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Fine-tuning readiness for mass casualties

By Christine Clarke, MD, Quality Operations Committee Chair; and Wayne McFarlin, Salem Health Emergency Preparedness Administrator

Salem Health is considered well-prepared for most emergencies – from snowstorms and EMR downtime to earthquakes and mass casualties, thanks to the diligence of leadership, staff and providers.

Our comprehensive Emergency Operations Preparedness Plan created in 2011 is continually fine-tuned. For example, our ham radio network has grown to 25 operators, from EVS staff to physicians.   

We make it a priority to stay current on emergency preparedness. Recently we created a permanent operations center in Building B that can become an instant command center during emergencies. Our exhaustive prep for the Aug. 21 total eclipse also sharpened our capacity and strengthened our partnerships with regional emergency responders. The eclipse preparations provided an ideal “test” we passed with flying colors, thanks to many of you.  

But what if the unthinkable happens?

Physicians and staff started thinking about situations like the Oct. 1 concert tragedy in Las Vegas long before it had occurred. These kinds of events flood local hospitals and max out emergency responders.Now, instead of wringing our hands, we’re rolling up our sleeves.

About 20 staff and physicians met with us recently to begin plans to boost preparedness for these types of tragedies. Identified areas to grow include: 

  1. Our mass casualty plan must be simplified and structured into fundamental building blocks. As Nicole VanDerHeyden, MD, explains it, “Our staff need to understand the gestalt of our plan.”
  2. Our exercises and drills must be designed to build individual capabilities in these building blocks and scheduled to ensure ongoing competency.
  3. We need to create larger “always-ready” mass casualty supply caches – for example, something that prepares us for at least 50 victims rather than the 10 we’re currently prepared to handle. We’ll work with physicians to identify contents and hope to create them by the end of the year.
  4. We’ll convert our plans to “building blocks” in January as part of our annual emergency plan update. Shortly after the update we’ll begin training and exercises. If you’re interested in helping, contact us or Dr. VanDerHeyden.

We’re also reviewing other health care disaster models that include expanding operating rooms and using other clinics for non-emergency services. We’ve reached out to ambulatory surgery centers, for example, to explore converting their procedure rooms for disaster-related surgeries, which would augment hospital ORs in providing timely care in a catastrophe.

We’re looking at a hybrid training model: Along with major simulations, we’re conducting short bursts of drills on small sections of the emergency plan. These short bursts of drills fine-tune the plan and train staff at the same time.

Also in the works is a peer support program for “second victims” – staff and providers who suffer physically and mentally from the side effects of caring for patients during emergencies. (More on that later.)

This is a wake-up call for all providers! Start with your own personal preparedness plan. Do you have a kit in your car? At home? How will you communicate with your loved ones, or get to the hospital if you’re called? Taking care of ourselves is the first step in caring for others.

Lastly, we’ll use the established Physician Leadership Council to finalize our recommendations and communicate to all medical staff. We’ll also update you through Common Ground. 

We strongly encourage your involvement. Contact Dr. Clarke directly, if you have ideas, questions or concerns at christine.clarke@salemhealth.org or by calling or texting her cell phone at 503-510-2177.

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