A FedEx truck carrying radiological material overturns. The driver is injured, and an ambulance rushes him to the nearest hospital. During transport, Emergency Medical Services (EMS) detects radiological material on the patient and alerts the hospital.
When the patient arrives, staff are ready: they’ve set up a decontamination room, put on their Personal Protective Equipment (PPE), and established a Command Center to monitor the situation. The patient is taken into the decontamination room, the radiological material on his body is located, and he is decontaminated, preserving the safety of patient and staff alike.
The situation described above never actually happened—at least, not at Temple. But if it, or something like it, were to occur, staff and hospital need to be prepared.
That’s why our Emergency Preparedness team recently modeled this scenario in a large-scale exercise, choosing Temple Health-Chestnut Hill Hospital as the location. Participants included the Chestnut Hill Hospital Emergency Department, Nursing, Administrative, and Nuclear Medicine teams, as well as the Temple Transport Team (T3), Montgomery County’s Hazardous Materials Response Team and Division of Emergency Management, Temple University’s Office of Emergency Management and Environmental Health and Radiation Safety (EHRS) Department, and the City of Philadelphia’s Office of Emergency Management.
They did a full-run through of the situation—using a mannequin, rather than an actual patient—to test the effectiveness of team members’ training and their ability to safely handle a radiological incident.
Drawing on Expertise
“This exercise drew on my previous experience as an Emergency Manager in Wake County, North Carolina,” explains Jeffrey Dever, MSEM, CHEP, Temple University Hospital-Main Campus’ Manager of Emergency Preparedness, who designed the simulation. “Because Wake County has a nuclear power plant in its jurisdiction, it’s FEMA-designated as a Radiological Emergency Preparedness County, and required to participate in annual exercises testing its emergency preparedness.”
“One of those exercises is called a Medical Services (MS-1) Drill,” Dever continues. “It tests how area hospitals respond to radiologically contaminated patients. How do you decontaminate them? How do you protect your staff, other patients, and visitors from that radiological material? Right now, our Emergency Management team is in a place to conduct more functional exercises to test our experience and our plans. So I drew on my experience in Wake County, and put this exercise together.”
To prepare, clinical teams received First Receiver Training through EHRS, which included emergency procedures and how to properly put on, wear, and remove PPE. Dever also ran discussion-based tabletop exercises for Administrators on Call on the Incident Command System, which is our leadership structure during a disaster situation detailing how to open and run Command Center, which personnel should be involved, and what actions would need to be taken during the incident.
The exercise was planned approximately two months in advance, with participants selected based on experience and availability. Because nearby Montgomery County, like Wake County, is a Radiological Emergency Preparedness County due to the presence of a nuclear power plant in Limerick, Dever invited County officials to supervise. “I wanted that expertise here,” he explains.
“An Example of Emergency Preparedness”
The morning of April 1st was cold and clear—and, until the ambulance arrived, relatively uneventful. In a real incident, our Emergency Departments would be notified through our Dispatch/911 Centers, Juvare (the statewide incident management software run by the Southeastern Pennsylvania Healthcare Coalition), and/or Temple Health’s internal mass notification platform, RAVE. The key, then, is to follow protocol while remaining calm—which is exactly what everyone involved in the exercise did.
T3 transported the patient through a side door into the decontamination room, where Maria Meinel, Temple Health’s Manager of Nuclear Medicine, used a Geiger counter to detect the radiologic material on his body. He was then decontaminated, and participants headed to the Command Center for a debrief.
“I thought it went very well,” Dever said of the exercise, after receiving positive feedback from all of those present. “During this situation and in any emergency, our top four priorities were patient and staff safety; incident stabilization and control; property preservation; and continuity of care. There are things we need to work on through further training, but I’m happy with how we executed on all of them.”
“Throughout my career, I’ve found that I can teach as many FEMA courses about Emergency Management as I want, but that the best way for people to learn is just to get out there and do it,” he continues. “These exercises take time to put together, but my goal is to hold one every two years at each facility in the Health System.”
Dever also wants team members across Temple Health to know they can rely on Emergency Management as a resource. “I’m open to any calls and questions from our staff and providers about emergency preparedness,” he says. “I want to have discussions about we can make our Health System more prepared, and I’m available 24/7. Let’s work together to make Temple Health an example of emergency preparedness in our region.”
