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EMS personnel train for the worst

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Photo by Pat Sunderland In this training exercise, emergency responders assess the injuries sustained when a helicopter crashed into a parking lot full of people.

In the midst of planning for a mock mass casualty exercise, personnel at Delta County Memorial Hospital found themselves faced with a real-life incident when a commercial bus rolled on Highway 133 near Paonia Reservoir, injuring 23.

The bus crash occurred at about 6:12 a.m. in the morning of Tuesday, April 30. The Colorado State Patrol reports the bus was northbound on Highway 133 near mile marker 23 when a large rock fell onto the roadway. The front and undercarriage of the bus collided with the rock, which became lodged under the bus. The bus went off the right side of the roadway, went down a steep embankment and rolled one full revolution.

The 2009 International had picked up hard rock miners from several points in Delta County, and was transporting them to the marble quarry in Marble. The bus was driven by a 57-year-old man from Olathe who suffered minor injuries. The other passengers, all adult males, sustained minor to moderate injuries.

Because the accident was caused by the rock, and alcohol and drugs were not a factor, the driver was not cited.

The hospital received word of several injured parties, but had no idea how many patients were headed that way due to the lack of cell phone coverage in the area.

Jillian Emmons, the hospital's trauma coordinator, said the emergency room ended up receiving 23 patients, most of whom were transported to DCMH by private vehicle.

"Despite the lack of communication, hospital personnel handled the situation well," Emmons said. All the crash victims were treated within two and a half hours, and just one required transport to St. Mary's Hospital in Grand Junction. Staff members were quick to respond from other departments and from the community. "Everyone worked well together," Emmons said.

Three days later, a mock casualty exercise took place during the Trauma Conference hosted by the hospital. Care Flight provided a helicopter which, in the scenario that played out behind the hospital, crashed into a parking lot full of people. The helicopter was carrying a patient and three flight team members. Then there were the wounded on the ground, including some that required extrication from a parked vehicle. The "patients" were portrayed by LPN students from the Technical College of the Rockies, who showed a real knack for moulage -- the art of applying mock injuries for the purpose of training.

The condition of each injured person was carefully assessed. EMS personnel employed a widely understood tag system to designate the walking wounded as "green." Those with serious injuries received red tags, and one deceased actor received a black tag.

The goal of the exercise, Emmons said, is to identify each individual's injuries and get them where they need to go, whether it's to the emergency room, the operating room or transferred to the nearest highest level of care.

The personnel involved in the mock exercise included basic EMTs, intermediate EMTs and paramedics from Delta County Ambulance District, North Fork Ambulance District, Ouray and the West Elk Mine, as well as hospital nursing staff.

"Once we got through the initial chaos, we all started to work together as a team," Emmons said. A debriefing followed the exercise, where participants could evaluate what went well and what didn't, to share with their respective agencies. The more mass casualty exercises of this type, Emmons said, the better everyone is able to react.

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