The announcement came just after 2:10 p.m. at Toronto’s St. Michael’s Hospital.
Outside, the weekday was mundane, but the announcement was anything but ordinary: “Pan Am venue. There’s been an explosion. Suspected gas release.”
With the subsequent call of “Code Orange CBRNe Stage 3,” a group of doctors, nurses and clerical and support workers from across the hospital converged and suited up, comic hero quick, to attend the coming wounded.
And the wounded came — by foot and car and gurney. With broken limbs, dizziness and concussions, many coughing and sputtering from their exposure to the toxic cloud, they straggled in.
They came to a hospital immediately locked down by the code orange CBRNe call, a top-order emergency declaration alerting staff that patients exposed to chemical, biological, radiological, nuclear or explosive contaminants were on their way.
And the St. Mike’s team, now sheathed head to toe in protective haz-mat suits, stood in front of a decontamination tent — unfolded and inflated within 10 minutes in the hospital’s ambulance bay — to meet them.
Of course, on this mid-June day, the patients and their injuries were fake. Indeed, there was a festive spirit among the dozen or so hospital workers, clad mainly in T-shirts and shorts, who’d volunteered to be soaped up and hosed down by their colleagues.
But with the Pan Am Games set to begin on July 10, the exercise had a decidedly serious side in light of the security concerns such international events bring.
The timing of the exercise was a fortunate coincidence, says Dr. Sara Gray, chair of the hospital’s emergency preparedness committee.
The $25,000 “decon tent,” which received funding three years ago, had recently been delivered and her team needed to train in the new facility.
But, Gray adds, the Queen St. E. hospital’s proximity to the athletes village and several other Pan Am venues would make it the city’s primary medical response centre in the event of a real terrorist attack.
“The timing for us was just lucky,” she says. “We had a previous tent that we did so much training on that it developed holes.”
The purpose of the CBRNe decontamination response team and its tent is twofold, Gray explains. “The goal of this is always to make sure that you don’t have the contaminated people (and whatever is on them) inside your hospital. It’s also saving the patients, because usually whatever the chemical is, it’s toxic enough that it’s going to be dangerous to them if it stays on too long.”
The tent and team can be deployed for a single patient or handle a maximum of 100, Gray says.
And the size of the response would be proportional to the number of incoming injured, with dozens of hospital staff being trained in classrooms and in haz-mat suit exercises to prepare for disasters large and small.
The suits themselves dictate that staff by the dozens be familiar with them and the decontamination protocols and duties for which they’re worn.
Sealed and waterproof, they lock in body heat and on hot days can incapacitate anyone wearing one within 15 minutes.
“We would have to be able to swap people in and out very rapidly in the event of a real incident,” says Lee Barratt, a nurse educator in the hospital’s emergency department and a key team co-ordinator.
That means workers of all stripes are trained for haz-mat duties.
“We have to prepare people for our team who have no clinical experience at all,” Barratt continues.
“One day they’re working in the print shop, the next they’re part of our decon team. So these exercises are critically important.”
Meanwhile, in a true contamination incident, physicians and nurses would be called en masse to the emergency department, which would be culled of all but the most critically ill or injured patients as the decon team worked just outside.
Reports from attack or accident sites, paramedics, physicians and suited nurses in the ambulance bay would also be pointing doctors in the ER to likely antidotes they’d need. St. Mike’s has medications to treat dozens of radiological, biological or chemical agents available on site.
The hospital would also co-ordinate with police to seal off streets and sidewalks near the hospital, and haz-mat-suited security staff would steer any errant pedestrians away from the tent.