Regional Preparation Key at Minneapolis Bridge Collapse

     The lead EMS agencies responding to this summer's collapse of the I-35 bridge across the Mississippi River in Minneapolis all credit one thing for the success of their coordinated response - preplanning.

     The Wednesday, August 1 collapse spurred a major interagency rescue operation in which responders initially faced confusion about the location of the incident, the scope of the incident, and how to reach disaster areas rendered inaccessible by normal routes.

     The Minneapolis Fire Department's first-arriving deputy chief served as IC and established unified command, said fire department EMS Director Charlotte Holt. Hennepin County Medical Center (HCMC) EMS Branch Director Tom Ward was in charge of staging EMS and consulted with IC on patient numbers and movement.

     "As you might expect, there was a lot of chaos and mayhem initially," Holt says. "We had people still trapped in vehicles, people that were actually in the water swimming to shore or to the bridge segment that was in the water. We had a number of injuries and fatalities that were spread across the entire span of the bridge collapse."

     Holt says she can't speak highly enough of the job EMS supervisors and personnel did in getting ambulances into each sector of the response area. Almost all of the patients-who surprisingly totaled only about 50-were transported from the scene within one hour and 53 minutes. A final group was removed later by pickup truck.

     Area responders have been networking since at least 1999, when they established the Metropolitan Medical Response System, Holt says. For several years they have also followed a common response plan for mutual aid and major incidents.

     "There wasn't anybody in the command post who didn't know each other's name, their role and their capabilities," she says. "That's what a lot of emergency preparation is all about-establishing those relationships, being aware of what resources you have available to you and feeling confident everyone will do their job. That was a great thing, and I think certainly we can be proud of that."

     Holt says it begins with sitting down at a table and saying, "What if?" Agencies must then come up with a plan, train on it, and work together at every opportunity. This may aid in the response from both a logistical and a personal standpoint.

     "I don't think you can ever be ready for having to deal with catastrophe," Holt says. "I don't think you can ever completely prepare yourself emotionally for having to handle something like tough decisions about triage-but you can put in place the systems that will carry you through."

     Ward says the bridge incident was of a magnitude greater than most previous training scenarios, but these had prepared them for the same issues.

     Ward's responsibility to position EMS personnel at the scene involved finding alternate routes due to bridge wreckage and overcoming confusion about compass directions; most of the region's bridges run east/west over the Mississippi, and many people were unaware that the I-35 bridge runs north/south, confounding their attempts to discuss locations. "It was stunning how confusing it got," he says.

     Also, one issue surfaced that had escaped previous scrutiny-control of EMS radio traffic. The rescuers' 800MHz system was adequate, but the primary EMS channel was overrun by at least 29 ambulances, 18 supervisors, three doctors and other staff, despite the availability of additional channels. Ward says a more robust EMS communications plan will need to be developed.

     While Ward sees room for improvement, "For all the things we can comment about," he said, "people took initiative where they needed to, understood how everybody's role fit into the big picture, and by and large rose to the occasion and got the job done very quickly. It was quite impressive."

     Any delays were the result of problems getting ambulances to collection areas. Once in position, personnel loaded up patients quickly, as the message to all responders was to focus on BLS treatment and get moving.

     HCMC EMS Director Martin Van Buren adds that mutual aid played a key role that day not only in responding to the emergency but in backing up HCMC to provide regular EMS coverage.

     "The region acted as one system... that's what it was designed to do," he says. "All the work we did to build relationships and to ensure that we support one another paid off in the long run."

     The principal mutual aid partners to the disaster response were North Memorial Medical Center and Allina Hospitals and Clinics, with numerous other agencies contributing.

     North Memorial Ambulance Operations Supervisor Jeff Czyson, who was stationed at his ambulance headquarters during the response, said one of his agency's contributions was actually to help contain the response by sending just six ambulances until receiving further requests. By following their established plan rather than self-dispatching all available resources, they avoided contributing to a potential crush of unneeded personnel.

     Czyson attributes the success of the regional response plan to keeping it simple and using it on a regular basis. "Build relationships, get into each other's areas, keep contacts up to date," he says. "We use mutual aid every day. It really comes down to that."

     North Memorial Ambulance Operations Supervisor Mike Murphy states that on the scene, "The fact that we had practiced made it easier to understand what everyone was trying to accomplish, and when asked to help, to know how and why... This was a process of people with cool heads doing their job and sticking to a plan proven to work."

     A formal review is underway to examine numerous aspects of the bridge response, including radio communications, the incident timeline and utilization of resources, for future improvements to the coordinated response plan.

     To read more on the bridge response, visit www.EMSResponder.com/OnlineExclusives.