Hospital conducts casualty drill to test itself and learn

A mass casualty exercise June 7 was the first one held at the Wrangell Medical Center in its 16-month-old facility.

The drill, which simulated a plane crash, was used to see where improvements could be made in the emergency operations plan. It involved about 70 staff members from the hospital, EMTs and volunteer firefighters.

Eleven community volunteers of various ages were made up to resemble victims with head wounds, lacerations and other traumas requiring stabilization, medevac or blood transfusions and the like.

"Anytime we run a drill like that, the goal is to stress our systems, seeing where those potential issues could pop up to see where we need to improve," said Carly Allen, hospital administrator. "It helps us push past our comfort zone."

Allen said the drill ran from 5:30 to 7:30 p.m., at which point they fed staff and volunteers and held what is known as a "hotwash" or debriefing of the event to find out what worked and what didn't. It helps the hospital administration create an after-action report.

"What we're looking for are the gaps, the missteps," said Michelle Walters, operations manager for Seattle-based Tegria, a company that facilitates such simulations with hospitals, clinics and communities across the country. "We believe systems either support people to do the same thing every time or they're not built to do that. How could the hospital, the policies, the process make it run more smoothly?"

SouthEast Alaska Regional Health Consortium contracts with Tegria to conduct the exercises.

The Tegria team is comprised of doctors and nurses with specialties in areas like emergency medicine or obstetrics. Physician and nurse facilitators help create a scenario that would likely happen in a place like Wrangell which would lead to the medical system being stressed, such as a plane crash. Those same team members are trained in moulage makeup and creating realistic looking injuries for the volunteers.

"It gives (medical staff) something to respond to, otherwise it can be too much imagining to get in the right state of mind," said Ian Doten, a physician facilitator and emergency medical doctor with Tegria. "It's not an everyday occurrence and mass casualties are all relative. (Wrangell's) mass casualty exercise is going to have (11) patients, where in Sitka they had 50 patients."

Christina Mason, a nurse facilitator with Tegria, applied a head wound and spinal injury moulage to volunteer Kathy Watkins, giving a backstory to the wounds. "She wasn't wearing a seatbelt, so she hit the ceiling, then she came down," Mason said. "It's helpful to staff to give them a trail to go down."

For the volunteers, it's a chance to have a new experience and help emergency responders. Sisters Jada, Asia and Siena Matthews wanted to have fun, but they also wanted to volunteer for their mom, Liza Matthews, who is a nurse at the hospital.

While the drill was the first at the new site, Allen said it wouldn't be the last. "Our goal is to do an actual drill annually."