When Plane-crash Victims Arrived at Stanford Hospital, Medical Teams Were Ready

STANFORD, California – Years of disaster training and preparation culminated in an extraordinarily executed response July 6 when 55 injured passengers were brought to Stanford Hospital and Lucile Packard Children's Hospital for treatment after the crash of Asiana Airlines Flight 214 at San Francisco International Airport.

The Stanford hospitals were among nine in the Bay Area that were called into emergency action to evaluate and treat the crash victims. The disaster claimed two lives.

"The many hours we devote to disaster planning and training really paid off," said Brandon Bond, administrative director of the Office of Emergency Management for Stanford and Packard hospitals. "Throughout both of our hospitals, everyone immediately knew what to do to evaluate and treat these patients while maintaining normal hospital operations."

That preparation and readiness meant that emergency professionals from the Stanford Level-1 Trauma Center, the Marc and Laura Andreessen Emergency Department and the Office of Emergency Management had an incident response plan in place that had been well-rehearsed during many emergency drills and mock scenarios.

Hospital officials quickly activated the command center after receiving word of the incoming casualties. They initiated a code triage, bringing together more than 150 healthcare providers in cross-functional teams from emergency, trauma, operations, security and more to safely and efficiently coordinate the expected surge of patients.

Eric Weiss, MD, medical director for the Office of Emergency Management, said the mobilization was rapid. "Within 30 minutes we had admitted or discharged most of the patients who were previously being treated in the Emergency Department," said Weiss, who is also an associate professor of emergency medicine at the School of Medicine. "Our combined team included physicians, nurses, technicians, clerks, registration personnel, social workers, translators and other vital specialists from throughout Stanford and Packard Children's hospitals."

To evaluate and treat the influx of trauma patients from the crash, the hospitals mobilized seven trauma teams with fully trained surgeons and five perioperative teams. "We also implemented our rapid admission and rapid discharge plan, plus we set up an expansive and well-staffed triage area outside the emergency department to accommodate the surge of additional patients," Weiss said.

Of the 55 patients evaluated and treated, 11 were admitted to Stanford Hospital and seven to Packard Children's. "The injuries were of varying degrees," said David Spain, MD. As chief of trauma and critical care surgery at Stanford, Spain was already on site when patients started arriving by ambulance and helicopter. 

"Some of the injuries were life-threatening and serious," added Spain, who is also a professor of surgery at the School of Medicine, noting that several surgeries were required. 

Adding to the challenge of this particular emergency were the patients' language needs and the involvement of multiple security and diplomatic agencies, said James Hereford, Stanford Hospital's chief operating officer. "We knew we would have Korean and Chinese nationals who would need translation services. Our patient services group found us the interpreters we needed and we had some staff physicians who were native speakers who could attend to patients in their own language. The response of physicians and staff at all levels went above and beyond." 

Those involved in coordinating the hospitals' response said it was obvious that the many hours devoted to emergency preparedness were worthwhile. "Everyone came together right away to deal with a rapidly evolving situation and do what they do best, which is save lives," said Bond, who also leads the hospitals' emergency preparation for other types of crises, such as power outages and earthquakes.

When Ann Weinacker, MD, chief of staff at Stanford Hospital & Clinics, reported to the command center shortly after the midday notification went out, it was already operational and fully staffed. "What was remarkable was how calm and smoothly everything was running. It was incredibly well-organized," she said.

She also did a walk-through of the emergency department and was amazed by what she saw. "The emergency department was calm," said Weinacker, who is also a professor of critical care medicine at the medical school. "There was not a lot of drama. It was almost like business as usual—only there were many more people.

"The staff did a remarkable job of taking care of things," she added. "I was just blown away with how well this worked and how expert everyone was in their job. Mostly we're glad there was no greater loss of lives and no more severely injured people than there were. We all fear something really massive, where there are many, many more victims than there were."

Reflecting on the events of the weekend, Amir Dan Rubin, president and CEO, expressed his profound thanks to the medical and support staff who rallied to care for the injured. "This tragedy demonstrated just how remarkable our people are," said Rubin. "I feel honored to be a part of this amazing group and want to thank everyone involved, from our physicians and nurses to our translators, social workers, guest services representatives and security personnel, as well as the hundreds of professionals behind the scenes. Your collective focus on the well-being of our patients was truly inspirational. This event will undoubtedly have a profound effect on the survivors for their rest of their lives and hopefully, the respect, caring and compassion demonstrated by the Stanford community will start them on their respective recoveries."

Lloyd Minor, MD, dean of the School of Medicine, commended the teams for the care they delivered. "Stanford Medicine's faculty and staff have done an amazing job treating people from the crash," Minor said. "As often happens in a crisis, many individuals stepped up and worked tirelessly to provide the best possible medical and social care to patients. But it was more than a willingness to help that was on display; it was the work of professionals trained to respond in an emergency situation. While this was the first time in decades that we activated our mass-casualty plan, staff took on their assigned roles with intelligence, compassion and creativity."