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Hospital evaluates hazmat readiness

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EMERGENCY PERSONNEL GET dressed in hazmat suits for a drill at Porter Hospital Tuesday afternoon. Unlike many mock incidents, which often simulate traffic accidents, Tuesday’s drill taught the emergency teams how to deal with hazardous materials.
Independent photo/Trent Campbell



September 27, 2007

By CYRUS LEVESQUE

MIDDLEBURY — A few people who drove to the emergency room of Porter Medical Center during a brief period Tuesday afternoon were confused to see a decontamination tent set up near the entrance and emergency personnel covered from head to foot in protective gear. But there was no actual disaster: Porter staff were going through a regular drill to test their preparedness for a worse-than-usual accident or emergency.

The drill began around 3 p.m. Some in the Local Emergency Planning Committee (LEPC) were in on the planning process for the past several weeks and many more knew in general terms that something was planned for that day. But for a few people, it was a surprise. Registered Nurse Anne Griffith, coordinator of the emergency room workers for this dril, said she only had about five minutes’ warning.

Porter holds such exercises about twice a year, as part of a requirement by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) to ensure that the hospital is prepared for an unusually large emergency.

Many such events are simulations of mass casualty incidents — a traffic pile-up involving a half a dozen cars, for instance. But in this exercise, personnel had to deal with only three injured people, but those people had been exposed to hazardous materials, so the hospital had to deal handle them very differently from most patients.

“It’s pretty complicated how to keep everybody as clean as possible,” said Dr. Fred Kniffin, president of Porter’s medical staff and director of the emergency room services, who organized the drill.

Pat Jannene, vice president of patient care services at Porter, said that the necessary precautions for handling a hazmat emergency would pose significant challenges if it actually happened in the area.

“Given what we have to do to get them decontaminated and into the building, it’s a big deal,” she said.

In this exercise, the hospital set up an inflated tent on the exit side of the drop-off loop outside the emergency room, where a patient could be cleaned off simply with soap and water. Personnel in the tent worked in powered air purifying respirators (PAPRs). Although they don’t provide protection from the most dangerous kinds of contamination, PAPRs are still watertight, according to Kniffin.

The tent had flaps on either end, as well as windows on either side through which someone could watch without being exposed to danger. The tent also had several compartments in the floor to prevent contaminated water from flowing out.

In previous years, the Porter simply used kiddie pools in drills and would have used them if a real situation involving hazardous materials. Two years ago, though, the hospital received a grant from the Department of Homeland Security to fund the compartmentalized inflatable tent, as well as about 20 PAPRs.

“It’s a huge step up,” Kniffin said.

Unlike in a mass casualty event, where the “victims” are taken into the emergency room and have to be treated quickly and efficiently, the challenging part of this drill took place outside. The tent kept any of the contamination from getting into the hospital, where it might endanger other patients.

Jannene said that the hospital’s goal is to be able to decontaminate up to three patients in this kind of condition, but ideally they will never have any. On-site emergency workers from agencies like a fire department would normally take care of decontamination, she said, but the hospital still has to be prepared because someone exposed to a dangerous chemical might drive himself or herself to the hospital, for example.

Had a real emergency come up during the drill, the tent would have had to be moved quickly. Personnel directed traffic at the parking lot entrance to keep all but serious emergencies out. In addition, the drill was not handled exactly like a real emergency would be: Only one ambulance was used for the drill, and the other was kept in reserve, just in case.

The number of personnel involved in such drills can vary greatly. Sometimes, the hospital has to involve dozens of volunteers from community groups and the fire department. For this demonstration, three volunteers came from within hospital staff, about a dozen people were directly involved with the set-up and decontamination, and many more worked behind the scenes to make it happen with minimal disruption to the normal hospital work.

“It is labor-intensive,” Kniffin said. “It’s hard to get people motivated to do drills, but if you don’t drill, it’s hard to handle (the real thing).”

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