Archives for November 29, 2006

Aussie Mass Casualty Drill: "A Royal Disaster"

And lest you think I’m being judgemental, I don’t think our joint would do any better:

If the calamity sounds unfamiliar, that is because it was fiction: a massive and intricate role-play designed to reveal any cracks in the preparations of the nearby Royal Adelaide Hospital for a disaster – specifically one in which people were contaminated by chemical, biological or radiological fallout.

Pretty normal, except that the test designers did more with their victims than have them sit on the ground and wait for the school bus:

But as the actors in the so-called Exercise Supreme Truth ran around wildly, demanding medical attention patiently or aggressively in line with instructions on their individual scenario cards, it was not chinks in the hospital’s emergency armour that were exposed so much as gaping chasms…..

“Some were instructed to refuse decontamination. Another had to drive onto the footpath with a dead contaminated friend in the back. We told seven people, ‘without breaking anything, we want you to see if you can get into the hospital’. Within 15 minutes they all got in … All the focus seems to be on police and security but if there is a mass casualty incident where do [authorities] think all the people are going to end up?”

The hospital’s plan demands immediate lockdown, with entry via a single point which is strictly policed. Amid the chaos of Supreme Truth, that proved unenforceable and contaminated patients repeatedly entered “clean” areas…..

And that’s without a real disaster.  We’ve been luck so far, as regards a big intentional BW or radiological mass casualty, and I pray our luck holds out.

Beer Goggle Formula

Yes, there is now one.  In the BBC, via the Houston Chronicles’ SciGuy.

"Do you know who I work for?"

In the ED we treat all kinds of people, all walks of life, without prejudice (we strive, but we’re people, too).  And, interestingly, people like to tell me what they do when I’m chatting with them.  This is different than the medical history, and usually while performing whatever procedures we need to do.

The most reticent to tell me what they do are lawyers (and I’m just guessing here, but if I was a lawyer in an ED I’d worry a little that I’d get over-tested and overdiagnosed due to medmal paranoia; so far as I know not one of my colleagues has ever gotten as much as a phone complaint from a lawyer they took care of, and that’s the sort of thing doctors would talk about).  That kind of reticence is not the same in people who work for lawyers. 

I was reminded of this by a post from Overlawyered about the couple on a Southwest flight who (allegedly) were attempting to join the Mile High club, in coach.  One of the coitus interrupti (allegedly) said, when denied further alcohol service, “I work for a lawyer,” joining a not terribly select club of people who think their bosses’ importance in one field confers special powers to them in the ED.  Usually while drunk.

“Do you know who my boss is?” is slurred, at highly indignant volume just often enough for the staff to say, in unison “No, and we don’t care”.  It’d be terribly funny were it not for the now emasculated and indignant drunk we still have to take care of.


So far, nobody has tried to join the mile high club in any of my ED’s, but I practice pretty close to sea level.  And nobody cares who I work for.

Update: at least one lawyer says I’m right!