Voices from the front lines

Here are some compelling first-hand accounts from ED personnel at the disaster sites in New York City and Washington, DC:

Brian Miluszusky, RN, BSN, director of nursing for the ED at New York (City) Presbyterian Hospital, Cornell Campus:

"They asked us how many patients we could take. We told them about 150. They said, Well, that’s what you’ll probably be getting.’ Ten minutes later, the building collapsed. I don’t think I have ever seen a disaster [response] run so smoothly, and so well- organized. We had everything we needed. The only thing we didn’t have was patients."

Thom Mayer, MD, FACEP, chairman of the department of emergency medicine at Fairfax Hospital in Falls Church, VA:

"That first night, at 2:30 in the morning, it was cold and dark, and everybody was trying to figure out how to get in this building. In the midst of that, I saw a couple of Marines putting a flag on a fire engine that had been burned. I suddenly got the idea, We need a flag, the biggest flag we can possibly find.’ I called an Army major and told him, By first light you need that up by the crash site, so that no one can take a picture of the Pentagon without that flag, a symbol of the American spirit.’

Later he told me, The flag won’t go up until later today and I can’t tell you why, but you’ll be very happy.’ President Bush arrived later that day, and shook hands with every single person on that site, as they unfurled the flag. When taking care of rescue workers, we call it flying the flag,’ because we are acting as a symbol, that we’re here to take care of you if you need it. In this case, it was more of a literal flying the flag."

Douglas Yoshida, MD, ED attending physician at Bellevue Hospital Center, New York City:

"We saw about 200 patients in the main ED during the first 12 hours. Only a few patients had major trauma. The vast majority had mild to moderate smoke inhalation, conjunctivitis, acute stress reactions, or minor injuries. There were surprisingly few lacerations. Everyone that was near the site had a fine white dust covering them, with rumors that it was anthrax. We did not think it was plausible, because there was way too much dust, and we did nothing in the hospital to decontaminate them. I believe that we could have handled over a dozen major trauma victims at one time and hundreds in the first 48 hours. It is too bad there were so few survivors."

Kevin Chason, DO, director of prehospital care and disaster management for the Department of Emergency Medicine at Mount Sinai Medical Center in New York City:

"We have done an emergency department critique and debriefing and will do a hospitalwide critique. We will continue to drill as in the past, with the goal of conducting more live drills than tabletop, with full participation, and continued improvement of the disaster plan. The immediate follow-up training will include HazMat and a review of communications."