When the frontline of the hospital is the last to go

An ER physician recalls the evacuation of Northern Lights

19 May When the frontline of the hospital is the last to go

Coughing kids with fevers, someone slumped over in abdominal pain, a guy with an elevated ankle, twisted and swollen purple thanks to a run gone awry, a woman cradling her migraine-inflicted head in her hands—and that’s just the minor treatment area. Meanwhile a tube is being threaded through the trachea of a patient who can’t breathe and an ambulance has just arrived with a vehicular trauma.

It’s just another day in the ER, full of sights and sounds like this, but something staff wish they could see? The sky. Sometimes the absence of light—natural light—darkens moods.

That’s why on May 1, 2016, the fateful day Fort McMurray caught fire, no one in the Northern Lights Emergency Department had a clue.

“It was beautiful when I came into work, seventeen degrees, sunny and clear,” Dr. Brian Dufresne, ER department head recalls.

“We have 26 beds, one trauma bed, six to ten beds in fast track, normally with three physicians on. By eleven a.m. we were at full occupancy. No one knew what was billowing outside. We only have one window.”

By one p.m. texts from concerned family and friends started flooding phones: Fort McMurray was on fire.

“Code green was called,” Dufresne says. “I didn’t even know what it meant.” Evacuation of the hospital—it had never happened before.

Emergency services were called but with most of the town on evacuation, virtually all EMS were busy, out on fire trucks. There weren’t enough ambulances to move patients out. Desperate times called for desperate—and innovative—measures.

Picture patients as passengers as public transit was enlisted, drivers called to a duty they could never have imagined. Some 80 patients needed to be evacuated and while critical care patients were taken out by air, the remaining were loaded onto city buses.  About a third of those were long-term care patients afflicted with all kinds of geriatric issues, including dementia.

The commute was complicated by the backlog of traffic as tens of thousands of residents fled from their homes. There was a virtual standstill on the road north and thus a two-hour trip became an eight to ten hour hellish ride.

“We had long-term care patients on buses with minimal support,” Dufresne recalls.

Seats occupied by a sea of grey heads, frightened faces pressed to windows without views, thanks to the thick smoke outside, no access to sustenance—or services. When those patients finally arrived at an oil camp and the doors of those buses swung open, the sight—and the smell—would have stunned awaiting medical staff.

While the rest of the hospital had been evacuated, ER staff and patients were the last to leave. Doctors and nurses and even some patients piled into private vehicles that were soon stopped: the road north was closed. Redirected south, en route to Edmonton, they were stopped again—this time with the offer of another mode of transportation. Leaving their vehicles behind they gratefully accepted helicopter lifts to the northern camps.

“Luckily we had some helicopters that were loaded with drugs, equipment, staff and even a couple of patients,” Dufresne says.

Dr. David Murray traveled with a take-it-all-in-stride kind of a guy. Apparently the patient was getting a CT scan when all hell broke loose. By the time the scan was finished, the ambulances were gone. He ended up in a helicopter with Murray, and in an ironic turn of events, went from having pictures of his body taken, to taking pictures. Snapping photos, he became the unofficial photographer, chronicling events.

Sites were set up at Suncor, Syncrude, and Firebag.

“The nurses were amazing. They got right down to work,” Dufresne says, smiling. “While the doctors wondered where the coffee was.”

Along with patients, 8,000 civilians were sent up and they needed assessment. Twenty-four hours a day, planes were taking off and within 48 hours civilians were evacuated from camps but by then the area of Wood Buffalo was threatened. On May 7th Firebag was evacuated, Cold Lake Forces piling people into Herc planes.

Back in Fort Mac, tents were set up as portable isolation containment systems. “You don’t always think about the people who bring in supplies,” Dufresne says, “but one of our fears was running out of supplies…even porta potties had to be brought in.”

People had trouble sleeping due to the horrific air-quality conditions as heavy smoke smothered the city.

A lot of lessons were learned, the biggest being preparation, according to Dufresne. “There was a plan in place, but it needed to be practiced.”

Miraculously the airport and the hospital stood solid through the fiery hell, thanks largely to the heroics of exhausted firefighters who worked tirelessly to protect important structures.

Smoke damage was extensive but the doors to Northern Lights opened on June 1st, exactly a month later. “We had a fully functioning ER by mid August. By September 80 to 85% of the community had returned,” says Dufresne.

People are resourceful—88, 000 of them safely evacuated. They are resilient—they will rebuild. They are courageous and they are compassionate. Hundreds of millions of dollars were donated, homes and hearts opened up. Canadians can be proud of how the nation came together to help keep #Fort McMurray strong.