A lesson in preparing for tragedy

“Code triage-external” blares from the hospital speakers. There are reports of mass casualties somewhere in Medford. Up to 10 patients are on route. Make that 14. No, 18. Children 12 to 16 years old with gunshot wounds.

Is the ED prepared? Are there openings in the OR? Do we have enough pediatric providers, anesthesiologists and beds?

If this sounds like pandemonium, it is. Which is exactly why ARRMC, along with the Medford School District and more than two dozen local agencies, held a simulated school shooting response last Thursday. The goal was to test our preparedness for a real-life tragedy.

The drill began at Oakdale Middle School in Medford with an announcement of shots fired. The Medford Police Department deployed a SWAT team while volunteer students posed as the wounded. They were taken to ARRMC and Providence by ambulance, bus and helicopter.

Meanwhile, Asante’s incident command team gathered in a ground-floor conference room at ARRMC to game out the scenario. More than 20 representatives from Nursing, Emergency Preparedness, Risk Management, Safety, Materials Management, Facilities, Security and others discussed what would be required when the patients arrived. The Emergency Department, trauma providers, social workers and others assessed “patients” outside the ED. Just as in real life, new details emerged by the minute, requiring constant pivots.

The exercise let participants find gaps in the process, whether it’s figuring out which communications should go to whom, to where families should gather to await updates. In an after-event debrief, the incident command team agreed that the exercise provided crucial preparedness training.

“Disaster exercises are critical to testing our plans, policies and procedures, especially where we interact with community partners,” said Scott Clemetson, Asante emergency preparedness coordinator. “Large exercises like this one and smaller scale tabletop exercises that are coming in 2023 and 2024 will strengthen our muscle-memory response to crisis. More important, they increase personal and system resilience to disasters.”

Staff from ATRMC and AACH supported the exercise too by evaluating the learning objectives for improvements. Emergency Preparedness, with the support of the emergency preparedness leadership committee, will create an after-action report and improvement plans to enhance resilience against future hazards.

A film crew from HBO joined the exercise to gather footage for an upcoming documentary. This is believed to be the largest drill of its kind in Southern Oregon.