If disaster strikes Toronto will be ready to respond

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Sunnybrook and Women’s College Health Sciences Centre is Canada’s first and largest Trauma centre caring for more than 1,200 patients a year who require immediate and life-saving care. As home to the Toronto Land Emergency Medical Services (EMS) and Ontario Air Ambulance Base Hospital Programs as well as Ontario’s only Emergency Medical Assistance Team (EMAT), it is only natural that should disaster strike, Sunnybrook & Women’s would be among the first to respond.

To prepare for such an event, Sunnybrook & Women’s recently led the hospital component of a simulated disaster exercise at Humber College inviting health-care students from GTA universities and colleges to be among the hundreds of participants from St. Michael’s, Hospital for Sick Children, University Health Network and Mount Sinai, Police, Firefighters, and EMS who came together to test the city’s emergency preparedness.

The goal of the exercise was to equip health-care providers in Toronto with valuable skills and knowledge to help them become a cohesive and focused team in the event of a real disaster. “We recognized that there would be some success and some opportunity for improvement,” says Dr. Brian Schwartz, Director, Division of Pre-hospital Care at Sunnybrook & Women’s. “The event identified gaps in knowledge that will help the system to evolve.”

A year ago the hospital participated in an exercise with the Toronto Police Emergency Task Force and Toronto EMS. It was here that the hospital recognized the value of such an exercise and decided to create another specific to health-care providers, this time in conjunction with the Toronto Chemical Biological Radiological Nuclear (CBRN) response team. After endless hours of research, Sunnybrook & Women’s Emergentologist Dr. Laurie Mazurik, Program Manager of the Advanced Care Program Dean Popov, and the CBRN team leaders, decided to base the exercise on chemical exposure consisting of sarin, a human-made chemical warfare agent classified as a nerve agent also known as GB.

Sarin is the same agent that was used in terrorist attacks in Japan in 1995 in a subway system killing 12 people and harming over 5,000. It is a clear, colorless, and tasteless liquid that has no odor in its pure form. The extent of poisoning caused by sarin depends on the amount of chemical the person was exposed to, how the person was exposed, and the length of time of the exposure.

A mock healthcare system consisting of CritiCall, EMS, Police, Firefighters, Central Ambulance Centre, two base-hospital physicians in radio contact with paramedics and the receiving hospital (Hospital X) was set-up to manage the casualties. When patients arrived at Hospital X, they were treated in a 20-bed care centre, riddled with challenges like scarce resources, bed shortages, and full emergency rooms.

Hospital X received simulated casualties who were triaged and treated for their exposure using decontamination equipment and antidotes. “The exercise was created to orient the staff and residents with a disrupted plan and test the decontamination procedure and determine the needs of personal protection,” says Dr. Mazurik “it provided health-care professionals with exposure to available technologies to increase efficiency and safety.”

A wealth of information was gathered by the participants and taken back to their hospitals for further review. They gained experience with disaster situations that will help them be a cohesive and focused team in a disaster situation. As a result of the overwhelmingly positive response plans for a disaster exercise next year are already in the works.