ED swings into action following helicopter crash

Cooperation with fire department was essential

When an Aero Med helicopter crashed and burst into flames on the roof of an 11-story tower at Spectrum Health Butterworth Hospital in downtown Grand Rapids, MI, on May 29, 2008, during a training run, the ED team swung immediately into action to get to the two victims and prepare the department to receive them. They also needed to prepare to receive inpatients from areas of the hospital evacuating due to the fire.

The ED learned of the disaster in real time, notes Jim Schweigert, MD, the medical director. "One of our techs happened to be at the triage desk and saw it crash on their screen," he explains. Schweigert notes that the cameras are there to monitor Aero Med landings when patients are being brought in.

"I coordinated with the charge nurse and set up response in the trauma bay area, making sure there were other places to see patients," he recalls. "We immediately discharged any patients that were stable to make extra room."

At the same time, knowing that Schweigert, the nurse supervisor, and the charge nurse were all in the department, Jeanne Roode, RN, MSN, CNA, CNRN, director of emergency, trauma, and neuroscience services, says she "went as close as I could to the site and get a sense" of the situation. She found herself meeting the fire department on the stairwell and directing them up the stairs at the same time. The elevators were not operational because the fire alarm had kicked in.

"Essentially what I was doing was preparing for what we might be encountering as far as survivors of the crash," says Roode, who dispatched a team of nurses, physicians and techs to the site to assist the first responders.

Roode also helped the fire department work more efficiently. While the first crew climbed all 12 flights of stairs with their heavy hose, she took a second crew up the next-door tower elevator to the seventh floor, where they were able to use a bridge across to the other tower and met the first crew coming up.

The ED team contributed directly to patient care, after waiting until the fire department extricated the patients from the hot zone. Then they carried the two victims down to the seventh floor on back boards.

The upper floors of the hospital had begun to fill with smoke and had to be evacuated, and again the ED staff was incorporated. "I was stationed there so I could also coordinate with the pediatric ED evacuation going on at the same time, and had stretchers waiting for them at the seventh-floor stairwell," says Roode.

ED 'reconfigures' to meet disaster needs

The ED leadership took steps to ensure there was a seamless response to the disaster.

"We decided to go on diversion status. We found ourselves with a significant amount of media outside our doors," Roode says. "There were a number of people curious about what was going on."

The decision also was made to house patients evacuated from the affected floors. This required one section of the ED to be dedicated to pediatric patients. "We cleared that section to accommodate some of the sicker 'peds' patients from the [upper] floors," Roode explains. "We took in 14 inpatients along with physicians and nurses."

Many of the kids in the ED were discharged and relocated to another part of the department, says Roode. "When their families realized a helicopter had crashed on top of the building, there was no resistance," she notes.

The ED managers took steps so that other facilities impacted by a lockdown received additional help. Because Butterworth also is the only Level I center for adult trauma in the city, the ED leadership team decided to send a couple of pediatric trauma nurses to the closest hospital, and they obtained privileges for one its trauma surgeons to operate there in case any trauma cases came up.

"We also deployed four nurses and one or two docs to our other ED" in Spectrum Health's Bladgett facility, adds Roode. "We sent four nursing staff and one physician and midlevel tech to help manage the surge over there, with us being closed." The Bladgett ED is only about one-third the size of the Butterworth ED.

Sources

For more information on dealing with an accident at your facility, contact:

  • Jeanne Roode, RN, MSN, CNA, CNRN, Director, Emergency, Trauma, and Neuroscience Services, or Jim Schweigert, MD, ED Medical Director, Spectrum Health Butterworth Hospital, Grand Rapids, MI. Phone: (616) 391-1683.