Sharing the story with others involved in emergency preparedness planning about how a small rural hospital responded to mass casualty incident is an opportunity that Linda Brothwell, the facility manager for Nipawin Hospital, thought was important.
Linda Brothwell, facility manager at the Nipawin Hospital, speaks at the Emergency Preparedness Planning Sparks Conference last
month in Toronto.
“In terms of emergency preparedness, we face similar challenges in both rural and urban centres,” Brothwell said. “There may be differences in type of services available, but the goal is to provide the best care we can for our patients.”
Nipawin and Tisdale hospitals were the first to receive patients after the Humboldt Broncos tragedy. Due to the large number of casualties, patients were sent to two hospitals. They were treated and stabilized before being transferred to Saskatoon by road ambulance, Saskatchewan Air Ambulance, and STARS.
The Nipawin Hospital, pictured, and Tisdale Hospital, were the first facilities that received patients from the Humboldt Broncos tragedy on
April 6, 2018.
The Nipawin Hospital was the only rural location with specific stories about a Code Orange (mass casualty) response to present at the Emergency Preparedness Planning Sparks Conference last month in Toronto. Other presentations about Code Orange were from the Sunnybrook Health Sciences Centre (Toronto Van Attack), and St. Michael’s Hospital (Danforth Shooting, Toronto).
Brothwell said the conference provide an opportunity to give a voice to a rural hospital like Nipawin, and discuss what the staff, physicians and the community went through in responding to an emergency. She noted that many of the struggles are the same, including one that, at first, surprised her.
“One the things that we think is a challenges is that the site of the collision was 35 minutes from the hospital, but people in Toronto have to travel that distance all the time. It might only be five miles, but it can still take more than 30 minutes to get there. That is a similarity for a different reason,” Brothwell said. The travel time is not only about how long it can take for patients to reach the hospital, but also for the call-out for additional staff and physicians that are needed to support the emergency situation.
However, there are some challenges specifically faced by smaller hospitals, such as the fear of not having sufficient staff responding, and the communication requirements to ensure a smooth transfer of patients to a tertiary care centre. Brothwell said some people also asked why patients were transferred to other facilities.
Brothwell said there was both good planning and very responsive community people who offered their assistance to the staff and physicians at the Nipawin Hospital. Everyone came together to assist however they could on that night and the days following the accident.
“Everything did go very well,” said Brothwell. “The timing was on our side. It happened when most staff and physicians were in the community.”
“The emergency department that evening was easily cleared of patients by either discharging or moving elsewhere in the facility,” Brothwell said. In addition a visiting specialist physician had just left and came back, providing one more physician at the site. A church in Nipawin was opened for people to wait at rather than having them gather in a small area at the hospital. A phone number for inquiries about patients diverted calls to the Melfort Hospital, freeing up staff resources in both Nipawin and Tisdale.
In addition to the presentations about Code Orange experiences, Brothwell said the discussion about other emergency preparedness needs was also valuable. There were presenters from Toronto, Kingston, and Montreal who were involved in mass casualty, shooting incidents in those centres.