Administration

I have received several questions from people about the Mass Casualty Training we had performed Wednesday, April 23rd, with multiple other agencies. Given the different roles and locations y’all have, I realize many of you may not have much exposure to this type of event.

Let me start by saying that for those of you involved in the event, or helped prepare for the event, please accept my sincere gratitude for all your time and effort. This was a significant undertaking by many and allowed us to critically evaluate our response to a mass casualty event. In addition, if you have ideas for making things better, please forward them to your supervisor and/or me.

For any of you curious about the event, see below for a simplified slide show we used in outlining the design as well as some photos from the day (thank you Taylor for the amazing photos). That said, here are the basic details:

• The event was designed to simulate how we would navigate a mass casualty event in this area.
• Olgivie Raceway and Sundown Campgrounds were used as a site to put on the event.
• Each area had a separate “evaluator” that provided feedback (i.e. EMS evaluator on scene, Fire Department evaluator on scene, Communications evaluator, Emergency Department Evaluator, etc.).

The context:

• A school bus carrying high school students was traveling westbound on MN 23, approaching Ogilvie at the intersection of Highway 47.
• A sedan was trying to overtake another eastbound vehicle, moving towards the bus.
• The bus swerved to try to avoid the eastbound sedan, striking one of the eastbound sedans and then colliding with another sedan facing northbound on 47. The second sedan was waiting to turn westbound on 23.
• The bus ultimately tipped over on its side with the two sedans impacting it.
• There were 24 people in the vehicles; 20 were transported to Welia Health’s Emergency Department in Mora.

The 911 call was simulated at 1:00 PM.  The response times for the different organizations were mimicked based on their locations:

• Ogilvie Fire/first responders were on scene first and established incident command.
• Welia Health EMS ambulance #1 arrived next, which took medical command.
• Further support followed with Welia Health EMS, Mora Fire Department, North Memorial EMS, Lakes Region EMS, Lifelink, North Air, and Essentia Health EMS.

First responders began initial stabilization, triage/extrication and organizing patients. Patients were then transported to Welia Health’s Emergency Department.

• Upon arrival at Welia Health ED, patients were triaged in the ambulance bay by hospital staff.
• After triage, patients were moved from the ambulance bay into appropriate areas in the Emergency Department where clinical decisions were made utilizing our limited resources.
• During this time, communication was key in determining who to transfer, when, how and where.
• Some interesting numbers:
  • On scene:
    • Critical patients: 5
    • Serious patients: 7
    • Walking wounded: 10
    • Deceased: 2
  • Transport to Welia:
    • 20 patients total by EMS
    • 2 simulated by air (for the drill: 1 was airlifted at scene, circled the site and landed at scene)
    • 1 trauma patient needed decontamination (simulated diesel fuel contamination)
    • 1 OB patient with trauma
  • Transported to other facilities:
    • 7 patients

Following this exercise, there was a debrief at both sites.

Some thoughts I’d like to convey to all:

• There are certainly some areas identified where we can improve. That’s the reason for the exercise. Overall, the performance of our teams was fantastic and I’m really, really proud of our group.
• Our local fire departments did exceptionally well in their response. There’s a myriad of things that were being considered in their performance (location of vehicles, scene control, time it takes to extricate victims, safety of the scene, etc.).
• Welia Health EMS arrived and established medical command, communicated with the fire departments, continued the triage process, started stabilization, prioritized patients for transport, communicated with the other EMS services, and then started transporting. I was very impressed with the efficiency, professionalism, communication and prioritization. Very nicely done!
• Welia Health ED/Hospital did a great job with preparation, communication, prioritization of resources and thinking through how to get so many people through our facility in an efficient manner. There were so many of you involved!
• It was absolutely fantastic having so many other entities as part of this exercise. It was humbling to meet so many people dedicated to the population of East Central MN, and I’m really grateful for their participation and dedication to our area.
• Being able to utilize the Ogilvie Raceway and Sundown Campground for the exercise was maybe a bit serendipitous, but the sites worked extraordinarily well. They were both very generous with their properties and supportive of our efforts. A very special thank you to those organizations!
• In a real-life situation, all these patients would most likely not come to the Welia ED. There would also be other resources that would be available through the state. But there are conceivable situations where we would need to rely on local resources until other entities become available (especially if there are weather conditions causing or impacting the event). In that regard, this exercise has some real credible components.

Lastly, from my standpoint, this was an incredibly valuable learning experience. The degree of complexity in communication between all the entities and different resources is astounding (look at slide 4 for a hint). But what stood out most is the rock stars among us. Welia Health, along with the other entities, all brought their A game last week. You should all be proud that we have so many people in our community dedicated to helping in emergency situations—including many amongst our staff. In the event we were faced with an event like this, I’m confident our teams would (again) respond exceptionally.

Again, thank you to all involved in any way. I really appreciate your time and efforts!

BDN