June 25, 2008

Getting gassed

Hospital, emergency personnel test readiness during mock disaster

By Jeff Kaley

WAURIKA —

By Jeff Kaley

When you went outside and took a deep breath Thursday, were you feeling a bit odd the rest of the day?

As the day progressed, did you experience difficulty in breathing and bouts of coughing? Maybe you noticed your heart beat picked up or, perhaps, it slowed down dramatically.

Were you smitten by flu-like symptoms; nausea, vomiting, a headache?

Even more startling, by Thursday evening, were you completely worn out? Did you see discoloration spots forming on your body? Was there a frothy “mucus” in your mouth or nose?

If you noticed any of these unusual physical experiences, then you were among the hundreds of people in western Jefferson County who were exposed to phosgene gas, what your grandfathers or great-grandfathers called “mustard gas.”

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OK, before the power of suggestion takes over and you start calling a physician or driving to Jefferson County Hospital to be examined, what you just read is a fantasy. Western Jefferson County WAS NOT invaded by a cloud of phosgene gas; no one in these parts really came down with the array of symptoms mentioned, and the threat of a poisonous airborne agent was a fabrication.

But what if it had been real? How would area medical and emergency personnel have reacted if a dangerous chemical had been released and hundreds — perhaps, thousands — of area residents had been in need of emergency treatment?

That’s why the Duncan Score 2008 Exercise was held on Thursday. That’s why medical and emergency workers from Ardmore to Waurika to Lawton to Chickasha were involved in a four-hour interagency exercise that focused on field-level and hospital response to a terrorist incident.

In this case, the terrorist incident involved an explosion at a hypothetical chemical plant in Duncan, which released phosgene gas into the atmosphere. An area from Grady County down to the Red River was exposed to what World War I veterans remember as “mustard gas,” and the resulting public health emergency brought a variety of agencies into play. (See scenario story Page X.)

During the mock disaster, Jefferson County Hospital became a decontamination site that was staffed by hospital personnel and members of the Jefferson County Health Department. In addition, the hospital was a action/communication location for the Jefferson County Emergency Management Agency, whose director, Steve Goza, was one of two evaluators for the exercise.

Members of Boy Scout Troop 4460 acted as “victims,” who were brought to JCH for decontamination, observation and treatment of the various symptoms that accompany the poisonous gas. The hospital’s performance was “graded” by Kendal Darby, an HCC evaluator for the regional Medical Emergency Response Center (MERC) based in Lawton.

“It all went real well,” said Jefferson County Hospital CEO Jane McDowell. “Kendal and Steve, the two evaluators, said we did very well in getting our ‘victims’ decontaminated and taken care of.

In addition to response to “victims” being brought to JCH, the evaluation process included assessing facility security, protection of staff and notification procedures.

Such exercises are necessary, because what looks good on paper isn’t always effective or efficient in practice. As McDowell noted, “One reason you hold these exercises is to find out if there are things that you need to do differently and to look into other methods you might use in a real emergency.

“We did find some problems in our communications — mainly, we needed to have hand-held walkie talkies, which would have made it much easier and faster to communicate with personnel inside and outside the hospital.

“But Kendal and Steve thought we got our decontamination showers and equipment set up real quickly, and they were impressed by how smoothly things went within the hospital. I was pleased with our staff.”

This was the second mock disaster exercise in a year that’s involved Jefferson County medical and emergency personnel. In June 2007, a five-county Mass Immunization Prophysaxis System/Point of Distribution System practice run was held in reaction to a public health epidemic that was instigated by animal rights activists.

“Exercises like this really are important,” McDowell noted. “You like to think you won’t have a disaster like this, but you never know, and you need to be prepared for any possibilities.”

An complete evaluation of the Duncan Score 2008 exercise will be done by MERC and the Regional Medical Response System, with its conclusions to be presented in late July.