Dr. Etienne van der Linde has spent his entire career preparing for the call his emergency room received on the afternoon of September 2. The procedure has been massaged into muscle memory over the course of 21. years of practice, lying still until the right words come into play.
Code orange. Mass casualties. Be ready for anything.
There was an explosion at the refinery at Come By Chance, about 45 kilometers off the Trans-Canada Highway on the Isthmus of Newfoundland’s Avalon Peninsula. Eight people were injured, some critically.
What followed was an event that experts say has the potential to overwhelm emergency services in even the busiest cities in Canada, but it was quickly handled by the cooperation of medical staff. medical staff, firefighters, pilots and staff, centered on a small eight-bed emergency room in Clarenville.
Questions remain about what caused the explosion, but one thing seems certain – the actions of the responders saved these people’s lives that night.
“It has been a humbling experience to be in a department that observes professionals,” said Van der Linde, head of emergency services at GB Cross Memorial Hospital in Clarenville. “I think many of the teams on our staff are proud of what they have achieved in this event and I think they have reason to be proud too.”
The worst-case scenario comes just after 4pm on September 2 – the end of a workday to head into a long weekend. When reports surfaced of a possible explosion at the Come By Chance refinery, paramedics from the Lesser Ambulance Service were ready to arrive on the scene.
When Dion Park, the hospital’s senior site manager in Clarenville, was alerted to the situation, he called up Code Orange – a rare move that is only triggered when an unforeseen disaster has struck and Mass casualties are expected.
When the call went off, staff started flooding the hospital.
“We have employees who report for work but are not reported to work. We have employees who stay on the day shift, employees who arrive early for their night shift,” Park said.
By 5 p.m., the first injured workers arrived at the hospital. Employees were not authorized to talk about their condition, but witnesses from the scene said workers were dealing with severe burns from the flash fire. A total of eight people were injured, and seven required ventilators.
Van der Linde said workers were met with a “whole team response”. Nearly every healthcare worker in Clarenville is there to do their part.
“We have three ER doctors, one ER nurse, one surgeon, two general internists, one anesthesiologist, a respiratory therapist, a team of about 16 to 20 nurses, X-ray technicians, labs, and ancillary resources all play an important role.”
But as more casualties began to arrive, it became clear that the full replenishment of the Clarenville hospital would not be enough. Most patients will need to be sent to the Health Science Center in St.
The Health Science Center began moving patients out of the intensive care unit, taking them across town to St. Clare’s Mercy to prepare for the incoming workers.
Call for support by plane
By 8 p.m., staff at GB Cross had stabilized the three patients to the point where they could fly – but there was a problem.
The hospital only has a small helipad, not large enough to land the type of aircraft they need to transport patients along with the necessary medical staff and equipment.
There was an unorthodox solution – the police moved quickly to block the road around the hospital and round up the Sobeys parking lot next door.
By 8:45 p.m., a Cougar helicopter touched down on the paintwork between the trunks, followed by a massive Cormorant search and rescue. The first three patients were loaded onto the ship for transport, flanked by healthcare workers as dozens of shoppers and bystanders watched.
“It was a bleak experience. Everyone was thinking about the workers and their families, but the response from the emergency personnel was impressive,” said Peter Troke, a Clarenville resident who was standing nearby. “Cleaning up the Sobeys parking lot was quick and efficient, but it also highlights the need for a safe, appropriate helipad in Clarenville.”
The patients arrived at 10 p.m. and headed to St. John’s. It was a moment that would stay with van der Linde forever.
“The success of this event involved the teams perfectly, no questions asked, coming and ready,” he said. “One thing that’s important to the public – when you need it, the system won’t devote any resources to giving you the care you’re asking for.”
The helicopter landed at the Medical Science Center around 10:30 p.m., and the patients – hooked up to machines and covered with blankets – were transferred to a waiting ambulance. They were met at the emergency room door by staff in scrubs, masks and gloves, and opened the door inside.
Two more patients will be transported overnight. The five injured workers remained in hospital at the Health Science Center on Friday. Three people were treated and discharged from the hospital in Clarenville.
Van der Linde says the feedback from his colleagues signals the capacity of smaller hospitals in the province, but it also exposes gaps in areas where those facilities are facing shortages. serious shortage of staff.
“This is an event that makes you think about how important it is to have rural care facilities open and ready to care for you,” he said.
A shortage of doctors has led to temporary emergency room closures in towns such as Whitbourne, Baie Verte and Buchans – each of which is close to industrial sites handling hazardous materials and machinery.
Van der Linde says every second matters in a mass casualty event, and driving through a closed emergency room can be devastating – especially in places where the next doctor may be away more than 100 km away.
He hopes those emergency rooms will find a way to stay afloat, and believes the powers given to them will make them a priority.
“Rural people matter. They deserve access to urgent care and they have the right to urgent care.”