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Report from Reno on the Reno Air Show MCI

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It was ironic that I was in Reno, Nev., on Friday when the Reno Air Show crash occurred. As an MCI specialist, I had the unique vantage point from the National Association of EMS Educator’s Conference at the nearby Peppermill Resort to see live video feeds of the events as they were occurring. As you can expect, all the local media outlets went to constant, live coverage of the incident as it unfolded and was managed.

JEMS will obviously bring you an in-depth review of this event in the future. But I thought I’d share my front-line observations with you because there were many important management perspectives that are worthy of noting.

Much like the view many of us had on 9/11/01 when aerial news video allowed us to see more that commanders on the ground could see, I was able to watch the events unfold and be managed by on-site personnel, particularly crews from REMSA (the Regional Emergency Medical Services Authority).

I know the REMSA organization, and many of their personnel, very well, having covered their system for years, and watching their crews compete during the JEMS Games Advanced Clinical Competition at the EMS Today Conference over the past six years.

You might wonder why I would mention this in the context of a disaster report, but I have a good reason for doing so. I have watched the participating 3-person teams from REMSA “perform” and compete during the JEMS Games Competitions and have always found them to be well-trained, professional, composed under extreme pressure, solid in their triage and treatment capabilities and, most importantly, very well organized when presented with multiple patients.

So, I was not surprised, nor should you be, that the REMSA and on-site crews had their act together at this massive air show MCI. The event unfolded in seconds at about 4:30 PM when, during a 400 mph past over the grandstands, something apparently went terribly wrong with expert pilot Jimmy Leeward’s World War II vintage P-51 Mustang and it plunged into the tarmac in front of VIP boxes. It disintegrated into thousands of pieces, spraying shrapnel into the crowd like 1,000 grenades, killing a man and woman almost instantly and injuring dozens in seconds.

There were 300 photographers on site so there will be hundreds of photos to assist EMS, fire, rescue and law enforcement officials in better understanding the event and how it was handled, but from my perspective it was managed like a well-executed MCI should be: Fast, coordinated, composed, methodically and with proper patient distribution.

Within seconds, fire, EMS and security personnel arrived and ringed the area. Announcers immediately, and repeatedly, told spectators and injured parties, to stay where they were. They were told “Do not move. Stay where you are. Trained professionals will be with you momentarily.”

That did not occur by happenstance, but because of extensive pre-race planning by the air show and Reno area public safety officials. The area was locked-down rapidly and scene tape put up to restrict access, control people and keep them from leaving the area before being seen by medical personnel and interviewed by law enforcement investigators, and to ensure that evidence was protected to aid in the follow-up investigation.

Well defined triage, treatment and ambulance staging areas were rapidly established and patients were evenly distributed among the area's Level II trauma facility. There appeared to be solid EMS-to-hospital communications, with each hospital calling in off-duty staff members and instituting their hospital emergency Incident Command Systems.

One of the most innovative use of resources that occurred almost immediately after the crash was the use of a nearby, restored, vintage Vietnam era Huey helicopter to transport patients to Pickett Park near Renown Regional Medical Center. On-site personnel pushed the Huey over to a fueling area on its attached skid wheels, had it fueled up and then placed multiple patients in for transport to the hospital facility. It was a novel and helpful asset deployment that most people did not realize occurred. (See www.remsa-cf.com for more on REMSA)

A.J. Heightman, MPA, EMT-P, is Editor-in-Chief of JEMS and specializes in Mass Casualty Incident Management analysis and instruction.

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