By Emily Andersen
The Gazette,
IOWA CITY, Iowa — When emergencies happen, and multiple people are injured — some severely — hospitals can be overwhelmed with patients, stretching their resources and straining their ability to respond.
That’s why training events like the one held at the University of Iowa Health Care Stead Family Children’s Hospital on Friday are so important.
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The hospital — which does not have an emergency department — could receive patients in a mass casualty incident, so it’s important for staff to practice their emergency protocols, drill organizers said.
“The emergency department is not located in the children’s hospital, but people seeing the tower, especially if they have injured children, will come here. So, we need to help stabilize them before they get the care that they need,” said Carlyn Christensen-Szalanski, an emeritus professor of emergency medicine and co-chair of the Pediatric Disaster Task Force for the children’s hospital.
As part of the drill, volunteer children and teenagers — family members of hospital staff — used makeup to simulate injuries, and arrived at the hospital a few at a time. In Friday’s scenario, the patients were coming from a youth rodeo where the bleachers had collapsed, injuring many people at once.
“It’s an all-hazards approach. So, you try to have something that will have a universal application, and you want to think about, who’s the staff that will come, where are the supplies that we can readily ask for, where’s the room that we can use, and what’s the system?” Christensen-Szalanski said.
The children in Friday’s drill were directed to an area that was quickly blocked off in the lobby of the hospital. They were asked to sit on one of three colored tarps: green for minor injuries, yellow for moderate injuries, and red for severe injuries. They were then examined by doctors and other medical staff to determine what immediate actions needed to be taken.
Meanwhile, other staff members observed and took notes about what was going well and where there might be room for improvement in the response.
Kristel Wetjen, the pediatric trauma program manager for the hospital, said Friday was the first time the children’s hospital staff have practiced emergency triage outside of the emergency department, but she said it’s an important part of being prepared for mass casualty events, when emergency rooms can be overwhelmed by the number of people injured.
“If ambulances take people, they take people to the emergency department. The event here was people self-presenting. Something bad happened, and they just needed help, and so they came to the first place they could find,” Wetjen said.
Wetjen said one of the biggest successes of the drill Friday was that staff walked away knowing exactly what the protocol is for a mass emergency situation, and were able to experience the on-paper plans put to action.
John Heinemann, the interim director of emergency preparedness and full-time director for clinical operations, said the main goal of the drill was to test the processes outlined in hospital policies, and make sure they work how they’re intended to work.
“We don’t really get the opportunity to test in the real environment, and so anything we can do to mimic what actually would happen in a situation, like the drill we’re having today, I think, gets it a little more realistic for all of the care team,” Heinemann said. “Things look good on paper, but you really learn the details and fine-tune what works and what doesn’t work when you get to test them out in the real space.”
The hospital stayed open during the drill, and Heinemann said a lot of planning was involved in making sure staff were available throughout the hospital while those who are most likely to be involved in an emergency situation were able to run the drill, and making sure the space used for the drill didn’t block hospital operations.
“That’s part of that planning process, intentionally picking a time when we think we can do that, when we know we’ve got the ability to bring some extra people in,” Heinemann said.
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