Planned exercise improves emergency coordination

Shots ring out from inside Beebe Healthcare's medical center. Police storm the building. Helicopters circle overhead as paramedics and ambulances speed down Savannah Road.

With all the intensity of a true emergency, a planned exercise took place Dec. 12 at Beebe Healthcare, testing the readiness of local agencies to respond if an active shooter were able to enter the hospital.

Cheryl Littlefield, Beebe emergency management coordinator and a trauma nurse, said the exercise was staged to include every emergency service agency that would be involved in an actual event, including Lewes and Delaware State Police, Sussex County Emergency Operations Center and county paramedics, Lewes Fire Department, LifeNet, Delaware State Police Aviation Unit and Delaware State Police Victims' Advocates.

Joseph Hopple, spokesman for Sussex County Emergency Medical Services, said bringing all the emergency groups for a training session is always effective.

"Anytime we get to practice something that's unusual, it's a success for us," he said. "It brings all the agencies together."

As the scenario played out in two sealed-off hallways in the hospital's emergency department, evaluators watched every move with clipboards in hand.

Littlefield said the exercise was unlike any other the hospital has conducted. “This one hit real close to home because everything changes when it involves the staff and the hospital becomes a crime scene,” she said. “Even though people were playing roles, some got overwhelmed; it really affected some people. The emotional component plays into it.”

In the scenario, a distraught husband barged into the emergency room looking for his wife, who was being treated after being hit and abused. As two hospital security guards confronted him, he pulled a handgun from his backpack and shot them.

He then went from room to room firing shots as he went through the halls. In all, about a dozen people received mock wounds during the exercise.

Littlefield said domestic abuse is something hospital staff deals with on a regular basis in the emergency department. “We've had people come looking for their partner before, but not with a gun,” she said.

As soon as 9-1-1 was called and the hospital alarm went off, the hospital was put on lockdown. “That means no one comes in and no one goes out,” Littlefield said. “That includes trauma surgeons and other hospital staff who are trying to reach the hospital.”

Because of that, the first line of treatment is hospital staff in the immediate area.

The gunman eventually was subdued by two Lewes police officers as state troopers followed up to secure the scene and provide safe access to the victims. Lewes emergency medical technicians and county paramedics went into action to prioritize the injuries; the most serious were treated at Beebe, while others were transferred by helicopter to other area hospitals. The county's mass casualty plan was instituted during the exercise, which puts other hospitals on alert.

Littlefield said once the scene is secured, police take over. “We still run the hospital, but we take recommendations from them. It's a unified command,” she said. “We hope something like this never happens, but it's something we have to practice.”

If Beebe were ever closed for an emergency, Hopple said, paramedics would have to decide where to transport sick patients from the area who would normally go to Beebe for treatment. The exercise helped EMS personnel think about what they would do, he said.

The fact that the exercise occurred the same week as the anniversary of the Sandy Hook Elementary School shooting was not lost. “We know this kind of emergency has been happening around the country, and it could happen here,” Littlefield said.

The exercise occurred a week before a gunman entered a medical facility in Reno, Nev., and killed one person and wounded two others before taking his own life.