The Joplin Globe, Joplin, MO

Local News

May 15, 2013

First responders prepare for chemical, biological, radiological, nuclear, explosive emergencies

JOPLIN, Mo. — Skip Harper, emergency preparedness coordinator for Freeman Health System, is a realist about what might happen in the Four-State Area that would put lives in danger.

“You plan for the worst, hope for the best,” he said.

The necessity of planning ahead was underscored in May 2011, when staff at Freeman wrapped up a four-day disaster training exercise just two days before an EF-5 tornado slammed into nearby St. John’s Regional Medical Center along with about a third of the city. In the first 24 hours, Freeman staff treated 750 patients in an emergency room with 41 beds.

“The medical surge Freeman experienced after the tornado was the largest in U.S. history,” Harper said. “No single event had so many patients needing treatment at one time.”

“But we had practiced with no phone, no power, no computers,” he said. “It was so valuable. We still had the paperwork out when the tornado struck. The same scenario we had just practiced saved us hours in response.”

On Wednesday, responders from 18 agencies, including fire departments, police departments, other medical providers, Missouri Southern State University and Freeman staff, participated in training in assessment, triage, mass decontamination, treatment and stabilization.

For the past two years, Harper has been among Freeman personnel who have crisscrossed the U.S., from Los Angeles to Boston to Texas to Iowa, to present to hospitals the basics of preparing a disaster preparedness plan.

Four times a year, Freeman also opens its doors to first responders in outlying communities to train them on how to treat patients who have been involved in a disaster, whether manmade or natural.

“With Interstate 44, think how many tankers come through our area carrying chemicals,” Harper said. “When you see a train go by, count how many black tank cars there are carrying some kind of liquid. Think about meth labs.”

As a result, he said, the potential for an accident is always there.

“Things happen almost every day,” Harper said. “You plan for the same response for a terrorist attack as you do an accident on I-44.”

The training at Freeman, which continues today, is federally funded through a collaborative effort with the Texas A&M Engineering & Extension Service and the Missouri Office of Homeland Security.

In one session, using a fully automated human patient simulator — think a plastic dummy wired to a MacBook laptop — trainers from TEEX took participants through a range of scenarios.

“They’ve been swamped since the bombings in Boston,” Harper said of the trainers. “We’re really glad to have them here. They’re the best you’re going to find anywhere.”

While trainer Bill Arnold used the laptop to control the patient’s vitals, like blocking his airway and changing his respiratory rate, trainer Jeff Case helped with the responders’ assessment and intervention.

One simulation necessitated treatment of a 65-year-old farmer who called emergency personnel to his farm after experiencing difficulty breathing and blistering on his arms and hands. The eventual diagnosis was that he had come into contact with old cans of the chemical agent mustard — commonly called mustard gas during wars in the last century and which vaporizes at 55.7 degrees.

They learned his grandchildren, who were visiting, and his wife, who had taken them to Wal-Mart to try on clothes, also had come into contact with it, as did the first responders themselves, increasing the potential for a more widespread medical disaster.

Chief Robert Ward, a 20-year veteran of the Aurora Fire Department, said he came away from the simulation with a refreshed understanding of how to approach such emergencies.

“We have chemicals come through on rail, in boxes and in vehicles in our community,” he said. “We also have home users of chemicals, who have them in their garages, use them in their gardens, have them under the kitchen sink. There could be ingestion by a small child.”

He and three other staff from his department plan to return to Aurora and share information with hospital and other emergency personnel.

Debbie Hudson, who is the interim director of the emergency room at Freeman in Neosho, said the simulations were giving her a better understanding of hazardous materials and emergency response, including how to decontaminate people who have been exposed to chemicals.

Neosho has several industries, including a plastics plant, a fertilizer plant and a dog food plant, that use chemicals, “so it isn’t out of the realm of possibility we would see this,” Hudson said of such emergencies.

Harper said responders having such skills obviously help the patient but also protect first responders and the hospital to which they respond.

“If a patient gets in our hospital and is contaminated, just one person can mean evacuating the entire hospital,” Harper said.

He is planning a round-table training session on June 20 that will be discussion-based as to possible emergency scenarios. It will be geared toward city councils, school boards and others in similar administrative capacities.

“After the tornado, one of the goals established at Freeman was to build even stronger relationships with all area response agencies,” he said. “We reached out for this exercise and asked, ‘What’s your highest risk? What are you worried about? How would you handle it?’”


Wednesday’s agenda also included sessions in radiological and nuclear disasters. Today’s agenda includes sessions in biological agents, explosives and pediatric simulations.

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