thinking out loud - Logan Airport Disaster Plan

thinking out loud - Disaster Plan for Logan Airport

10 injuries to 1 million injuries

1. dispatch all fire and ambulance units within 128 - call back off
duty staff to man extra units - get coverage from outside of 128

2. have a procedure to use off duty doctors, nurses, medics etc -
either from airport terminals or nearby hotels or nearby neighborhoods
- have them report to north staging or south staging - wand them with
a metal detector and then drive them via any available vehicles to
disaster site

3. put cordon around area - make sure no one slips thru staging areas
or over airport fences - use MSP and BPD and suburban PDs and feds

4. use medevac helos to bring MDs to scene from Worcester,
Springfield, Hartford, Portland ME, Albany NY, etc - land the helos at
Logan - have MDs set up MASH onfield - use helos to fly critical
patients to trauma centers in Springfield MA + Hartford CT + Albany NY
+ ?Nashua NH? + ?Manchester NH? + Providence RI

5. helicopters cant fly in bad weather so alternative plans are needed
- maybe commuter trains could be used - coast guard helos - any IFR
helos - medevac planes etc

6. of course all hospitals in eastern mass will be on disaster alerts
- hopefully 100 operating rooms would be available - the hard part
will be getting the patients from Logan to the hospital

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timeline

Boston has 4 or 5 trauma centers - so hypothetically 5 victims could
go directly into surgery upon arrival at the trauma centers - then
some more could go to Lahey Hospital and South Shore Hospital - and a
couple more could go to Worcester or Providence

Within one hour - hopefully 50 more operating rooms would be available
- Everett, Newton, Cambridge, Boston, Milton, etc

Also within 1 hour - medevac helos would land at logan with 5 trauma
surgeons - hopefully they could do surgery at the Logan fire station

Therefore - the triage goal for the first hour - is to send 5 to 10
critical victims to Boston area trauma centers - and - 0 to 50 less
critical patients to eastern Mass hospitals - and 5 less critical
victims via medical helicopters to out of state trauma centers

This is the best case scenario that we can see at this time

Worst case scenario might be 600 burn and trauma patients - there
might be no advantage to running any sort of triage in this case - the
only question would be 'which hospital should victims go to?" - a good
rule of thumb might be - if you are a Brockton ambulance, then you
should go to Logan and get 1 or 2 patients and take them to a
Brockton hospital - if you are a Lowell ambulance - you should get 1
or 2 patients and take them to a Lowell hospital - this will make
distribution of patients much easier

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Lets look at this another way

time 00 minutes post crash - 500 critical patients at scene
time 15 minutes post crash - 10 patients enroute to trauma centers -
490 patients at scene
time 30 minutes post crash - 40 more patients enroute to hospitals -
450 critical patients still at scene
time 45 minutes post crash - 50 more patients enroute to hospitals -
400 critical patients still at scene

Looks like 400 people are going to bleed out waiting for an ambulance
to arrive - or waiting for an operating room to open up - maybe not -
if medics can get tourniquets and IVs into 400 people in 1 hour - 1
medic can do 10 people in 1 hour - gonna need 40 medics at scene fast
- if all of Logan Fire and Logan Police were medics - that might be
possible

Interesting
time 0030