KEALAKEKUA — The injured burst into the triage center, glass and lumber sticking out of injuries, limping on shattered ankles and covered in blood Thursday at the Kona Community Hospital.
It was a drill that hospitals islandwide took part in to emulate the collapse of a home after the area was hit by an earthquake and subsequent tsunami, performed as part of the humanitarian assistance and disaster relief exercise during RIMPAC 2016. The Rim of the Pacific exercise is a biennial multi-agency and military training event held in Hawaii.
One of the worst injured was Ian Taylor, 17, whose upper legs were cut up, with shards of glass standing upright. In addition, both of his femurs were broken. The cut on his head seemed ancillary.
When he came in, staff got to work. He was triaged and personnel determined how critical his injuries were. Taylor was listed “red” and headed for immediate treatment. Those with less injuries, skipped the treatment center and were sent to a holding area.
As Taylor and others were being examined, social worker Becki Kulm came in to see how patients were doing and if they had messages for family members.
“How are you doing?” she asked when she reached Taylor, her second stop.
“I’m going to die,” he said.
After explaining his mother was in the holding area, she asked “What do you want to tell her?”
“That I’m going to die,” he said.
Kulm left, returning with his mother, Yvonne Taylor, who was in the holding area. Both mother and son were injured, but Yvonne’s wounds were considered slight enough to delay care.
The two were reunited under the watch of Kulm.
“He’s my son and I can’t even touch him?” the mother said to Kulm, who explained that it was a poor idea. Yvonne tried to console her son, saying he wouldn’t die, even as he insisted he would.
Finally, Kulm led her away.
But the concern over dying did not leave with his mother. He next asked nurse Bianka Libarios if the simulated injuries would kill him. Did the red tag mean he would die?
“I wouldn’t just be standing here,” she said, explaining the tags only indicate death is likely if treatment was not received.
One issue Libarios and others ran into was how to tag people. After consulting with fellow nurse Greta Roberts, they settled on taping the tags to the paper bracelets to ensure they remained attached.
This issue was just one of many participants were trying to probe out during Thursday’s disaster drill, which was run as close to reality as possible and included not only triage, but initial treatment, surgery and evacuation via Black Hawk helicopter.
Keeping the drill real, allows emergency personnel to work out issues and apply previous lessons before an actual incident, said Patricia Kalua, chief nurse executive for the hospital.
They’ve learned in previous emergencies they will be flooded by families checking on loved ones and people trying to help, she told West Hawaii Today. That was particularly obvious during the October 2006 earthquakes.
Similar to 2006, Thursday’s drill centered around a local earthquake, which, unlike 2006, featured a subsequent tsunami, which Kalua said was especially dangerous because there is little warning or time for evacuation. She stressed the importance of residents planning ahead of time for such an event.
Ahead of the drill, leadership met in a conference room, with Sean McCormick, risk and compliance director, running through everything needed for the drill, or a real-life disaster. They expected about 10 to 12 people with injuries from such an incident. Staff were instructed to find already hospitalized patients that could be discharged to make room for new patients, if necessary, and to delay any elective surgeries.
They also had to check blood, drug, fuel and other supplies to ensure they were ready for whatever the disaster would bring.
The issue of crowd control was also addressed with the group arranging a location for families to remain, as well as how to handle unexpected volunteers.
No immediate corrections were needed following the exercise, said Judy Donovan, hospital spokeswoman.
However, Christopher Sonne, CHEC assistant director, Healthcare Emergency Management, with HSS, a company that assists hospitals, among others, in emergency preparedness exercises, “will present all input from the post event ‘hotwash’ in a report. From that report, we’ll move forward with the group’s findings.”