More than a dozen ambulances raced to a Delta farm this weekend, as B.C. Emergency Health Services responded to one of their biggest calls of the year in the region.
It’s what the agency calls a “mass casualty event,” with dozens of potential victims, some in serious to critical condition. More than 40 people were taken to hospital for carbon monoxide poisoning after they’d been power-washing a greenhouse.
Despite the confusion at the start as to what exactly happened, the response was “very, very well executed,” BCEHS executive vice president Linda Lupini told Black Press.
“The call came in … as symptoms that the patients thought were related to cleaning fluids: itchy, stinging eyes, dizziness and not feeling well generally.”
The 911 dispatcher ran the caller through a series of questions prompted by the medical dispatch priority system, a computer program that tells dispatchers what questions to ask based on the answers they input.
“They’re trained to use a system because human judgment in those situations is important, but in a secondary way,” said Lupini. “This computer system is better than most individuals.”
Dispatchers still have access to about 30 on-call doctors around B.C., as well as an advanced care paramedic sitting in on the call.
‘Well executed response’
In a press release issued by the company on Dec. 10, Windset farms said workers were disinfecting the greenhouse with gas-powered pressure washers in preparation for the new crop, something that happens annually at this time of the year and which the company says is considered standard practice in the industry.
When the first employee reported a feeling of being unwell, the on-site health and safety team took immediate steps to evacuation of the greenhouse, called for emergency support, and began triaging those most affected.
The first emergency responder sent to the Delta farm was a technical advisor who assessed the scene, Lupini said. They, as well as all other paramedics, are equipped with carbon monoxide monitors that begin to buzz when entering a contaminated area.
Thirteen ambulances were deployed. Paramedics assessed 10 patients in critical condition, and 32 in stable condition. Then, they began looking for hospitals to take the unexpected influx, as well as determining the most efficient means of transportation.
“In this case, it was clear that most of the patients weren’t severely impacted, so they were put into a bus with four paramedics, some equipment, and then paramedics following the bus,” said Lupini.
The bus delivered patients to hospitals throughout the Lower Mainland: Surrey Memorial, Royal Columbian, Burnaby Hospital, Lionsgate and Vancouver General.
The most severe cases went to the closest hospitals that could treat them: Delta Hospital and Richmond General. Most hospitals can provide the oxygen needed to treat carbon monoxide poisoning, but not all have hyperbaric chambers for the follow-up appointments that the most severely affected patients will need.
“That chamber is pressurized in such a way that massive amounts of oxygen go through your system and replace the carbon monoxide in your body,” said Lupini.
Carbon monoxide poisoning prevents oxygen from circulating properly. The initial symptoms are often flu-like; nausea, headaches, light-headedness. Left untreated, the lack of oxygen will start affected organ functions which can lead to seizures and a coma.
In a press release, Windset Farms it will ensure its workers receive whatever follow up care they require over the coming days and weeks, adding it’s people and their health and safety in the workplace is the company’s top priority.
The farm will be reviewing the incident and considering what changes to its protocols are needed, as well as “working with both public and private agencies to fully understand and further strengthen our response and programs.”
“We are grateful to our site management, our health and safety officer, and our first responders for taking immediate steps to ensure everyone’s safety.”
BCEHS Director of Patient Care for Vancouver Samantha Wilbur explains the paramedic expertise and high degree of coordination with other agencies involved in dealing with the mass casualty chemical incident yesterday at a Delta farm. pic.twitter.com/KX5vgq1utu
— EmergHealthServices (@BC_EHS) December 11, 2017
Paramedics can fall pray to carbon monoxide poisoning too and are required to take a high-risk hazards course and come equipped with personal protective gear. The course also prepares paramedics for other hazardous substances, such as fentanyl, although Lupini said there’s been no recorded instances of that, despite widespread concern.
“The training teaches front-line paramedics not to just run into a scene and not to assume.”