patients. Roger Rewerts, the FCC Denver coordinator, said the goals include “enhancing capacity, building sustainment and creating surge for receiving medical facilities.”
A follow-up debriefing enables hospital staff to give feedback on what went well and what did not, and a team of evaluators observes the action and takes notes. A 30- to 40-page “after-action report” is generated and disseminated to hospital leaders, who can then make any necessary changes.
Training sessions are a regular occurrence at Parker Adventist. In addition to the two disaster exercises, the hospital conducts 12 fire drills and two infant abduction drills, as well as security assists and lock downs. While the departments often get notice for major exercises, there are some that go unannounced.
Lyndy Duffy is already a veteran volunteer. She has been the subject of surprise abduction drills in which the staff is tested on their response. With her mother in sight, Lyndy is kidnapped by an actor and screams to get the attention of staff. Watching the reaction of the staff members is gripping, Molly Duffy said.
“She’s never made it off the floor,” she says.