PREPARATION: Emergency responders, educators participate in simulation

NASHUA – The playground of Ledge Street Elementary School was the site of a gruesome scene Friday afternoon featuring bodies of children wrapped around swing sets, propped against a chain-link fence, and wedged under the front tire of a crashed car.

These were not real bodies, however, but life like mannequins dressed in jeans and active wear, their faces, knees and arms covered in carefully painted wounds made to mimic ones sustained from a car accident.

The display was created by Southern New Hampshire Medical Center in collaboration with the Nashua Police Department, Nashua Fire Department and American Medical Response, and Ledge Street School staff members to simulate a pediatric mass casualty incident. The scene involved a driver, distracted while texting on their phone, speeding through the school zone, veering off the street, and crashing into Ledge Street Elementary School’s crowded playground.

Southern New Hampshire Medical Center Director of Emergency Management Mark Hastings: “I’ve been working with the city’s responders now for a little over 11 years on disaster management exercises and training, but we’ve been working on this particular one since February. We try at least once a year to have a joint effort like we’re doing here in a high-risk type of area.”

The main goal of the exercise was to evaluate systems’ preparedness in the event of a community disaster. Organizers also provided training materials to emergency responders, as well as directors and educators connected to the Nashua School District through the production of a simulation recap video and photos.

“This was something we’re definitely happy to be a part of,” Nashua School District Assistant Director for Safety & Security Christopher Lessard said.

“Anytime that we can be involved in emergency planning, it’s a benefit to us, as well as the first responding agency, so we’re very enthusiastic about helping out.”

American Medical Response Regional Director Christopher Stawasz said children who have suffered serious injuries require different levels of care in comparison to adults.

“It’s a really good opportunity for us to practice in a controlled setting where we can sit down later and learn what we can do better,” he said.

Through the accident was staged, all parties involved strived to simulate a very real and accurate response to the situation, considering not only the role of the emergency responders, but how teachers, parents, and patrons of the park might react to such dire circumstances. Southern New Hampshire Medical Center even brought professionals from Arrow Security in Nashua who are experts in putting together disaster simulations. They worked on the moulage, creating convincing injuries on the mannequins to increase the realism. They also applied clothes and placards that described the nature of the child’s injuries.

“We wanted to make it as realistic as possible in order to prepare for a scenario like this,” school Principal Chas Miller said. “Pediatric mass casualty tends to scare people. It’s a daunting exercise that’s hard on both the staff here and the staff at the hospital because it puts them well beyond their comfort level.”

Onsite, at the start of the simulation, were role-playing bystanders and parents of the wounded “children” as well as the real staff and principal of the school. As the parents and bystanders frantically called for an ambulance and panicked over the critical state of their children’s injuries, the principal and staff members rushed to help the victims. They did their best to calm everyone as they activated the 911 system and waited for professional assistance.

The school staff participants included front office personnel Lisa Moreau and Blanca Chavez who both work in the school’s front office, as well as Miller.

“As a principal, it’s hugely important for me to be able to see exactly how multi-agency emergencies happen and how the agencies react to one another,” Miller said. “If something ever did happen, I’d have a greater idea about what to do when everything comes together. It’s one thing to see it on paper, but it’s even more effective to actually see it in action.”

After the 911 system was activated, a rush of emergency officials soon arrived to tend to the situation. Police asked questions and reported on the number of injured adults and children, in addition to working to determine the cause of the accident.

Firefighters and AMR officials assessed the severity of the injuries, applied tourniquets, and performed CPR when necessary. School staff members continued to act as mediators, comforting both the parents and the injured children, applying pressure to wounds, and assisting the responders when necessary.

The “patients” were then either strapped to gurneys and backboards, or simply carried by firefighters from the playground to ambulances. After receiving additional attention in the ambulances, the victims were transported to the Southern New Hampshire Medical Center ambulance bay for treatment.

The simulation concluded with a debriefing in the hospital’s boardroom, exploring what went well during the exercise and what could be improved in the event of a real emergency.

“Distracted driving is a big concern,” Nashua Police Lt. Carlos Camacho said. “We’re doing everything we can to educate people on ways to stay safe while driving, especially encouraging them to stay off their phones and concentrate on driving. The more we tell people about distracted driving, the more awareness it brings and the less people will do it. Just like, the more you train, the better prepared you will be for any event that happens.”

The knowledge will be applied to real mass casualty events, while a video documentation of the simulation will be available for use, especially in training schools, hospitals and local business on how to respond in emergency situations.

“I think everyone can benefit from a simulation like this,” Hastings added. “It’s a great training venue and we’re just happy to provide it to the public.”