PMH mock exercise deals with a potentially explosive agent

“Is she on a backboard? We can do it one of two ways, you can either set these up or you can use those cots as a ‘dirty cot’ and put them on those cots…”

That’s the sound of Dr. Mike Rigsby, co-disaster coordinator for Pocahontas Memorial hospital directing staff as they prepare to receive patients who may need to be decontaminated prior to entering the hospital for emergency care.  It was part of an emergency services exercise held on September 18^th at the hospital.

The scenario was a truck carrying barrels of Acetone that crashed and leaked some of its contents near the mini park in Marlinton.  A little after 10 am on the 18th the hospital was notified of the accident, that ambulances would soon be arriving with patients and the decontamination tent would be needed.

Hospital staff quickly sprang to action, retrieving the tent and all its accessories from an out building near the hospital and transporting it to the front of the hospital lot. Meanwhile, the nursing staff was getting ready to receive patients with incident commander Mary Walkup instructing her staff.

“I’m going to stay here, we’ll help to triage and the EMS will help triage and get people in here,” said Incident Commander Mary Walkup. “They need to rinsed off for 10-15 minutes in the water…if you have real patients come in you ask them if they’ve been exposed to any chemicals on their skin.”

And it wasn’t just doctors and nurses who were being tested.  Susan Wilkins, Public Relations and Special Projects coordinator for PMH found herself filling the role of public information officer for the very first time.   Although nervous, she handled the role with assurance and grace under pressure while answering questions from the press.

[Heather] “I noticed there’s a decon tent out in your parking lot – can you tell what’s going on?”

“Absolutely – we’ve had an accident downtown, a truck has turned over and a few people have been contaminated,” said Wilkins. “So we’re just decontaminating them before they come up to the facility and getting them medical care.”

“What the nature of the contamination, what’s the agent?”

“Acetone, it’s nail polish remover.”

“What’s the process for taking the patients in?”

“As they come off the ambulance, they go through the decontamination tent, it’s basically a shower,” said Wilkins. “As soon as they are out of that, they’ll come through the emergency room here because we don’t want to contaminate our own emergency room and our own personnel.  So as soon as they come through that tent which only takes a couple minutes, they’ll be seen in the emergency room.”

Most know acetone as the primary ingredient in nail polish remover.   In fact, in large quantities the chemical can be quite dangerous.  It’s highly flammable, and heavier than air, so the vapors tend to travel low to the ground and to areas of lower elevation.  Exposure in humans can cause dizziness; can burn eyes and skin, and can even lead to suffocation in sufficient quantities.  Evacuation protocol according to the 2012 Emergency Response Guidebook is 1000 ft for a large quantity.   If exposed to a fire source, it could spark a very large fireball and the minimum evacuation would be half a mile.

PMH CEO Barbara Lay was one of the ‘patients’ in the drill. She was pleased with how it played out.

“It’s nice to see things from that perspective,” said Lay. “I think it went really well.  Of course you know we’re all hands on learners, so this provides us an opportunity in a mock drill situation to look at what did we do well, and what were our opportunities to improve should this ever occur in real life.”

“We’ve been doing mostly table tops [exercises], that’s kind of the trend.   But I think we’ve decided that when you do this type of a disaster drill, it gives you better opportunities to look at where’s some things that we need to improve and I just think it’s a great way to learn.”

Dr. Rigsby agreed with Lay’s assessment of the exercise.

“I think it went very well,” he said. “We’ve got a few things we need to work on, just getting everybody trained, but everybody participated well, I think everything went really good.  We’re going to do more of them, yes, we need to.”