Oklahoma School Explosion Kills 6 EMS Disaster Planning Pays Off
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Emergency services personnel have been known to complain about having to rehearse full-scale disaster procedures. The attempt to coordinate fire fighter, EMS, ambulance, police, and hospital personnel in controlling costumed role players is hectic and time-consuming. But every once in a while, pre-disaster planning pays off.
It did in Spencer, Okla., last Jan. 19.
At approximately 12:17 p.m. that day, an unidentified caller notified the Spencer Fire Department that an explosion had occurred at the Star Elementary school at N.E. 23rd and Douglas Blvd. The caller advised that he was at a restaurant across the street and that he did not know what had exploded, nor could he tell the dispatchers the exact location of the building involved.
The Spencer Fire Department immediately dispatched two units, Engine 120, a 750-gpm pumper, and a combination rescue and first attack pumper, manned by Chief Tommy Taylor. The apparatus arrived on the east side of the school grounds at 12:21, where numerous children with minor injuries and others who were unhurt had been evacuated from the building by school officials.
Taylor was advised at that time by unidentified persons that the school cafeteria and kitchen area in the northwest corner of the facility, had exploded and that there were numerous casualties, some of them serious. The chief immediately radioed his dispatchers to contact the Midwest City Fire Department (MWC) and Midwest City Ambulance Service and to request that all available squads and ambulances be sent to the scene.
Taylor and Captain Bill Raney ran across the back of the schoolyard and entered the northwest corner of the structure where they discovered the cafeteria manager, partially buried in debris and rubble, suffering severe head trauma and experiencing difficulty breathing. They attended the victim by opening and maintaining her airway, then they left her to begin initial triage on additional injured by opening airways and checking for severe bleeding.
During this time Midwest City Ambulance and fire department personnel arrived and began assisting with the triage. Also arriving at this time was Spencer Police Chief Larry Hannah with the Spencer Fire Department’s rescue unit. Tony Miller, Midwest City Ambulance paramedic, assumed the duties of triage officer as everyone on the scene began assisting in the removal of the victims from the cafeteria.
When the Midwest City Fire Department was notified of the emergency at approximately 12:22, it immediately dispatched Engines 4 and 3, and Rescue Squads 1 and 2. Engine 4, housed only 1 mile from Star Elementary, arrived within three minutes, as did the first of three MWC ambulances, which were dispatched from MWC Hospital, about 3 miles from the scene.
Disaster plan in effect
When MWC Ambulance Director Romeo Opichka received word that there were likely to be multiple injuries in the incident, he immediately put his disaster plan into effect. The MWC Ambulance Service, operated by the city, normally has two fully equipped ambulances on duty, but one was out of town at the time of the explosion. Opichka began readying two reserve ambulances at once. His pre-disaster planning procedure, which he modeled after programs he developed for the United States military, centered on having each ambulance equipped with a “disaster box” containing supplies to treat 50 casualties independently. The first ambulance dispatched carried a three-person crew and one of Opichka’s disaster boxes. He meanwhile alerted all hospital personnel of the explosion and the expected heavy casualties and called in off-duty ambulance workers. Within minutes he had loaded additional IV solutions, oxygen regulators, needles, pediatric supplies, and backboards into a reserve ambulance and dispatched it.
Opichka left a short time later with the third ambulance. By the time he arrived at Star Elementary, triage was almost completed.
EMS and fire fighter personnel first on the scene faced two major medical emergencies. Because most of the victims were eating lunch at the time of the explosion, there were many airway blockages. So emergency personnel first began clearing airways. Second, there were a number of cases of lifethreatening bleeding. The closely managed triage which had been immediately established went quickly and smoothly, partly because all ambulance personnel had close familiarity with the fire fighters involved, having interfaced with them in previous countywide disaster planning. Both of these groups and attendants from AMCARE, the countywide, privately owned ambulance service, which dispatched eight units to the scene, four of which were used to transport the injured (AMCARE aid cars transported the fatalities after the injured were on their way), functioned harmoniously with fire fighters from Spencer, Midwest City, Choctaw, Edmond, Del City, Jones, Forest Park and Harrah.
Photos by Wide World Photos
Agencies mesh well
Without these disparate groups being mutually familiar with each other, the instant, efficient care the injured received might well have been delayed, which might certainly have caused greater life loss.
About 50 of Star Elementary’s 290 students were eating lunch in the cafeteria at 12:17. This was the time for the second lunch period when third and fourth-graders took their turn in the cafeteria. Fortunately, there was spring-like weather that day, with temperatures nearing 70 degrees. Colder, more typical winter weather would not only have likely slowed rescue efforts, but more children would probably have remained inside, lingering in the cafeteria on their lunch breaks.
When the explosion occurred, it blew apart the northwest corner of the onestory cinder-block building, collapsing several walls in the cafeteria/kitchen area and showering occupants with light and heavy debris. The explosion killed five students and one teacher, probably instantly, and injured at least 34 others, many of them seriously. Despite water and natural gas lines in the affected area being ruptured by the blast, there never was a fire. All the damage was inflicted during the one explosion.
Stabilized before transport
All the victims were stabilized and IVs were started before any of the injured were transported to the hospital. All six deaths occurred before the first emergency personnel arrived.
Only 52 minutes elapsed between the time the first ambulance arrived on the scene and the last time the last, ambulance transporting the injured left the scene. Although stabilizing all the victims before beginning t ransport seemed to uninformed bystanders to cause delay in treatment, this procedure accomplished two important things. First, once transport began, it was accomplished quickly and efficiently. Second, area hospitals, which had been put on disaster alert, had time to prepare for the heavy number of casualties by calling in off-duty personnel and readying emergency supplies. Once the victims began arriving at the hospitals, and a total of four hospitals received them, a sufficient number of doctors were on hand so that each victim had a doctor in attendance; that is, there was a oneto-one ratio of casualties to doctors. Hospital officials credited the performance of emergency medical personnel on the scene, and especially the stabilizing before transport, with preventing further loss of life.
Indeed, transport went so well, despite there being only one driveway into and out of the school grounds on the northwest side of the building, that two medi-flight helicopters which had been requested initially, and which landed in a shopping center parking lot that police seemed to clear of cars instantly, did not have to be used to transport patients. The helicopters were used later to transport patients between hospitals.
When MWC Fire Chief Canfield arrived at Star Elementary, about seven minutes after the explosion and about three minutes after the first Spencer units arrived on the scene, only about three of the more seriously injured had been removed from the cafeteria. Canfield first consulted with Taylor, and they agreed to set up a command post with Canfield as the incident commander while Taylor returned inside the school to oversee the evacuation operations.
Crowd control needed
From the command post, Canfield directed the many responding police units first to secure the area and provide badly needed crowd and traffic control. Hysterical parents, relatives and friends began arriving immediately and threatened to disrupt the rescue scene. Also, police set about securing the 3 miles of road to MWC Hospital. Canfield immediately called for MWC street and public works crews to move heavy equipment to the scene. These operators were prompt and expert, and their presence alleviated one chief worry at the command post, that further collapse might occur during rescue and treatment.
As pleased as officials were with the success of the operation, no such effort is free of problems and complications. For instance, the first-arriving Spencer fire fighters had no portable radios. Had Taylor had a portable radio, he could have alerted all local fire departments on the mutual aid frequency of the status of the incident. This way he could have better prepared arriving units on where to report, what to prepare for, and the like.
Identification a problem
Because most of the victims were children, who seldom carry identification, identification of the victims was difficult, especially since the one adult fatality was the teacher of many of the injured. Mrs. May Allen, the school secretary, was requested by Taylor to assist in the identification, which she did, yet many of the casualties were not identified until much later in the day.
Star Elementary was a neighborhood school, so most of the children lived nearby. Understandably, some of the children who were unhurt walked home in the confusion. Similarly, some nearby parents rushed to the school in the first few minutes of the incident and picked up their children. This subsequently caused confusion when trying to account for all the students.
Star Elementary sat on a major fivelane road, so traffic and crowd control was definitely a problem. But controlling traffic and people will always be an obstacle in such a situation, and they will almost always be out of control early on. Police units did all they could.
In Canfield’s view, there was eventually too much help available. Quite understandably, Taylor had initially put out a general call for all available assistance. But the resources at hand proved difficult to control and manage. While no exact count of all emergency personnel present is available—although certainly over 100 responded to the incident—the agencies represented included several area fire and police departments, including Oklahoma City’s, two ambulance services, city and county sheriffs departments, the Red Cross, County Civil Defense, Oklahoma Highway Patrol, Army National Guard, Air Force Reserve, and, no doubt, others. Even after the command post was established, controlling scores of persons and agencies proved impractical. There exists rather general agreement that too many police responded.
A variety of communication problems developed. Telephone lines were jammed into city hall, to fire and police headquarters, and to most area hospitals.
Emotional trauma
Many of the emergency personnel suffered severe emotional trauma at having to deal with the pain and suffering of large numbers of eight and nineyear-olds. Such victims test one’s ability to stay sufficiently detached to function efficiently. A related problem that Tony Miller of the MWC Ambulance Service encountered was that persons entering the cafeteria to assist with the treatment and evacuation instinctively approached the worst injured first, which usually meant those already dead. Miller ordered sheets put over the fatalities so that time would not repeatedly be wasted by persons trying to aid the children who had not survived the explosion.
These problems, mostly minor and inevitable, were certainly offset by what worked in the operation and by what was learned. The incident commander managing the scene out of a command post was effective. As difficult as it is to organize such a scene, it is surely impossible without a focal point of authority where decisions can be made rapidly and consistently. The incident commander’s main task is to identify available and needed resources and match the two. Effective management of the resources on the scene is as important as the resources themselves.
The communication problems noted could have been avoided by assigning appropriate personnel at city hall to man a special telephone extension to receive disaster-related calls and to pass on a single prepared response. Regular switchboard operators were hopelessly beleaguered.
The plan worked
The disaster plan that had been rehearsed countywide worked well. In fact, to many at the scene and at the hospitals, the entire episode felt very much like those earlier disaster drills. And without the usual role-playing mock victims, the operation was completed even more quickly than the drills. Two and one-half hours after the explosion, all hospital emergency rooms were cleared of blast victims.
Let me in closing touch briefly on what might be called part 2 of the rescue operation. About an hour after the explosion occurred, the scene was secured, all the injured had been transported, and the attention of the command post shifted to the receiving area which had been set up for parents and other relatives of the victims who would be seeking any available information. Earlier at Star Elementary, Canfield had directed the county civil defense director to have the Red Cross set up such an area on the east side of the school. At the same time, the MWC Community Center, near the hospital, was established as the main receiving area away from the scene, and was manned mostly by police personnel. Canfield requested that clergy, psychologists, and related professions be brought to the facility to deal with the emotional anguish of relatives of the children.
Although this concept was good, Canfield believes he allowed insufficient notice to Community Center personnel. More police, more help in general, with more time to prepare for the onslaught of the people who flocked to this facility would have helped. The lack of preparation time caused no serious problems, only unnecessary confusion at a particularly delicate point.
Canfield and Taylor agree the entire operation went as smoothly and effectively as could possibly be expected, especially considering the number of seriously injured.
Cause of the Star School explosion remains under investigation. Oklahoma State Fire Marshal Jack Sanders has said that a 75-gallon hot water heater exploded, apparently after both the thermostat and pressure-temperature valve failed. The reason for their failure is not known at this time. □ □
