Ambulance Buses and HSC faculty members respond to explosion in West
Posted: Wednesday, May 01, 2013 · Volume: XLVI · Issue: 9
By Rosanne Fohn
While much of Texas and the nation followed the news of the fire and explosion at a fertilizer plant in West, Texas, on Wednesday, April 17, five faculty members from the UT Health Science Center San Antonio were treating injured patients or coordinating the medical response to the disaster.
Faculty from the Department of Emergency Health Sciences (EHS) in the School of Health Professions and the Center for Emergency Medicine (CEM) in the School of Medicine were deployed to assist. They included:
Emily Kidd, M.D., assistant professor in both the EHS and CEM, interim medical director of the San Antonio Fire Department, project director for the Texas Disaster Medical System, and a member of the Southwest Texas Regional Advisory Council and the Texas Emergency Medical Task Force;
Craig Manifold, D.O., assistant professor in both the CEM and EHS, also is a colonel in the Texas Air National Guard, joint surgeon for Texas Military Forces and assistant medical director for the San Antonio Fire Department;
Craig Cooley, M.D., M.P.H., EMT-P, FACEP, assistant professor/clinical and program director of the emergency medicine fellowship in the CEM. He also assists with medical direction for the San Antonio Fire Department;
David Wampler, Ph.D., LP, assistant professor of EHS in the School of Health Professions; and
Todd Burgbacher, D.O., clinical instructor and an emergency medicine resident in the CEM.
State support and assistance
Dr. Kidd was notified within 10 to 15 minutes of the explosion due to her multiple roles involving emergency preparedness, planning and response.
She arrived in West around midnight, about four hours after the explosion, and found that most of the severely injured had already been transported to area hospitals. “The first responders had, for the most part, gotten all of the injured out of there and to area hospitals, so I didn’t see any patients as a doctor,” she said. “That’s great! That’s exactly what you want – for the local responders and their mutual aid partners to get patients triaged, treated and transported as quickly as possible.”
On Thursday, April 18, she went to Austin as an acute care medical advisor at the state medical operations center, which involved planning, operations and deployment of state disaster resources to West. On Friday she went back to West in the role of medical director for the Emergency Medical Task Force resources and to assess the needs there.
“The Texas Emergency Medical Task Force has eight regions, including the South Texas Regional Advisory Council based in San Antonio, that we can call on for assistance in a disaster,” Dr. Kidd said. “And at the state level we have four types of teams that we can deploy.” They include:
ambulance strike teams — teams of five ambulances that can go anywhere in the state to assist during an emergency;
ambulance buses — large-scale transports staffed by paramedics that can take up to 20 patients in critical condition to a hospital;
mobile medical units (MMU) — hospital emergency rooms on wheels; and
RN strike teams — groups of nurses who can provide care when local nurses are injured or when extra nurses are needed to care for patients.
“We deployed one MMU but did not need the other teams because of the excellent response from the local and area ambulance teams and hospitals,” Dr. Kidd said.
Military assistance
Dr. Manifold deployed in a similar advisory role with the Texas Air National Guard. “I responded as the joint surgeon for Texas Military Forces (National Guard). As the senior physician and advisor to the adjutant general, Maj. Gen. John Nichols, I was observing response activities and assuring that National Guard medical assets were available if requested. A civil support team was deployed, which was able to monitor the area for potential hazards and also has medical expertise. Additional search and extraction teams, medical responders, fatality assistance and behavioral health experts were available if needed,” the colonel said. “I was able to review response activities and visit the site along with the Texas Task Force 1 physician responders.”
He added, “In the Department of Emergency Health Sciences, we have been a partner and provided subject matter expertise for the development and deployment of the MMU and Texas Medical Task Force assets. Dr. Kidd has been a leader in the development of these teams for the State of Texas,” he said.
Examining patients
Three faculty members also provided care in the MMU in West:
Dr. Cooley was notified of the disaster that Wednesday evening and assisted with setting up the MMU in West. “I was the only physician seeing patients at the MMU from 6 p.m. Thursday through Friday afternoon, when I was relieved by Dr. Burgbacher,” he said.
“In the MMU, we are capable of evaluating and treating injuries ranging from minor bumps and bruises to stabilizing critical patients. Most everything I saw while I was there were relatively minor symptoms related to the blast or other minor injuries,” Dr. Cooley said.
Dr. Burgbacher said, “I was asked to deploy Friday around 8:30 a.m. I took over patient care from Dr. Cooley around 4 p.m. until we shut down at 6 p.m. on Saturday. We were able to care for more patients on the second day compared to the first, I believe, because the public was not aware of our presence at first. Most of the victims had already been treated before our arrival, but there were lots of patients who had chosen not to go to the hospital initially and then came to us. We cared for a variety of patients who needed medications or had minor blast injuries. I did see a patient with abdominal injuries who needed to be transferred to a trauma center.”
Dr. Manifold added, “Dr. Burgbacher is one of two emergency medicine fellows in the CEM. In addition to treating actual patients, he was able to actively participate in planning and deploying in a complex multiagency response to a live disaster. This is something that few programs in the country are able to provide and that few fellows are able to participate in.”
Dr. Wampler also deployed to the disaster staging area Wednesday evening. He assisted with setting up the MMU in West and worked there as a paramedic from 6 p.m. Thursday afternoon through Friday night, returning home early Saturday morning. “I was deployed to support the first responders there and the explosion victims who were not taken to the hospital,” he said.
“Dr. Wampler has been an integral member of the team since its beginning and provides active treatment and assessment of patients in the MMU,” Dr. Manifold added.
With the medical emergency under control in West within a few days, the MMU was redeployed to San Antonio to provide minor medical care during Fiesta. “This is one of the planned exercises that the Texas Emergency Medical Task Force does through the Southwest Texas Regional Advisory Council to relieve and back up the downtown hospitals here,” Dr. Kidd said.