Jan. 17, 2003 – Triage is the key to saving lives, a consultant to the V.I. Territorial Emergency Management Agency said Friday at the first VITEMA disaster drill ever held at the Myrah Keating Smith Community Health Center on St. John.
"You have to prioritize hazards," Milton Jacobs of Safety Solution Consultants, a firm based in Springfield, Massachusetts, said.
"Triage," an old military battlefield medical term, refers to sorting those in need of help into categories or classifications, determining who needs immediate attention and who afford can wait until the more pressing cases are attended to.
Jacobs led VITEMA and its allied agencies through the day's mock-disaster exercise. While the various agencies often have drills, this was the first time all had come together.
The exercise had three separate disasters happening at the same time. In one, a man was down a cliff — in this case, the health center's sloping front lawn — complaining loudly of a neck injury. In another, two visitors showed up at Myrah Keating Smith's front door with smallpox symptoms. In the third, the health center was experiencing a gas leak.
Chaos reigned, but Jacobs said that was good because the participants would learn from their mistakes. "We've got lots of opportunity here," he said.
On the positive side, he said, everyone pulled together and the equipment worked well. A big problem, though, was communication.
But "communication is always one of the major ones," he added.
Marty Alperen, president of St. John Rescue, pointed out after Jacobs' comments that St. John faces huge electronic communication problems. He said the island does not have enough repeaters to send cellular telephone signals across the hilly terrain, "and there's not enough mutual communication."
Alperen, commenting that "we all have room for improvement," said volunteer group members learned a lot from their rescue of the neck-injury patient. St. John Rescue members couldn't locate the cervical collar needed to stabilize the patient because it had been stashed in the wrong bag. But he said he was pleased that the members had no trouble using the winch attached to the organization's rescue vehicle.
In the case of the apparent smallpox victims, Erica McDonald, Myrah Keating Smith administrator, said that normally such individuals would be admitted to the health center through the emergency room, located on the east side of the building. However, since the third-scenario gas leak was occurring in that area, the two people had to be directed to a nearby ambulance for evaluation.
McDonald said they could not be allowed to enter the center through the front door because if they did, indeed, have smallpox, they could contaminate the entire building, "and then we wouldn't be able to treat anybody."
The V.I. Fire Service did not have trucks on hand to deal with the supposed gas leak, but McDonald said it was the appropriate agency to deal with that problem.
Fireman Elvis Lewis pointed out that a static spark from an emergency radio could ignite the leaking gas and cause an explosion.
The exercise drew about 50 people from St. John's emergency response groups — government services, volunteer agencies and businesses. Afterward, the participants gathered at VITEMA headquarters to discuss ways of addressing their shortcomings so that next time they'll do better, whether it's another mock-disaster drill or the real thing.

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