Public Health Emergency - Leading a Nation Prepared
On a rainy July night in rural Blount County, Tennessee, a cargo train carrying hazardous materials passed through a residential area. During that trip, a wheel on the train had rubbed a hole into one of the tankers carrying the flammable and toxic chemical acrylonitrile. The acrylonitrile began leaking from the tanker, hitting the ground and sinking into the soil. Initially, the train operator did not even know that there was a leak.
Emergency calls were quickly made as the train came to a swift halt and within 20 minutes of the incident, emergency personnel were alerted to the problem. First responders arrived on site, cordoning off the area and notifying residents of the spill.
Long before the incident unfolded, the Hospital Preparedness Program (HPP), a federal program that works with health care entities across the nation to ensure local, state, and regional health care systems are coordinated, trained, and prepared, helped to train and equip Blount Memorial Hospital emergency and health care personnel so that they were ready to respond to this type of emergency.
HPP had funded decontamination and preparedness trainings and part of their training included detailed knowledge of chemical hazards and the proper decontamination steps. In addition, HPP supported the construction of decontamination showers at the hospital, as well as the radios and state-wide notification system, which form the backbone of a prepared community. The training and communication systems ensured that health care emergency preparedness personnel at multiple hospitals and across county lines were coordinated to save lives.
As a direct result of their participation in this HPP-funded training, Blount Memorial Hospital emergency and health care personnel immediately noted that acrylonitrile, when exposed to water, becomes the toxic gas cyanide. Suddenly, the rain that night turned from inconvenient to life-threatening.
With nearly 30 of the 57 cars on the train carrying hazardous materials and volatile natural gas, first responders had to act quickly and effectively. Over 5,000 residents were evacuated and within hours, the Knoxville/East Tennessee (KET) Healthcare Coalition (HCC) worked with Blount County Hospital to aggregate cyanide treatment kits across 15 counties. Funded by HPP, HCCs coordinate at the local, regional, and state levels to bring together local hospitals, other health care facilities, and emergency personnel to plan for and coordinate responses to health care emergencies that exceed the day-to-day capacity of the health and emergency response systems.
Over the course of three days, 157 patients were decontaminated, monitored, and/or treated for cyanide exposure at Blount Memorial Hospital, most of whom were first responders.
“Due to our training, we were synchronized in our response. During the peak of this emergency, we were able to reduce the intake time - from the door to the doctor - for patients with chemical exposure entering the busy emergency department from 28 minutes to 13 minutes. On top of the more routine emergency patients with heart attacks, strokes, and traumas we receive on a daily basis – that’s extremely impressive.” noted Carole Chambers, Director of Safety and Emergency Management. She credits the success of the disaster response to the “collaborative efforts of the community, the dedicated and well-trained hospital staff and the partnership between HPP, the Tennessee Department of Health, and local coalition members.”
The partnership between HPP, the Tennessee Department of Health, and local HCC members ensured that the situation was properly identified as a serious threat that required swift and coordinated action.
“Midnight on the night of a chemical spill with potential cyanide exposure is not the time to be creating relationships,” said Wanda Roberts, Regional Hospital Coordinator and liaison for the local HCC. “Thanks to HPP-funded exercises and trainings, I knew exactly who to call and I knew they were knowledgeable and prepared. I wouldn’t have it any other way. HPP funding saves lives.”
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