When Disaster Strikes

Triage nurse Mary Peters needed to act quickly. A tractor-trailer had overturned on I-95 in Miami, spilling thousands of gallons of a dangerous chemical onto the roadway.

Simulation: During the mock disaster drill, nurses dressed in hazmat suits decontaminate a patient exposed to a dangerous chemical.

Peters knew that in less than five minutes, the first casualties exposed to vapor and fumes from the spill would be arriving at the hospital. She’d have to quickly don a hazmat suit and station herself, along with other nurses, inside a decontamination tent, where the victims would be hosed down and scrubbed before entering the emergency room.

The chaotic scene outside the hospital, though, was making her job difficult, as families and reporters had already started to arrive, demanding information about victims.

Mass-casualty incidents like this one test the skills of the nation’s nursing corps every year.

For Peters, however, this disaster was only a drill, a simulation that was part of a three-day training session designed to teach graduate students in the University of Miami’s School of Nursing and Health Studies how to prepare for and deal with patients who have been exposed to dangerous substances.

Following proper procedures when reacting to a mass-casualty incident “takes so much longer to do than when you just read about it in a manual,” says Valerie M. Bell, M.S.N., M.A.C.P., C.R.N.A., associate program director- Nurse Anesthesia Program and simulation coordinator at the school. “We wanted to give our students the knowledge base to respond to such an incident and experience what it’s really like. We’re making a big push for experiential learning.”

About 17 nurses from Jackson Memorial Hospital’s trauma, intensive care, and operating room units joined the University of Miami students during the training session, which was conducted by experts from the American Nurses Association (ANA) and the International Chemical Workers Union Council. The training covered everything from how to identify and sanitize patients exposed to hazardous substances to the proper way to don a hazmat suit and set up a triage center and decontamination area.

Donning protective gear before rushing to the aid of chemically exposed patients is critically important for nurses, the ANA’s Holly Carpenter told students during the session’s opening day, citing a 2008 incident in Durango, Colorado, in which a nurse fell gravely ill after she helped a man who showed up at the hospital soaked in unknown chemicals.

Inside a large decontamination tent, nurses used hoses and sponges to cleanse chemically exposed victims before they were taken by stretcher into the emergency room.

At the incident command center, Jackson staff nurse Susan Rodney, R.N., and Corey Jago, R.N., University of Miami nurse practitioner graduate, directed the massive disaster response, tracking the status and condition of patients, issuing press releases, answering questions from the media, and setting up a rumor control hotline.

Among the crises that occurred: An infant had to be intubated and transported to Miami Children’s Hospital and a chemically exposed pregnant female delivered a stillborn fetus.

“The students appreciated the symphony of organized chaos,” Bell said, noting that this was the first training of its kind to be offered at the school