Thursday, September 10, 2009

By Steve Twedt, Pittsburgh Post-Gazette
Darrell Sapp/Post-Gazette

Josef Turner, a resident at Allegheny General Hospital, lies on a gurney yesterday in the hospital emergency room during the preparedness drill. He had simulated burns, an open fracture and neck injury.

Fred Peterson's job requires the mind of a military strategist and the imagination of a Hollywood screenwriter.

Mr. Peterson, vice president for professional services and emergency management at the Hospital Council of Western Pennsylvania, is a key player in ensuring that Pittsburgh-region hospitals are ready for medical emergencies during the G-20 summit.

Since July, he has been meeting with local public safety leaders and hospital officials to go over the multitude of possible scenarios when world leaders and protestors converge on Pittsburgh in two weeks.

Mr. Peterson knows it won't take mass casualties, or an assassination attempt, to disrupt the system. With only three adult trauma centers in Pittsburgh -- AGH, UPMC Presbyterian and UPMC Mercy -- all it would take is one world leader's serious injury from a fall to tie up one hospital, a half-dozen critically injured demonstrators at another, and the city would be down to one available trauma center.

"One of the greatest challenges is the unknown," he said. "We're trying to find that delicate balance between over-reaction and under-preparedness."

Individual hospitals are doing their part, too, as evidenced by yesterday's mock G-20 disaster drill at Allegheny General and West Penn hospitals. The University of Pittsburgh Medical Center held a similar drill in the last two weeks.

"It could be a nice, calm event, but we have to be prepared for a lot of casualties and hope for the best," said Dr. Ron Roth, medical director for Pittsburgh EMS and a UPMC emergency medicine physician.

Dr. Roth's tenure as medical director for the Pittsburgh Marathon gives him valuable experience for anticipating what could happen when large numbers of people are out in the streets of Pittsburgh. The G-20, he said, "is essentially a marathon on steroids."

The script for yesterday's exercise at AGH and West Penn had 5,000 demonstrators marching from East Liberty to the security perimeter surrounding the G-20 headquarters at the David L. Lawrence Convention Center. Along the way there were fights, explosions, gassings and clashes with police.

In less than two hours, the hospital teams dealt with 18 fake injuries, one fake death, two fake burn patients and an "injured" woman who showed up at the emergency room with a small baby.

"We don't want to lose sight of the fact that, although we're having this significant event, we still need to take care of the normal health needs," Mr. Peterson said.

AGH got a taste of that yesterday when, amid all the staged injuries, someone came to the emergency room with H1N1 flu symptoms.

In truth, said Mr. Peterson, these international events usually don't unfold so dramatically. His counterparts in cities that hosted meetings of world leaders, Olympic games or a presidential inauguration have told him that traffic through their emergency rooms actually declined during their moment in the international spotlight.

"The assumption is that the indigent population knows something is going on and they want to stay away," he said. "And the protestors try to take care of their own. They will actually bring in some street medics."

Dr. Roth said UPMC has been practicing response to worst-case scenarios, for example an explosion plus a weapon of mass destruction such as a dirty bomb. Both UPMC Presbyterian and AGH have decontamination facilities.

"The issue is how to prepare for both," he said. "We can't predict what's going to happen with the people who want to express their free speech rights. There's no game plan or, if they do have a game plan, they're not sharing it with us."

Steve Twedt can be reached at stwedt@post-gazette.com or 412-263-1963.

Fred Peterson's job requires the mind of a military strategist and the imagination of a Hollywood screenwriter.

Mr. Peterson, vice president for professional services and emergency management at the Hospital Council of Western Pennsylvania, is a key player in ensuring that Pittsburgh-region hospitals are ready for medical emergencies during the G-20 summit.

Since July, he has been meeting with local public safety leaders and hospital officials to go over the multitude of possible scenarios when world leaders and protesters converge on Pittsburgh in two weeks.

Mr. Peterson knows it won't take mass casualties, or an assassination attempt, to disrupt the system. With only three adult trauma centers in Pittsburgh -- AGH, UPMC Presbyterian and UPMC Mercy -- all it would take is one world leader's serious injury from a fall to tie up one hospital, a half-dozen critically injured demonstrators at another, and the city would be down to one available trauma center.

"One of the greatest challenges is the unknown," he said. "We're trying to find that delicate balance between over-reaction and under-preparedness."

Individual hospitals are doing their part, too, as evidenced by yesterday's mock G-20 disaster drill at Allegheny General and West Penn hospitals. The University of Pittsburgh Medical Center held a similar drill in the last two weeks.

"It could be a nice, calm event, but we have to be prepared for a lot of casualties and hope for the best," said Dr. Ron Roth, medical director for Pittsburgh EMS and a UPMC emergency medicine physician.

Dr. Roth's tenure as medical director for the Pittsburgh Marathon gives him valuable experience for anticipating what could happen when large numbers of people are out in the streets of Pittsburgh. The G-20, he said, "is essentially a marathon on steroids."

The script for yesterday's exercise at AGH and West Penn had 5,000 demonstrators marching from East Liberty to the security perimeter surrounding the G-20 headquarters at the David L. Lawrence Convention Center. Along the way there were fights, explosions, gassings and clashes with police.

In less than two hours, the hospital teams dealt with 18 fake injuries, one fake death, two fake burn patients and an "injured" woman who showed up at the emergency room with a small baby.

"We don't want to lose sight of the fact that, although we're having this significant event, we still need to take care of the normal health needs," Mr. Peterson said.

AGH got a taste of that yesterday when, amid all the staged injuries, someone came to the emergency room with H1N1 flu symptoms.

In truth, said Mr. Peterson, these international events usually don't unfold so dramatically. His counterparts in cities that hosted meetings of world leaders, Olympic games or a presidential inauguration have told him that traffic through their emergency rooms actually declined during their moment in the international spotlight.

"The assumption is that the indigent population knows something is going on and they want to stay away," he said. "And the protestors try to take care of their own. They will actually bring in some street medics."

Dr. Roth said UPMC has been practicing response to worst-case scenarios, for example an explosion plus a weapon of mass destruction such as a dirty bomb. Both UPMC Presbyterian and AGH have decontamination facilities.

"The issue is how to prepare for both," he said. "We can't predict what's going to happen with the people who want to express their free speech rights. There's no game plan or, if they do have a game plan, they're not sharing it with us."

Steve Twedt can be reached at stwedt@post-gazette.com or 412-263-1963.
First published on September 10, 2009 at 12:00 am