Each year, Voula McDonough fills the halls of Suburban Hospital with smoke and noise from blaring horns and helps dozens of bloody patients limp across the lawn of the National Naval Medical Center.
The exercise is part of an annual mass casualty drill, a simulation of tragedy spurred by Sept. 11, 2001. McDonough, a clinical nurse educator at Suburban, coordinates the drill with officials from other hospitals. During the drills, which began six years ago, some patients act as if they have radiation poisoning.
She said the drills are meant to combat the panic she and many others working at the hospital felt on 9/11 — that they weren't prepared for the worst. She said each year since has helped mitigate that worry.
“Every drill we learn more about what we're doing well and the processes we have in place,” she said.
No casualties related to the 9/11 attacks were brought to Suburban Hospital. If there were, McDonough said, Suburban likely would not have been able to handle a significant influx of patients, such as the hundreds sent to New York-area hospitals.
The drill, and the preparations that lead to it, are organized by the Bethesda Hospitals' Emergency Preparedness Partnership, a collaboration of Navy Med, the National Institutes of Health Clinical Center, Suburban and the Uniformed Services University of the Health Sciences.
The group's mission is to coordinate medical equipment, personnel, supplies and information during a disaster in the District of Columbia or Montgomery County.
As Bethesda's largest civilian trauma response center, Suburban Hospital is central to any action, as wounded are brought there first, said hospital spokeswoman Rana Borenstein-Levy.
In the event of a major incident, the 233-bed hospital can expand to house 500 patients, she said. The partnership also has coordinated to buy an inflatable, 50-bed mobile tent. Previously, the hospital had no way of handling a workload beyond its general capacity.
The hospital uses digital tracking to better monitor patients, and sends them to NIH or other facilities for advanced care or to make room for other patients, Borenstein-Levy said.
Shortly after it was established, the partnership received a $12 million Department of Defense grant to create a laser-based telecommunications network that would connect its institutions and expand resources through purchases such as the inflatable tent.
But those funds are not as common as they once were, said Jack Herrmann, senior adviser and chief of the National Association of County and City Health Officials' Preparedness Program. His group is worried the focus on emergency preparedness will lessen as time goes on.
In 2004, the federal government spent about $850 million on emergency preparedness through the Centers for Disease Control and Prevention. This year, that number dropped to $614 million.
“Where we saw major advances, we're seeing declines,” Herrmann said. “We've made gains but risk going back to being underprepared.”
Health officials say pharmacists will play major role in disasters
To organize low-level disaster response from local pharmacies and health departments, Montgomery County's Department of Health and Human Services introduced a new website this summer.
The website, referred to by health officials as “a new toolkit,” was launched by the county's Advanced Practice Center for Public Emergency Preparedness and Response Program on Aug. 18. It was designed to showcase health studies, tips and county and state resources for pharmacists and health groups to utilize during a major emergency, such as the widespread outbreak of a disease or an incident resulting in mass injuries, said health department spokeswoman Mary Anderson.
County health officer Ulder Tillman said the aim is to get pharmacists and pharmacies in Montgomery County to work together in such incidents to ensure medical resources, such as immunizations, are administered effectively.
He said this could be seen most clearly in 2009, when fear spread across the county about an H1N1 flu — a type of influenza virus — pandemic, when demand for a vaccine to protect against the virus was high, but health officials hoped to focus its use on the certain, threatened populations, such as senior citizens.
“During the H1N1 influenza outbreak, Montgomery County relied on our pharmacy partners to help communicate to the public the urgency of the target groups getting the vaccination,” he wrote in a press release.
The website is www.rx4prep.org.