Hospitals prepare for the Big One with emergency plans, field tents

This story originally appeared in the San Gabriel Valley Tribune.

Peter Stokman, of Miller and Severson Incorporated, shows Terri Starkman, PIH public information officer, the seismic improvement work at Presbyterian Intercommunity Hospital's Plaza Tower in Whittier on Friday, Oct. 14, 2011. The tower is built to meet seismic standards. (SGVN/Staff photo by Watchara Phomicinda)

A devastating earthquake in Southern California would almost certainly collapse bridges, destroy roads and render hundreds of hospital beds useless, while leaving tens of thousands in need of medical care. After experts predicted in 2008 that a magnitude-7.8 earthquake would knock out 60 percent of the hospital beds in Los Angeles, San Bernardino, Riverside and Orange counties, first responders have become prepared with alternative medical care policies for when a catastrophic event strikes.

Still, with key medical health facilities out of commission, emergency responders say many of the injured would be treated in tents set up at field hospitals wherever needed.

The County Office of Emergency Management has helped the region's 103 hospitals, 73 of which have emergency departments, prepare with disaster planning scenarios.

Surge tents would be used for initial triage and sorting of patients for short-term care, Fruhwirth said.

The number of available beds "is really dependent on the level of impact, but we have plans and we know in general what hospitals can do to meet increased demands for a lot of people who need medical care," she said.

Thirteen hospitals in 10 locations throughout the region have Disaster Resource.

Centers, which are equipped with tent shelters to each house at least 40 patients for the first 48 hours. "All hospitals do planning for disasters, but these centers have additional supplies and equipment, which can also be moved to the impacted area," Fruhwirth said.

Each center has cots, gurneys, heaters, medical and pharmaceutical supplies, and communication equipment.

And hospitals have arrangements with one another, in the event one is significantly damaged. For example, Greater El Monte Community Hospital is part of a seven-hospital chain - including Monterey Park Hospital, San Gabriel Valley Medical Center, Alhambra Hospital and Whittier Hospital - and if one is damaged, patients can be transferred to the another, explained Dennis Jarmin, assistant administrator at Greater El Monte Hospital.

They also have arrangements to temporarily transfer stable patients to skilled nursing facilities, opening up more hospital beds at undamaged hospitals, Jarmin said.

The county also has at its disposal two $3.5 million mobile medical systems, which encompass two 53-foot big rigs and a portable field hospital center that when combined can create a mobile medical facility for 200 people.

"It's basically an emergency department on wheels," Fruhwirth said. "It's a semi-trailer that has 14 treatment areas, where we can do initial emergency treatment of patients."

It is designed to be deployed within six to eight hours, after which doctors can perform surgeries and have access to X-rays, lab work, ultra sounds, medical supplies, crash carts and IV pumps.

A quake-stricken area would also have access to at least one of the state's three mobile hospitals - a series of huge tents, each large enough for 200 beds. The tents include emergency rooms, laboratories, intensive care units and up-to-date supplies. Stored at undisclosed sites around the state, they are designed to be deployed within 72 hours.

"In an earthquake, our challenges would be what roads are open and what hospitals need attention," Fruhwirth said.

That's where first responders come in.

They "have plans of where they would set up staging areas, field treatment sites with the goal of always working with us to find out where there is a hospital that can take care of patients and move them to those facilities," Fruhwirth said.

After an earthquake, responders will survey their service areas and roam the streets to assess damage of high hazard buildings, including schools, hospitals, freeway overpasses and government buildings, County Fire Inspector Don Kunitomi said.

One of the first tasks will be to set up triage centers in quake-stricken areas, where responders will address life-threatening emergencies first, he said.

"Our job is take people from the emergency situation and to the emergency room," Kunitomi said. "We do advanced life support to stabilize the patient to get them to the ER."

Responders also will be in regular communication, he said.

"We coordinate activities with first responders every day and they can communicate with us and we can give them what hospitals have capacity to take patients and then they distribute the patients depending on how large the event is," Fruhwirth said.

In the case that Los Angeles County hospitals are too overwhelmed with patients, health officials have policies in place to partner with hospitals in neighboring counties, including Orange, Ventura, Santa Barbara and Riverside.

"We would try to move patients to hospitals that were operational and use tents to hold patients until we can distribute them to neighboring counties," Fruhwirth said. "You need to expand that circle of where you would go based on how many patients you're dealing with."

Staff Writer Andrew Edwards contributed to this report.