T’was the Night Before MCI Class

Sound asleep all tucked in his bed after preparing triage tags and other training supplies for a two-day mass casualty incident (MCI) workshop in Wake County, N.C., this past weekend, I was awoken by the fire alarm system at the Renaissance Hotel.

It was 2:30 a.m., and what I thought was my alarm clock turned out to be a real fire in the hotel, forcing the evacuation of over 250 guests.

With memories of working a major hotel fire/MCI in Bethlehem, Pa., many years ago springing to mind, I got dressed, stuffed my pockets with triage tags, and went to the nearest fire exit/stairwell.

While exiting via the fourth floor stairwell, I was joined by a couple visiting Raleigh for a relative’s wedding. They were coaching their elderly relative in her pajamas down the stairwell. I was just about to tell the couple to take their time and not overly exert the woman, but then I smelled smoke as I passed the third floor. I told them to continue their journey and immediately thought of Jim Page, who always told me, Never stay above the eighth floor in a hotel beyond the reach of a ladder truck!

Once again, Jim Page’s words of wisdom appeared to be paying off.

As I exited the building, I was directed underground to the rear of the structure where I came upon a Raleigh Engine Company. The engine was occupied only by its engineer, because the crew was inside the structure. As I passed the engine, I asked the engineer where the fire was, to which he answered, I don’t know.”

Like a scene from a movie, I looked over the top of the engine’s cab and out of the engineer’s sight and saw smoke rolling up the side of the hotel.

Walking to the front of the hotel, with 40 triage tags in my pockets (of course), I was expecting to see an IC (with a vest on) directing fire operations … but I saw none. There was just one ladder at the front of the structure and about 100 hotel residents sitting on planters and benches listening to the God-awful sound of the alarm system and watching white strobe lights flashing throughout the building.

The Raleigh Fire Department is an exceptional department under solid leadership and I’m certain that the response to this incident was an anomaly, probably due to the reaction of the hotel staff calling in the alarm as an odor of smoke or a smoke investigation. It turned out to be a small fire that was quickly extinguished and contained on the third floor, and after 45 minutes of chatting with fellow evacuees I was able to go back to sleep and continue dreaming of larger MCIs.

If you guessed that Wake County EMS had a preplan for high risk facilities like they do for everything else you’d be correct. I’ll share it with you here:

Wake County (N.C.) EMS:Preplanning High Risk Facilities for Evacuation

I. Identifying Target Hazards within your Community

a. Large occupancy facilities
b. Special needs groups
c. Other potential hazard facilities

II. Developing cooperative relationships with Facility Administrators/Staff

III. Performing the On-Site Preplan

a. Review the necessary data points for the plan
b. Compiling it in a manner it can be used
c. Verification of data

IV. Developing a Response Plan

a. Establishing a location for the Transportation Group
b. Patient Triage and Tracking
c. Managing patient supplies and articles
d. Developing a patient movement plan
e. Establishing a Traffic Plan (and adapting due to impediments)
f. Ambulatory versus Non-ambulatory Patients

V. Relocation Options

a. Direct to a pre-established “Sister Facility”
b. Indirect use of an intermediate point for additional sorting
c. Hybrid approach

VI. Integration of the Wake County EMS Medical Ambulance Bus to Evacuations

a. What and where are they? Pics and description of buses, map showing locations in State
b. How to access them to be defined first
c. What information needs to be provided with request?

i. Incident street address
ii. Staging street address
iii. Point of contact (Transportation Group Supervisor)
iv. Communications Plan (with and without Viper)
v. Projected destination for patients
vi. General acuity of patients
vii. Available manpower on scene to assist with loading/unloading

Smoke coming from the third floor below my hotel room.
Smoke coming from the third floor below my hotel room.
A Raleigh firefighter enters the structure.
A Raleigh firefighter enters the structure.
Raleigh Fire Department ladder moving into position.
Raleigh Fire Department ladder moving into position.
Comforting one of the late night evacuees.
Comforting one of the late night evacuees.
Evacuees in the hotel lobby.
Evacuees in the hotel lobby.
One of the youngest evacuees.
One of the youngest evacuees.
Front of the Renaissance Raleigh hotel.
Front of the Renaissance Raleigh hotel.

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