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N.C. tests new mobile command truck in disaster drill

By Tim Simmons
The News & Observer
Copyright 2008 The News and Observer

RALEIGH, N.C. — An emergency drill that forced WakeMed employees to transfer dozens of critically ill “patients” across town Monday taught the area’s largest medical provider a couple of lessons.

First, it is possible to move people out of intensive care and over to Rex Hospital after a tornado, even if it means carrying patients down stairwells to do it.

Second, it’s a whole lot easier with the right technology.

WakeMed revealed its newest piece of gadgetry Monday when it rolled out the first communications command center designed specifically for hospitals.

Valued at more than $500,000, the truck is the product of months of work among the hospital, Cisco, IBM, Lenovo and others. The companies helped pay for the center with equipment donations and technical help to complement federal funds. The truck was built by LDV of Burlington, Wis.

“There are thousands of mobile command centers in the U.S. for police, fire and military use,” said WakeMed CEO Bill Atkinson. “But there is nothing else in the country like this center.”

Mobile communications represents an important and growing segment of medical technology, which is one reason IBM was particularly interested in working with WakeMed on the project, said Melissa O’Neal, an IBM sales representative who handles the WakeMed account.

WakeMed’s command center, which can also be used in disasters that don’t involve the hospital, is the kind of equipment that states or regional associations would likely buy, Atkinson said.

That point was underscored when hospital workers found they could barely communicate with one another or reach major medical centers after Hurricane Katrina raked the Gulf Coast in 2005.

The problem only got worse as time went on and hospital workers could no longer rely on state and federal agencies’ equipment.

With that in mind, the mobile center was built so it could tap into the medical information systems of any cooperating hospital through satellite feeds, said John Tuman, WakeMed’s director of network services.

It uses technology provided by Cisco that lets rescue teams talk with one another even if they aren’t broadcasting on the same frequency or using the same equipment.

“You couldn’t have done this five years ago,” Tuman said. “The technology just wasn’t there yet.”

On Monday, workers in the mobile command center followed the unfolding “emergency” from their outpost on Atlantic Avenue.

The exercise began mid-morning when drill organizers told hospital officials that a tornado had hit WakeMed’s critical care unit. The storm took out the substation that provides electricity to the hospital, leaving it with a backup generator for power.

Employees had about two hours to move the most fragile patients across town to Rex. If they failed, batteries that power machines in each patient’s room would start to die. Then the patients would die — in this case, a simulation made eerily real by mannequins that look and react like humans.

While clearly fake, the patients are programmed to provide a pulse and heartbeat. Eyes open and close. Pupils dilate as lights go down. Vital signs respond to medication attached to intravenous lines.

“It is very much like working with a real patient,” nurse Pamela Wood said. “If we don’t do our job, he dies.”

Organizers released information intended to present one challenge after another. Backup power was lost before the substation could be repaired. Elevators were useless.

Dozens of administrators were broken into teams to handle tasks.

The drill ended about 4 p.m. when the simulators and a few dozen “paper patients” — cardboard cutouts or patient files — arrived at Rex. Without the adrenaline rush and chaos of a real disaster, it’s hard to know whether the drill mirrored reality.

“We’re living and learning,” Atkinson said after a debriefing. “The great thing about simulation is you can do it over and over.”