Sunday, November 23, 2014

MCI Drill - Mass Casualty Incident

McMurdo is huge by comparison to Palmer (~1,000 people vs 40) and as such has vastly more capable medical facilities.  However, we're still small by comparison to anything in the real world and while we do have a doctor and multiple other medical personnel on station year-round, our four-bed clinic is just that: a clinic.

Given how large our population is, and how much heavy equipment we have driving around, the possibility of a medical emergency that would completely overwhelm our facilities is very real.  So once a season, we have a Mass Casualty Incident drill; simulating an event with at least ten severely injured people that requires the entire medical and fire/rescue teams to run at full capacity.  We did similar drills like this at Palmer (where any more than a single injured person was considered a Mass Casualty Incident), but McMurdo has significantly more resources to make the drill more realistic.

This season's scenario was that during a party at one of the bars, there was a fire/explosion in the furnace room, resulting in multiple broken bones, lacerations, and lots of people generally running around and screaming.  And because I responded to the e-mail within ten seconds flat, I was one of the lucky people to get to act as an injured victim :D

We all gathered at the bar roughly half an hour before the drill was to start.  They already had the fog machine going at full tilt, to provide a nice hazy environment for the firefighters to have to search through.

"Yes, I would like one alcohol please!" "I'm sorry, you must rescue at least three victims before you get bar privileges."

But then we got to break out the actual MCI kit, full of fake blood and prosthesis.  Various gloves and sleeves you could slide over different body parts to simulate an injury, and enough powder to make liters of fake blood! :D

There were to be a total of 14 victims, and there were plastic cards that we could attach to ourselves to tell our rescuers what our vital signs were supposed to be, as well as describing what injuries we had.  I immediately grabbed the one that said "Unresponsive, found laying in a pool of blood with a head injury."  Because . . . pool of blood!  :D

We didn't have long to prepare ourselves before the drill started.  Most people grabbed whatever prosthesis their injury cards specified; quite a few broken arms, broken legs, broken wrists, lacerations here and there. I was sad to see that no one wanted to go through the trouble of hooking up the squeeze pumps to simulate a gushing blood injury; most people just got a couple drops of fake blood and smeared it around on their skin a bit.

But I . . . I went for a different approach.

I was bummed that we didn't have any skin putty or makeup to blend the head wound in better.
I mixed up a packet of fake blood powder that's supposed to make a full liter of blood into just a couple cups of water, making a thin paste that I smeared over most of my face.  This dried quickly, and then I dumped a full liter of normal fake blood all over my head and face to complete the effect.

I had planned ahead and raided Skua for clothes, so I didn't ruin my own

With the drill starting in a few minutes, we all scurried to get into position.  Perhaps because of my previous experience of being a UT, or just because they didn't want a pool of fake blood to get all over the nice bar floor, I was in the furnace room, behind the building.

The red tissue paper with a flashlight in it was supposed to simulate the fire.

Two things to know about the furnace room; For safety reasons they'd shut down the furnace about an hour beforehand, and that there was no other heat in there.  By the time I laid down, with a head and shirt soaking wet with fake blood, it was barely above freezing.

And there I lay . . . for forty-five minutes.

Interestingly, when firefighters are presented with a room full of smoke and screaming people (including one girl who's explicit instructions were to run around hysterically and get in their way as much as possible), they get a bit preoccupied.  So much so that they forget to search the furnace room until the very end of the drill when their chief has to remind them that they haven't finished searching the building, or found the 14th victim, or found the source of the fire.

Twenty minutes into my wait I was getting borderline hypothermic, when I looked over and realized in the corner of the room was sitting little electric space heater, probably for use by the UTs when they're in there fixing stuff.  I dragged it over, turned in on full and curled up around it, which prevented the fingers from going completely numb until they finally found me almost half an hour later.

Now even though I knew I'd dumped a ton of fake blood on myself . . . I had no idea what I actually looked like.  It had all been done last minute, while sitting in the furnace room so I wouldn't get blood into places that people cared about.  So it was only when I was being carried out of the little room (and getting dropped twice.  Thanks, firefighters.  Apparently a scrawny 165lb guy is too much for a couple of firefighters to carry without scraping my back over gravel and ice) that I heard their initial radio reports back in of "We've found another victim . . . oh god . . . massive burns to face and neck, head trauma" that I began to suspect the makeup had been pretty effective.

I was transported via ambulance and wheeled into the clinic among shouts of "We have another code red here!  Out of the way people, code red!", and occasionally I could hear other commends of "Nice makeup, dude!" as I was presumably wheeled by people who were supposed to be more conscious than I.

They had simulated intubating me in the ambulance, and as I was wheeled into the triage area one of the nurses slapped a paper towel on me to simulate a bandage (it wouldn't make sense to use actual medical equipment for this large of a drill).

At which point the doctor came over to look at me, and as I'm laying there I hear her say:

"Well, if we have time we'll give -some medication that I can't remember- and treat for the trauma, but . . . I have to be honest, this guy isn't going to make it.  Presenting vitals like this, with massive frontal head trauma and likely brain injury, burns this severe to most of the head . . . if we were in a Level 4 trauma center, I'd give this guy maybe a 10% chance of survival, and likely never a full recovery.  He's a goner, he's a code Black. In this situation, when we have overstretched facilities with many other patients that we can save, we're not going to spend any resources on him.  We'll just keep him comfortable until he goes."

Through this whole thing, I had two primary thoughts:

1. Stay in character, you're unresponsive, unconscious, stay quiet, keep the drill fairly realistic . . .


For the first time in my life I managed to keep a straight face as they shuffled me off into the corner  of some office, basically leaving me there to die. 

An aid stayed with me (and we made out-of-character small talk) until the Chaplin arrived, at which point the aid went off to continue doing medical things as the Chaplin spoke about what he'd do in the situation.  Perform last rights, pray for me and my family, and basically make sure that if I did have to die down here, I didn't die alone.

Oddly, this was the first MCI drill that anyone could remember that they'd actually had a Code Black, a patient that died or was likely to die.  It sparked a lot of interesting conversation and debate during the de-brief, regarding the realities of triage and what people need to be mentally prepared for in a real MCI.  For the next few days I had many people commenting "Oh, YOU were the code black we heard over the radio!  We didn't know what they meant at first!  We had no idea what was going on until we heard them call for the Chaplin".

Once the drill was officially called and I was allowed to get up did I see people's reactions to my makeup.  And as many of them had been busy and hadn't seen me when I was wheeled in, the reaction on their faces when they laid eyes on me for the first time was PRICELESS.  The X-ray tech, who's also a sysadmin that I work with every day, said he didn't recognize me until I started talking.  Only once I found a mirror could I really appreciate my own handiwork . . . at which point I realized the only logical thing to do was run around rest of the station like a zombie.

And scare the bejeezus out of half the galley staff, who were only peripherally aware than the MCI drill was happening somewhere on station.   I would say I'm sorry . . . but that would be a lie.


Group photo of all the victims! (After they got me to stop hiding around corners and jumping out to scare people)

It took me three showers to get the fake blood out of my hair, nose, ears and got knows where else, after which the shower looked like a murder scene.  Something else I didn't realize was that the stuff actually stains the skin very effectively; my face was purple for three days after, and it still hasn't washed completely out of my hair two weeks later.  The sacrifices we make for art!


Jerry Quinn said...


This is the best Brendan exploit in years.


Tracy Overby said...