Tanker trucks carrying hazardous liquids ply the winding roads of Pocahontas County on a daily basis. Just in the past few years, two gasoline tanker trucks have overturned on local roadways and spilled a portion of their contents. But trucks also carry chemicals that are more problematic than gasoline for first responders and medical personnel. A disaster drill last Wednesday tested the ability of local emergency and hospital personnel to handle a spill of acetone, a flammable industrial chemical that can injure the eyes and skin and damage equipment.
Pocahontas Memorial Hospital Director of Emergency Services Gary Brown described the purpose of the drill.
“We have to have so many preparedness exercises every year,” he said. “A lot of time we do those as table-top exercises. We did one of those back in the spring and we decided we needed to get out our decontamination tent and set it up. We’ve got a lot of new employees here and it’s been awhile since that had been done. We decided we’d actually do it hands-on and actually bring patients in through the ER [emergency room] and do a hazardous material scenario, where we’d have to do decontamination.”
Only a core group of hospital and emergency planners were aware of the scenario.
“The scenario was an overturned truck in the middle of town that had acetone spilling out of 55-gallon tanks,” said Brown. “It’s a realistic scenario because there’s trucks that go through this area every day carrying that type of chemical up towards Elkins, up that way where all the flooring factories are. They use that chemical in the process of making flooring.”
Local first responders were alerted about 10 a.m. Wednesday morning. Marlinton Fire and Rescue arrived quickly at the Mini-Park in Marlinton, the site of the simulated acetone spill. Pocahontas County Emergency Management Services Director Shawn Dunbrack supervised the training at the scene.
Six volunteers acted as patients during the exercise and wore placards, indicating their injuries and condition. Two suffered from inhalation injuries and four had acetone on their person and required
decontamination. Ambulance crews treated the patients and transported them to the hospital.
By the time patients arrived at PMH, a hospital response team had set up a bright blue inflatable decontamination tent.
Hospital staff placed the four contaminated patients on gurneys and wheeled them through the decontamination tent. The tent contains multiple sections for successive decontamination treatments. A large rubber water tank was connected to a fire hydrant, but not filled. A water pumper, similar to a large pressure washer, was set up, but not used during the exercise. Hospital staff simulated hosing down the patients as they moved through the tent.
Brown said the exercise provided hospital employees an opportunity to step into leadership roles.
“It was a good scenario to let us set up our incident command system here inside the hospital,” he said. “We took out key players, such as myself and Mike Riggsby, who in normal circumstances would be the people in charge. We took us out of the picture because we wanted other people to assume leadership roles, and everybody responded very well.”
The director was pleased with the results of the exercise.
“We did identify some minor communication issues that we had between the decon area and the emergency department.” he said. “But overall, it was a very positive drill. We did hands-on in the ER. We worked through just like they were real patients. We ended up with six patients, which kind of taxed our ER staff a little bit. The ER was full and we had staff from other parts of the hospital coming in to help the ER, because normally we just staff two nurses. We evaluated how they handled the actual triage of who was the most emergent patient versus someone who wasn’t. That part of the drill was handled extremely well.”
Dunbrack said Marlinton and Hillsboro EMS squads were evaluated during the exercise.
“We identified that there probably needs to be more hazmat training for the EMS and fire responders in the county,” he said. “Probably just a little better coordination efforts with the departments, as far as their incident command and things like that. It was evident that they need to work on some things with identifying who’s in charge of the incident. I think everybody got some good experience with triaging patients and determining who’s most critical and who to send first.”
The EMS Director said the state can provide help with hazmat training.
“It can come from state-level training from the State Fire Marshal’s Office,” he said. “We can send people outside of the county for classes or we can work on getting more training classes within the county.”
Dunbrack said a future exercise should include deployment of the decontamination tent to the scene of an incident, so that patients can be decontaminated before they are placed into ambulances.
“Decontamination can be something that happens on-scene, rather than happening at the hospital,” he said. “You get that ambulance contaminated and it can’t be used again for awhile. That’s a big resource for this county. It seems like we have a lot of ambulances, but then again, if we get a big disaster, we don’t.”
Brown and Dunbrack stressed the value of training exercises like last Wednesday’s and said more exercises are needed.
“We discussed it with the hospital,” said Dunbrack. “More people at the hospital need to be trained. Obviously, more of our responders need to be trained. So that’s something that’s going to happen more often. We talked about doing something with the decon tent – at least for awhile – maybe once every couple months. We probably need to be doing it at least every six months with the outside responders.”
“Before it gets too cold, we’re going to try and get the tent out a couple more times for set-up, so that people who weren’t here that day can have the opportunity to do it,” said Brown.
Dunbrack said readiness is critical because the danger of a serious hazmat incident is all too real.
“It’s something that definitely can happen,” he said. “We just don’t know what’s on the trucks that pass through this county. We get something called a commodity flowsheet and we know what comes into the county and what goes out of the county on trucks, but we don’t know what’s just passing through on a day-to-day basis. We just don’t know.”