To the editor:
On March 5, a routine commute on U.S. Highway 20 just east of Webster City changed in a split second when drivers entered a sudden, black smoky fog that brought visibility down to zero. Many vehicles slowed and or stopped, causing a chain reaction of severe accidents. The number of accidents and the severity of each prompted Van Diest Medical Center to activate their "External Code Green" disaster alert.
That Monday morning, I was walking past the emergency department admitting desk when I heard multiple ambulance tones, similar to pager tests that are performed weekly. The admitting staff stopped me and said, "Every ambulance in the county has been called out to an accident on the interstate." Our ED nurse on duty confirmed the reports but had little other information. I notified the director of nursing, Deb Thielen, we may need additional nursing assistance in the ED. The original call for our EMS to respond was at 7:38.
Soon thereafter, I was told there was a phone call for me at the ED desk. Our COO, Janet Naset-Payne, was on the line and reported she witnessed a multiple car high speed crash on Highway 20, there was fire involved, and there would be more injured than our facility could routinely handle. The decision was made to call an "External Code Green," our disaster code for the hospital, and prepare for multiple patients.
At 7:45, Van Diest Medical Center entered into disaster operations and initiated incident command. Elective procedures were postponed and the Same Day Surgery Department was turned into a treatment area for less severe injuries and the Specialty Clinic converted to a treatment area for the walking wounded. All available IV pumps, monitors, and stretchers were brought to the ED. Calls were made to the off duty staff of all the clinical departments as well as the admitting departments to respond while all available staff from every hospital department reported to assist in the ED.
Immediate requests were made for air ambulance support and we learned early on that the fog had made air transport impossible. All three of Van Diest Medical Center's Paramedic Level ambulances had reported to the scene of the accident and it was clear we would not be able to cover additional 911 calls in the city, nor handle the multiple transfers of trauma patients that were predicted. Trinity Regional Medical Center in Fort Dodge responded to our requests for assistance and not only were gracious enough to send a fully staffed ambulance to cover the city of Webster City but also sent an additional ambulance to transfer a separate trauma patient in our ED, unrelated to the accident.
It was truly amazing how quickly the ED filled with available staff to help and all the supplies we would need. Everyone did as they were instructed, without question, and went beyond what was asked of them. A quick briefing was held to ensure everyone was on the same page regarding the event at hand, plans for triage, and how patient care would be handled. A general question of "is there anything else we need to do" was shouted out and someone responded we could use a prayer. Spontaneously, the staff in the area gathered around and had a quick prayer for those who were injured and guidance for our staff in treating the injured. The atmosphere in the ED calmed.
At 8:08, our first trauma patient arrived to a sea of nurses, doctors, and technicians ready to transport and treat whatever came through the ambulance door. In the end, 10 patients from the scene requested treatment and all were transported to our hospital. Two patients were injured severely enough to need transport to a Level 1 Trauma Center after initial stabilization, four patients were admitted to Van Diest Medical Center, and four patients were able to be discharged to home. There were no fatalities.
Although our organization is more than 100 years old, we have only been in our current facility 17 months. This was our first test of a large scale event in our new building. Several days later I also learned this was the largest multiple car crash in Hamilton County history. I can say not only for Van Diest Medical Center, but for all the multiple emergency response agencies in Hamilton County, "the system worked" on Monday, March 5, 2012.
Michelle Stapp RN, CEN
Emergency Services Nurse Manager
Van Diest Medical Center
Chief Operating Officer
Van Diest Medical Center