When disaster strikes

REDWOOD FALLS – The scenario set up in the Jackpot Junction Convention Center involved a gas explosion at a local hospital with mass casualties and fatalities. A triage tent, a mobile medical hospital and a mobile morgue were set up to teach more than 250 healthcare workers and law enforcement officers from 60 agencies how to respond to a large-scale disaster.

The region’s emergency personnel came together Thursday and Friday for an emergency preparedness training exercise put on by the Southwest Emergency Preparedness Team. SWEPT is one of eight federally-granted regional healthcare system preparedness organizations in Minnesota that trains and prepares public health workers for disasters.

“Today is special because we have a lot of assets here in one place,” said Jane Braun, director of emergency preparedness for the Minnesota Department of Health. “These types of exercises don’t happen very often at this large of a scale. Southwestern Minnesota has done a lot of work… and we’re hoping that as these processes get figured out, this learning will be shared throughout the state.”

Dan DeSmet, North Memorial Ambulance’s operations manager for the Marshall region, has participated in multiple SWEPT training events before and was glad to have the learning opportunity provided by SWEPT.

“It’s a huge collaboration effort between agencies with support from the metro and other regions,” DeSmet said. “We also get to build working relationships with so many other agencies and disciplines.”

Brad Hanson, regional healthcare preparedness coordinator and manager of the Willmar Ambulance Service, was evaluating the mock disaster and helping participants improve their methods and practices.

“The 911 call comes in that there is this massive explosion, that there are victims everywhere, and the response starts with your local ambulance service, fire department, law enforcement and emergency management,” said Hanson. “They get triaged in the ambulance strike team base-of-operations tent, they go over to the mobile medical hospital and then from there they get taken care of just like they were at the hospital.”

Hanson is also one of the leaders for the Minnesota Ambulance Strike Team that runs triage for patients to determine who needs care the most.

“They can do basic, minor care in the triage area,” said Hanson. Behind the triage then, the mobile medical hospital takes in more severely injured patients. “They can do anything from sutures to cracking a chest open.”

Parked next to the triage tent and the mobile medical hospital was the Ridgewater College Simulation Lab trailer. It is usually used to train hospital and EMS staff for everything from delivering a baby to taking care of trauma patients, but “today, we are taking it out of its training role and utilizing it as a potential treatment area,” Hanson said. The trailer is essentially a mobile emergency room, equipped with monitors, medical instruments and mannequins that simulate real-life patients.

Tracy Oevermann from Ridgewater College was in the trailer, demonstrating the simulation lab’s capabilities with their life-like mannequins that do everything from blink and breathe to sweat and talk.

“His lips turn blue, his airways fall shut, his pupils react to light… we have headphones and can make him talk in real-time. Anywhere you can feel a pulse on a person, you can feel a pulse on him,” Oevermann said. “He basically lives and dies based on what you do.” The mannequin also produces a readout of real-time vitals that are displayed on a monitor above his stretcher.

“He adds emotion to the training,” Oevermann said. “You’re looking at him, he’s looking at you and talking to you.”

Another mannequin in the trailer is set up for birthing training.

“She actually gives birth,” Oevermann said. “She has a mechanical arm that pushes the baby out. We can do breach, C-section, limb presentation, any scenario she can do.”

The youngest member of the mannequin family is baby Hal, who is set up to simulate a pediatric patient. Hal, like the other mannequins, gives real-time vitals and reactions to treatment.

Even though the practice mannequins were present, most of the patients in the drill were real people who played the roles of patients with specific injuries and conditions.

“They’re people that might be EMS providers or emergency managers or healthcare workers,” Hanson said. “They are here as volunteers to be our patients, but they are also learning how this all works.”

A medical transport bus from the Minneapolis Airport Fire Department was also on hand to familiarize participants with its stretcher transport, monitoring and life support care capabilities for up to 21 patients. The bus would be used to move patients from a disaster scene to a medical center or for an evacuation of a hospital or nursing home.

Beyond the medical units were mental and behavioral health workers who were poised to take care of traumatized patients and children who’s parents were not present.

“Anytime you have a major disaster you have behavioral health issues, so we have behavioral health teams working here and setting up too,” Hanson said.

“And unfortunately, when you deal with this kind of situation, you may also have to do morticiary work,” Hanson added. “That’s why we have the Minnesota Department of Health’s mobile morgue unit here. Their main job is identification, to figure out who people are.”

In order to keep everything running smoothly and all of the different teams coordinated, Hanson said that a command center must also be set up to asses the disaster.

“You have to have a command structure in place to make sure everything is going like its supposed to,” Hanson said. “We use a unified command system… law enforcement, fire, healthcare, public health, all the entities that are working on this event would come together and send their lead people to work together.”

The disaster simulation was re-enacted three times during the two-day event to give participants a chance to hear feedback and improve their systems and performance.

“We get feedback, take that information and learn from it. Then we run through the whole thing again, and we get better at it each time,” Hanson said. “With the next drill we do, we can build off what we learned today and get better and better prepared.”