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Airplane crash puts hospitals' 'mass casualty plan' to the test

Original post made on Jul 12, 2013

Within minutes of Saturday's crash-landing at San Francisco International Airport of an Asiana Airlines flight carrying 307 passengers, employees at Stanford University's two hospitals prepared to execute their long-rehearsed "mass casualty plan."

Read the full story here Web Link posted Friday, July 12, 2013, 9:23 AM

Comments (23)

Posted by neighbor, a resident of another community
on Jul 12, 2013 at 9:40 am

Good job Stanford. All of the disaster planning and practice exercises paid off. I'm sure a lot was learned about how to improve things for the next time.


Posted by San Bruno?, a resident of another community
on Jul 12, 2013 at 11:11 am

" Saturday's alert was the largest Stanford hospitals have faced at least since the 1989 Loma Prieta earthquake,"

They didn't take any casualties from the PG&E defective pipeline disaster in San Bruno?


Posted by Lydia Kou, a resident of Barron Park
on Jul 12, 2013 at 1:16 pm

Being ready for any disaster or any emergency!

Join the Emergency Services Volunteer (ESV) Program supported by Palo Alto's Office of Emergency Services made of residents. There is a role for everyone who is interested in participating. It is your choice as to decide which role would be the best fit. The different teams are as follows:

- Block Preparedness Coordinator (BPC) Team – helps ensure residents can participate with the City in disaster preparation, response and recovery. This program trains volunteers to staff Block Preparedness Coordinators positions for each block and to functions as the "eyes and ears" following a major disaster. They stay in their block and inform the city of the status of their block. Residents participate with the City in disaster preparation, response and recovery, as well as Crime Watch, since The Neighborhood Watch program is a part of the BPC Program. The next class is July 20, 2013, 10AM-1PM at Cubberley Community Center, Room H-1.

- Neighborhood Preparedness Coordinator (NPC) – Community members serves as the leader of the neighborhood emergency preparedness teams by supporting and keeping all involved, including residents, updated with preparedness and safety tips and fostering resiliency. During emergencies/disasters, NPCs are incident commanders in the neighborhood and coordinates communications with resources to the city, damage and injury assessments, recovery and response. The next class is July 20, 2013, 10AM-1PM at Cubberley Community Center, Room H-1.

- Community Emergency Response Team (CERT) program trains - Community members are trained in basic disaster response skills, such as small fire suppression, light search and rescue, and disaster medical operations. Using the training learned in the classroom and during exercises, CERT members can assist others in their neighborhood or workplace following an event when professional responders are not immediately available.
In a disaster, CERTs will be deployed as either:
-Neighborhood CERTs
-Citywide CERTs
-Shelter & Human Services CERTs
-Public Works & Flood/Storm CERTs
-Logistics

- Emergency Medical Unit (EMU) Team - is a team of Volunteers who have a background in various areas of the medical field. They are tasked to set up and maintain a field medical unit during a large scale disaster. Using their medical knowledge and team skills they will take care of injured people when hospitals are inundated with patients and transport is difficult.

More information is available at the following links:
Web Link
www.paneighborhoods.org

If you have any questions, email us at epvolunteers@paneighborhoods.org


Posted by Peter Carpenter, a resident of Atherton
on Jul 12, 2013 at 1:20 pm

Peter Carpenter is a registered user.

This remarkable response is worth remembering the next time someone wants to lambast Stanford for not serving the community.

Thank you Stanford Hospital and the Lucille Packard Children's Hospital - Well Done.


Posted by Gethin, a resident of Midtown
on Jul 12, 2013 at 2:02 pm

Congratulations to Stanford for its successful leadership and work providing emergency services such as these


Posted by SF General, a resident of University South
on Jul 12, 2013 at 2:11 pm

Not to downplay Stanford, but SF General has an even better trauma center and burn unit. Plus, by the time the ambulances arrived, they had already set up triage tents and a trauma unit in the parking lot!

A friend and his wife were among the casualties of the crash, the wife still hoitalized in Critical Care at SF General. Well-to-do, they are used to good medical care as a fact of life, but have nothing but praise for SF General's readiness and excellent care and attention.


Posted by Not an issue, a resident of Community Center
on Jul 12, 2013 at 3:48 pm

Well said, Peter. Surprised we did not hear complaints about too much traffic and too much noise from the helicopters.


Posted by Not an issue, a resident of Community Center
on Jul 12, 2013 at 3:51 pm

BTW, SF general-- if you read the weekly story you will see that Stanford also had tents set for triage as well-- the are pictures.
Stanford has better treatment for AS.


Posted by SF General, a resident of University South
on Jul 12, 2013 at 5:54 pm

But not tents for trauma care. What does AS mean and what does it have to do with anything here?


Posted by Not an issue, a resident of Community Center
on Jul 12, 2013 at 6:35 pm

Sf general- 6 pf one, half dozen of another. Would depend how the hospital is set up and the protocol the hospital uses in these cases. Does not mean that one hospital is better than another.
AS= ankle shattering as opposed to MS.


Posted by neighbor, a resident of another community
on Jul 12, 2013 at 7:47 pm

They are both outstanding hospitals -- and they did an amazing job after the plane crash.
No controversy here at all.


Posted by Wayne Martin, a resident of Fairmeadow
on Jul 13, 2013 at 7:07 am

It's hard to have anything but kudos for all of those involved in responding to this crash. As the dust settled, and the various media outlets carried various stories, I got to wondering:

1) What kind of Master Plan does SFO have?
2) What at SFO is in charge when emergencies like this one occur?
3) How does SFO alert outside agencies to request support/resources?
4) How many regional hospitals are partnered with SFO in their Master Plan?
5) What local agency has oversight of the emergency response capabilities of our regional airports?

Relative to this crash:

6) How many ambulances responded to this crash?
7) How long did it take to remove all of the injured from the scene?
8) What was the origin of these ambulances?
9) What First Response capability does SFO have?
10) Will there be a minute-by-minute review of the Emergency Response to this accident?
11) Will there be a review/rating of SFO's response to this accident?

I'm also interested in how the hospital's bills will be paid? Will the hospitals charge the individuals, who then will pay through their insurance? Or will the airline offer to pay all of the bills of those on the flight?

The regional hospitals seem to be ready to handle small emergencies, but what about the airports and other aspects of our regional emergency response "infrastructure"?


Posted by wondering for Wayne, a resident of Walter Hays School
on Jul 13, 2013 at 10:23 am

Uh, any more questions, Wayne? Feel good to post a bunch of questions, and then do nothing about it?

Oh! I get it! You want other folks to do your searches for you! How, uhhh, "nice".

Okay, I'll take #8, origin of ambulances, for 200, Alex:

What is.... hmmm.. the origin of ambulances? Ambulances were first used for emergency transport in 1487 by the Spanish....

Can I Wiki anything else for you today, Wayne? Go to the Stanford or SFO or any number of sites that have info posted about your wonderments?

Curious: did it take longer to type your questions and post them than actually doing the search yourself? Thought so...

And yes, Wayne, some of your answers are not posted to a website for security reasons. I checked.


Posted by neighbor, a resident of another community
on Jul 13, 2013 at 12:06 pm

Wayne:
There is a very sophisticated disaster planning effort in the Bay Area. A little web searching will give you more information.

Hospitals, public facilities such as schools/airports, and all cities/counties/the state are required by law to have disaster response plans. Public facilities must practice them annually (or 2x/yr. or MORE for many entities). Also, 100s of Bay Area neighborhoods have citizen disaster teams (CERTs in Palo Alto) in case of a region-wide disaster when most local areas may have to wait as more critical areas are addressed.

All of the entities that would be part of a real disaster --- health facilities, police/fire, city and county gov't, CERTs, etc.--- are part of annual drills. Hospitals and ambulance crews simulate victims' injuries to practice triage. A central Incident Command center coordinates. You might have seen emergency exercises on the news (often exercises occur in April and October).

We are fortunate that the emergency response personnel and emergency managers in the Bay Area have such good plans. SFO, Stanford and UCSF have particularly long histories with emergency/disaster planning -- and they have a lot of practice.

That's why things went so well. But no matter how much planning and practice you have the reality of a situation is different -- after all, disasters are called disasters for a reason.

The runway response time at SFO was actually good -- but it's a long way from the terminal to the end of the runway. I suspect that issue will be addressed, and that the response plan will be modified to propose new closer satellite FD. That will cost money -- be sure to vote for the bond issue if there is one.

The hospitals set up disaster triage areas to receive patients before they arrived. SU and UCSF did a great job.

The next exercise will no doubt test the issues that didn't work so well, along with practicing new issues. There will be lessons learned from the SFO incident.

However some of the recommendations coming out of this disaster will cost money. Please support disaster response spending.


Posted by Wayne Martin, a resident of Fairmeadow
on Jul 13, 2013 at 12:40 pm

> Ambulances were first used for emergency transport
> in 1487 by the Spanish...

What a bizarre way to read this question. What I was asking was:

Is there a pool or ambulance services that are registered with the Airport, and these ambulance services called as they are listet? Are they all called? Are public ambulances called before private services, or are all treated equally?

What the historical origin of ambulances would have to do with this crash is hard for me to fathom.


Posted by Wayne Martin, a resident of Fairmeadow
on Jul 13, 2013 at 12:46 pm

@Neighbor ..

Thanks for the posting. I was actually aware of some of this information, but had not seen any of the details i was wondering about appear in any of the local/national media reports.

I have not seen many of the Emergency Response Plans on-line, and probably would accept the general claim that there is some "sensitive" information in some of them. However, some overview of these plans should be available for public access/review, it would seem to me. I reviewed the Palo Alto Emergency Plan some years ago in paper form. There wasn't anything "sensitive" in that version, as far as I am concerned.

Remembering back to the Oakland Hills Fires, I'm not as convinced that all of these local agencies are as prepared for "mass emergencies" as others.


Posted by neighbor, a resident of another community
on Jul 13, 2013 at 3:45 pm

Wayne---- the post by "wondering for Wayne" was meant to be funny. Seriously though

1. Yes, the pool of ambulances who respond at the airport is known before a disaster.

2. Ask the PA City Council to see a summary of your local plan. It will identify who responds, who is in charge, how decisions are made. Many entities (cities, counties, schools and colleges etc. put plan summaries online. BETTER YET, sign up for the CERT training and you'll get an intimate knowledge of the local Plan and how the coordination of resources happens.

3. The Oakland Hills firestorm (22 years ago) changed disaster response planning just as many other disaster events have -- whether they are local or not. It's cumulative. 1989's Loma Prieta response, the 1994 Northridge Earthquake and the Malibu Fire in Southern Calironia, etc. led to planning modifications and, of course, 9/11 changed everything for emergency planning all over the U.S.. This airplane crash will lead to many lessons learned.

One issue remaining is getting all of the Bay Area emergency responders on shared radio frequencies. Local voters have been unwilling to pay for this.

It was one of the strongest recommendations after 911 in NYC -- responding firefighters and police couldn't talk to each other and the firefighters climbing up the stairs in the second tower never received the message to suspend operations.


Posted by Wayne Martin, a resident of Fairmeadow
on Jul 13, 2013 at 8:28 pm

@Neighbor:

Thanks for your response, again.

However, I was hoping for more detail--such as links to the emergency plan that spells out the ambulance pool membership, and the alert sequence for emergency transport services.

I decided to do a little googling, and found a nice web-site for the SF Dept. of Emergency services:

Web Link

Which has some information about this office's responsibility for transportation emergencies (including SFO):

Web Link

I will contact them with my specific questions, since they should know the answers.

> sign up for CERT ..

Well, had some of that training as a Company Commander many years ago. Was required to be fully cognizent of all of our Company-level and Battalion-level SOPs (Standard Operating Procedures), many of which involved emergency evacuations in time of combat, as well as providing periodic updates to these SOPs, as required by higher level command.

> One issue remaining is getting all of the Bay Area
> emergency responders on shared radio frequencies.
> Local voters have been unwilling to pay for this.

Am unaware that there has ever been a coordinated SF.BayArea ballot issue to fund "shared radio frequencies". What year was this on the Ballot?

But you are correct about the issue of radio communicatons being an issue. For instance, did you read this article about the problems at 49er Park?

Web Link

In this case, the SF.PD seem to want to use cell phones--and ultimately there is only so much channel capacity when thousand of civilians want to use their cell phones also. So--how much would it cost for San Francisco to fix this problem of adequate communications for its combined Fire and Police Departments?

> Ask your City Council for a copy of the Emergency Plan.

Why would I do that, when I should be able to find it on the City's web-site (as I was able to do for the SF Dept. Emergency Services? I wrote in an earlier posting that there weren't many of these around. Perhaps I was wrong. (Anyway, I was really only interested in the SFO plan for the purposes of this posting.) There was a copy of an older version in our local library at one point, but I doubt anyone on our City Council would have a copy.

If the folks in SF respond to these questions, I will post the answers--even if this topic has been aged into the archive.


Posted by Wayne Martin, a resident of Fairmeadow
on Jul 13, 2013 at 8:38 pm

> shared frequencies (Radio Interoperability)

This topic has been kicking around for several years now. I remember it's being discussed by the PA CC at least five years ago. The following link points to a short memo that seems to suggest that this interopability project is well under way:

Web Link


Posted by neighbor, a resident of another community
on Jul 13, 2013 at 10:32 pm

Again....hats-off to UCSF + SU hospitals for their great response to the plane crash disaster. It shows that "prior planning precludes poor performance." Their preparedness paid off.


Posted by member, a resident of Downtown North
on Jul 14, 2013 at 10:58 am

It was to good to see such cooperation among the different agencies, emergency personnel and hospitals.

This was a good test of emergency response, but it is hardly what I would consider a major disaster where the casualties may be in the thousands.

It would be interesting to learn how we would cope with a larger scale disaster.

Why don't you do a story about this?


Posted by wonderment, a resident of Adobe-Meadows
on Jul 14, 2013 at 11:55 am

Congrats, Wayne, on learning how to use the google machine, and the phone. "wondering for Wayne"'s post must have worked. Nice Jeopardy reference!

Ain't it a wonderment.


Posted by DE-myelinated, a resident of Palo Alto Hills
on Jul 16, 2013 at 4:07 pm

@not an issue--- MS is nothing to be light about. The sufferer is slowly dying, the nerves being stripped of their insulation by the disease. It is totally debilitating, and eventually the patient stops breathing.


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