Thursday, August 9, 2007

Behind the Bridge

When I set fiction or essays in a pharmacy, readers gobble up the behind-the-scenes aspects and ask for more. So when I found myself gobbling up the details in a recent post to a pharmacy listserv I belong to, I paid attention.

Scott Knoer, director of pharmacy at a Minneapolis hospital, gave permission to distribute the following -- excerpts from his personal observations and learnings during the first hours after last week’s collapse of the I-35 bridge.

At approximately 6:30 I received an Orange Alert page and immediately drove to work. By the time I got there, the response from our staff was overwhelming. We never had to initiate a call tree because so many people either called us or just showed up and asked how they could help.

One learning from this is that when a major artery like Interstate 35 is closed, it has a ripple effect on traffic. It took me about an hour to make a 20 minute drive to the hospital. Another learning is that cell phone communications are difficult as the system is overwhelmed by people across the country checking in with loved ones. I had about a 10% success rate when trying to contact staff and the hospital on my way in.

All of the disaster training really pays off. When I pulled up, there were police at the entrances ready to direct and guide traffic. The ED [Emergency Department] was full of physicians, nurses, pharmacists, lab staff, etc. Everyone had their occupation taped to their back so they were easily identified. Signs were on the walls indicating where you could find Pharmacy, Lab results, etc...

At one point we had four pharmacists and three technicians in the ED, running up supplies, drawing up doses, checking allergies and interactions, and handing out morphine, antibiotics, vaccines, etc. The rest of our team manned their stations, keeping supplies moving, entering orders and answering a tremendous number of phone calls.

Another learning is that while we have a stockpile for disasters, it is aimed primarily at bioterrorism. The things we really went through for this trauma event were cefazolin, lactated ringers, and tetanus vaccines. We also quickly overloaded our [pneumatic] tube system's capacity and had to use runners to get things from Pharmacy to the units.

Our Command Center was also not prepared for the huge volume of phone calls from the media and families calling the hospital. We needed more phones and people to answer them in our Hospital Command Center. We were also unprepared for the number of families that showed up at the hospital looking for loved ones. Our plan was directed at patients, not families. We did initiate a lockdown.

You generally think of physicians, nurses, pharmacists and other caregivers in a response like this, but I got to witness every department in the hospital putting their plans to work. Our Food Services staff were wheeling carts of water and sandwiches to the ED personnel. They also set up coffee and food for the families in the lobby. Our facilities people were dealing with tube volume issues and our security people were everywhere. Our volunteers and social workers were here to help patients and families.

Well done, Minneapolis! Thank you, Scott!

As for me ... I've already tucked away the “occupations taped to their backs” detail for a future story.

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