Keeping calm in case of catastrophe

Every March, departments across the Hospital of the University of Pennsylvania participate in a mass casualty incident (MCI) drill, where medical students in the Perelman School of Medicine's Wilderness Medicine electivepose as patients who were struck by a radioactive bomb.

Immediately after the drill, representatives from each department meet with Jonathan Bar, director of Emergency Preparedness and an assistant professor of clinical emergency medicine, for a "hot wash," or a facilitated discussion to identify drill processes that worked well, and any concerns or proposed improvements for procedures in the Emergency Operations Plan.

Emergency preparedness isn't limited to these large-scale drills for catastrophic events like this, though. For a small, but dedicated group, it's a nonstop job.

In 2014, as the deadly Ebola virus spread to the United States, the HERT at Penn Medicine developed a plan for managing biohazards, including the extremely contagious virus. The plan outlined what personal protective equipment (PPE) staff should wear, treatment protocols for triaging and quarantining patients, and who to contact at local and national agencies.

The plan for triaging patients in tents outside the hospital entrance while staff wore PPE was instrumental in Penn Medicine's response to the COVID-19 pandemic in 2020. Thanks to their extensive planning for Ebola, PPMC was able to quickly set up tents and establish a triage system for patients coming through their emergency department that kept both patients and staff safe in mid-March, even before stay-home orders had been issued, and cases in Philadelphia were still low. In less than a week, all Penn Medicine hospitals had similar structures and systems in place.

"People who work in emergency preparedness are catastrophizers," says Jack Welsh, a nurse in the department of Emergency Medicine at HUP, and HERT leader. "While in any emergency, there are things we won't be able to anticipate, we try and dream up all possible scenarios and prepare contingencies for the most likely things to go wrong."

Welsh recently developed an emergency response manual for any type of radiation emergency-from a nuclear bomb explosion to an accident with radiological equipment on campus, to managing a patient with radiation toxicity.

Welsh underscores that not only is the HERT meant to engender confidence from the community in the event of a catastrophic event, but also among health system staff.

"When a crisis happens, it's scary-we all remember what it was like at the start of the pandemic. But this prep is meant to majorly account for staff safety during an emergency. If we can't keep our own people safe, we can't keep our patients safe, we can't keep our community safe."

Read more at Penn Medicine News.