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Institute for Crisis, Disaster, and Risk Management Crisis and Emergency Management Newsletter Website |
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October
2004
Volume 7
- Number 1 |
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Valerie Seefried The only sound in my head was a dull ringing. Where was I? I lifted up my hands and discovered that they were filthy. My clothes were covered in dust and debris. I tried to sit up but a woman gingerly pushed me back down. Images began to filter back into my mind: an explosion and a pain in my chest as all the air was pushed out of my lungs. Nausea was overriding all my thoughts. I still couldn’t hear. What was happening? This was my scenario. As a mock victim in the Washington DC Mass Casualty Exercise on September 23rd, 2004, I was being transported along with 30 other ‘victims’ to the VA Hospital in the Washington Medical Center complex. We had all survived one of several dirty bomb explosions in the city. Each of us held a little slip of yellow paper describing our condition, symptoms and vital signs. Our performance would help determine the hospital’s ability to assimilate a surge of potentially contaminated patients. Problems arose only minutes after being loaded into the ‘ambulances’. Gate 2 of the medical complex is the quickest way to reach the hospital’s decontamination entrance but an overly-diligent officer guarding the gate denied the vehicles access. We were forced to return through the main gate and circle around the building. In the event of a real incident, the main entrance would be heavily congested with passenger vehicles and other emergency response transport making access very difficult. The decontamination facility at the VA hospital is also situated at the back of the hospital. Should a radiological mass casualty incident occur, all incoming patients would have to enter through decon to avoid contamination of the main hospital floor and ER. It would be immeasurably difficult to divert walk-in patients towards the decon entrance, denying them access through the main doors. The first batch of mock victims were unloaded from the vehicles only to wait a long 20 minutes on the hot asphalt outside the decon entrance while the hospital staff donned their protective gear. This was also a realistic problem, as it is unlikely that the VA hospital would get sufficient notice that contaminated patients were being dispatched to their facility. We were guided through the decontamination process by eerie forms in ‘space suits’ that did nothing to inspire confidence or comfort, especially since the full protection hoods allow for very little interaction. After a bomb blast, hectic emergency transport and a lengthy decontamination process, we were finally face to face with ‘real’ people. We stepped through a set of doors and medical personnel quickly began asking questions to conduct triage, we responded vocally with statements of our own. “What happened? I need help. Have you seen my family members or friends? What’s wrong with me? I can’t hear. I don’t feel well.” The explosion of questions and voices was overwhelming and made the triage process extremely difficult. Among the problems that arose: - Nurses were unable to administer any care or offer water to potential radiological victims without a physician’s approval; - Isolation rooms were difficult to come by; - The elevators slowed down to a stop under the burden of ferrying victims to different floors; - The hospital would not allow out-of-state calls even though many victims are bound to be visitors or tourists. These were but a few of the obstacles faced by ONE hospital dealing with a mere THIRTY victims. A real incident would have thousands more seeking treatment for symptoms that could be associated with the terrible fear of being exposed to radiation, regardless of their proximity to the blast. Is the DC medical response infrastructure really prepared for an incident? |