Transport, Triage, and Treat training with NHB Mass Casualty Exercise

By Douglas H. Stutz, Naval Hospital Bremerton Public Affairs

BREMERTON, Wash. (NNS) -- Naval Hospital Bremerton held a mass casualty exercise March 21 to test after-hours response capabilities of limited staff on duty.

The exercise, held in conjunction with force protection exercise Solid Curtain/Citadel Shield 2012, and in cooperation with Naval Base Kitsap and Command Navy Region Northwest Fire/Emergency Medical Services, focused on how those on duty could handle a scenario involving multiple casualties in need of immediate medical assistance.

"We plan and practice several mass casualty drills a year and for this one, we wanted to see how our weekend and after hours staff would respond if they were suddenly surged due to an influx of multiple injured patients. In such a scenario, they're going to be the only ones for about the first hour. They need to know how to deal with all that's needed during that time," said Terry Lerma, NHB emergency preparedness coordinator.

The exercise scenario involved a vehicle accident on Naval Base Kitsap Bremerton. A passenger van swerved to avoid a pedestrian, tipped over and rolled, causing 12 people to sustain various injuries. NBK Bremerton Federal Fire Department initially responded with NHB helping to handle the surge of multiple patients needing medical treatment.

"As always, when an actual emergency happens, it won't be at our convenience. It will be when we least expect it and we have to ready. Planning and training to prepare for that actual emergency will give us the experience needed to be able to handle whatever needs to be done," said Lerma.

On any given weekend and after normal working hours, there are duty personnel in such areas as Operating Room, Emergency Department, Nursing Services, and Clinical Support Services. The objectives of the exercise were to primarily stress the capabilities of the emergency department and main operating room with the patient surge, and assess the ability of the after-hour staff to respond, triage, treat and/or transport injured patients to appropriate treatment areas. The exercise also tested the collective communication capability of the staff on duty.

"The communication during the exercise was good. Our emergency department did really well. The turnover and interface with the fire department delivering the incoming casualties was very good, as was the triaging and transferring of some of the injured to the operating room and multi-service ward," said Lerma.

According to Lerma, one of the top three after action report items after any emergency exercise is always about internal communications. This mass casualty exercise gave the command the opportunity to activate the alternate hospital command center (HCC) and iron out information-sharing and various means of informing staff, patients and beneficiaries.

"We primarily used landlines, but also had our command radios on hand for the exercise. Our command duty officer relayed inputs and updates to the HCC which was very timely," Lerma said.

"This exercise was valuable. It allowed us to talk things through, especially regarding communication," said Russ Kent, NHB Facilities Management Department head and HCC operations section chief.

Of prime importance to the HCC during any emergency is ensuring that the timely and accurate word gets out to staff on reporting to assigned places of duty. During an after-hours emergency event, the duty section has the immediate responsibility as other staff members are notified to augment the caring for casualties.

"We do have several ways to quickly recall additional clinical support and every emergency exercise can pose a different scenario. If we're dealing with an earthquake, that could impact our network connectivity and we might have to use other means. If we're handling a number of casualties from a automobile accident, then we can use our internal pager system. We will use the best methods available to get the word out to staff if they need to immediately report to the hospital. Social media also gives us several options that we will utilize," said Capt. Mark Turner, NHB executive officer and HCC incident commander.

"I would say this training is very valuable especially for the emergency medical technicians and firefighters. They were the ones who went through and practiced their training. I learned the importance of triaging. We don't normally see these kinds of cases on a day to day basis so being able to do it in a drill makes you more aware. The hospital staff was very professional. They treated me like I was an actual patient and I was impressed," said Hospital Corpsman Andrew Colbeck, of Branch Health Clinic Puget Sound Naval Shipyard.

"There are always three priorities in any emergency," said Lerma. "There is life safety where we take care of the sick and injured; incident stabilization that in a mass casualty scenario we treat every patient; and property conservation/business continuity where we still provide services to care for other patients when dealing with mass casualty casualties. We did all of those today."

Naval Hospital Bremerton is part of Bureau of Navy Medicine and Surgery, a global healthcare network of 63,000 Navy medical personnel around the world who provide high quality health care to more than one million eligible beneficiaries. Navy Medicine personnel deploy with Sailors and Marines worldwide, providing critical mission support aboard ship, in the air, under the sea and on the battlefield.

Training as well as health and wellness are important elements of the readiness area of the 21st Century Sailor and Marine initiative which consolidates a set of objectives and policies, new and existing, to maximize Sailor and Marine personal readiness, build resiliency and hone the most combat-effective force in the history of the Department.