Airport drill imagines mass casualty at Martha’s Vineyard Airport

In this file photo, firefighters spread fire-quenching foam at a simulated crash at the airport which led to mass casualties and fire. — Photo by Ralph Stewart

At 10 am Sunday morning, March 18, smoke and flames boiled out of two dumpsters and two six foot by ten foot metal cylinders near an overturned van, all scattered on the tarmac at Martha’s Vineyard Airport (MVA), several hundred yards past past the normal runway.

At 10:01, John Coskie, MVA administrator for airfield and FBO (fixed-base operations), shouted, “Aircraft in distress. The alarm’s been called.” His call came after airport supervisor Geoffrey Freeman in the airport tower received a call from the distressed plane and sent out the Island-wide alarm, beginning the response action..

His alert, 10 minutes before the simulated crash, signaled the beginning of the airport’s triennial, simulated aircraft disaster drill, required by the Federal Aviation Administration (FAA) for airports in the MVA category.

The alert galvanized Island-wide response from an estimated 80-90 public safety and emergency response to the scene by personnel from town and regional ambulance services, police and fire departments and emergency preparedness groups. The alert also went to Martha’s Vineyard Hospital, which would minister to as many as 20 passengers injured in a commercial flight “crash-landing,” that culminated in a an end-of runway collision with an occupied vehicle.

And, the U.S. Coast Guard and Massachusetts State Police helicopters hovered in the distance to provide off-Island transport.

More than 100 Island residents participated as responders in the drill, which was a success despite its ambitious complexity, MVA general manager Sean Flynn said Monday.

Two airport fire trucks arrived within a few minutes of the alarm, followed by a West Tisbury fire truck at 10:11, and five minutes later, by a Tri-Town ambulance. In rapid succession, over the next 20 minutes, fire, ambulance and medical support from all Island towns pulled onto the tarmac.

Firefighters spent the next 25 minutes putting out the “blaze,” and fire engines foamed the wet tarmac – pre-watered to stimulate jet fuel – so medical staffers could access the “victims” who were on a VTA bus nearby. The bus served as the fuselage, (passenger section) of the faux airliner.

At 10:37, EMTs were cleared to run to the victims and began aid and assessment. At 10:48, the first victim was wheeled to a waiting ambulance for transport, within 35 minutes of the crash and 11 minutes after medical staff began treating victims.

Treatment leader Ben Retmier, Tri-Town EMT, directed the off-runway triage site, where victims were assessed, then placed on red, yellow or green tarpaulins, according to the severity of their injuries. Patients were continuously monitored and their conditions upgraded or reduced, shifted from the least severe (green) to the most severe (red) as their conditions changed.

By 11:30, all of the “red” and most “yellow” patients had been transported to the hospital via a shuttle of eight ambulance and EMS squad vehicles. By noon, the scene had begun to look like a normally quiet Sunday at the airport.

Preliminary assessments

“My sense is that everyone performed in a very professional way. Response (to the alarm) was fantastic. Working with a script slows you down a little,” Mr. Flynn said. Studies show that the process speeds up even faster in real emergencies.

Noting that the simulation scenario was on a much larger scale and had greater complexity than prior triennial drills, Mr. Flynn said, “We wanted to create a scenario that tested the limits of the Island community to respond, and the response was excellent. I’m not an EMT, but I’d say response was well within the window of survivability for even the most critical patients.

“I can’t thank enough the Island people and the agencies who participated. Most of these folks are volunteers, and their professionalism is outstanding. The performance compares favorably to communities with professionals in these jobs. Island residents can feel very confident in the quality of responders they have protecting them on the Island.”

A debriefing will be scheduled within 10 days for the 25 agencies and public service groups involved in the simulation.

“We’ll develop a list of things to improve on, certainly. Things that were awkward. We’ll ask ourselves what would happen if we added 15 more people to the response team, for example,” Mr. Flynn said. Perhaps the only noticeable glitch occurred early on when a fire truck acting as a standby safety vehicle had a mechanical problem, leading the team to call another waiting truck to take its place.

Expected and unexpected crises

“That (mechanical failure) is a real-life scenario. That could happen, so we can learn from that,” Mr. Coskie said on Monday.

The FAA does not set specific guidelines but asks each airport to test its ability relative to its size and according to the resources available to it, Mr. Coskie said.

Responders, including Martha’s Vineyard Hospital, asked to process up to 20 emergency victims, are not told the scenario in advance, Mr. Coskie said, noting that volunteer victims wear a card with a story of who they are and the specifics of their injuries.

At the hospital on Tuesday, Carol Bardwell, chief nurse executive Carol Bardwell said her institution received 15 patients and used the simulation to practice the hospital’s mass casualty communication, triage, and registration systems. Patients were not admitted or assigned treatment rooms, she said.

“This incident would have been between a Level One (10-20 patients) and a Level Two (greater than 20 patients). We used on-duty staff who volunteered for the triage team and checked the triage telephone list to determine how many staff would have been available and their estimated response time. Had it been a real Level One accident, 80 per cent of the entire hospital staff would have been called in,” she said.

Ms. Bardwell noted that the hospital is involved in every Island incident training exercise that occurs and noted that the airport ‘crash’ fit with MVA policy for a mass casualty exercise each year.

Taking it all seriously

Though a simulation, both medical and safety providers and their patients took their roles seriously on Sunday. For example, victim volunteer Linda Cotto, a Dedham resident, was assigned medium priority status (dazed, confused, shallow breathing) and played her assigned role as a daughter who had been flying with her mother. “Where is my mother? She’s 75. I can’t find my mother,” she said to an attending EMT.

Her “mother”, actually a friend, Lisa Mullinix, also of Dedham, was severely “injured” in the crash and among the first victims transported to the hospital.

Eva Balboni a slightly injured Martha’s Vineyard Regional High School senior, sat with her “classmate,” Edgartown resident Joan Shemit. “We’re on our way to our 35th high school reunion,” Ms. Balboni said, holding a hand to her “injured” face.

The experience was an eye-opener for Tyler Johnson, a “victim” drenched with fuel oil. “I’m taking the basic EMT course right now. Being able to watch them work is good for me,” he said. Tri-Town EMT Heather McElhinney of Tisbury was impressed by the teamwork factor. “We rarely get to work with everybody at one time. It was good to see,” she said on Monday.

Shortly before noon, Kyle Altieri and Alex Guest, both MVRHS seniors and Edgartown volunteer junior firefighters, clambered, gear in tow, aboard a VTA shuttle bus back to the airport staging area.

“I was a victim in the last drill. I’ve been able to see the situation from both sides now,” Mr. Altieri said.

For Mr. Guest, the perspective gained about his community was compelling. “Something like this shows how many people in our community are willing to help,” he said.