March 5, 2018
It’s important for London Health Sciences Centre to be prepared to respond to large scale emergencies and disasters. A code orange is the hospital’s emergency code for an external disaster or an event that has created an immediate demand for services that outstrip the hospitals resources. A code orange could happen at any time of day, or day of the year.
CBRNE stands for chemical, biological, radiological, nuclear, and explosives; and represent the types of materials that can result in significant human injury or death due to either man-made or environmental hazards.
The emergency services program at LHSC developed the CBRNE emergency response team (ERT) to respond to a CBRNE event. The CBRNE ERT is multidisciplinary group composed of nurses, emergency department technicians, unit clerks, environmental support workers and security guards, with a little over half of the team members coming from the adult emergency department. The balance of the team works in the paediatric emergency department, security, and most recently, the nursing resource team.
The purpose of the CBRNE ERT is to keep the hospital safe during a CBRNE event, by securing a perimeter, decontaminating (showering and washing) casualties or victims of the event before they enter the hospital. They will respond whether it is a small event that involves one or two people or a large event like a mass casualty incident. To ensure they are prepared to respond at any time, the team trains up to three times a year.
“We know in a crisis situation that people tend to fall back on their training, so we try to ensure that people have the opportunity to regularly train,” says Myron Steinmann, Emergency Preparedness Patient Safety Specialist at LHSC. “It is important to keep practiced with donning and doffing the CBRNE personal protective equipment because if we ever need to respond, there will not be time to review the procedures, we have to be ready. Survival of patients and the safety of the staff inside the hospital depend on the CBRNE emergency response team.”
Most recently, winter training sessions were offered to help team members prepare to respond while dealing with the unique challenges that take place when the temperatures are below freezing. This year the training sessions happen to fall on extremely cold days where temperatures had plummeted to a bone-chilling -14C. The training reviewed donning and doffing of the CBRNE personal protective equipment (PPE) and initial set-up procedures, but focused on cold weather decontamination challenges. Specific challenges include preventing hypothermia of patients and staff, moving patients outside safely, and preventing and responding to a build-up of ice in the decontamination area.
Physically placing people outside in the cold dressed in their PPE was essential for understanding how the team and equipment (PPE) function in freezing temperatures.
The team is led by Dr. Michael Peddle, an emergency medicine physician who is the medical director for emergency preparedness, and Steinmann. The team continues to work closely with programs within the hospital and our community partners, Middlesex-London Paramedic Services, Ambulance Communications Centre, London Fire Department and the City of London.