Pediatric Disaster Drill


Blog post by volunteer Arielle Glenn c/o an article released by "The Bridge" at Cedars-Sinai


Cedars-Sinai's Emergency Department provides care to 240 to 300 patients daily. But what happens if a bus carrying two dozen school aged children crashes, resulting in major physical and emotional trauma? Can the medical center handle such a pediatric surge?
If the disaster drill on June 11 is any indication, then yes it can.  Sponsored by Los Angeles County Emergency Medical Services and Children's Hospital Los Angeles, the disaster drill was part of a countywide simulation to test Los Angeles hospitals' abilities to handle an influx of pediatric patients.
"In our day to day operations, we know that great work takes place at all levels of the medical center," said Ryan Tuchmayer, MPH, manager of Disaster Preparedness at Cedars-Sinai. "But it's when we can create an exercise of this magnitude — one that pulls us out of our comfort zone and under duress— that we can understand where improvements are needed."

Cedars-Sinai was one of more than 50 hospitals participating in the drill, said Miguel Magana, disaster surge coordinator. Twenty five students from the Cedars-Sinai Youth Employment Development (YED) program acted as pediatric patients, ages 5 to 12. They not only faked injuries but, when questioned, many could not provide basic information, such as their parents' names and phone numbers. Some didn't speak English, which added to the staff's training.
Injuries ranged from minor scrapes, bruises and lacerations to fractures and trauma to the abdomen, head and spine. While most required simple pressure dressings, observation and medications, others needed more invasive care, including surgery.

After being triaged by first responders at the scene near the Davis Building, patients were either transported to the Emergency Department (ED) by PRN Ambulance, or they walked over. At the ED, they were triaged again and then taken in for treatment or observation. Some went to Imaging, the operating room or the Intensive Care Unit (ICU). The medical center's Command Center was active during the drill, which facilitated the Hospital Incident Command System, Magana said. The Command Center is staffed by an incident commander, who is responsible for the overall response to the incident, and support staff.
Eleven volunteers from Volunteer Services portrayed family members of the pediatric victims. As they made their way to the ED to inquire about their children, they were met by staff members and received updates about their loved ones' conditions. When it was difficult to identify patients — due to a language barrier or a patient's inability to speak because of injury — parents were asked to provide photos to medical center staff.

The drill included staff from the ED, Nursing, Pediatrics, Case Management, Social Services, Central Transportation, Registration, Lobby Services, Admissions, ICU and operating room. Arielle Glenn, simulation technician from the Cedars-Sinai Women's Guild Simulation Center for Advanced Clinical Skills, provided makeup and fake blood known as moulage.