Disaster Preparedness

“Today around 12:30, a truck transporting chemicals to UGA labs crashed into the UGA Health Sciences Campus. The driver ran a red light at the intersection, hit several oncoming vehicles and flipped onto its side. A small fire is seen near the cab of the truck and the distinct odor of chlorine is present.”

So began an exercise realistic enough that local media outlets had to be informed in advance that the “emergency” was, in fact, just a drill. The four-hour interprofessional event, held on an otherwise calm Saturday afternoon in March 2016, was a joint effort by the College of Pharmacy, the UGA Division of One Health and the UGA Medical Partnership to instruct veterinary, pharmacy and medical students in disaster management and the importance of interdisciplinary cooperation.   

During the simulated disaster, participants were grouped randomly into teams and assigned tasks ranging from patient triage to community call center management. Students from every discipline were thrust into situations that did not necessarily coincide with their chosen course of study. Veterinary students were charged with managing the flow of patients within the suddenly overloaded hospital and pharmacy students were asked to triage—simulated—chlorine-poisoned dogs. Placing participants in these foreign situations and asking them to interact with students from different disciplines provided each with an opportunity to learn new skills, develop a better understanding of fields outside their own, and function more efficiently in unfamiliar situations.

“I believe that the professionals don’t talk to each other enough,” said Susan Sanchez, a professor of infectious diseases, chair of the UGA Division of One Health, and assistant director of the UGA Biomedical & Health Sciences Institute. (Sanchez also heads the Microbiology and Molecular Biology sections of the Athens Veterinary Diagnostic Laboratory.) “They live in their silos and try to deal with ‘One Health’-type problems by themselves,” she continued, referring to the concept that the health of humans, animals and their environments are inextricably linked and thus threats to any one of those areas should be approached with an interdisciplinary mindset. “I think if they knew each other and if they knew each others’ capabilities, they would really talk to each other and work more in groups, and, they would be more efficient.”

That sense of cooperation, cohesion and novel thinking permeated the day. Students were encouraged at every step to consult with each other and consider aspects of a problem outside of simple pharmacokinetics or first aid. At the Hospital Surge post, pharmacy and veterinary students managed the flow of patients and their families through Athens Regional Medical Center. A large, tabletop-sized map served as a planning table on which to strategize where to send not only patients, but also their families, doctors, hospital clergy and the worried well. At the incident command post, students were required to consider logistics, finances and the media response when formulating solutions to the challenges phoned in from the scene. Even ethical considerations became a concern for participants. “You kind of had to throw away this idea of ‘I want to help everybody’ and you had to put on your ‘This is an emergency situation’ hat,” noted one participant.  “Realistically, who is going to benefit the most from being transported first?’”

Drs. Lisa Bazzle and Ralph Askren (DVM ’88) were the veterinary team that led the pet decontamination and triage training module. A team consisting primarily of pharmacy students and a handful of veterinary students were presented with three “dogs”—lifelike dummies—apparently affected by the disaster. Bazzle, a clinical instructor of Emergency and Critical Care at the CVM, instructed the students on how to prioritize patients, how treating an animal differs from treating humans, and in particular how animals communicate injury and illness. Askren, an esteemed and active alumnus of the CVM, then supervised as the students worked together to triage the animals. “As a team, we’d like you guys to approach these animals as best you can,” he instructed. “Try to assess their state and needs. What do you want to know about the animals other than what you see?” 

The students, clearly unsure of the exercise at its outset, quickly became active and engaged, asking questions, feeling the dog’s “pulse” and attempting to discover as much as possible about this dog to diagnose it. “Her eyes and mouth are watering,” said one pharmacy student. “She’s probably relatively non-responsive.” In response to the question in her voice, Askren claps in front of the stuffed dog’s nose and the students burst into laughter. “You could actually feel how their body language said, ‘Wow this is so cool! This is so interesting!’” said Sanchez, who participated in the exercise. “It was really kind of cool,” agreed one pharmacy student, “because we were all kind of wondering how is pharmacy relevant to this anyway? So hearing her talk about the medicines and then having an ‘Aha!’ moment about how these things we learned are practical was really nice.” Sanchez highlighted the importance of imparting this sort of interest in students at an early stage in their training to encourage collaboration later in their careers. “It’s just they don’t know what the others do,” Sanchez said, “but it’s good to have this diversity. If they understand what other professionals do, they will be able to relate better, ask the right questions and integrate better to solve problems instead of thinking, ‘How do I talk to this person?’” 

While the pharmacy school took the lead in organizing the event and recruiting first responders to participate in the simulated emergency, the veterinary students and One Health club also played an active role in making this event a reality. “The students did a lot of fund-raising last year which helped to fund the food, water and everything else,” explained Sanchez. Last year, the veterinary and pharmacy students joined together to organize a 5K race, which also helped fund the training exercise. Sanchez noted that while this exercise may become part of the veterinary curriculum in the future, the veterinary students who participated in the exercise and fund-raising this year did so for no reason other than a self-motivated desire to learn. “Everything the vet students did was voluntary,” she emphasized.

The collaborative zeal exhibited by veterinary, pharmacy and medical students alike shows promise that the One Health ideology will not only be practiced, but embraced, by the next generation of medical professionals.

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