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February 2010

Suburban On Alert

By: Karen Blum
Date: February 4, 2010

The Bethesda Hospital practices annually with its partners to guard against catastrophic emergencies.

Nurse Taryn Giza (center) from the Emergency and Trauma Department cares for a mock patient.
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Nurse Taryn Giza (center) from the Emergency and Trauma Department cares for a mock patient.

Cindy Notobartolo and her colleagues at Suburban Hospital, located just seven miles from the nation’s capital, have prepared for just about any disaster you can think of. And probably a few you can’t.

Notobartolo, corporate director of emergency/trauma, safety and security services at the hospital, coordinates the medical center’s participation in a powerful emergency preparedness network that combines the resources of Suburban, the National Naval Medical Center and the National Institutes of Health Clinical Center.

After 9/11, when terrorists struck the Pentagon, leaders at the three institutions realized that they didn’t really know each other and met to discuss how they could work together in an emergency. During their session, Navy Vice Admiral Donald Arthur pointed to an aerial photo of Bethesda that included the three hospitals and said, “We have here a medical megaplex,” recalls Suburban CEO Brian Gragnolati. “By creating a partnership among a military facility, a research organization and the regional trauma center, we could do something very different here.”

In 2003, the hospitals launched the Bethesda Hospitals Emergency Preparedness Partnership to establish an infrastructure for emergency medical response that would far surpass what each could do individually. The National Library of Medicine joined two years ago.

Using money from a $12 million grant from the Department of Defense, the partners have purchased emergency medical supplies, including a 50-bed inflatable, mobile tent for treating patients. The tent has generator capacity for heat and air conditioning, and electrical power for medical needs like oxygen. A laser-based telecommunications network now connects the institutions so they can communicate needs or see into each other’s command centers by videophone. They’re also developing computer-based disaster-training modules that allow staff to participate in exercises in a virtual world.

The network stages annual mass-casualty exercises involving thousands of participants, including the partnership’s hospitals and community hospitals; local police, fire, EMS and public health services; and even the National Guard, which one year airlifted some mock patients to treatment centers in North Carolina. These exercises, which started in 2004, have grown more elaborate each year. “We try to push the boundaries as far as we can,” Notobartolo says.

Last fall’s scenario featured several mock explosions in downtown Bethesda buildings and at the National Naval Medical Center. Then, each of the Montgomery County community hospitals discovered a suspicious package. Through it all, participants worked together quickly to triage or accept hundreds of mock patients, while others helped evacuate units in hospitals with potential bombs.

Another goal of the partnership is to expand the science of emergency management. Coordinated by National Library of Medicine scientists, 11 projects are under way to improve disaster care.

One is testing the use of a radio-frequency-identification device to track patient movement throughout the hospital. Another, called the “lost person finder,” aims to reunite disaster victims and their families by capturing and posting online patient information, including photos. In the triage area, scientists are testing a digital pen containing a tiny camera that records triage notes as they’re being written. The information can be transferred to an electronic database where it immediately becomes available to clinicians and decision-makers in the hospitals’ emergency command centers.

—Karen Blum