AAMI News April 2018

When Disaster Strikes: How HTM Rises to the Occasion

Hurricane Harvey
Experts say preparation is key to meeting the challenges associated with disasters such as Hurricane Harvey.

On Oct. 1, 2017, Stephen Paddock of Mesquite, NV, killed 58 people and injured 546 on the Las Vegas strip, testing the disaster preparedness and collaborative teamwork os six local hospitals as never before.

“Our emergency department was notified by emergency medical services, and we saw 26 gunshot victims,” says Kyle Sprague, director of plant operations/environment of care and a safety officer at Valley Hospital Medical Center in Las Vegas. “We’re not a trauma center, but we do get gunshot and stab wounds, which typically are transported to the county Level I trauma center across the parking lot.”

Certain pieces of equipment, including transport ventilators, defibrillators, and ancillary monitoring equipment are maintained and on standby, “just for emergency management purposes,” Sprague said. Still, he couldn’t help but imagine how, under such trying circumstances, an equipment failure in the operating room (OR) would have magnified the level of catastrophe.

“With such an influx of patients of a critical nature, if equipment failures had occurred, it would have been a double whammy,” said Sprague. But because of the facility’s diligence and preparation, the patient care team was able to meet the challenge head on.

Hospitals must conduct an annual hazard vulnerability analysis to prepare for major man-made and natural events. Sprague said that staff review the emergency operations plan annually. Similar to HTM staff assessing and assigning levels of risk to medical devices, risk mitigations also must be put in place for hazards related to potential disasters, such as utility or equipment failures resulting from natural events like floods.

Basement flooding during Hurricane Harvey, which dropped 50 inches of rain in parts of Texas and Louisiana in August 2017, was a problem at the Michael E. DeBakey Veterans Affairs (VA) Medical Center in Houston, according to Rola Omoruyi, chief biomedical engineer at the facility.

“During Harvey, our crucial server room with 170 servers suffered a lot of leaks,” she said. “That could affect equipment almost everywhere, and it’s an ‘aging’ area. At first, we couldn’t locate the leaks. We realized they were below a landscaped area with planters that was not completely covered on the outside.”

Rain didn’t compromise the hospital’s electrical system, though the leaks gave HTM staff more than a few headaches. “After that, we worked with engineering to implement a project to fix that for the future,” said Omoruyi.

At the VA, every department, including HTM, maintains standard operating procedures and contingency plans. Omoruyi’s team also stores and maintains portable ventilators that are only used during emergency situations.

“Knowing Harvey was coming, but not knowing how bad it would be, we positioned all of those ventilators in critical areas in case we lost power,” she said. “They undergo annual preventive maintenance, but we checked them carefully before the hurricane struck. We also informed everyone who might need them, such as respiratory therapists, of their exact locations.”

Some HTM staff slept at the hospital for three or four days, rotating shifts. Omoruyi’s team also interfaced with other facility staff at twice-daily meetings where anyone in the system could call in to report or ask questions. “We also held a major meeting before Harvey with our surgery and biomed departments, and we discussed potential problems,” added Omoruyi.

Staff identified rooms to receive emergency power, those critical to overall operations that must be utilized. “We needed to have enough power cords and outlets available if power went down and we had to switch equipment,” said Omoruyi. “Thankfully, we didn’t lose power, while other hospitals around us did. We had learned a lesson from Hurricane Ike in 2008, and all wiring had been installed underground.”

This article was excerpted from a feature by Stephanie Stephens that was originally published in the March/April 2018 issue of BI&T, www.aami.org/bit.