NNMC Bethesda to Host Mass Casualty Exercise

Story Number: NNS100930-14Release Date: 9/30/2010 10:39:00 PM
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By Chris Walz, National Naval Medical Center Public Affairs

Bethesda, MD (NNS) -- National Naval Medical Center (NNMC) will implement a new scenario to evaluate the coordination of area hospitals in the event of a mass causality during its annual Collaborative Multi-Agency Exercise (CMAX) Oct. 14.

Unlike previous exercises, this year's mass casualty exercise will not feature fake explosives and actors with mock injuries sprawled about the grounds. The design of this year's exercise is more of an off campus exercise with more than 28 hospitals within the region participating.

NNMC Command Emergency Manager Chris Gillette said the lack of improvised explosive devices or collapsed buildings, as in years past, does not mean the exercise is smaller in scope.

"In all of the years we've been doing CMAX, the 'incident' has been on our campus," said Gillette. "Now we want to look at other aspects of our surge plan and how we track patients coming into our facility from outside our gates in a situation where our system is overloaded."

Gillette said CMAX '10 may be the largest exercise ever because it involves coordination with more organizations than any previous CMAX. It will be in concert with Joint Forces Headquarters' Capital Shield 2011 and will include Joint Task Force National Capital Area Medical (JTF CapMed) and 28 hospitals in D.C. Metropolitan area.

In this year's exercise NNMC will have 50 staff members act as patients. Twenty to 30 will return to the medical center as patients while the remaining actors are taken to a local hospital.

"That's why we train, [receiving 20 to 30 moderately to severely injured patients at once] would be significant," said Gillette. "It would tax our system, and we would activate our mass casualty plan. We don't know when a terrorist will strike, that's why it's so important for each staff member to know their role in the event that we have to activate one of our emergency codes."

Melissa Knapp, emergency management program specialist, said asking 28 hospitals to collaboratively track hundreds of patients across a grid as large as the D.C. metropolitan area is a monumental task. She said it's necessary because patient tracking is critical during a mass casualty event. Knapp said it is so critical that officials will be using two separate mechanisms to track patients through the system.

One of the mechanisms is a JTF CapMed initiative that allows caregivers to input patient data and tracking information via hand-held devices. It is used throughout Maryland's hospital system. The other system is radio-frequency identification (RFID) that helps keep tabs on a patient's location with a barcode and scanner.

Bethesda Hospitals' Emergency Preparedness Partnership between NNMC, National Institutes of Health Clinical Center, Suburban Hospital and the National Library of Medicine helps alleviate some of the local confusion associated with emergency situations.

"Our community partners have been great in terms of sharing resources and personnel, and it has really evolved into everything we envisioned when the partnership was created in 2004," said Knapp.

She said patients will be transferred to each others' facility during the exercise.

"We have core objectives that we'll be able to test as well," said Knapp.

Knapp said the National Library of Medicine's position in the partnership is an important one. Besides having an instrumental role in the RFID research, they are also evaluating the digital pen technology. The digital pen allows medical providers to document a patient's condition on a specialized form and the pen automatically imports that information into a computer.

The exercise satisfies a Joint Commission requirement, which requires medical facilities to test and evaluate six critical areas: communication, resources and assets, safety and security, staff responsibilities, utilities management, and clinical activities. Knapp said evaluators, made up mostly of internal NNMC staff members, will be trained to look at their assigned areas critically, and they will receive an exercise evaluation guide (EEG) to aid them along the way.

Knapp said NNMCs Emergency Management Office will combine the evaluators' EEGs with feedback from the fake victims and other staff members to create an after action report. Officials will then select areas to track throughout the year, where improvement is needed.

Staff members not actively engaged in the disaster response are still required to help meet the Joint Commission requirements, Gillette said.

Staff members will find skills booths, lectures at the auditoriums, Web-based courses online and other training opportunities, Knapp said.

For more news from National Naval Medical Center, visit www.navy.mil/local/nnmc/.

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