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UTHealth holds mass casualty incident to prepare students for the worst


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By Michelle Ray | November 22, 2017

Screams were heard as a runaway car plowed through a crowd before the vehicle crashed and the wreckage was engulfed in flames. The chaos was heightened by the sirens from fire trucks and ambulances rushing to the scene. After firefighter cadets from the Houston Fire Department (HFD) subdued the flames, more than 300 students and volunteers from The University of Texas Health Science Center at Houston (UTHealth) rushed onto the smoky field, ready to triage and respond to those injured in the accident.

Fortunately, the casualties that played out were all part of a well-scripted scenario, staged at the Houston Fire Department’s Val Jahnke Training Facility, and orchestrated weeks in advance. Students from Cizik School of Nursing at UTHealth, McGovern Medical School at UTHealth, UTHealth School of Public Health and UTHealth School of Biomedical Informatics participated in the mass casualty incident drill.

“This event all started in the aftermath of Katrina in 2005 when I realized that so few people, not just nursing or medical professionals, knew what to do when disasters happen,” said Elda G. Ramirez, Ph.D., R.N., professor of nursing at Cizik School of Nursing and project director of the mass casualty incident drill. “Our goal is that every single student who goes through this exercise is going to be able to know what to do when any kind of natural or man-made disaster takes place.”

The annual mass casualty incident drill offers UTHealth students the training they need to hone their emergency first responder skills in a realistic simulation and presents them with a rare opportunity to learn with experienced faculty and staff by their side.

“As a student in the Emergency/Trauma Care Nurse Practitioner program, we are going to see these types of patients once they come to the trauma bay,” said Rachael Chapple, R.N., student at the School of Nursing. “This training gives you a better appreciation for the hard work that takes place in the prehospital emergency care setting before they reach the emergency department for us to perform definitive care.”

As the sun intensified throughout the morning, two first responders were assessing a patient and noticed an unknown substance in the patient’s hand. Upon touching the pseudo-narcotics they were notified that they been exposed to the unknown substance and would soon “die” from the exposure.

Upon further investigation, the students identified the pseudo-narcotic substance a Carfentanil (or fentayl), the strongest opioid in the world and known to be 100 times more potent than morphine.

“Today with the staged Carfentanil overdoes and the two initial exposures of the first responders, it’s an important reminder for the students to wear gloves at all times because even during a mass casualty event or disaster, there are other types of exposures they will need to be aware of,” said Angela Di Paola, M.S., graduate assistant and doctoral student at UTHealth School of Public Health.

In the afternoon, a large and disorienting sound came from a nearby tower. What sounded like an explosion at first was followed by rapid and repeating cracks – the sound of gunfire.

The students sheltered in place until the Houston Police Department SWAT team was able to clear the tower and apprehend the shooter. In the following minutes, the students learned the true definition of a mass casualty – when the immediate needs outweigh the amount of available resources.

“The biggest takeaway for the students here today is to learn how to interact with the other professionals and students in their different disciplines as an emergency responder,” said Jennifer Laine, M.P.H., safety manager of occupational safety and fire prevention at UTHealth. “It’s imperative to learn what your resources are and how to benefit from each other’s experience.”

“During this training the students have the opportunity to see what it’s like to be the ‘boots on the ground’ and what it takes to consider scene safety, package and properly triage a patient to give them the best opportunity to survive,“ said Houston Fire Department Capt. Steven Johnson.

Additional organizers of the event included Deborah L. McCrea, M.S.N., R.N., instructor of clinical nursing at the School of Nursing and Kevin Schulz, M.D., assistant professor of emergency medicine at McGovern Medical School.

The mass casualty incident drill highlights the mission of one of the sponsors, the UTHealth Center for Interprofessional Collaboration. The center promotes education, practice and research within the framework of a health care team so that students from all schools at UTHealth have opportunities to gain knowledge and skills for interprofessional models of care.

The Harris County Institute of Forensic Sciences and students from Wharton County Junior College Emergency Medical Services and Houston Community College Emergency Medical Services also participated in the event.

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