Mass casualty drill in Pedi ED keeps staff prepared for the unthinkable

Gregg Klaus, RN, manager, Trauma Program, and Kristen Clark, RN, assistant patient service manager, work on a "victim" who entered the Pedi ED with a "critical gunshot wound."
Gregg Klaus, RN, manager, Trauma Program, and Kristen Clark, RN, assistant patient service manager, work on a "victim" who entered the Pedi ED with a "critical gunshot wound."

Even before a gunman killed and injured moviegoers in an Aurora, Colorado movie theatre, the Pediatric Emergency Department and Emergency Management had been planning to stage a mass casualty drill that would test their preparedness for an emergency involving scores of young people.

"We hold drills regularly to test our preparedness and we learn from each one," said Donald MacMillan, PA, Emergency Management coordinator. "Each drill gives us the opportunity to see what works and what doesn't work so we can improve how we respond.

"Unfortunately, school shootings are no longer unthinkable in our country, so we have to be prepared for this type of event in the Children's Hospital," explained MacMillan.

Karen Santucci, MD, section chief, Pediatric Emergency Medicine, worked with MacMillan to create the life-like drill that included enlisting 17 students and four parents from her son's high school, St. Joseph's in Trumbull. Parents drove the students to the Dwight Orchard parking lot where hospital staff labeled them with their injuries which ranged from panic and asthma attacks to gunshot wounds to the head. "Real" ambulances transported the "injured" to the Children's Hospital where more than 50 staff members were preparing to care for them.

"You don't associate a pediatric emergency room with this kind of trauma but it could happen and we have to be ready," said Dr. Santucci. "Realistic drills that pull in everyone from Protective Services to social work to clinical staff prepare all of us to work as a team to triage the injured and save lives when time is of the essence."

At the hospital, Protective Services officers checked the incoming students for weapons and initially separated parents from their children. This drill actually included a student who was labeled "gunman" and his explosive device was literally taken out to the parking lot of the Children's Hospital where the New Haven bomb squad pretended to disable it. Protective Services also closed down the entrance to the Pediatric ED, which is now standard procedure in this type of event.

"These students really added so much realism to the drill for the staff," said MacMillan, who noted that department heads will write a post-drill report on what needs to be improved, who will make the improvements and by what date. "While you hope and pray this never, ever happens at Yale-New Haven, we must be prepared so we can save young lives and minimize trauma."