“I got a text from my fiancé telling me there was an emergency at the train station,” said Meika Roberson, chief medical officer at Hoboken University Medical Center, last week as she reflected on the events of Thursday, Sept. 29. That morning, reports hit the news that an accident with possible “mass casualties” had occurred in the Hoboken train terminal. In fact, a commuter train from Pascack Valley rolled into the station around 8:45 a.m. going 21 miles per hour, almost three times the speed limit, and crashed into the concrete platform.
While early news reports said three people had died, it turned out that one person had been killed by debris and two were in critical condition. More than 100 others needed medical attention. The hospital treated 23 patients and Jersey City Medical Center treated others.
Debris killed bystander Fabiola De Kroon, a Hoboken mother who left behind a husband and daughter.
Roberson was the first to alert the hospital to the crash, and that set all the gears in motion.
Chief Operating Officer Ann Logan said as soon as Roberson told her of the crash, she called a “code triage” and didn’t leave the command room from 24 hours.
When a code triage is called, available staff heads to one location. Some are dispatched to the Emergency Department to await incoming trauma patients.
Last week, the hospital staff reflected on what they can do to handle future crashes in such a densely populated mile-square city. They said that they were well prepared, however, for the Sept. 29 crash.
The command room “which is essentially our war room,” said Logan, is where hospital official make decisions about operations and patient care in times of crisis.
From the command room, she can make determinations about whether patients need to be moved or sent to other hospitals, which supplies the hospital needs more of, which elective surgeries can be postponed, and which machines (such as x-rays) can be made available.
Roberson and Logan both said the hospital staff was calm and collected as they waited in the Emergency Room for the ambulances.
Roberson said what was only a nine-minute wait felt like an hour as she waited for the first ambulance to arrive.
Logan said that although the hospital only treated 23 patients they were prepared for many more.
“We have an unbelievable staff” said Logan. “The community response here was amazing.”
Roberson said she remembers a nurse who was taking class in the building had dressed formally for the day, but when she heard the code, she changed into scrubs over her high heels.
Roberson said the staff was prepared. They have monthly drills to be ready for anything, from a fire to a mass shooting.
“Once we had kids from a local drama club come in and pretend as if there had been a mass shooting at school,” said Roberson. “They were such good actors. They were crying and covered in fake blood and it was so realistic I had to check and make sure they were actually okay.”
What needs fixing
Roberson said that although the hospital handled the emergency well, a few things needed adjusting.
She explained that the staff is supposed to all gather in one location and create a staff pool. Then, they’re dispatched to where they are needed throughout the hospital and into the Emergency Department.
In this case, most of the staff skipped this step and went to the Emergency Department.
“Families were calling each individual hospital looking for information on their loved ones.” –Dr. Meika Roberson
She said she believes the hospital will practice this more and ensure there is a designated staff pooling area in the hospital in case of emergency.
Roberson also said she believes the city needs to work with other municipalities in the area and the county to create a central phone line for families to call in case of an emergency.
“Families were calling each individual hospital looking for information on their loved ones,” said Roberson. “And we don’t have a way of knowing where that patient might be, so families had to call hospital to hospital.”
Roberson said she brought the idea up to Mayor Dawn Zimmer, who was responsive.
Roberson said at the end of an emergency situation the hospital staff gathers together for a debriefing in which every employee has the opportunity to speak about the day’s positives and negatives.
Roberson said she was surprised by the amount of people who were remembering 9/11 and having emotional flashbacks to that day.
“I hadn’t expected that,” said Roberson.
While the hospital was ready for Sept. 11 victims in 2001, people escaping the World Trade Center were largely handled at a triage center at the train station for minor injuries and dust.
Marilyn Baer can be reached at firstname.lastname@example.org.
CarePoint Health to open nine satellite emergency departments
Nine new satellite emergency departments have been proposed by CarePoint Health for various locations in northern New Jersey, according to an Aug. 4 CarePoint presentation to the state that was reported last week.
CarePoint Health has applied with the state Department of Health to open facilities in Hudson County, Bergen County, and Passaic County.
CarePoint made a 40-page presentation in hopes of placing satellite departments in Jersey City (one on the downtown waterfront and one in Greenville), Union City, Edgewater, North Bergen, Palisades Park, Carlstadt, Lodi, and Clifton.
According to the document, the satellite emergency departments will increase population access to ERs, relieve overcrowding of existing ERs, reduce costs, and allow the area to address the increased need of ERs because of an increase in elderly population.
The planned CarePoint ERs would be on Warren Street and Kellogg Street in Jersey City. 56th Street in Union City, and on River Road in North Bergen.
A letter at the end of the presentation from Executive Vice President and Chief Strategy Officer Kirat Kharode addressed to Cathleen Bennet, commissioner of the New Jersey Department of Health, states the need for the departments.
“The need for emergency care in these communities is based on a diverse range of factors, including the overutilization of hospital based emergency rooms, population growth, low socioeconomic status and an increasingly aging population,” wrote Kharode. “By creating additional access points to emergency care, patients in the target communities will have the opportunity to obtain necessary emergency care in a timely manner.”