Mass-casualty ambulance service based at Palestine hospital
By BETTY WATERS
blw@tylerpaper.com
PALESTINE — As part of the country’s effort to step up preparedness for emergencies and disasters, Northeast Texas has a new mass- casualty evacuation ambulance bus capable of transporting up to 20 patients at a time.
The specialty ambulance is stationed at Palestine Regional Medical Center ready to be deployed wherever needed.
“It is the first in the region and one of the first in the state and country,” said Chuck Skinner, emergency medical services director for Palestine Regional Medical Center.
“There’s just a handful of these operational in the whole world. It’s an amazing asset to have available in East Texas.”
The Federal Emergency Management Agency directed states to develop plans to care for massive influxes of patients – the kind that occurred after hurricanes Katrina, Ike and other events.
Texas Emergency Medical Task Force and Regional Area Trauma Advisory Council, which are part of the state emergency response system, partnered to provide eight multiple patient ambulance buses to serve regions across the state.
Palestine Regional Medical Center successfully bid to host one of the “ambuses,” the shortened term for referring to an ambulance bus. It is designated to serve primarily the Northeast Texas Region under the jurisdiction of Piney Woods Regional Advisory Council Trauma Service.
The region stretches from Anderson County to Louisiana and up to Texarkana and Paris. It includes these counties: Anderson, Bowie, Camp, Cass, Cherokee, Franklin, Freestone, Gregg, Harrison, Henderson, Hopkins, Houston, Lamar, Marion, Panola, Rains, Red River, Rusk, Shelby, Smith, Titus, Trinity, Upshur, Van Zandt and Woods.
Hospitals interested in bidding had to explain their interest, why they thought they could service the ambus, be the best responder and the best site to host the vehicle.
“We put our name in the hat and wrote up why we thought we would be worthy of it,” said Christi Watkins, chief clinical officer for Palestine Regional Medical Center.
Citing factors that contributed to attractiveness of the hospital to serve as host for an ambus, Ms. Watkins noted that the hospital’s location in the south part of the region gives it closer access to emergencies that could occur on the coast as well as in Northeast Texas.
Another reason Palestine Regional Medical Center is a fine site is the advanced intensive care training and skill level of the staff, she added, because the ambus is like a mobile intensive care unit.
The ambus requires a staff of six people. It is normally staffed with emergency medical technicians, although the hospital has the option of having a nurse and a physician on board.
Palestine Regional Medical Center has trained its entire emergency medical staff – about 50 people – to serve as a pool it can draw from to staff the ambus.
They have received extensive training in intensive care, emergency care, training in on-the-scene care and know how to respond to whatever the need might be, Ms. Watkins said.
The staff can be tailored to suit a particular situation. For example, if a lot of respiratory patients are being hauled from a nursing home, the ambus staff could include a respiratory technician from the hospital.
Not only have the hospital’s personnel trained to serve on the ambus, but they are training staff from other agencies in East Texas that might need services of the vehicle in a mass casualty event.
Palestine Regional Medical Center keeps the vehicle fully stocked with supplies, maintains it in topnotch shape and ready to roll. The ambus carries enough supplies that would normally stock six standard ambulances.
“It is equipped like a state of the art mobile intensive care unit in an ambulance and for a mass casualty setting,” Skinner said.
The ambus can carry ventilated patients and very sick patients, Ms. Watkins said.
Skinner added, “It has life support, emergent medications and a lot of maintenance medications for critically ill cardiac patients, respiratory patients, and pediatric patients. It has suctioning capability for patients with secretion issues for their airway. It has IV pumps. It has equipment for trauma patients and for pediatric special needs patients.”
It has monitors that can be strapped on a patient’s arm to monitor the heart, lungs and blood pressure at the same time and remotely transmit the information to a computer screen where staff can monitor the patient’s condition.
Although the main purpose of the ambus is for mass casualties in a hurricane or similar emergency, it can be used for other purposes, Ms. Watkins pointed out.
She cited as examples a wreck involving numerous vehicles on the interstate, an apartment complex fire, a school situation where victims would need to be removed and derailment of a train carrying a chemical, creating the need to remove people from an area to a place where they could be safely treated.
Another type situation that the ambus might respond to would be a nursing home that needs to evacuate its residents because of a gas leak. “We could take them to a safer area or for medical screening,” Ms. Watkins said.
The ambus could be used in any large type of evacuation where there are an exceptionally high number of patients to be moved, Skinner said.
“We have the option of responding and taking 20 people to the hospital instead of just one at a time in a (regular) ambulance,” Ms. Watkins said.
The ambus can haul a greater number of patients faster, leaving regular ambulances and medical helicopters to carry the sickest patients, officials said.
Another potential use for the ambus is for examination and mobile assessment of people to see whether they need to go to a hospital.
The ambus is 41.4 feet long, plus it has a 15-foot ramp that can be extended for loading and unloading patients. It cost $400,000, allocated by state and federal agencies.
There are less than 100 of the ambulance buses in the U.S. currently, said Mark Neel, a supervisor with Palestine Regional Medical Center. “We are one of the fortunate ones to have one in our area,” he said.