The Joplin Globe, Joplin, MO

October 16, 2012

Freeman, other health agencies participate in mock disaster

By Andra Bryan Stefanoni

— Wearing white hazmat suits, green rubber gloves and black rubber boots, Felix Karuga and Karen Watts knelt over a patient on a backboard in the Freeman Hospital West ambulance bay Tuesday morning.

He was unresponsive. After a medical evaluation, they attached an orange bracelet to his wrist.

“He’s ‘red,’” said Watts, who works at Freeman as an infection prevention officer. That meant the patient needed a more acute level of care than patients lying nearby marked “yellow” and “green” after having been exposed to a toxic chemical.

Karuga, a nursing student at Labette Community College in Kansas, and Drew Patton, a student in the emergency medical technician program at Missouri Southern State University in Joplin, carried the patient to a decontamination area.

It was just a drill, and the patient was plastic, but the supervisor, Freeman health and safety officer Skip Harper, knew that the situation and the patient could just as easily be real.

Staff members at Freeman had wrapped up a four-day disaster training exercise on Friday, May 20, 2011. Two days later, they put to use everything they had practiced when an EF-5 tornado began a six-mile path of destruction just a half-mile northwest of the hospital, leveling neighborhoods and schools and putting St. John’s Regional Medical Center out of commission.

“We had practiced with no phone, no power, no computers,” Harper 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.”

All of Freeman’s staff — from leadership to maintenance to security to housekeeping — goes through an initial disaster preparedness training course. Once a year, staff members practice response to a tornado, and they periodically simulate other possible scenarios that might require multiple first responders working in tandem across the community: an earthquake, a pandemic, a chemical spill.

Hundreds joined forces for Tuesday’s exercise, including representatives from EaglePicher, Missouri Southern State University, Landmark Hospital, Mercy Hospital of Joplin, Mercy McCune-Brooks Hospital at Carthage, Joplin and Jasper County emergency management, and the Joplin and Jasper County public health departments.

“After the tornado, one of the goals established at Freeman was to build even stronger relationships with all area response agencies,” Harper said.

“We reached out for this exercise and asked: ‘What’s your highest risk? What are you worried about? How would you handle it?’”

During the drill, Freeman respiratory therapist Rebeka Liles took on the role of patient tracking officer from her station inside the emergency room. Using a walkie-talkie and spreadsheet, she communicated with other members of the disaster team about each patient’s status as they moved through the various levels of decontamination.

A patient on that list was Sarah Volkl, one of several MSSU students participating in the mock disaster.

The students, all roughly the same age, knew one another and had reported to the MSSU student health center with similar symptoms as part of the exercise. The school nurse, also participating in the exercise, directed them to Freeman.

“I am a student at MSSU, and I have flulike symptoms,” Volkl told Watts and Patton at the triage station. “I am tired and sick. I hear it’s been going around.”

The students had been “exposed” to a highly toxic substance called ricin, which in a dose as small as a few grains of salt can kill an adult human. It is used in chemotherapy drugs, in research by state universities and by terrorists, Harper said.

Volkl was not as acute as the other patients who were being seen, so she got to skip the first level of decontamination. There, Dale Stiver, a Freeman housekeeping manager, was one of several employees in hazmat suits with respirators who were on hand to accept the most heavily contaminated patients and scrub them with chemical-removing soap.

“Just knowing the actual procedures and getting patients from zone to zone has been valuable,” Stiver said.

Harper deemed the event a success because of the professionalism exhibited by staff members and the cooperation of all involved.

“Everyone on the ground worked well together,” he said. “We shared resources and understood that in these types of situations we are not competing, we are cooperating.”

But, he said there is room for improvement.

“We had 40 people participating in different areas here,” Harper said of Freeman’s effort, “and that was stressing us to the limits. It was a lot more intensely hands-on than we anticipated. You just don’t realize what you’ll actually need until you go through this.”

Coordinated effort

IN ADDITION to Tuesday’s training at Freeman Hospital West, other area health care providers conducted drills on patient evacuation and hazardous materials response. Those involved in the disaster training exercise will meet sometime in the next week to discuss the operations, said Skip Harper, Freeman health and safety officer.