The large room was dark with only minimal light seeping in from gaps in the brick and cinder block walls. It was far too large to be certain in the actual dimensions of the facility. There was an eerie stillness in the twilight, sporadically broken by the sound of dripping water, the scraping of something on a rough surface and an occasional moan. The air inside was stagnant and somewhat chilly on this February afternoon.
Beams of light cut through the darkness, flashlights wielded by an unseen group. They were not strong enough to reach the opposite wall. The lights swept along the debris cluttered floor and then, tentatively, some angled up, illuminating an insignificant section of a dilapidated ceiling some thirty feet above. The building was not safe. It groaned as if greeting the light it has not seen in some time.
“Search and Rescue! If you can walk, come to the sound of my voice!”
“Help me!” a woman’s tortured voice responded from the darkness. In the distance something fell and bounced on the dusty cement floor. There was a scuffing sound as if someone was pulling themselves across the floor.
The beam of one of the lights fell on a young girl. She could not have been older than eight, small and scared, wearing a dirty coat. Her hands were bloody and there was a smear of blood on her face. “My daddy is hurt,” she pleaded. “Please help him.”
It was less than an hour earlier that a call went out to Colorado’s North Central Region’s volunteer responders of the Community Emergency Response Team, the Civil Air Patrol and the Amateur Radio Emergency Service. It had been snowing for over a day now, a thick heavy snow, accumulating in excess of an inch an hour, forming drifts higher than six feet. The official snowfall totals broke two feet at noon and some areas experienced well more precipitation than the official numbers had suggested. Accident alerts had been replaced with travel restrictions, not that many vehicles could overcome the drifts in the roadways. Police, fire and ambulance units were no longer able to respond in their customary vehicles. The snow was so deep that they were covered up to their bumpers and hopelessly stuck. Paramedics were responding to calls for help on the backs of snow mobiles. And that was still good news. Now, coming up on mid-afternoon, emergency dispatchers were taking calls for sagging roofs. Some were still putting up a fight against the rapidly accumulating snow. Others were in the process of giving up.
Such was the case here. A 90,000 square foot facility, a two acre building, finally gave in to all the snow. Power failed. A portion of the roof caved in. Walls and supports buckled. The acoustic ceiling and hanging signage and lights all collapsed. It was the worst case scenario that everyone had feared. Dozens of people trapped in a shattered facility, many hurt. And rescue was not coming. Powerful as a fire engine is, it simply could not plow its way beyond the doors of the fire station. Too much snow. And too many calls for help.
An event such as this was foreseen by emergency planners years in advance and in the summer of 2002 Bill Owens, then governor of Colorado, signed an executive order creating the infrastructure for establishing regional emergency response coordination and implementing mutual aid agreements between a multitude of agencies that had never even considered working together in the past. It was not long before these All-Hazards regions were taking advantage of a resource that had not been utilized before – their own citizens, who were willing to be trained to respond in the event of a disaster.
There are a lot of things involved in responding to a disaster. Volunteers are trained in triage, treatment, search and rescue, the psychology of a disaster. There is training in the Incident Command System and the National Incident Management System, both now mandatory for all professional responders in the United States. And there’s additional training in operating shelters, rescuing animals, responding to special needs facilities, evacuation, traffic control. The list goes on. Volunteer responders are not expected to be on call 24/7 or to risk their lives when it comes to saving others, but many who train are ready and willing to do anything needed at a moment’s notice.
A team of responders entered a section of offices along the south wall of the building. They evaluated the ragged walls for stability and safety. There was moderate damage. Any more snow up above and this section of the building might go as well. The first collapse on the back side of the building was not kind to any part of the facility. Ceiling tiles littered the floor and electrical wires dangled down from up above. If they entered this area, their search would have to be quick.
Slowly and carefully the team moved in. The beams of their lights illuminated a dusty and littered hallway with office doors on either side. There was a single dim bulb dangling down from the ceiling. It cast negligible light, but what little there was offered a welcome supplement to the flashlights.
In one of the corners the responders spotted a young woman sitting among the debris. There was a bloody cut on her forehead. The team leader knelt down in front of her.
“We’re going to help you,” he said. “What’s your name? Tell me what happened.”
What happened was really irrelevant. Everyone knew the series of events. The reason for the question was the head injury. These can be tricky. There’s always a lot of blood with a head wound. Sometimes the victim is okay to get up and walk out. Other times they may have a concussion and be suffering from disorientation. And in a worst case scenario, they may be going into shock or have suffered neurological damage. Assessment is vital before moving the patient.
“My leg hurts really bad,” the woman said.
That was good news. She was responsive. She had sensation. And she understood that these were first responders. The cut on her head, messy as it looked, was secondary. A second team member knelt down by the woman. As the leader worked to expose the leg, bandages were produced from the first aid hit.
“Right leg is broken,” the leader said. “She won’t be able to walk out. We’ll need to take her.”
The team worked quickly to bandage the woman’s head and splint her leg. The break turned out to be an open fracture, exposing the tips of bone through torn skin. It was grizzly to look at. There was a lot of blood. There was a tremendous danger of infection and rapid treatment was highly desired, but it could not happen here. She would have to be taken to the medical staging area and then be processed in order of injuries. Exposed bone is bad. But there were other life threatening injuries being brought back that would take priority. For now the team needed to prepare her.
In a disaster medical packaging tends to happen quickly. You really only have seconds to evaluate a patient and give them a priority. First aid in the field is minimal. You stabilize them to prevent further damage, try to keep them comfortable. And you do your best to get them back to where better medical help can be provided.
The bleeding was controlled, if not stopped, and the broken leg was splinted. It still needed to be cleaned and the exposed bone kept viable, but that would not be done here. And the break would not be set until the woman reached a hospital. Mass casualty events such as this call for compromises when it comes to treatment. The responders, already stretched to the limit, must provide the greatest amount of good for the greatest number of people.
“We need to check the rest of the rooms,” the team leader told the woman. “We’ll be right back.”
“No!” the woman yelled. “Don’t leave me!”
It was too late. The team had moved on. This is a part of the procedure, too. Never split up. Never expose your team to unnecessary danger. A lone traveler in a large scale disaster is at the whims of the environment. Structural instability, chemical agents and potential for looters all expose the responders to dangers that are better met as a team.
“Please don’t leave me!” the woman wailed. “I don’t want to die!”
It can be hard to step away from a patient. The seconds you spend with them build an emotional bond. You see their pain, their distress. You try to remain an impartial observer, but when you touch them, talk to them, feel their pain, you take something back with you and continuing down a dark corridor, having left your patient behind, you inevitably acknowledge to yourself that you are afraid for them.
The entire disaster feels more real than anything else you’ve ever done. There’s blood and screaming and a ton of litter that makes you think a bomb may have gone off in here. You feel adrenaline pumping through your body. Every noise makes you jump. You are using real medical supplies from your go-kit and the sweat beading on your forehead is merely uncomfortable until you tilt your head and it runs along the rubber guard of your helmet and manages to drip into your eye.
If this isn’t real, it feels like it should be, but deep down inside you know that this is only a drill. It’s a miserable 20 degrees outside and the ground is covered with three inches of snow that fell the day before. There’s no immediate danger. No one is going to die today. But it all feels real and the only hint that you are in a simulated disaster are the two instructors watching your team and the television crew with their big camera that keeps getting in your way. Pressure to perform? You’d worry about looking good on TV, but that’s not the concern right now. You don’t even feel the pressure of having an instructor three feet behind you. You figure they will remind you of the five things you could have done better later on in the hot wash. It feels real and you’re on auto-pilot. You drilled this one scene a hundred times. You saw different faces and different settings. Sometimes there was too much light. Sometimes too little. Some days it was cold. Others it was hot. Your patient was a young boy and an elderly woman. You did this in the wind and in the rain and it always boils down to one factor. You’re here to save lives. You have a patient. She is afraid. She is bleeding. You have to splint a broken leg so you can load this patient on a backboard without causing additional damage. You saw that broken leg with the protruding bone a hundred times. This is one hundred and one. You know how to fix it. Do it fast.
How do civilians find themselves in a situation such as this?
The short answer is that you volunteer for this sort of stuff. There are many reasons that people do this. Most feel that they have to give something back to society or that they need to be the guardians of their neighborhoods. There are no adrenaline junkies here. You get through an exercise and your only thought is that you’re wiped. It’s stressful, overwhelming. It’s made to feel real. No one does this because it’s fun. It’s done because it’s necessary, because someone has to do it. Not all rescues turn out well.
A beam of light hurried along the floor, coming to the tattered wall. It darted up and across, hitting the front of an old walk-in freezer. Someone stepped into the light, obstructing the view. Another beam joined the first, focusing on the fatigues of a rescuer. The helmeted figure tugged at the door. It took an effort to have it open. It was pitch black inside.
“Light!” came the order.
Three people slowly walked into the freezer. Another member of the team stood at the freezer door, holding it open. The risk of having it close with people inside was too great.
“What is it?” someone asked.
There was a long pause in sounds and action as hesitation and indecision swept over the group, then one of the responders stepped out and keyed his radio.
“Base, Team Two.”
“We just entered Zone Two. We have two fatalities in a walk-in freezer.”
In disasters people die. That’s an inevitable fact of life. Some will die long before rescue arrives. Others will linger only to die during the rescue. For some it’s a matter of the right aid at the right time. For others it’s destiny. Nothing the rescuers can do will save them. In our training we practice dealing with death as much as we practice saving lives. The responders must understand that they will not win all the time. Sometimes the damage is too great. Other times it’s a matter of how the situation comes together. Is the right answer searching to your right or to your left? Do you as a search and triage team pause to bandage a cut hand or do you tag the location and let the extraction team behind you deal with that. Do you clear the airway twice on an unconscious patient or do you do it three times before moving on? Speed is always important in a rescue, but speed can cause problems of its own. A sloppy neck brace will still result in a paralyzed patient. Sometimes you won’t get to the freezer in time for those inside to be saved. Sometimes you won’t even think that you need to look inside.
We train a lot. We focus a lot of our energies on emergency response. We know that we will never save the world, but we live in a metropolitan area pushing three million people and should disaster strike, we know that there won’t be enough professional responders to handle all the problems. We know that a large scale disaster is far less likely than a million little ones, but in the large scale exercise we’re exposed to a little of everything that can happen to us.
In 2006 the Arapahoe County emergency manager requested that we take over the execution of Citizen Corps regularly scheduled exercises for the county. Planning an exercise is a very labor intensive task. We didn’t really understand what we were getting into at the time. It turned out that there’s a lot to planning an exercise. You don’t just sit down and write a script. You have to find the right facility and negotiate for it, you have to get your responders and your volunteer victims. You need to solicit your served agencies to provide you with instructors and safeties. And you need to budget resources for dignitaries and observers who will come see how the exercise works. Local media is both your salvation and your bane. You need the world’s best public information officer to keep the media interested and on a short leash. The media is a fickle animal. They’ll bite your hand just as soon as they’ll shake it. We all have a fundamental fear of being interviewed. You can give the most brilliant five minute speech of your career and have it edited down to a thirty second sound bite that will make you sound like the world’s greatest moron. And then there are all the incidentals. There are supplies for the exercise, meals and drinks for the mob, PR with local businesses and paperwork. In triplicate.
Pulling a large scale disaster simulation together takes four to five hundred man hours. This is the time invested by our group. The immediate contribution is that we save this much time for the professional responders. It’s time that they can use to write grants, file regulatory paperwork, catch bad guys and put out real fires. Their only commitment comes down to helping out at the exercise by making additional instructors and safeties available.
Our first disaster exercise was in July of 2006. It was Operation Tornado Alley, where a tornado ripped through a subdivision on a sleepy Saturday morning. Well over a hundred people participated in the exercise. It was the biggest civilian driven disaster exercise ever held in Colorado and it was an overwhelming success. The first attempt always has a make it or break it component. Everyone loved it and the emergency manager asked us to host another exercise.
On February 4, 2007 we hosted Operation Snowflake. It turned out to be an ironically topical exercise as Colorado was hammered by severe snowstorms in December and January. We may not have planned the weather, but the exercise was put on the books in the fall and the weather only served as good publicity for us.
The disaster was a crippling winter blizzard that paralyzed the metropolitan area and caused extensive damage that required rescue operations. Ten members of OMEGA participated in the exercise. Six were staff for the exercise and four were responders taking part in the event. We spent three months planning this exercise with the last six weeks being a frenzy of meetings, e-mails and phone calls to make sure all the “i”s were dotted and all the “t”s crossed. We thought, after our first experience of running an exercise, that the second time around will be easier because we will have a better idea of where our attention needs to be focused and will have a fundamental exercise planning infrastructure in place. That was a mistake. Like every fingerprint (and every disaster), each exercise plan is different from the last. About the only thing that we recycled was the ICS-207 Organizational Chart form. And even there we moved roles around to give everyone an opportunity to try different planning roles. Just like the responders we are now training, it is our goal to insure that any one of us can take on any role that needs to be filled.
There is always stress leading up to the exercise. We’re counting confirmations from the participants, trying to make sure that we have all the proper gear reserved. Always worrying that we’ll run out of something that we desperately need or that we will fall short on the projection of the number of responders and role players who will attend.
We had a snowstorm just before the exercise. There was fear that it would prevent people from coming. No one wants to go someplace on a miserably cold day with snow on the ground. We underestimated. We had a great turnout, once again breaking the 100 participant mark and matching our previous exercise in size. Now we were worried about having enough food!
Our exercise staff, having worked closely together for months, now split off in different directions, trying to get our respective areas ready for the event. A 90,000 square foot building is about as big as it sounds. It was a tenth of a mile long and half that in depth. We did a lot of walking. Personnel from the Arapahoe County Sheriff’s Office, South Metro Fire and Aurora’s Office of Emergency Management took our script and mulaged the role players. After two of the instructors got a walking tour of the facility, they gave the tour to all other instructors and safeties as they arrived. Things came together well for the exercise. Denver’s ABC and CBS affiliate stations had their crews come in just before the exercise got started. They requested that each crew be deployed with a team going inside to get a feel for what a real rescue is like.
The exercise was on!
Our objective for the exercise is not to have a flawless rescue. We know that it won’t be flawless under any of circumstances and while a nice dream to hold on to, the real purpose of the exercise is to refresh skills and evaluate skill sets that need to be supplemented with additional training. We’re always training, after all. Technology changes, medical knowledge evolves, better methods to do the same old thing are created. And the dynamics of teams change. We have no guarantees who we will respond to a disaster with. We need to meet responders from local municipalities and agencies, practice our craft while wearing different hats and treat each disaster as a separate event rather than use a cookie cutter approach to resolving these incidents.
The event was not perfect, but it accomplished our objectives. We were able to identify areas where additional training is needed and it will allow us to plan better for the future. Additional classroom refreshers will be scheduled for the existing responders and future volunteers may see an altered curriculum to help them grasp all the fine points of managing a disaster. And we are once again at work, looking for a new facility for an exercise that is being targeted for late spring or early summer.
Both KCNC and KMGH spent the twenty-four hour news cycle after our exercise running the footage they shot on every news program they had. We got a lot of coverage and a lot of good publicity. As one of the responders later commented, “they made us look like rock stars”. The editing was flawless and the reporters showed and explained what it is that we do and how we do it. We could not have asked for better coverage!