On April 10, a tanker carrying almost 800 million gallons of liquid natural gas exploded in Narragansett Bay. Everything within a one-mile radius of the explosion was immolated, while downtown Providence was mostly flattened by the blast and had several large fires to combat. Three of Providence's main hospitals were destroyed. Up to 100,000 people were injured, and 38 seconds of exposure led to second-degree burns. How could such a thing have happened?
This apocalyptic scenario was the subject of a mass casualty incident drill held by Brown Emergency Medical Services on Sunday afternoon. EMS Director Richard Lapierre defined a mass casualty incident as "one more patient than you can handle given the circumstances."
The first floor and basement of the Health Services building were transformed into a disaster zone, complete with injured and hysterical "victims" - mostly student actors and some mannequins - scattered debris and a power outage. The parking lot became a center of command and a treatment area for extricated victims, who were often strapped to spine boards or wearing neck braces. Victims themselves were removed from the building, treated and then placed onto tarps according to a color system: green victims were able to walk, yellow had non-critical injuries, red were critically injured and black were dead.
About 104 people, all volunteers and mostly Brown students, participated in the drill.
"I didn't really know what I was getting into," said volunteer Arminda Smith '08. She played a hysterical woman whose baby died in the incident, meaning that the emergency medical technician also had to focus on calming her.
Teams of emergency medical technicians were divided into five crews. All crews had a chief, who in turn worked under an incident commander. Necessary positions, like team security officer, were assigned as soon as the incident commander's team arrived on the scene, roughly 10 minutes after the scenario started. Half of Brown's senior student EMTs were in command positions within the scenario while the other half evaluated them.
To ensure the safety of the teams and volunteers involved, everyone was given a code word -"banana" - to use in case of an actual emergency. Using the code word would bring the simulation to a halt.
EMT Nick Mark '06 planned the scenario. He said he chose a liquid natural gas explosion because "it's an actual concern - this could actually happen."
Brown EMS tries to hold one mass casualty incident drill per year, "primarily so when the big one hits, we'll know what to do," Lapierre said. Last year, the scenario was an earthquake that devastated the area. This year, the situation was even worse.
"What complicates this one is that our normal backup (Providence Medical Services) isn't available," he said. "Brown EMS is on its own."
Brown EMTs worked for the duration of the drill and afterwards met to discuss what went well and what did not.
Incident Commander Andrew Pfeffer '05 rated his and the rest of the EMTs' performance as "a little better than average."
"We had a little difficulty setting up," he said. "I think at the beginning we didn't allocate our resources well enough."
Pfeffer said if he had to do it all over again, he would have waited until the outdoor setup was ready to send rescue crews into the building .
Some victims were "killed" on impact in the scenario, and at least one patient, who had been critically wounded at the start, died as other victims were treated. But as the saying goes, practice makes perfect - and in this line of work, perfection can mean the difference between life and death for some victims.
"You can sit in a classroom and talk about MCIs," said Senior EMT Matthew Sarasin '05, "but without actually doing it, you lose a lot."
