Carlton Complex Fire Disaster Medicine Erica Hickson White

Introduction:  My Background  Moved to the Methow Valley 1989  Permanently moved back 2000  My parents, siblings, aunts, uncle, cousins and many close friends live in the Methow Valley.  It is my community and my family.  I have worked locally  Graduated in May 2014 from Gonzaga  Went to work in June 2014 as an ER provider at Three Rivers Hospital.

July 17th  Driving home from work in the morning.  Something was happening  Fires had never been so close  Drove through the valley and saw fires all around, on both sides.  Within hours:  Word came that the pass to Omak would be closing cutting off our access to Mid Valley Hospital.

July 17th  Power will be out within hours and last for weeks.  Road to Brewster will most likely close soon as well.  How would I get to work?  What would this mean for my community? My family? My friends?  The closest emergency room was in Sedro Wooley, almost 3 hours away over a mountain pass.

July 17  With all the smoke and fire, if we needed it, would a medical helicopter be able to transport in and out of our valley?  I knew something needed to be done to help and a plan began to take shape that had its roots in the past with fellow Methow Valley ER providers and other EMS personnel…  How do we get ER services in the Methow Valley?

July 17  I began making phone calls  I did not have Cindy Buttons phone number  I did not have the hospital CEO cell phone number.  Power was out, land lines were not working, only communication was with cell phones, and only with Verizon.  Eventually I reached Cindy, we planned a meeting for Friday morning.

July 17th  I texted and sent facebook messages  Eventually I was able to reach our CEO Scott Graham who gave me the full hospital support to run a disaster satellite ER out of the AeroMethow building in Twisp.  Thursday night, the fire ravaged the entire valley through Pateros and forever changed the landscape.

Friday July 18th  Fires still burning, roads all closed, power out.  I met with Cindy at Aero Methow and we came up with our plan.  Use the building  Work together as a team  I will have backup via cell phone with the hospital doctors and Wenatchee.

July 18th  Supplies:  I had roughly 10 minutes to text a supply list to the hospital  Vicky Buzzard contacted her husband Ottis who contacted the state patrol and they would be sending an officer to the hospital to pick up supplies and deliver them to us, driving down a valley on closed roads.

July18th  Local medical support:  Shawn Maxwell, Kurt Hill and Dr.Richard Campbell  Dr. Joe Jensen, his staff of Kathy Kirner and Kathleen Manseau  Dr. Ann Diamond and Danielle Micheletti

July 18th  Supplies arrived  TEAMWORK to get the room set up  Paperwork: SOAP notes, obtained printer for drivers license and insurance information  PLAN: patients would get transported to aero methow building for me to assess and treat if we could.  Obvious trauma would get either flown out, or if the roads were open transported to Chelan or Wenatchee.  Saw my first patient that evening.

July 19th  I stayed at the aeromethow building during the time we were set up.  4 hours without cell service  7 patients  Awesome team work!!  Dr.Jimmy Wallace  Dr. Larry Smith

July 21st  Power was still out  Fires were still raging  Roads to the hospital were open  I had to leave We treated patients at a mobile Mash style disaster ER for 4 days. Flew one patient out, transported 2 via ground. Treated tourists and locals Kept our EMS crews as close to home as possible!

Take home notes: 1. Have a supply list ready at all times: Disaster list and urgent care list 2. Have a phone list posted at various locations, with cell numbers! 3. Have conversations regarding billing and insurance first. 4. KNOW YOUR RESOURCES!!

Final thoughts:  “What are my gifts?”  Bringing food  Organizing supplies  Allocating water  Checking on the elderly at home  Heaving lifting, manual labor  Medical needs: current licensure and liability  Counseling for the victims  The clean up, the months and years of re- building

 Care for the workers  During any disaster, take the time for self care, even if its 10 minutes of quiet time per day.  Drink water and eat!  You cannot give more of yourself if your too depleted!!  And remember to talk to those around you, encourage laughter, positive attitude and teamwork!!!