HMN-A Toledo hospital has been training to be ready for any hazmat situation that’s comes its way. After 2 recent patients, the hospital thinks it is time to train for more. (Toledo Blade)
When exposure to potentially dangerous substances twice sent multiple people to the hospital in a span of a week, the staff at Mercy Health St. Vincent Medical Center was trained to be ready.
The Toledo hospital became the treatment epicenter after two recent hazardous material incidents events sent more than 20 people there, including several police officers.
Hospital staff declined to discuss care for specific patients, including those from the two recent hazmat incidents, but Mercy Health Police Chief Pete D’Amore said decontamination procedures are triggered for a variety of reasons — including for biological, chemical, or radiation exposure.
“This is [for] anything that could pose a threat inside the hospital if it got airborne or anything that could go inside the hospital to other patients,” he said.
Among the biggest concerns are synthetic opioids like fentanyl and carfentanil, which can be deadly in small quantities and can be absorbed by accidental inhalation or skin contact.
Though testing of substances from both incidents is not yet complete, such synthetics are suspected. Court documents identify fentanyl as being at the first scene July 25, though police declined to confirm that, and the opioid-overdose reversal drug naloxone was used on several patients at the scene.
No naloxone was administered in the second incident on Tuesday, according to Toledo police.
Chief D’Amore this week walked through the hospital’s decontamination procedure, which begins by outfitting the response team in personal protective equipment.
“We have a number of people inside the hospital on the decontamination team,” the chief said, including physicians, nurses, and respiratory therapists. “We try to have all of the disciplines represented on the ‘decon’ team so we can handle whatever patient comes in.”
Team members receive specialized training updated quarterly so staff remains current on best practices.
Contamination victims remove all clothing and personal items under a large red tent, used for privacy, and items are bagged. Patients then enter a room with shower heads and an eye-wash station to get a head-to-toe cleaning with dish soap. The type and level of exposure dictates how long they must remain under the water, but it’s usually about five to eight minutes.
Once clean, patients dress in paper robes and can enter the hospital like any other patient for treatment.
Proper decontamination procedures are essential for effective medical care, said Dr. David Johnson, medical director of the St. Vincent emergency department.
“The important thing is that your medical staff is not exposed to whatever chemical or exposure, because they can’t render care to other people,” he said.
During such emergencies, hospital staff communicate with police, fire, and Lucas County EMS to anticipate the number of patients and their conditions. Additional staff may be called in or the hospital might divert patients not related to a hazmat event to other facilities.
Emergency medicine physician Dr. Nicholas Sauber came in to work during Tuesday’s incident. In the case of possible opioid exposure, they monitor for signs of overdose, such as slowed respiration and pinpoint pupils, said Dr. Sauber, who also serves as regional EMS medical director for Mercy Health.
The hospital is better positioned than ever to handle such events, Chief D’Amore said, thanks to upgrades built into the hospital’s new emergency department that opened in November.
Construction included a new decontamination shower with an exterior entrance so patients don’t enter the hospital until they are clean, as well as a sealed tank that holds used water until it can be removed and properly disposed of.
Between the two recent incidents, St. Vincent’s team used 660 gallons of water.
Such large-scale efforts involving police are relatively rare.
Chief D’Amore recalled an October, 2010, case when two officers became ill and nine were sent to area hospitals as a precaution after a suspect was found to have illegal mushrooms and a component of the toxic chemical ricin. But the hospital’s decontamination procedures are implemented for cases large and small, he said.
That could include the person who gets accidentally doused with gasoline while working on a car or, as Chief D’Amore shudders to think about, a nuclear incident involving radiation exposure.
Should St. Vincent face an even larger event, such as a busload of arriving patients needing decontamination, the chief said, there is a separate setup in the hospital’s hangar.
Each incident is a learning opportunity, Chief D’Amore said.
“We learn a lot the more we use it,” he said. “We’re constantly improving it. If we see something that doesn’t work as we’re going through the process, we know we’re going to have to make an adjustment.”