Total eclipse of the chart: How WMC prepared for the biggest event in the sky
By Kristy Bleizeffer Aug 8, 2017
For more than a year, we’ve been meeting, running table-top exercises and double checking our inventory. We’ve ordered extra supplies, padded staffing schedules and walked through multiple what-if scenarios.
And that’s just inside our walls.
Wyoming Medical Center, as the largest hospital in the region, has been working with dozens of city, county and state agencies to prepare for the total eclipse on Aug. 21. We are one of more than 25 medical agencies to coordinate for an influx of 30,000 or more people. (Thanks to Audrey Gray, preparedness manager for Casper-Natrona County Health Department, for leading this team through more than a year of planning.)
In this interview, Andy Dunn, M.D., walks us through how Wyoming Medical Center has prepared for the largest gathering the area has probably ever seen.
Has Casper, as long as you can remember, ever really planned for an event this large?
No. The last time we had a mass casualty incident was when we had a school bus crash on I-25 five or six years ago, but that will pale in comparison to what is going to happen for the eclipse. They are predicting anywhere from 30,000 to 75,000 people. Douglas is supposed to get an obscene amount of people too.
And, the duration of the event is a challenge as well. This isn’t just a one-day event. People will be here throughout the weekend.
We’ve never experienced anything like this before. But this is cool because this will lay the foundation for big events coming to Casper in the future. We will have a medical framework – protocols for triage, for example – already in place for the next big event.
How has the medical community come together for the influx of people?
While Wyoming Medical Center has always worked with other agencies for county-wide disaster and preparedness training, this event has really helped bring the medical community together. We had to develop a triage system to bring all the medical sites together, while directing patients to the right level of care.
How do you feel about the preparation?
It’s been impressive. It’s great when you have EMS, fire, police and sheriff departments, Wyoming Behavioral Institute, Community Health Center, Central Wyoming Counseling Center and all these specialties in town coming together and doing table-top exercises to be prepared for many scenarios. So if someone gets hurt at the Pluto Run, a 5K during the eclipse, and they show up at the first-aid tent, where do we send them? They don’t have to go straight to the Emergency Room. They can go to the walk-in clinics at Mesa or Sage Primary Care and leave the ER clear for more serious conditions.
We have been able to link up with agencies we wouldn’t normally link up with, and that is very helpful. I think it’s going very well.
What is the priority when triaging patients off-site?
Keeping the ER clear for serious injury or sickness is one of our big priorities. There will be a series of first-aid stations set up at various events, and we have developed a list of medical diagnoses that will tell them which level of care is needed. Then volunteers can direct people to the appropriate clinic – or the ER.
Sage and Mesa Primary Care will have doctors and other providers roaming the events to help at the first-aid stations as needed, and we will also be available via phone.
We also have some doctors and EMS personnel who will be taking phone calls at the first-aid stations to help walk people through the triage process. The Wyoming Medical Center Referral Center and Emergency Room doctors will be heavily involved to help triage as well. Finally, we will have ambulances stationed at different events so we can get to people quickly when needed.
What kind of illness and injury do you expect to see most?
We expect a lot of the typical medical cases you often associate with large crowds: Sprains and broken bones, forgotten medications, digestive issues, dehydration and heat-related illnesses. We also expect a number food-borne illnesses – either through poor preparation or storage when people are planning for picnics or barbecues.
Of course, with more people travelling to Casper on our highways, we have a greater chance of car crashes and serious traumas. That, along with a higher percentage of people who could suffer heart attack or stroke, is why we want to keep the ER clear when possible.
Explain our Clinical Decision Unit and how will it be utilized during the eclipse.
Our CDU is a designated unit providing an alternative to discharge or hospital admission. It is for patients who may benefit from an extended period of testing, evaluation, treatment and/or observation before they are either discharged from the ER or admitted to the hospital.
The CDU relieves pressure on staff and resources during high-volume periods in the ER while also reducing lengths of stay in the ER for many patients.
We have protocols for falls and some medications, for example, that require 14 to 16 hours of observation. If that observation is done in the ER, the patient is taking a critical care bed that is both more expensive and resource intensive.
We can also admit some patients directly to the CDU so they don’t have to stop in the ER at all.
Dr. Dunn is board certified in family medicine and is medical director of Mesa Primary Care and Sage Primary Care. He grew up in Denver and moved to Casper to complete his residency at University of Wyoming Family Practice. He was a Wyoming Medical Center hospitalist for several years.