First Responders: LMA hospitals ready for mass casualty events

June 13, 2014
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When mass casualties occur, society turns to hospitals to treat the victims. Two local Longwood Medical Area hospitals—Beth Israel Deaconess Medical Center (BIDMC) and Brigham and Women’s Hospital (BWH)—said they’re ready for those events and have their training to thank.

“We run exercises and train. We learn things. It is an ever evolution,” said Barry Wante, director of emergency preparedness at BWH.

He added later, “Our plan would be equal, if not better, than anyone else’s.”

Wante pointed to the “Urban Shield” exercises held last month, where local first responders gathered to train responding to mass casualty events like a terrorist attack. He said that there is “tremendous planning with all the different agencies,” such as police, fire and EMS.

Daniel Nadworny, the emergency department clinical manager at BIDMC, echoed Wante’s sentiments on planning between partners  and the level of training, saying the annual drills that the hospital runs helps set it apart from others.

He added, “BIDMC was the first hospital to attempt a full-scale evacuation drill of a neonatal intensive care unit. That work has since by reviewed and tested by other Boston hospitals, such as Boston Medical Center.”

Nadworny said BIDMC response to a mass casualty event depends “on the scale and nature of an incident.”

“In cases like a fire we may notify our respiratory team, for a transit accident more of the Medical Doctor teams are notified,” he said.

Wante said BWH plans for a mass casualty event calls for “decanting a portion of the emergency department to co-locate patients.” He said the hospital puts elective surgical cases on hold in case surgeons are needed and puts all inpatients floors on alert if additional beds or staff are needed.

“Each critical department has call back lists, but we wouldn’t call back in every situation,” Wante said about requesting off-campus staff to return.

He said that when mass casualty events occur, BWH uses the Incident Command System, which is common nationally. Wante said that that system has a group of pre-identified people to contact. There are back-ups to contact.

“There are very strict rules on who can activate the system and who it goes to. Those folks have pre-determined responsibilities,” he said.

Both Wante and Nadworn said their respective hospitals have conducted reviews since the Boston Marathon bombing and have found places to improve.

Wante said that during the bombing, BWH had an overwhelming amount of volunteers that contributed to a “minor traffic jam.” The hospital has since fine-tuned the plan to locate volunteers.

He also said that BWH has improved the process to identify patients after the bombing to ensure that X-rays, lab results and the like follow the right path. It was hard to identify some patients because of the injuries associated with the bombing.

Nadworny said BIDMC has implemented its mass casualty plan several times since the marathon bombing, including responding to a porch collapse on Mission Hill last year and the March Back Bay fire where two firefighters where killed.

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