In early 2005, our city learned about an event that would affect our lives for the next several months. Tall Ships, sponsored by Pepsi Americas' Sail 2006, was to be held in Beaufort, N.C., from June 30-July 6, 2006. So what did that mean for our emergency response system?
Having been to a Tall Ships event in Chicago, Ill., in 2000, I had an idea about what would be necessary in order to make the event safe and successful. I was immediately interested in the planning and preparation and being part of the response effort. My main concerns were the number of visitors it would bring to the area, which is quite unique and beset with a few challenges.
The area has limited high-speed, high-volume avenues of access and evacuation. One hospital is located within the county, in Morehead City, and the next nearest hospital is 40 miles away.
The summer season typically brings many beach visitors and thus challenges our resources and facilities. The event would obviously add to the average summer population surge within the county, and we knew we would face especially limited EMS resources.
We also realized that with as many people as predicted in a single location, security ƒ for the visitors and those who dedicated themselves to protect, serve and aid them ƒ was a major concern.
Thus, the event planning required many hours and much thought to provide optimum opportunity for success. What follows is an after-action review of the methods that worked well and aspects that may benefit from additional planning in the future.
The acronym "SAMPLE" ƒ one familiar to anyone in EMS ƒ was modified to fit this article. You could JEMS data and SAMPLE to determine a realistic expected number of calls for any size event.
The Disaster Medical Assistance Team (DMAT), part of the National Disaster Medical System (NDMS), has a field hospital set up at the Old Beaufort Middle School, in close proximity to each of the three areas of attraction at Pepsi Americas_ Sail in Beaufort, N.C.Size
What would the size of this event be and how would it impact the area's infrastructure? The business and event planners told us to expect 400,000-500,000 people. The current demographics and infrastructure of the county and cities are geared to handle a summer beach surge of 175,000-200,000.
Morehead City is centrally located within the county and has the highest call volume of our EMS agencies. Beaufort, Newport and Atlantic Beach follow. As mentioned, Carteret General Hospital is the only hospital located within our county, and the next closest hospital capable of receiving patients (provided beds are available) is located in New Bern, N.C., about 40 miles away.
Using the statistics from the "JEMS 200-City Survey," I did an analysis to predict the number of calls we might expect. I compared the estimated number of visitors with the demographics of the surveyed cities and then broke the per annum calls down to calls per week (by dividing the number by 52). I came up with an estimate of 800 total requests for assistance.
My paramedic students were amazed by this estimate, because we had discussed planning and preparation in EMS management class. One of my students called her former hometown, Traverse City, Mich., which hosts a similar event to get a second opinion. Her conversation confirmed the number, and we thought, "We'll be busy. Very busy!"
What kind of actions do you take to prepare for a large event? The 5 Ps must be adhered to for this type of event: Prior Planning Prevents Poor Performance. Also, what area should host the majority of the event?
Countless meetings and hours of preparation went into the plan. Many people were involved in the planning process, and I wish I could recognize them all. The Carteret County Emergency Manager Allen Smith and his staff (Assistant EM Joann Smith and EMS Coordinator/Director Lou DeGillio) along with the Beaufort Police Chief Steve Lewis did an excellent job in anticipating and acquiring additional resources based on the projected number of visitors.
We considered and planned for logistical, tactical and practical issues using the Unified Command Approach and the ISC response matrix. Jim Thullen, MD, headed up the volunteer medical effort for the event, organizing that group and its deployment. Many additional agencies from federal, state and local levels were also involved in the preparation and response.
The mission was easy to determine Ï protect all who attended and prepare a response for any type of natural or other event that might endanger people and/or property. That being said, how many resources do you commit without jeopardizing your ability to respond to something else? This dilemma faces many event planners. Given limited resources, budget and personnel, we all have to decide where to "draw the line " in our resource commitment.
The most tiring process of any event is the planning. Countless hours of brainstorming and preparing for each and every detail with a contingency plan can debilitate the staff. Private sector groups plan for events from a different perspective and often at different times than the public sector. During this event, the communications between the private and public sectors showed the greatest opportunity for improvement. Planning is complex, and requires coordination for even the smallest details.
The logistics of an event is always a major source of headache in the preparation of a large event. An invaluable skill is adequately determining what resources are needed to conduct a response and making the arrangements necessary to have those items in the right place at the right time. The coordination and transportation of the resources from the supplier to the event must be choreographed as well as funded well in advance of the event. Detailed planning can aid in a timely, effective response. Organizing a resource list and maintaining a rapport with the suppliers is an ongoing process. Backup resources must also be organized to ensure effective responses to any event.
Consider the event for response and training. Engage your specialized response teams Ï DMAT, SMAT and HAZMAT teams, among others deployed to the event Ï as resources and offer them the opportunity to train during the event. The utilization and deployment of these teams is viewed by some as "overkill," but I believe this utilization to be effective team training management. A part of the specialized team training is to deploy and conduct operations anywhere. They must plan, move, maintain operational security, reconnoiter and set-up for the mission in the area of operation on short notice. What better way to train than to conduct this type of operation during a non-emergent situation with deadlines and real challenges they must improvise for, adapt to and overcome?
The Tall Ships came, and the plan was implemented. Opportunities for improvement were discovered, but so was the planning talent in our area. The preparation and planning allowed us to handle the influx of visitors with no major incidents impeding the event. The hospital set a new record for ED visits, but the numbers would have been much higher without the presence of the DMAT, SMAT and medical volunteers to treat patients on site. Public health was also present, conducting health surveillance and preparing for their role as first responders.
Thank you to all who planned, prepared for, facilitated and participated in the Tall Ships event. Many agencies and departments made this event safer for everyone who attended.
Randy Shaffer, AA, NREMT-P, is the EMS education coordinator at Carteret Community College, Morehead City, N.C. Contact him firstname.lastname@example.org.