Girding for battle vs. bioterrorism

“Ready to go to war, man?” Wasiu Ojuolape, a member of Washington Hospital Center’s Protective Services staff, said lightheartedly to colleague Chine Livingston during a recent training session in the Emergency Department’s extra-spacious Ready Room.

The remark was apt in more ways than one.

Mr. Livingston and others were encased in bulky protective suits and about to don hooded shields that, when tucked into place with breathing apparatus engaged, would seal them off from the outside world. When fully uniformed — complete with sidearms — the assembled group resembled moon people intent on some kind of special earthly mission, which in a way they were.

Protective Services personnel are the first line of defense responsible for guarding the hospital center and helping with victims in the event of a natural or man-made catastrophe that could be a chemical, biological or radiological attack.

Practice sessions directed by Craig DeAtley, a former paramedic and physician’s assistant who is deputy director of the center’s Institute for Public Health and Emergency Readiness, are held periodically for personnel in different hospital departments to rehearse routine procedures in the event of such a dire emergency.

The institute is part of the center’s grand plan — Project ER One — to erect within the next few years a state-of-the-art emergency facility called ER One that would be a national model of its kind.

This particular day, trainees were reviewing the 24 steps required for putting on the special clothing and equipment that would be needed in the event of a major chemical, or possibly biological, attack. Each set of clothing and equipment costs $1,250; not all of it is reusable; and ideally it should be donned within a few minutes’ time.

The steps on printed reminder sheets led off with a suggestion to drink between 6 and 12 ounces of water beforehand to prevent dehydration while inside the crinkly air-filled suit, which sounded like popcorn exploding when personnel ran around outside testing the suit’s flexibility.

They were taught how to handle stretcher cases and wheelchair patients as well as the proper use of handcuffs and their hidden sidearm. Later, they entered a mock decontamination chamber before doffing the suit and equipment and storing them in an outsized black satchel.

Training like this has not been unusual at Washington Hospital Center ever since the institution took the lead locally in upgrading its emergency medicine department, headed for the past nine years by Dr. Mark Smith.

The hospital, located two miles from Capitol Hill and the largest in the Washington area in terms of number of beds, had a bioterrorism task force in place in 1997.

Its major effort to date includes a congressionally funded study and design for ER One, introduced in May 2003, that cost $2.2 million. The hospital is pledged to contribute $25 million to $50 million for any future building, Dr. Smith notes, because it already had planned to construct a new emergency center of some kind.

In 1999, he and a colleague, Dr. Craig Feied, had gone to Capitol Hill to get support for their new concept.

“We felt that, in the event something occurred, Washington Hospital Center would be a major receiving center, and no one had thought how to design an emergency preparedness center that was optimized to take care of the medical consequences. ER design had not really progressed,” he says, crediting the offices of Sens. Alan Specter and Bill Frist as being instrumental in getting funds for developing the design.

“In 1999, we were like someone else making statements no one believed,” he says.

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