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Downstate Times

The Newsletter for SUNY Downstate
University Hospital of Brooklyn

Downstate Times PDF
Issue 12, July 2013

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ISSUE 12 star JULY 2013

Preparing Residents and Staff to Respond to a Mass Emergency

Scene 1: A large group of Brooklyn church members just returned from China has arrived at the ER with symptoms of Avian flu. What is to be done?

Scene 2: In Williamsburg, a man suffers a broken leg and is exposed to a hazardous substance when a container breaks and falls on him.

These events didn't really happen—but what if? To prepare emergency medicine residents and hospital staff for such emergencies, Downstate staged a "Disaster Olympics" Exercise Plan on July 10. Held in collaboration with Kings County Hospital Center, the New York Institute for All-Hazard Preparedness, and the NYC Department of Health and Mental Hygiene's Medical Reserve Corp (MRC), this full-scale exercise involving 200 volunteers had six primary teaching aims:

  1. Setting up and carrying out decontamination procedures;
  2. Patient registration processes;
  3. Point of dispensing (POD);
  4. Don and doff—using protective gear;
  5. Crisis decision-making, coordination, and communication; and
  6. Educating hospital staff about their role in emergency response.

For the emergency medicine residents who were assigned to tend to the victim of the chemical spill, this meant learning how to set up a decontamination tent, donning and doffing decontamination suits, and showering to remove contaminants, both for themselves and the victim.

Evaluators stood by, timing how long it took each resident to complete these tasks. "Working quickly is very important, but working well is even more important to make sure that everyone is safe," said Bonnie Arquilla, DO, associate professor of emergency medicine and director of disaster management.

The training exercise for residents and staff helping the church members exposed to the Avian flu focused on setting up a POD to dispense antibiotics and vaccines.

George Allen, PhD, CIC,CNOR, director of infection control, was on hand to make sure everyone followed CDC guidelines by gowning and gloving and wearing face masks. Teresa Chan, PharmD, an emergency clinical pharmacist, supervised the team dispensing Tamiflu and Relenza.

A third leg of the exercise tested the hospital's ability to quickly evacuate patients if needed. Nursing, environmental services, and admissions staff teamed up to safely move 24 "patients" from NS 62 to Kings County Hospital.

Even though this was just a drill, everyone took it seriously. Many of the volunteers playing the part of sick patients gave Oscar-worthy performances. One had a breathing attack that was almost too realistic and another cried non-stop for her mother.

"Hopefully we will never face this kind of emergency," said a drill participant, "but if we do, we'll be ready for it."


Dr. Bonnie Arquilla, director of the disaster drill, makes certain the pharmacy unit is set to go.


Emergency medicine residents get ready to begin the drill.


Learning to set up a decontamination tent.


Residents help each other suit up for hazmat training.


Registering patients at the POD.


Triaging a patient in severe respiratory distress.

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