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Crash and Rescue Exercise
By: Errol Casiano, M.D. (Class 2000)
Posted: July 20, 2007
The author (right) with CREX Medical Coordinator Dr. A. Rillo (4th from right) and the Manila Sanitarium rescue team.
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The following takes place between 10:00 AM and 11:00 AM.
10:00 AM. An airliner crashes along Diosdado Macapagal Boulevard in Paranaque City and plows through a row of shanties by the road.
10:03 AM. Barangay Baclaran Fire Brigade arrives at the scene.
10:05 AM. Barangay Tambo Fire Brigade arrives at the scene.
10:08 AM. Airport Rescue and Fire Division Firetrucks arrive at the scene. Airport Medical Ambulance arrives at the scene.
10:09 AM. Philippine National Police and Metro Manila Development Authority implement emergency traffic plan. Medical Coordinator sets up Triage Area.
10:10 AM. Airport Police cordons crash site.
10:15 AM. Paranaque Fire Department arrives at the scene. Airport Operations/Safety sets up staging/rendezvous area.
10:16 AM. Bureau of Fire Protection raises alert level.
10:18 AM. Ambulance #1 arrives at the staging/rendezvous area. Philippine Air Force Rescue Chopper arrives.
10:20 AM. Command Post established. Airport Media Affairs sets up press briefing area.
10:21 AM. Ambulance #2 arrives.
10:25 AM. Pasay Fire Department arrives. Ambulance #3 arrives.
10:30 AM. Las Pinas and Makati Fire Departments arrive. Philippine Coast Guard Rescue Chopper arrives.
10:35 AM. Ambulance #4 arrives.
10:37 AM. Ambulance #5 arrives.
10:40 AM. Media/Press people attempt to enter cordoned area.
10:45 AM. Ambulance #6 arrives.
10:50 AM. Ambulance #7 arrives.
10:55 AM. Ambulance #8 arrives. Air Transportation Office investigators arrive.
11:00 AM. Survivors and casualties accounted for.
I am not Jack Bauer nor am I writing for an episode of 24. I received the above script two weeks ago from the Manila International Airport Authority (MIAA) Medical Division Manager. He was the Medical Coordinator of the event, which we call Crash and Rescue Exercise or CREX, a requirement of the International Civil Aviation Organization (ICAO) for international airports in order to test their emergency response capability. The Medical Coordinator appointed me Assistant Medical Coordinator of the event and the job not only entailed coordinating the projected series of activities enumerated above with the different parties involved but also doing some acting and directing at the same time since the event involved media coverage.
The Crash and Rescue Exercise was held last July 6, 2007 at the Diosdado Macapagal Boulevard in Paranaque City. At 7:00 in the morning, 101 volunteers underwent full body makeover by the Moulage Team and were briefed on how to act out their injuries which ranged from burns to lacerations to open fractures to abdominal injuries to shock. Eight cadaver dummies were placed inside the aircraft for a total of 109 victims.
At 10:00 in the morning, the aircraft burst into flames. The victims were scattered around the place. In a few minutes, sirens were heard from all directions. Rescuers and firefighters started arriving. Firefighting operations commenced. Airport police cordoned off the crash site. MIAA Rescue and Fire Division Firetrucks, which carry a special chemical that has a cooling effect on metal especially in fires involving aircrafts, arrived at the scene followed by the MIAA Medical Division Ambulance. After clearance from the Chief Fire Officer, the Triage Officer established the location of the triage area and set up the white flag.
In cases of mass casualties events, the first qualified medically trained person to arrive at the scene should be the Triage Officer until relieved by a more qualified person. The triage area should be a location that is upwind, upslope and ideally should be 90 meters away from the accident scene.
After the triage area was established, the red, yellow, green, and black flags were set up to represent the four standard colour-coded categories of casualties in mass casualties events.
Red is Priority I, requires immediate care, and uses the Rabbit symbol. Yellow is Priority II, requires delayed care, and uses the Turtle symbol. Green is Priority III, requires minor care, and uses the Ambulance with X symbol. Black is Priority 0 for the deceased and uses the Cross symbol.
Patients with major hemorrhages, open fractures and extensive burns of more than 30% should be brought to the Red Team for immediate care. Patients with closed fractures and limited burns of less than 30% should be brought to the Yellow Team while those with minor injuries should be brought to the Green Team.
One patient with abdominal injuries and another one who sustained an open fracture in the right leg were brought to Makati Medical Centre via a rescue chopper. A third patient who suffered extensive burns of more than 40% was brought to the AFP General Hospital via a second rescue chopper. The other casualties were brought to different hospitals in Metro Manila.
Several hospitals and agencies like San Juan De Dios Hospital, Manila Sanitarium, Ospital ng Maynila, Philippine General Hospital, Philippine National Red Cross, Ace Cor and Makati Rescue, sent their ambulances and rescue teams to the crash site to help in the transport of the victims.
The exercise turned real when one of the rescue choppers caught a small fire as it landed at the scene. The Philippine Navy chopper had just dropped off two batches of casualties to Makati Medical Centre and was on its third casualty pick up. Firetrucks rushed to the chopper to put out the fire.
MIAA General Manager Alfonso Cusi and Assistant GM for Security and Emergency Services Retired General Angel Atutubo, who served as "On-Scene Commander," graced the event. Department of Transportation and Communication Secretary Leandro Mendoza sent his representative.
At 11:00 AM, I reported to the Medical Coordinator, Dr. Augusto Rillo. We radioed the Command Post. "Triage: Red 38, yellow 34, green 27, black 10. Passengers and crew from aircraft 89. Victims from shanties 20. Total 109. All survivors and casualties accounted for."
Check on the link below for the GMA News video coverage of the crash and rescue exercise.
http://www.gmanews.tv/video/8800/Crash-and-rescue-drill-at-NAIA-turns-to-real-emergency
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