By ALVIN REINER
Staff Writer
ELIZABETHTOWN — A bucolic lane turns to havoc as two cars collide, resulting in seven occupants with life-threatening injuries and setting emergency responders in motion.
The scenario is enough to tax a small-town hospital, and though such events are rare, responders and medical facilities have to be ready for episodes like this, or worse.
The recent simulation by Elizabethtown Community Hospital (ECH) and the other responders was held to help ensure that established emergency plans allow for smooth operation in the midst of a crisis.
Assess and stabilize
Handling emergencies is commonplace for ECH, as there are approximately 900 cases of life-threatening, critical care and trauma cases per year. Although the hospital might not be the final destination for the patient, the facility is able to assess and stabilize for transport.
A whole cadre of responders are needed, though, to set a rescue in motion. In addition to ambulances and emergency rooms, dispatchers make the calls and provide updated information. Fire departments respond to vehicular accidents in case of flames as well as spilled oil and gas. Highway departments often have to re-route traffic, and police are needed to maintain control so the rescue workers may proceed.
In addition to doctors and nurses, other hospital personnel such as those in the X-ray and phlebotomy departments are notified. The custodial staff plays a role in making sure supplies are in place as well as directing traffic in the parking lot. A hospital administrator has to be on hand to coordinate efforts, and at times translators have to be summoned.
At the hospital, the ER nurse in charge at the time runs the show, summoning the personnel and equipment, as well as designating where patients are to be put. The parking lot may have to be cleared if a helicopter is summoned.
"It's a huge system, but it always has to work," said Jane Hooper, ECH director of community relations. "To many people, hospitals are a mysterious place, and in part due to privacy laws, it has kept people from understanding what happens there. The public is more aware of larger hospitals such as CVPH and Fletcher Allen. We're 50 miles away from a larger trauma center and have to stabilize patients, as they can't often make it directly to one of those centers."
The proximity to the Northway increases the likelihood that situations are more likely to arise. ECH covers 140 lane miles; basically from exits 30 to 32.
"We're thankful we live in a place that if there is an accident, there will be people who want to help others," said Hooper.
The event
Like constructing a movie set, two vehicles are towed into place to simulate a head-on crash. A baby mannequin in a car seat, is placed inside one vehicle, along with demonstration dummy Rescue Randy, who hadn't worn his seat belt and has suffered considerable trauma.
Elizabethtown-Lewis Emergency Squad President Patty Bashaw gives each "victim" a script that advises him or her of the extent of the injuries as well as how to act. Moaning and groaning as well as irrational behaviors are expected. In addition, they might not accurately tell the responders of the full extent of their injuries.
Diabetic teenager Kristi Napper claims she has not been drinking. Ah, but she has, and doesn't want her parents to find out. She keeps asking why she can't feel her legs.
In a reversal of roles, EMT Anita Deming is pleased to be called a 30-year-old pregnant female. She's in a daze, wandering outside her car with an open wound and upset about her baby.
Greg Hincksman, with a mid-shaft femur fracture, is found on the ground, not knowing how he got there.
A confused 16-year-old, Courtney Brown wanders through the scene, asking about her mom and baby brother. She adds to the authenticity by vomiting on the way to the hospital.
Sitting on the car's hood, Brandi Gough, a 26-year-old female, states she had a seat belt on, is sore all over and complains of shortness of breath due to an asthma attack.
The first responder to arrive, EMT Sabrina Westover, calmly surveys the scene, and then quickly checks each victim while performing a triage evaluation to determine priorities. A red (Priority 1), yellow, or green tag is attached to each victim.
There is also a call for additional responders as well as for a communication network to tell the hospital what is taking place.
At the ER, registered nurse Karen Crowningshield takes charge, summoning and briefing other nurses and Dr. Harry Davis as calls come in. Each ambulance lets the ER know how many patients there are and the severity of injuries as well as the ETA (estimated time of arrival).
Registrar Robin Supinaw is at the door to band the patients as they arrive. "Did Number Five arrive yet?" she asks.
The EMTs assist in moving the patients then wait in case they have to transfer the injured to another hospital facility. ECH provides a debriefing/work room for the responders to fill out forms and take care of other business.
"We have tried to make the hospital EMS friendly," Hooper said.
Throughout the evening, there is coordination among Davis, Crowingshield and the rest of the participants. Discussions ensue about who will be airlifted and which victims would remain at ECH. Making the exercise more dramatic, there is the unfortunate demise of Rescue Randy.
Real emergencies
While the re-enactment was taking place, there were two real emergency-room patients. Since they were of first priority, there was additional shuffling of rooms.
After the ordeal, those involved, including the "victims," met at the Elizabethtown firehouse to critique the evening's exercise.
There were a few minor points such as forgetting to "block" the car to prevent rolling, and a discussion as to the pros and cons of unhooking a vehicle's battery. There was also a shortage of EMTs.
Someone pointed out that the patients should have been "taken down quicker," or not left in a standing position. There was also a problem of non-interchangeable stretchers between ambulances, and the need for EMTs to become more familiar with each other's vehicles.
Overall, there was a general consensus that the exercise went well.
When queried about being victims, Gough replied, "It was a good experience. As good as it could be."
"I was nervous going around the curves," Deming said. "You feel so very insecure when you are on a stretcher in the back."
E-mail Alvin Reiner at: rondackrambler@yahoo.com
