Mackinac County's Local Emergency Planning Team practices its emergency response in a mock disaster at the Long Term Care Facility May 17. Nurses and aides prepare residents for evacuation to Little Bear East Conference Center. The residents are played by students from LaSalle High School. Administrators in charge of the evacuation are wearing vests. They are (from left) Helen Marks, director of nursing, Tom Alkire, a registered nurse and Long Term Care unit manager, and Greg Potter, the hospital maintenance director who is the designated Safety and Security Officer for the exercise. In the background, a fireman looks toward Unit One. To build competence and confidence among members of the county's emergency response network, one unit of the Long Term Care Facility at Mackinac Straits Hospital was evacuated as part of an emergency drill that simulated a large structure fire Wednesday, May 17. The drill involved city, county, and state police, the Red Cross, the St. Ignace Fire Department, Mackinac County Emergency Services, the Sault Ste. Marie Tribe of Chippewa Indians, and the hospital staff.

Bryce Tracey (right), 911 coordinator for Mackinac County, is incident commander for the mock disaster at Unit One of the Long Term Care Facility at Mackinac Straits Hospital. Here he consults with Steve Therrian of Allied Emergency Medical Services. During debriefing, all agencies involved agreed that the project was a success, and special praise was given to the hospital staff for exceptionally quick evacuation of residents, which took place immediately after a fire alarm was set off at 10:49 a.m. The simulated fire was caused by a sock that had found its way into a toaster.

Twenty-five LaSalle High School students took part in the exercise. They occupied the living quarters of the facility's regular residents, who were taking part in unrelated activities elsewhere in the building.

Just after the drill began, Jenny Massaway staggered outside and collapsed in front of the hospital. She played the role of an 80-yearold resident whose oxygen tank had exploded. Her face was painted to look as though it was burned and bleeding and a bolt from the tank was made to look as if it were embedded in her forehead.

"They put me on a stretcher right away and took me to the emergency room," she said. "I was supposed to be air-lifted to

Petoskey, but the ER caught on fire, and I was taken to the hospital at the Lutheran Church, where they took my vitals. Then they got ready to drive me to Petoskey."

Miss Massaway said that she felt well taken care of throughout the process.

"It was very lifelike," she said. "They were quick and good at what they were doing."

"The drill revealed that everyone knows their job," said Miki Della-Moretta, the director of Emergency Services for Mackinac County. "Hospital personnel are clearly ready for this type of incident. They concentrate on saving people first, and worry about structures later."

It was the first full-scale drill run by Mrs. Della-Moretta, who replaced Ben Thompson last year. Her job was to work with the Incident Commander, the first person on the scene capable of coordinating the efforts of the various organizations involved. In this case, the incident commander was Bryce Tracey, 9-1-1 coordinator and fire department sergeant.

The St. Ignace Fire Department, acting under mutual aid agreements, called on fire departments from Brevort, and Mackinaw City. Departments at Hendricks and Clark townships were on standby. Extra ambulances from Mackinaw City were also called. None of these groups actually came to the drill, but in a real emergency, they would have been here, Mrs. Della-Moretta said.

Buses equipped with mechanical lifts were provided for wheelchairbound evacuees, who were taken to Little Bear East Arena and Conference Center, the designated evacuation site for St. Ignace.

Mr. Tracey said he was impressed when he arrived at the fire 10 minutes after the alarm was sounded and saw that the hospital staff already had evacuated nearly everyone from the unit.

The fire department had deliberately delayed its response to simulate the reality that, in a town with a volunteer fire department, it takes extra minutes for members to get from their regular jobs to an emergency.

"We are trained to pull people out of burning buildings," he said. "This is time consuming and exhaustive for firefighters, but the hospital staff had already evacuated the residents, so we were able to get right in there and concentrate on the fire."

"It was impressive to watch the hospital staff react when the alarm went off," said City Manager Eric Dodson, who was there to evaluate the staff's effectiveness during the drill.

"They knew where they needed to be, and they got there quickly," he added.

Hospital staff said the evacuation was complete only five minutes after the alarm went off.

To make the drill more realistic, and difficult, Mrs. Della-Moretta added problems to the scenario. She directed two students to hide in closets, for example, simulating confused and scared residents trying to avoid the commotion of the evacuation. According to Mr. Dodson, the staff found and evacuated them in roughly 30 seconds.

While Mr. Dodson looked on, firefighters crept into the evacuated facility, staying close to the ground, a method they employ to avoid rising smoke and heat.

Throughout the drill, each organization was linked with radios tuned to a "special event channel." Mrs. Della-Moretta used it to keep all players in communication.

By 11:30, the fire was reported spreading toward the emergency room and the hospital was ordered to move it to the Zion Lutheran Church.

Five actors posing as seriously injured residents were sent there. The rest were evacuated to a Red Cross station set up at Little Bear East, where families of residents could also go to check on their loved ones.

Barb Davis, the hospital's quality control director who was in charge of medical care at Little Bear, reported no deaths and that all burn patients were subsequently transferred to Community Memorial Hospital in Cheboygan.

Wayne Burnett was among the Red Cross personnel who manned the entrance to Little Bear and documented evacuees as they came in.

"People arrived before we were fully set up," he said, but food and water was on hand. Soon, the room was equipped with cots for tired or injured residents, and nurses arrived from the hospital to help.

Again, pre-designed problems appeared in the scenario. Some evacuees did not cooperate with the Red Cross, for example, because they had been directed to act semicoherent and upset by the disaster.

"Several tried to escape," Mr. Burnett said, but Red Cross workers kept their eyes on them, conducted head counts every 10 minutes, and brought wanderers back into the shelter in a caring and gentle manner, he added. During this portion of the drill, the Red Cross volunteers realized that there were far too many unlocked doors in Little Bear East to monitor easily.

Joan Therrian, assistant coordinator of Emergency Services, evaluated the Red Cross and concluded that the Red Cross did well.

In all emergencies, real or simulated, certain things go wrong. Problems were noted in this drill, and the information will be used to make planning improvements before a real disaster occurs.

Tamie Hartwig, a member of the planning team, said there was good communication with other emergency services, but a breakdown occurred between the hospital and the nurses at Little Bear East.

Hospital personnel used walkietalkies to stay in contact, but the devices weren't powerful enough to keep in touch with the nurses working at the evacuation center. This problem will be dealt with internally, said Mrs. Della-Moretta. Most likely, the hospital will obtain some type of high powered radios.

That the hospital emergency room was in the midst of dealing with several real emergencies during the exercise added to the sense of drama.

Another problem arose when Mr. Tracey tried to get Mrs. DellaMoretta involved in the exercise. As director of Emergency Services, she is a critical link in the management

of any extended disaster in the county. When Mr. Tracey called the 9-11 dispatch center, however, they were unable to page Mrs. DellaMoretta. They contacted the Mackinac County Sheriff's Department instead, and the police were able to page her.

"It was good that this came up during a drill," Mrs. Della-Moretta said. "The problem was fixed easily the same day."

A third problem was noted by Tim McKee, emergency manager and 9-1-1 coordinator for Chippewa County. Mr. McKee was on site to evaluate the fire department's response, which was quite good, he said, but responders did not have of a copy of the hospital's floor plan.

Kathy Schacht, an English and drama teacher at LaSalle High School, oversaw the student actors. County Commissioner Lawrence Leveille evaluated the hospital maintenance crew, hospital security, and busing. St. Ignace Mayor Paul Grondin evaluated the ER response, and William Beethem, assistant emergency manager for Cheboygan County, evaluated law enforcement. All agreed the drill went well, despite minor problems.

As chair of the Mackinac County Board of Commissioners, the highest elected office, Dawn Nelson declared the situation a disaster and served as spokesperson, providing information to the media.

St. Ignace Police Sergeant Mark Wilk said the most difficult aspect of the drill was creating a true climate of realism. In a real emergency, he said, there would have been smoke and fire and people screaming, but planners could not add these details to the drill.

Emergency drills must not create serious problems of their own, he said, and above all, organizers must avoid causing real injuries.

To alert residents to the exercise, the event was announced in advance to Long Term Care residents and their families and to the public through The St. Ignace News.