It could be a natural disaster or a terror attack; a workplace shooter or an industrial accident. There’s no shortage of causes that could lead to multiple casualties, but whatever the reason, you’d better be prepared to deal with them.
That realization has driven emergency medical systems across the U.S. to increase their disaster capacities, and they’ve sought equipment to accommodate ever-larger numbers of victims. Among those new resources are vehicles such as trailers that can host various functions for those affected.
Hazmat Medical Associates partners with MED Alliance Group to offer trailers for purposes of decontamination and morgue services. Morgue trailers can be rented or purchased.
Indiana’s Methodist Hospitals have used the decontamination trailer for about a decade. Leaders acquired it because they lacked a self-contained decon area compliant with toughening safety mandates. Federal funds helped numerous hospitals in the state obtain such trailers.
“We had a dedicated decontamination area at our Northlake Campus, but it was older and didn’t meet what the new regulations required,” says Emery Garwick, Methodist’s emergency preparedness coordinator. “We had to look at options, and the trailer was our best option.”
Methodist obtained trailers for both of its campuses, Northlake (Gary) and Southlake (Merrillville). “We have them on board, and we’ve used them many times,” says Garwick. Now that both the system’s campuses have self-contained decontamination rooms, though, they’re moving the one from Merrillville to a hospital in nearby La Porte that doesn’t.
The decontamination trailer had several features that appealed to Methodist’s leaders, including direct hot and cold hookups. “It allows us to hook up our water source so we can keep the temperature warm,” says Garwick. “In northwest Indiana we have some pretty cold days, so that allows us to utilize water that’s at least tepid. You don’t want to use hot water on a decontamination, but it lets us make it more palatable for the people being hosed down.”
The HMA mobile decontamination trailer is 12’ x 8’, with a two-lane shower system. The bottom acts as a collection area, with an external drain that lets water be pumped out. It includes built-in lighting, roll-up deadbolt doors and optional gas forced-air heat.
Five hundred miles to the southwest, Greene County, Mo., has prepared for those who don’t survive the MCI with HMA’s morgue trailer, obtained about a year ago. “We just really didn’t have much in the way of resources for refrigerated storage of bodies,” says Tom Van De Berg, chief investigator for the county medical examiner’s office. “We finally got our own facility, but then we were able to secure a grant that enabled us to get this trailer and a secondary cooler that upped our capacity to well over 100.”
“We just really didn’t have much in the way of resources for refrigerated storage of bodies,” says Tom Van De Berg, chief investigator for the county medical examiner’s office. “We finally got our own facility, but then we were able to secure a grant that enabled us to get this trailer and a secondary cooler that upped our capacity to well over 100.”
That full capacity includes the trailer, secondary cooler and main facility; the trailer itself can accommodate 27 deceased: 19 on its fold-down racks, plus eight more via a pair of four-high racks on casters that Greene County added for extra storage.
“The HMA trailer provided the most capacity in the most compact package,” Van De Berg says. Other features include an electric generator, two 50-foot shorelines and a front wall-mounted refrigerator. It can be pulled by a standard three-quarter-ton pickup.
The plan is to use the trailer as a regional resource for mass-fatality incidents. It hasn’t been needed for that yet, thankfully, so thus far has been used primarily for training, including exercises with the Missouri Disaster Response System (MODRS).
“It’s easy to maintain, easy to keep clean, and it just provides us so much more capacity,” says Van De Berg. “If you have multiple fatalities at a scene, it’s much easier to bring the trailer out and be able to keep them all until you’re ready to move to the facility. This way we can keep control and keep chain of custody on all the bodies.”
Methodist’s decon trailer has seen uses beyond training, as the area has businesses such as steel mills and an oil refinery. But it was also the setting for an exercise that became a little too real.
Two years ago hospital leaders were conducting a joint hazmat exercise posing a scenario of contact with an unknown powder. Five minutes before it was to start, a nurse emerged from the ED and asked if, as part of the simulation, Garwick had drenched someone in actual gasoline.
“I said, ‘Well, first, we’d never do that, and second, that’s not part of the scenario,’” Garwick recalls. “As it turns out, a woman was actually pumping gas close to our facility. She got distracted and pulled the nozzle out while it was still engaged and accidentally doused herself with gasoline. So what we had scheduled as a drill turned into a real-world event.”
With the people and equipment on site, the woman was deconned and going through medical assessment within 10 minutes.