More than 50 James A. Haley Veteran’s Hospital staff members moved their base of operations to Tampa International Airport earlier this year when they joined with community partners to triage and transport victims of a massive earthquake in Mississippi to local hospitals.
Fortunately, while the victims weren’t real, the training received during Exercise Patriot South 2018 was as real as it gets. The 35 victims – played by both mannequins and live volunteers – arrived aboard an Air National Guard C-17 Globemaster III aircraft flown to Tampa, Florida, from Gulfport, Mississippi.
The exercise tested the hospital’s abilities to receive patients after a disaster as a federal coordinating center (FCC), part of the National Disaster Medical System. An FCC is a federal facility – either VA or Department of Defense – located in a metropolitan area of the United States or Puerto Rico, responsible for day-to-day coordination of planning and operations in a geographic-patient reception area.
While this was an exercise, the Tampa FCC has been activated for real-world events in the past. According to the facility’s Emergency Manager Travis Garrett, the system was activated in 2010 to receive patients evacuated from Haiti after an earthquake devastated the island. The scenario for this exercise was similar to that real-world event.
“Our situation is that there was a 7.7 magnitude earthquake in the New Madrid fault area in northern Mississippi that caused extreme devastation to the health and medical system up in that part of the country, so they’re having to evacuate hospital patients using the National Disaster Medical System to our Federal Coordinating Center here in Tampa,” area emergency manager Rick Rhodes, who was the incident commander for the exercise, told participants before the aircraft arrived. Once activated, the staff had to determine how many beds were available in the various hospitals around the Tampa area so they could determine where the patients would be transported once they arrived.
The center was staged out of a large hangar at the Sheltair Fixed Operating Base, a facility that normally works with private and corporate aircraft at the airport. Stretchers, patient handling equipment, medical supplies and communications equipment were all in place before the Air Force aircraft arrived. So were the staff who would move the patients from the aircraft to the hangar, in-process them to maintain positive control as they transited the medical system, triage them to determine what level of care they needed, and transport them to whatever facility would be their final destination.
While VA hospital staff made up the majority of the personnel manning the center, they were supplemented by members of Tampa Fire and Rescue, City of Tampa Emergency Management, Tampa International Airport, Florida Department of Health, U.S. Department of Health and Human Services, Tampa General Hospital and the University of South Florida.
The operation ran well, with 35 patients triaged, processed and transported (simulated since the volunteer patients had to be back on the aircraft within two hours to return to Mississippi). Dr. Timothy McGuirk, Tampa VA’s emergency department director, led the team of physicians who were assessing the patients and determining their level of injury to decide what hospital they would be transported to if this was a real life scenario.
“We’re trying to match the patient’s needs with the local hospital’s capabilities,” McGuirk said. “Overall I think it went very well. It was excellent training for our physicians.”
Barbara Donahue from Health Administration Service led the reception line team and was tasked with keeping track of every patient who came off the aircraft until they were received at an area hospital. She also said the scenario was realistic.
Angela Minzer from Florida Department of Health was one of the community partners working alongside their VA counterparts during the exercise. She helped set up the triage area and coordinated physicians from Tampa General Hospital to assist with assessing patients as they came off the aircraft.
“I think this is important because a lot of people don’t realize that we have to be able to support not just U.S. citizens and patients, but we have to be able to support other countries as well,” Minzer said. “Being able to include the community partners brings another level of knowledge to the table because they know what hospitals have what capabilities.”
Those community partnerships are key to a successful emergency response and have been developed over many years in Tampa.
“I think it’s the best in the nation,” Dr. Jose Lezama, the hospital’s chief of medicine, said of those partnerships. “We drill together every year. And every three years we do an event like this where we integrate in a complete fashion. The cooperation for this exercise has been very impressive.”