Coping With Multiple Disasters Made for an “Incredible Day” by Dan Davidson July 16 started out much like any normal day at the Dawson Nursing Station. Things have been a little abnormal this summer in that the station has been staffed with what the Acting Nurse Practitioner in Charge, Maurice Chiasson, refers to as "floating staff" most of the time. Nearly all of the regular medical staff have been on one kind of leave or another this summer, but this hasn't seriously affected the operation of the station. Chiasson himself has been in Dawson for earlier periods of service, so his main concern has been to make sure that the staff meshed seamlessly during the season, practising or talking through various events to see if people knew where everything was and who to contact. He'd had it in mind to brainstorm what they might do if several serious incidents occurred simultaneously, but on July 16 he hadn't yet mentioned it to anyone. By the end of the day he wouldn't need to. A mass causality incident calling on all the emergency medical services (EMS) in a community is a rare thing. It might defined in terms of a natural disaster, or a accident with a large tour bus. "That," said Chiasson, looking back at things a few days later, "would tax the resources of any rural community in the Yukon." In Dawson, a serious event might require the combined resources of the Nursing Station, the RCMP, the town's doctors, the Dawson Fire Department, and the Dawson Ambulance Service. Such an event was practised here earlier in the spring. By the end of July 16, all of those had been called upon to deal with a series of events that kept the EMS community busy between 1:30 and 6 o'clock that afternoon. A total of ten patients from around the Klondike region, involving 16 ambulance calls, and extrication work by the fire department, added up to what could be classed as a very taxing day. It began with a call for an ambulance to the Top of the World Highway. Four people needed to be rescued from an accident half an hour up the highway. This included both volunteer ambulance and fire fighting groups. The first ambulance came back with two patients around 3 p.m., and it was about then that the parade began. There were eight more patients in the next three hours, including the other two from the car, a walk-in for a minor problem and a firefighter from the Goldfields Complex who had had a tree fall on him and had been evacuated from there by air and then picked up at the airport. At about this point in the day, ambulance number 2, which has been the subject of complaints by the local service for a while now, collapsed and had to be repaired in order to make it through the day. Later it died completely and was replaced within a few days by a newer model from Whitehorse. A second firefighter arrived from the complex, felled by an allergic reaction to a bee sting. There were two more walk-ins at the clinic and a call for an attempted suicide at a local campground right after that. By this time the ambulance contingent had swelled from four volunteers to ten and everyone was quite busy. This was all taking place in a facility with two regular emergency examination rooms and another room with an examination area, as well as the hallway. Chiasson was once in charge of an emergency room in Vancouver, and says that would be enough to tax even those resources in that short a time frame. "But - and it's been my experience in the Yukon over the years - all of a sudden people come out of the woodwork and things happen.” In the territory, he explained, things work in stages. The first level of local care would be the ambulance crew, followed by the nurse practitioners and then the doctors. After that, it's a trip to Whitehorse. On July 16 three of Dawson's patients needed to move to that fourth level of care. "There was a complicating factor," Chiasson said dryly, thinking back to that smoke filled day when no planes were landing or taking off in Dawson. "We did some creative working. We winged it." There were 12 helicopters working fires in the Dawson area that day, and the air operations officer for the Wildlands fire management team made two of these available for flights to Mayo, where the regular air medivac service from Whitehorse took over the cases. What impressed Chiasson when it was all over was the number of people who were able to set aside their jobs or their personal lives to make this situation work. "We had volunteer ambulance people and firefighters, the RCMP, Wildland Fire people, helicopter pilots I don't even know, our doctors stayed late, and so did the rest of our staff. "All of this is for people who weren't even from Dawson. This is a community coming together to serve." All of this was happening during a week when every agency in town was meeting for at least an hour every morning as part of the Emergency Measures Organization, formulating and coordinating a batch of "what if" scenarios in case there was actually a need to swing an evacuation plan into service. "When all hell is breaking loose, " Chiasson said, "things happen. Maybe not on everybody else's schedule, but they happen, and it's the quality of the people that makes this. "Through all this, we never did call and say we had a mass casualty incident here. We just all fell into roles of dealing with it and never realized what we'd done until the end." So how did he feel at the end of a day that was far busier and more hectic than anything he had imagined? "That's the macabre part of it," he said. "We were all feeling good as nurses because things went well. It was an incredible day." | 
