Managing chaos

Emergency responders were at the ready. A triage area was already cordoned off. Ambulances were lining up in the parking lot. The ferry, followed by several emergency boats with their lights flashing, pulled up to the pier and docked. Immediately, a flood of bloodied passengers streamed off the ship as the first responders jumped into action.

The Watch Hill Ferry Terminal was the scene of a disaster Saturday morning—fortunately, a simulated one. NYU Langone Health held a “Mass Casualty Incident Full-Scale Exercise” on April 5 to test the hospital’s and local response partners’ ability to deal with an emergency involving many victims. The emergency exercise simulated a ferry accident out at sea to prepare first responders and staff at the NYU Langone Hospital–Suffolk.

The ferry departed the Watch Hill Ferry Terminal in Patchogue at 8 a.m. and returned about half an hour later, after reporting an accident that caused dozens of casualties. The “victims” of this incident were actually actors, some of whom were decked out with convincing makeup to imitate real-world injuries. After the ferry had docked, first responders got to work, moving the “injured” passengers off the ferry and into the triage area.

Once off the ship, the casualties were designated a specific color depending on the severity of their injury. People with more severe injuries were quickly identified and loaded into the waiting ambulances by EMS providers and driven to NYU Langone Hospital–Suffolk. EMS personnel at the hospital received wave after wave of victims. By the time it was over, the hospital had received 26 patients and two service animals from the simulated ferry incident.

Exercise leader Michele Miller emphasized the importance of the simulation. “We’re trying to test EMS on their triaging protocols to give them a little rundown, and then the real important part of this is for the hospital—to see how they would deal with a mass influx of patients,” Miller said. According to Miller, NYU Langone Hospital–Suffolk sees roughly 130 to 180 patients daily. This exercise provided over two-dozen patients in a 15-minute window, putting the hospital’s capabilities to the test.

While the ferry accident set the stage for a mass casualty incident, the general purpose of the exercise was to prepare emergency responders in any event where many victims require immediate medical attention. Last year, NYU Langone Health organized a simulated mass casualty shooting at St. Joseph’s Church in East Patchogue. With over a dozen agencies and departments involved Saturday morning, from NYU Langone EMS to Patchogue Fire Department, coordination was paramount for success.

Practicing an event like this is also vital for preparing hospital staff if an incident does occur. Nicole Hansen, the EMS manager at NYU Langone Health’s Mineola campus, said, “Drills like this are essential for preparedness—things like this don’t happen every day, so it’s really important for us as EMS providers to practice because it becomes muscle memory and a lot easier for us to respond to emergencies like this when we’ve seen it… before it actually comes down to life or death.”

By the end of the exercise, spirits were high. The actors got a free boat ride and lots of attention, all the agencies involved executed their duties, and EMS providers proved up to the challenge of a sudden inundation of patients.

Chris Schiera, a director with the Patchogue Ambulance Company and playing incident command at the ferry terminal, said the exercise went well. “It went quicker than we thought it would… all the mutual aid ambulance companies did a great job; they triaged quickly and evacuated [the victims] quickly.”

Tyler Rieger and Andrew Candio are reporters with the SBU Media Group, part of Stony Brook University’s School of Communication and Journalism’s Working News program for students and local media.