Emergency crews to face simulated attack
By Robbie Dingeman
Advertiser Health Writer
Emergency workers, police, firefighters, doctors and other public health officials will respond to a simulated terrorist attack today at the old NCR building, 720 Kapi'olani Boulevard.
Richard Ambo • The Honolulu Advertiser
The health and emergency workers don't know exactly what kind of attack and problems will be thrown at them. They do know to expect some 50 "dead or injured" from the scenario.
Dr. Jeffrey Nigl and registered nurse Rebecca Donovan, both from Kaiser, tend to "Charlie," a patient simulator, as part of training to respond to terrorist attacks.
The drill culminates three days of specialized training. Federal grants covered the $150,000 cost.
Honolulu is one of only three U.S. cities to get the training, and state officials credit Toby Clairmont, emergency program manager for the Healthcare Association of Hawai'i, as instrumental in bringing the sessions to Honolulu.
Clairmont said the training is especially critical because of the vulnerability of an island state, far from other government agencies.
"They just can't hop in a vehicle and drive here," he said.
The training was made more realistic with the help of two patient simulators, a kind of high-tech super dummy with a price tag of about $250,000. This pseudo-patient "breathes." It also talks via its human operator, and its vital signs change depending on what treatment it receives.
Take one action, and "Charlie's" blood pressure may skyrocket. Take another, and his blood pressure may plummet.
Paul Paiva, a Big Island Fire Department battalion chief who oversees emergency medical services, said he found the patient simulator to be the most valuable tool.
With a conventional drill, Paiva said, "it's hard to visualize and take appropriate action and care," but the simulator injects a lot of realism.
Registered nurse Patricia Coon, infection control specialist at Wilcox Memorial Hospital on Kaua'i, said she was most impressed with the hands-on training and real-life examples as well as the practical tips.
For example, Coon believes her emergency room can adapt some of the decontamination setups put together in other places cheaply with some new plastic piping. And some of the other skills she is learning will help her prepare for other scenarios.
"As a result, you can probably save a lot more lives," she said.
The course started at the Hawai'i Convention Center and has drawn more than a hundred participants from across the state, the Pacific and Alaska.
The Queen's Medical Center will play the role of disaster central for today's drill.
Susan Orr manages emergency room and trauma services at Queen's, which serves as the state's trauma center. Orr said the hospital agreed to take part "as an opportunity to expand our capabilities by increasing our knowledge and skills."
Although experience from other disasters will help those involved, part of the training stresses crucial differences between biological and chemical threats. Rescue workers, who traditionally run toward a problem, are being taught to stand off and assess before rushing into an area without protective gear.
Trainer Ed Jasper, a physician from the Thomas Jefferson University Hospital in Philadelphia, said that sometimes people near a disaster will walk, drive and catch cabs to the nearest hospital, even if they're not really sick.
Jasper pointed to the Tokyo Sarin attack of 1995, when terrorists released the gas into busy subway cars, killing 12 people and affecting more than 5,000. Almost 4,000 people who could be described as the "worried well" flooded hospitals even though they were not found to be physically affected by the gas.
Some of the training participants had a real-life test Aug. 1, when a bank teller reported that a man wearing gloves had handed her some paperwork and told her the papers contained something for her. After the man left the downtown Bank of Hawaii branch, the teller complained of irritation to her hands and arms.
Officials evacuated the bank, police closed nearby streets and the Fire Department's hazardous materials team decontaminated the teller and others who came into contact with her.
A co-worker drove the teller to Kaiser Permanente's Honolulu Clinic, because that's where the woman usually gets healthcare and because it was nearby.
However, that urgent-care clinic doesn't have a decontamination setup. Nurse manager Rebecca Donovan said hospital officials are considering changing that because they realize that people who are worried about a health problem will go automatically to where they normally receive care.
In the Aug. 1 case, police Capt. Paul Epstein said the paperwork showed no evidence of tampering.
"There wasn't a powder, a substance or any kind of agent," he said.
Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.
