When the world seems like it’s about to end, life needs to go on, at least according to Thomas Hayes.
Hayes, the director of human resources operations at the Ottawa Hospital, is in charge of the emergency preparedness office. When an emergency happens in Ottawa, whether big or small, his job is to ensure hospitals are ready to deal with any number of situations.
In an emergency, the first thing is dealing with a surge of patients, he says.
“We’re used to patients coming into the emergency department,” Hayes says. “But when you have a surge of 20 or 30 patients all coming at once because there was a bus crash, you have a totally different situation. You’re likely to overwhelm the emergency department,” he says.
To deal with situations like these, Hayes says Ontario hospitals have plans in place for what they call a Code Orange.
A Code Orange involves any event with mass casualties, according to Hayes. It’s a standard from the Ontario Hospital Association, and covers everything from fires in large buildings to heat waves, plane crashes and train derailments. When a Code Orange is declared, the emergency departments in the Ottawa Hospital get the authority to decide where and how to treat patients, Hayes says.
“We can fairly quickly get clinical leadership from staff involved,” Hayes says. “And getting patients out of the [emergency department] quickly into the units, whether we need to open up a unit that’s closed, or whether we need an extra patient on a unit.”
Second to dealing with surges in patients, emergency preparedness is mainly an infrastructure problem, Hayes says. This involves having the resources to perform necessary procedures, even when resources are scarce or failing, such as during an extreme weather event.
“For example, if there’s a prolonged power outage like the ice storm that results in a lot of power being out, hospitals will have emergency generators,” Hayes says.
The generators can run the hospital for days at a time, according to Hayes. If an emergency takes longer, the hospital has service agreements in place to get replacement fuel before it runs out. If for some reason the replacement fuel runs out or becomes unavailable, then the hospitals start prioritizing areas that need power.
“We can turn off the area in an administrative area, and turn off the water and the air, to make sure that we have enough left over for critical care areas,” he says.
Darryl Boyce, Carleton’s assistant vice-president (facilities management and planning), says Carleton has very similar procedures in place in case of a large disruptive emergency. Carleton’s generators can power a building anywhere from eight to 24 hours, according to Boyce.
In addition, Boyce says Carleton has a power distribution system in place that would ensure vital places get the power they need.
“It really provides enough power to continue the operation of fire alarm systems, safe lighting levels for the buildings, it’ll maintain heating system pumps for the building,” Boyce says. “Those sort of basic functions that would allow the building to continue to operate in cold weather in a safe manner.”
For a large disaster, like a nuclear bomb being detonated downtown, Hayes says in addition to hospitals, the fact that Ottawa is a national capital means several players would become involved.
“We have the city, we have health-care services, but also in the city we have military services and the federal government as two major players in disaster response to the city,” he says. “In that kind of a scenario, certainly the federal government and military services would have huge roles to play.”
For the hospitals, Hayes says it comes back to prioritizing procedures and efficiently using the resources available.
“We sit down and look: what are the things that we can’t do anymore either because part of our building or infrastructure has been destroyed or taken away from us? What are the things we can’t do anymore because we don’t have enough people?” he says.
That said, prioritizing treatments can get controversial because people can argue over which procedures are more important, according to Hayes.
“Essentially, it will boil down to deciding what are the things that are most critical that will serve the public the best, and what are the clinical treatments that can wait,” he says.
In the end, both Hayes and Boyce agree that Ottawa and Carleton are reasonably well-prepared for a large-scale disaster or apocalyptic event.
“In terms of large-scale disasters, the city is actually fairly well-prepared, and hospitals have good plans in place as well,” Hayes says. “You do the best that you can.”
