Cayman Islands emergency officials who responded to a staged school bus-tanker truck wreck on 19 January said the training exercise produced a largely positive result.
However, participants noted the exercise was conducted under ‘ideal’ circumstances. Some also said the drill showed the need for better communication between the police, fire and emergency medical services agencies that responded.
‘The emergency services needed to work together more,’ said Barbara Carby, Director of Hazard Management Cayman Islands. ‘Each agency knew their task very well and carried it out. But it needed some more coordination overall.’
Ms Carby said it was agreed there would be more joint training and exercises between the various agencies in the future.
‘Communication doesn’t begin at a major incident,’ said Emergency Medical Services manager Stephen Duval. ‘It has to be long term.’
The drill began at 10.26am Friday, 19 January as the Emergency Communications Centre was alerted to the staged wreck on Linford Pierson Highway near the riding school.
High school students who played the role of injured children from Red Bay and Prospect Elementary schools were made up to look like accident victims. Rescue workers actually removed the teens from the bus, and brought them to a patient treatment or ‘triage’ area near the accident site.
There was also an actual fire set inside an oil tank near the accident site for purposes of the drill. Fire crews responding to the scene used foam spray to put out the flames, and had to make sure everything was safe before any of the school children could be taken off the bus.
The Cayman Islands Fire Service was first on scene at the drill, arriving at 10.30am.; four minutes after the initial call. Police responded shortly after, and then the first ambulance arrived on scene at 10.34am.
An emergency communications command post was established once all the agencies had arrived.
Paramedics were not allowed near the scene of the staged accident until the fire was safely put out. Ambulance service records show that occurred at 10.38am.
Cayman Islands Fire Chief Roy Grant said that’s much faster than he would expect a real tanker truck fire to be put out in an accident like this one.
‘We played it as real as possible,’ said Chief Grant. ‘It wasn’t much of a fire so you can’t judge that.’
Royal Cayman Islands Police officers assisted the fire department in removing the ‘wounded’ students from the bus. Officers also kept a wide area blocked off around the accident site, allowing only emergency personnel through.
Chief Inspector Peter Kennett said he was generally pleased with the way officers responded, and that a closed-door review was scheduled to go over the incident with officers.
Once firefighters and police officers had taken the ‘injured’ children from the bus, it wasn’t simply a matter of putting them on the nearest ambulance and whisking them off to the hospital.
The drill’s victims, 24 of them, were organized into four separate groups in the ‘triage’ area, based on the extent of their injuries.
Ten were classified as ‘red’ or critically injured patients. Five were put in the ‘yellow’ group, as seriously injured but not necessarily in immediate danger of dying. Five more went into the ‘green’ group, classified as ‘the walking wounded’. Four other students were put into the ‘black’ group, which meant they had died for the purposes of the drill.
Mr. Duval said multiple ambulances were called out to the site to help transport the victims once they had been evaluated by a doctor and nurses who were on scene. He said the most critical or red patients were transported first, then yellow, then green.
Before transporting patients, ambulances needed confirmation that either George Town Hospital ER or Chrissie Tomlinson hospital had available space for the patients. Patients were also given ID tags and numbers at various stages of their treatment, so doctors would know they had been accounted for.
From the time the crash scene was declared safe at 10.38am to the time the first critical patient was transported at 11.10am, 32 minutes had passed. According to EMS records it took about 47 minutes for six ambulances to individually transport all ten ‘red’ or critical patients. The final ‘green’ patient was taken from the scene just before 12.21pm when the all clear was given at the incident site.
The transport time may seem lengthy. But retired public hospital system disaster coordinator and former emergency services manager Ella Conolly, who observed the drill, said it’s actually quite good.
‘That’s a rapid time for that number of people,’ said Ms Conolly. ‘In a real situation it would take longer.’
Mr. Duval said EMS was fortunate in the way the drill scenario played out.
‘The location was near the hospital, the weather was perfect. This wasn’t in Frank Sound or another remote area.’
All of the non-serious or ‘green’ patients were taken to Chrissie Tomlinson hospital to ensure there was enough room for more critical patients at George Town hospital.