Spring 2012

Volume 5, Issue 2 B.C. Health Sector Emergency Management Newsletter

Inside this Issue:

Reflections of the Health 1 Emergency Management In-Service

Managing Fire Safety in the 2 Health Emergency Management

St. Mary’s Hospital Full 3 Reflections of the Health Emergency Management In-Service Scale Code Orange Exercise Dr. Graham A. Dodd, MSc, MD, CCFP(EM), MADEM, Kamloops, BC.

Health Emergency 3 On February 22-23 I had the opportunity to Management attend the inaugural Health Emergency Man- Announcements agement In-Service held at the Justice Insti- tute of BC in . As a front- Evergreen Exercise 3 Update line medical clinician with an interest in emer- gency preparedness/disaster management I The Bright Lights of 4 found this event extremely interesting and Richmond would like to acknowledge the great work that Chris Smith (Director, Planning and Pro- Burn’s Lake Sawmill 4 grams) and his team from the Emergency Explosion: An Integrated Management Unit, Ministry of Health did in Emergency Response organizing and assembling an interesting B.C. Disaster Psychosocial 5 agenda. Included were topics such as: an in- Leanne Appleton delivers a presentation on the Services Response to Burns troduction to B.C.’s Mobile Medical Unit Mobile Medical Unit at the In-Service Lake, B.C. (MMU) and the Emergency Response Unit (ERU) of the Canadian Red Cross, BC Am- entations during the conference reinforced bulance’s Technical Advisory Program for the emergency management principle that the Upcoming Events! hazardous substances, updates from the success of a community (or facility) response emergency managers of the Province’s Health is largely dependent upon the degree of plan- 9th Annual Cross Border Workshop Authorities as well as a live demonstration of ning and preparedness that precedes a re- May 15-17, 2012 a Mass Notification System. I found it most sponse. Taking this concept one step further, Tacoma, Washington beneficial to have the opportunity to network as experiences from around the globe have www.pnwbha.org and discuss some of the unique challenges shown, the majority of emergencies or disas-

2012 EPICC Forum health emergency managers face throughout ters involve front-line health professionals at May 15-16, 2012 the province including geography, community the pre-hospital and hospital levels. There- New Westminster, B.C. remoteness, resource availability, and unique fore, it makes sense that we engage those http://epicc.org/ community risks and vulnerabilities. I felt this groups before they are called upon to re- Evergreen Quake 2012 In-Service built upon some of the discussion spond. From discussions held during the con- Exercise Series generated at the 24th Annual Emergency Pre- ference it was clear that considerable engage- Functional: June 5-6 www.emd.wa.gov/training/ paredness Conference held in Vancouver ment and leadership has emerged from the EvergreenQuake.shtml#ExSeries from November 29 to December 1, 2011. Ministry of Health, the BC Ambulance Ser- vice, and Health Authority Emergency Man- A Health Sector Mass Several different themes emerged during the Notification Capability is agers. I believe there still remains a need to coming to your organization In-Service. One theme that resonated the better engage front-line health clinicians such soon! most with me was the need to better engage as physicians and nurses to better prepare Watch for further information in front-line clinicians not just in the response the next issue of the HEM B.C. for future emergencies or disasters. newsletter . phase of emergency events, but also in the …(Continued on P. 2) planning and preparedness phases. The pres- Page 2 In Service Continued… (Continued from P. 1)… I would like to thank the In-Service ruary, as well as the 24th Annual Emergency Preparedness organizers for their foresight to include a few front-line phy- Conference it is clear that BC is fortunate to have world sicians as participants. Hopefully this will serve as a building leaders in both the field of emergency and disaster manage- -block for a future In-Service as well as planning and prepar- ment as well as health-emergency management. With this edness discussions at provincial, health authority and local strong base I believe we have an excellent opportunity to community levels. This may help identify and encourage develop similar levels of expertise in “clinical disaster those interested physicians to become emergency manage- health”, thereby increasing disaster resiliency for all BC ment “champions” at all levels. From the In-Service in Feb- communities.

Managing Fire Safety in the Lower Mainland Health Emergency Management Program. Scott Blessin, Manager, Fire Safety Management with Lower Mainland Health Emergency Management.

The creation of the consolidated Lower Mainland Health Emergency Management (LMHEM) Program in the fall of 2011 included the creation of a consolidated Fire Safety Management (FSM) function across Fraser Health (FH), Providence Health Care (PHC), Provincial Health Services Authority (PHSA), and (VCH). Collectively, the three person FSM team supports approxi- mately 64,000 employees, located in hundreds of acute, resi- dential, community health, research, support services, and corporate buildings throughout the Lower Mainland, Sea to Sky, Sunshine Coast and other sites throughout the prov- ince. While the scope of Fire Safety Management can range considerably from code consultation on new builds/ renovations to Fire Safety Plan development, the critical focus for the LMHEM Fire Safety Management team is peo- ple. More specifically the team focuses on finding ways to To ensure the broadest possible availability of FSM educate staff on prevention, how to respond to fires, and educational opportunities for staff of the Lower fire alarms in a variety of work settings. Mainland health organizations, the consolidated FSM team introduced an interactive "Code Red - Fire Safety One of the first challenges and opportunities for FSM has Acute and Residential" on-line course for those work- been to bring a consistent message to fire response educa- ing in in-patient facilities, and an 8 minute Fire Safety tion. Fortunately, the most basic actions to take during a fire video outlining fire safety concepts for all workplaces can be defined in a simple and internationally recognized (including those outside of acute/residential care). acronym – RACE (See RACE graphic). As the foundation for fire safety education is being With the support of their LMHEM colleagues, the established, FSM is looking forward to expand its fo- FSM team introduced RACE into Providence Health cus. A key element is the enhancement and standardi- Care (PHC) and Provincial Health Services Authority zation of supporting fire response documents in the (PHSA) (who were using other acronyms) installing form of checklists, internal fire response team guides, signage above pull-stations, on Evacuation Route team lead procedures, and flow charts to provide front Maps, on staff Code Response cards, and in general -line workers with the necessary tools to respond to fire response procedures for sites. To assist with the fires. Similarly data is being collected on fire alarm ac- introduction of this new concept, a series of one-hour, tivations and fire events across the Lower Mainland instructor-led fire safety in-services were provided to health organizations to aid in identifying causes and hundreds of staff at PHC and PHSA sites reviewing highlighting prevention opportunities. Should you have health care fire risk, fire prevention principles, building any questions, comments or potential collaboration fire protection systems, fire response, extinguishers, opportunities please feel free to contact Scott Blessin, and fire alarm response. Manager at: [email protected] Volume 5, Issue 2 Page 3dd St. Mary’s Hospital Full-Scale Code Orange Exercise David Reid, Lower Mainland Health Emergency Management Coordinator

SMH staff who participated in the exercise included senior level management staff, emergency department leaders, and staff volunteers.

The exercise lasted 3 hours and its primary focus was to test the hospital’s ability to deal with issues and challenges from an earthquake event. This included setting up an incident command post, managing and treating casualties, and deal- ing with infrastructure failures.

Denys Carrier in partnership with the Lower Mainland Health Emergency Management program has led SMH Emergency Management initiatives over the last year. These Saint Mary’s Acute Services Manager Sherryl Hoskins receives informa- have included: tion from staff during the Code Orange Exercise in Sechelt On March 14th, 2012 St. Mary’s Hospital (SMH) conducted • Creating St. Mary’s Emergency Response Plan a full-scale exercise to test its Emergency Response Plan. • Providing personal preparedness education The exercise was based on an earthquake scenario in which sessions to staff people were injured and local infrastructure was damaged. • Conducting tabletop exercises • Planning the full-scale exercise SMH’s exercise was coordinated with a larger regional exer- cise led by the Sunshine Coast Regional District (SCRD) and The full-scale exercise demonstrated that SMH is prepared included, the Sunshine Coast Regional District, British Co- for emergency and disaster events and has validated the im- lumbia Ambulance Service, Ferries, portance of Emergency Management training. SMH is pres- Sechelt Fire Department, the Royal Canadian Mounted Po- ently under-going an exercise review to create action items lice, the Salvation Army, the Sunshine Coast School District and initiatives to further improve its Emergency Plan. and the local Emergency Social Services. Get Ready for the Health Emergency Management Announcements

Evergreen Exercise Rosalie Page joins the Lower Mainland Shawn Carby joins the Emergency Manage- Melia Kelly Health Emergency Management (LM HEM) ment Unit (EMU) as the new Executive Di- Manager, Training team as an Emergency Management Advisor rector. Shawn comes to the Ministry of and Exercises, EMU for , the Jimmy Health with 30 years of emergency and Pattison Outpatient Facility, Fraser Health health service system experience. The BC Health Sector will be offices at Central City, plus residential/ participating in the upcoming community programs in Surrey. Norma Sorensen takes over for Emily Dicken as the acting Manager of Social Pol- Washington State Evergreen Christine Rempel has moved to a new role icy and Programs., EMU. Emily is on a tem- Earthquake Exercise Series within the Lower Mainland Health Emer- porary assignment (TA) with Emergency th taking place June 5-6 2012. gency Management team as the Emergency Management BC. If you would like to find out Management Coordinator for the BC Chil- more about your Health Au- dren’s Hospital and the BC Women’s Hospi- Elaine McCandless joins the EMU on a thority’s involvement please tal and Health Centre. TA as Administrative Assistant. She takes contact Melia Kelly at over for Jocelyn Hawse who is on a TA at [email protected], or Mark Phillips joins the LM HEM team as the Ministry of Forest Lands and Natural your Regional Health Emer- the Emergency Management Coordinator Resource Operations. gency Management Depart- for the Richmond Health Service Delivery ment. General information Area, based at Richmond Hospital. Chris Smith is leaving his role as Director, about the exercise is available Planning and Programs, EMU on a TA at Matthew Calvert joins the LM HEM team the Ministry of Energy and Mines. Chris has at: www.doh.wa.gov/phepr/ exercises/2012EvergreenQuake.htm as the Provincial Emergency Management been with the EMU for 15 years. Logistics Officer. Page 4 The Bright Lights of Richmond Dr. David Ostrow, President and CEO, Vancouver Coastal Health* I don’t get to watch a lot of TV. There’s never quite enough tients and manually crank our dialysis machines for almost time to stop and sit. But as I was talking with some friends an hour. Even patients became creative, like the man on the about the power outages that happened in Richmond on medical unit who called the nursing station on his cell phone March 12, 2012, the comparison that kept coming up was because the call buttons were not working. the old TV show M*A*S*H (now I know referring to a show that went off the air in 1983 is dating myself… but The other part of M*A*S*H that kept the show on TV over I’m assured that it is still widely in reruns). eleven years was the compelling stories of people. People who went about their work quietly and competently, doing In the world of M*A*S*H, every episode or two, some dis- whatever needed to be done, pitching in, making quick deci- aster would strike the camp and the surgeons and nurses sions, using professional judgment and offering a helping would be forced to operate in the dark, try a procedure they hand despite very stressful circumstances. Again Rich- had only read about or rise above their training. mond’s story fits the mould. Examples include sterile proc- essing supervisor Leana Gabrilo, who stopped in the hallway We all know that life is nothing like a half-hour sitcom. And to reassure the wife of a surgery patient or mental health and Richmond doesn’t have a lot in common with a war zone. addictions manager Lisa Ramage who walked down a flight But on Monday the power went out at Richmond Hospital, of stairs with a visitor on each arm to help them down Minoru Residence and Bowling Green. Shortly after that safely. two of the three emergency generators failed. Some of the resulting stories from the following hour really do sound like I know there are as many stories as there were on shift that something from a TV show. For example, the entire team in day. I would like to commend everyone who worked to- operating room 6 completed a bowel resection by only the gether to keep our patients safe, calm and well cared for. light of a handful of flashlights. The ICU team under Dr. Justin Wong and the ICU team leader pulled together to * Reprinted with permission from Up for Discussion: VCH’s Execu- hand ventilate and manually monitor our most critical pa- tive blog for staff. Visit www.blog.vch.ca to join the discussion.

Burns Lake Sawmill Explosion: An Integrated Emergency Response Kelsie Carwithen, Manager, Communications and Media, BC Ambulance Service

On January 20, 2012, at 8:00 p.m., tragedy struck the small Those who were at the scene during this incident noted the community of Burns Lake. Babine Forest Products, a large excellent response and teamwork displayed by BCAS staff, first sawmill employing many local residents, spontaneously ex- responders, hospital staff, health professionals, and emergency ploded and caught fire. managers.

Immediately after receiving a call for assistance, the BC Am- “All of the agencies and individuals who responded to this inci- bulance Service (BCAS) dispatch centre in Kamloops began dent should be extremely proud of their efforts,” said BCAS implementing a provincially-integrated response. Superintendent Craig Parnell. “Despite multiple patients and cold, challenging conditions, patients received the highest level Faced with some of the worst weather conditions the area had of care possible.” seen all year, paramedics leapt into action and responded with ambulances from the outlying communities of Burns Lake, Large-scale incidents such as this often require an integrated Southside, Fraser Lake, Vanderhoof, Smithers and Houston. response and meticulous coordination with many other agen- Twelve patients were triaged at the scene and transported to the cies. As the incident unfolded, BCAS worked in partnership Lakes District Hospital and Health Centre in Burns Lake for with , BCBedline, Emergency Management treatment. Air ambulances were also deployed to transport BC, Vancouver Coastal Health, the Ministry of Transportation four critical patients to higher levels of care at health care facili- and Infrastructure, the Ministry of Health and others to ensure ties in British Columbia and Alberta. appropriate arrangements were made for patients.

Working through the night, BCAS dispatchers and paramedics, While the aftermath of this incident will continue to affect the nurses, doctors, hospital staff and agency partners coordinated community for some time, the integrated emergency response resources, executed a timely emergency medical response and from all agencies resulted in excellent care for patients during provided support, all while maintaining normal service levels in an extraordinary event. the area. Volume 5, Issue 2 Page 5 B.C. Disaster Psychosocial Services Response to Burns Lake, B.C. Carolyn Sinclair, Disaster Psychosocial Services Volunteer, B.C. Disaster Psychosocial Program

of the response. It was evident that everyone wanted to help and was dedicated to doing what they could. Eager to offer support, my partner and I signed up for the next shift of emotional support workers at the Hall.

People working at the Hall and those who gathered there shared stories and memories and recalled events that had taken place over the years. For many this event triggered years of trauma, loss and abuse. Clinicians and DPS volun- teers worked collaboratively to triage appropriate support. The Lake Babine Nation , Burns Lake. Image by Carolyn Sinclair. In addition to the Hall, there were other community meet- On January 21, 2012 a request came from the Municipality ings and support services that were provided to community of Burns Lake to assist with a response following an explo- members. Later in the response, sessions were set up at the sion at the Babine Forest Products Mill on January 20, hospital to support those victims who had sustained burns 2012. Like all responses our Provincial Health Services Au- and had returned home after being air lifted to hospitals. thority (PHSA) lead initiated a callout seeking available Dis- The “dressing circles” were a natural fit for DPS volun- aster Psychosocial Services (DPS) volunteers to respond. teers. We worked alongside hospital staff to support the Our primary task was to arrive on scene as promptly as workers as they reintegrated into their community and possible to conduct a needs assessment. coped with the loss of their two colleagues.

Initially myself and one other DPS volunteer prepared to There were many lessons learned from this event. How- depart while our coordinator managed the logistics of plane ever, the most important lesson I learned was to “Stop, tickets, a rental vehicle, and accommodation. This was a Think, Plan”. It was essential to listen to what community more challenging task than one might assume as respond- members had to say and to work together to help meet the ers, media and interested parties descended on the small needs of the community. Following 10 days of support and rural community. Despite the snow storm that mother na- a debrief it was clear that everyone felt privileged to re- ture unleashed, responders from BC Coroners Service, spond and appreciated the warm welcome from the com- RCMP, Work Safe BC, BC Ambulance Service, Police Vic- munity of Burns Lake. tim Services and others arrived to assist with tasks such as site searches for the two missing workers, scene investiga- The B.C. Disaster Psychosocial Program tions and providing support for responders, family mem- bers, and the community as a whole. The Disaster Psychosocial Services (DPS) program operates under the Provincial Health Services Author- Once in Burns Lake we attended the Margaret Patrick Me- ity. This program works collaboratively with a wide morial Hall on Lake Babine Nation land. Community mem- range of health sector partners, emergency manage- bers were welcomed to this location and gathered to sup- ment, and non-governmental organizations to pro- port each other in prayer or through sharing stories and duce a comprehensive psychosocial response plan for hugs over coffee. The facility had been open 24/7 since the individuals, families and responders in the event of a incident. In addition to basic necessities, resources were disaster in British Columbia. The Disaster Psychoso- being organized to provide emotional support and counsel- cial Services Volunteer Network is a voluntary re- ling. Many of those who attended demonstrated signs of sponse group made up of registered professional shock and confusion. The signs of accumulated loss and mental health clinicians and paraprofessionals. These grief were evident as people struggled to make sense of volunteers are activated in the event of a disaster what had happened and what was going to happen next. where local resources are unavailable/depleted or when volunteers are requested through an EOC/ Briefings took place at the Band Office to coordinate re- PREOC. The purpose of the network is to provide sources. As this was an industrial emergency, traditional the “calm in the storm”, encourage resilience, and supports were not in place. Numerous groups and individu- provide support. For more information about the als were involved with this response including Band Chiefs DSP Program contact [email protected]. and federal agencies, which contributed to the uniqueness