After Boston bombings, Morris County wants to be ready for mass casualties

When thousands of runners swarmed the Morristown Green a few weeks ago for the Verizon Wireless Corporate Challenge 5K in brutal heat, the predictable happened. Even though the race was scaled back, a handful of people needed to be treated for heat-related issues.

That was expected. But emergency officials in Morris County knew it could have been worse. It’s part of their jobs to imagine how.

On April 15, they didn’t have to imagine. That was the day they watched news reports of chaos and carnage in Boston, when two homemade bombs killed three people and injured hundreds of others at the Boston Marathon. They heard about severe bleeding and lost limbs — about the sorts of injuries that need immediate care in an overwhelming situation.

And they knew that if it could happen in Boston, it could happen here.

“The (local ambulance) squads do a great job with the day to day,” Morris County Office of Emergency Management Director Jeffrey S. Paul said. “We’re focused on the types of incidents that rarely happen, that you hope never happen.”

The Verizon race is far from the biggest event in the state — or even in the town. Every year, Morristown hosts the county’s St. Patrick’s Day Parade, drawing upward of 50,000 people to its downtown.

At the race, runners saw two key resources that point to the county’s stepped-up preparedness effort in the months since Boston — the county Mass Care Response Unit, and its Mobile Ambulance Bus. They may not be as visible at every large event, but they’re nearby, supplementing the vehicles and supplies already available to local ambulance squads.
In the time since the Boston attacks, the county has used grant money to purchase about $20,000 worth of equipment meant to provide triage care in the event of a mass-casualty incident.

“We had bleeding control covered, but did we have it covered as well as it could be?” OEM Deputy Director Karl Klingener said.

Now, the county has on-hand 10 small kits meant to provide rapid response in the event of a catastrophe. Half are focused strictly on triage — the others include more supplies.

Such supplies include commercial tourniquets, military-style compression bandages and suction devices used to clear airways. The supplies are far more portable than their traditional counterparts, and fit into small packs easily transported throughout a disaster scene.

“We wanted to outfit people with something small that packs a big punch,” Klingener said.

The focus in a mass-casualty incident, Paul and Klingener said, is to reposition airways so victims can breathe and to stop any severe bleeding. After that, it’s generally time to move on to the next victim.

“There’s no CPR in the triage process,” Paul said. “You’re talking about massive numbers of people. We’re talking about missing limbs. A caregiver isn’t going to be able to sit with one person and go through that process. It’s very quick.”

Victims are marked with colored tags that identify their level of injury (black, for instance, signifies someone who isn’t breathing and doesn’t have a pulse; yellow marks someone in need of care that can be delayed for the moment). Each ambulance squad in the county has been given matching colored mats that can accommodate several victims at once as they lay out, awaiting care and transportation to hospitals.

But the county’s focus hasn’t been on equipment alone, Paul and Klingener said. The Office of Emergency Management has increased its coordination with other area agencies, public and private. For instance, the supplies were purchased in consultation with Atlantic Health System, which runs Morristown Medical Center, and the OEM consulted with Dr. Louis DiFazio, director of Surgical Critical Care/Trauma at Morristown Medical Center.

And the OEM has entered into a new partnership with the Morris County Sheriff’s Office, to have one of its EMTs (who more typically provide care in the county courthouse) available at all times.

Fire departments, EMS squads, volunteer Community Emergency Response Teams and others also play a role, Paul said.

“We recognize in changing times, we have to work together,” Klingener said.

OEM and various other emergency services are working together on a new mass-casualty plan of action that will further refine the roles various emergency officials take on in a crisis, he said.

Paul said the goal is to keep operations current without expending unnecessary resources. Partnerships like the one with the sheriff’s office allow the county to be better prepared without taking on new staff, he said.

“We live in a time where people expect more with less, and we’re trying to do that,” he said.