Jersey City Medical Center Response to 911

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Jersey City Medical CenterResponse to 9/11

• Marc M. Grossman, MD
• Jersey City Medical Center Emergency Medicine
• Co-Medical Director, Jersey City Medical Center
  EMS
• Asst. Professor, Mt. Sinai School of Medicine,
• New York

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JCMC WTC 1993

• JCMC played an important role
• No mutual aid agreement between NYC and JC, but
  help was needed
• JCMC EMS provided ambulances in response to a
  direct request by NYC-EMS

(1993 attack was planned and carried out from
Jersey City)
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JCMC WTC 1993

• Other first-aid squads freelanced by going to
  ground zero independent of official requests
• This left many areas in NJ potentially uncovered
  for ambulance care
• Led to a Mutual Aid Agreement between States of
  NJ and NY

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JCMC WTC 1993

• Also, representatives posted at all Hudson River
  Crossings to prevent ambulances not requested to
  respond to stay in their home area
• No patients brought to NJ, also no commercial
  Ferry crossings at that time

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JCMC WTC 9/11

• JCMC notified early that they will be needed
• Main Communication ability lost with radio tower
  on Building 1
• Backup system utilized but very inefficient one
  channel available for all communication was time
  consuming and difficult to follow

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JCMC WTC 9/11

• Ferry service thousands of people brought across
  the Hudson by boat, with some injuries
• Initial reports that one ship had 300 patients,
  but no communication with the boats available,
  and location of docking unclear led to confusion
• NJ State Police set up triage area in Liberty
  State Park, with units checking in to account for
  all responders
• Ellis Island set up as a temporary morgue and
  treatment area

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JCMC WTC 9/11

• Hospital operations
• All patients rapidly and safely dispositioned
  (admitted or discharged) to make room for
  incoming patients
• All elective surgeries cancelled, all clinics
  closed
• ER divided up into Trauma, Critical Care, and
  Acute areas,
• Hospital Auditorium set up as Sub-Acute treatment
  area
• Many services relocated to these treatment areas,
  such as pharmacy, radiology, psychiatry, social
  services, etc.

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JCMC WTC 9/11

• Again, communication very difficult
• In the ER, we had no direct communication with
  ambulances because of the loss of the radio
• No communication with WTC scene, or Liberty State
  Park Triage area
• Information obtained through rumors and
  television news
• Also could not communicate with staff who were
  home to give instructions whether or not to
  respond to the hospital

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JCMC WTC 9/11

• 175 patients brought to JCMC, 5 critical
  condition
• No decontamination set-up in Jersey City, but was
  set-up in Hoboken
• Again, related to communication issues, what were
  the patients covered with?
• This could have been yet another disaster

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JCMC WTC 9/11

• Solutions
• Radio system upgraded and redundancies introduced
  
• 2-way pager system used for better communications
• FEMA grant for 3 million for upgrading of
  systems and make up for money lost that day
• State-wide hospital communication radios
  installed for group notifications and
  inter-hospital linking
• NBC training, ICS training

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JCMC WTC 9/11

• Other Problems
• Difficulty with staff reaching the hospital once
  on the road, because of road blocks and security
  checkpoints
• Once they arrived, how do you manage staffing to
  ensure that there is a team ready to work later
  tonight or tomorrow and so on
• Security of the Hospital We only want people to
  be there who should be there, not potentially
  hostile visitors or others who can complicate
  an already chaotic scene

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JCMC WTC 9/11

• Metropolitan Medical Response System (MMRS)
• In Coordination between local City, County and
  State agencies with the US Dept. of Justice
• Provides for money and training for response to
  major disasters
• Was in place before 9/11, but increased
  participation after
• A Major Drill to take place this coming spring to
  test the ability of our emergency services to
  deal with a mass casualty incident, and terrorism

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JCMC WTC 9/11

• Decontamination
• System to allow for mass decontamination is being
  installed
• New facility will have a decontamination area,
  new Trauma Center and Clinical areas
• Training in Personal Protective Equipment is
  underway
• Training in recognition of a Bio or Chemical
  attack is being provided
• Inter-agency training also underway

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JCMC WTC 9/11

• Conclusions
• Jersey City Medical Center played an important
  role on September 11th, 2001 (3rd busiest
  hospital that day)
• Problems identified and solutions installed, some
  problems still need resolution
• Funding is a major factor
• Key items are adequate communication and
  training, preperation
• Planning for possible attacks or natural
  disasters is a primary responsibility of the
  emergency workers and administration of the
  hospital and region