Mass Casualty Incident Training: Behind the Scenes with UC Health

This mass casualty incident was only a simulation. But emergency management officials know that it’s a matter of when-not if-the region is affected by a real-life event that threatens to overwhelm emergency medical services.
The 2019 mass casualty incident exercise was organized by several Hamilton County, Ohio agencies and the Greater Cincinnati Disaster Preparedness Coalition, specifically to test how the region’s hospitals would respond to a real-life disaster. Forty-five organizations and health systems from around Hamilton County were involved, including 395 volunteers and 170 first responders.
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[@TifleTifle-xd2pf]

I once worked on the day an MCI, I was working regular duty that day on an ambulance. It was still early and the ER was alerted and getting ready. It was an explosion at a plant in Louisian. We entered to ER with a patient that was not related to the MCI but the patient was seizing. We could not find anyone in the ER to help us as we waited on the wall. Everyone was busy getting ready. As we waited our patient began to seize. There was no one to help us in the ER. I had to run out of the ER and grab the ALS bag from the unit and the paramedic had to treat the patient in the hall. An IV was started in route. Moral of the story. Patients are still coming in so be ready. Later that day I did a return trip to the same hospital. Not one patient from the MCI made it to that hospital, they were sent elsewhere.

[@victornuestro4849]

What a helpful simulation video to show how the emergency medical system and hospitals and all their staff to coordinate with each other during a disaster in a community

[@miken8820]

This is a great simulation training video. I found it helpful to show this to EMT teams so they have an idea what might be going on at the hospital while they are in the field.

[@amerigo88]

Things to consider: 1 - Ammonia explosion yet none of the paramedics at the site of the explosion are wearing masks or other breathing apparatus. What happened to the ammonia fumes? 2 - No mention of ammonia effects within the hospital. Wouldn't the patients need to be decontaminated, preferably during transportation to the hospital? However, many patients will be contaminated then transported in personally operated vehicles and arrive while still contaminated. 3 - It would be helpful to see coordination with other hospitals as a Mass Casualty Incident (MCI) of this scale would overload a single hospital. Also, hospitals vary in terms of their ability to provide emergency/trauma care. 4 - Coordination should also involve other first responders. For example, police would be needed for traffic management and would establish crime scene procedures at the site of the MCI explosion. Fire department personnel would also accompany the ambulances responding and would have breathing apparatus available, as well as water/chemicals that could assist with decontamination. They mentioned a fire having occurred, so the fire captain on site would manage it as a fire site as well as a crime scene, at least until the fire was completely extinguished. 5 - Given that a car assaulted the crowd and then triggered an ammonia leak, typical of a terrorist attack, another concern is a second explosion that targets first responders. Was this given any consideration? There could be a second MCI that injures and degrades the ability of first responders to provide care. This is still a great exercise, but the scale is fairly small. Perhaps a city wide exercise that forces more co-ordination would be even more helpful. This would be quite useful before Cincinnati is struck by an actual tornado or floods (Ohio River) of the type that devastated nearby Kentucky in 2021 and 2022, respectively.

[@ImperiumLibertas]

Looks like this was a one hospital drill. I know they do larger drills in my state that coordinate everyone even the national guard but they're infrequent due to their size and cost. I see posts about them around once a year.

[@xPRODIGYxGAMER]

Ammonia contamination concern yet no one is experiencing any of the onset of symptoms? Very very low concentrations (about 5 ppm) causes odor. And also low concentrations (about 50 ppm) causes rapid onset eye, nose, and throat irritation. As well as airway restrictions causing coughing. Still within OSHA PEL. If first responders aren't noticing symptoms in open air its fairly safe to say there isn't enough to harm them. Only concern would be confine space, but that would be left to a professional anyways. Ammonia gas is lighter than air. So depends on time after incident but likely wouldn't be much left in the air. Patient contamination would be my only worry. Patient decon isn't always treated as a priority in transportation (but probably should be) and definitely should be priority before putting them into a hospital.

[@LynnDeatherage-q3k]

Called a code orange 🧡 in some hospitals. In Minnesota twin cities metro areas after I-35W bridge collapse in August 1,2007. And I was hurt badly and I was carried away from the sidewalk and the MPLS cop Thurston who carried me to the medic rigs there were 3 rigs.

[@Bill.R.124]

Helpful to see this. You all should have recruited some theater students. The "victims" were pretty dull and didn't do anything to "amp" up the drill.

[@LynnDeatherage-q3k]

That day of the bridge collapse is I ended up in Region hospital ER and Janice as well as the other side of her own life.

[@Shola_Omishakin]

Always in Ohio…

[@sydneym4527]

when they do a simulation do they actually discharge real hospital patients

[@ericaking4769]

no. they can generate fake charts to give to the doctors, they then look at those and determine which of the fake patients to hypothetically discharge.