2025 NCDS PRESENTATIONS

Almost every mass casualty external to the hospital, and even some that are internal, can be broken into operational phases that progress and change as the incident evolves. When examining past incidents, many times there are false assumptions upon which  hospital emergency managers build their plans, leading to disruptions and poorly coordinated responses. The most important time frame in the operational response to mass casualty is the initial one, essentially the first 30-60 minutes, when the machinations of the hospital emergency response is spinning up. WIthout a solid foundation of response and planning for the first 30 minutes, the next operational phases will be on unstable ground and may be bound for difficulty or even failure. This lecture will discuss some of the historical and past incident data that informs where the failures in the first 30 minute response exist, and will propose a simple, common sense road map to initial hospital response that will set a solid foundation for the hospital to be successful.

Reid Smith - Virginia Hospital Center, Arlington - Attending Physician

Overview and lessons learned from hospital-based disaster response.  Events include mass decon, mass casualty, "suspected" active shooter. How these events have changed and forced UNC Health Wayne Emergency Management to evolve as the joint commission standards evolve.

MikePaul – UNC  Health Wayne - Director, Emergency Management

This presentation discusses the NextGen 911(NG911) capabilities available to Public Safety Answering Points (PSAPs) across the state of North Carolina provided through the NC 911 Board, how PSAPs were impacted during Hurricane Helene, and how planning for the future and implementing NG911 technologies are the keys to success in saving lives and property in North Carolina.

Kristen Falco –  NC 911 Board - Eastern Regional Coordinator 

Tom Rogers – NC 911 Board- Network Engineer and Program Manager

Pokey Harris - NC 911 Board - Executive Director  

Greg Dotson - North Carolina NG911 MAC Manager 

Effective communication and accurate information dissemination are crucial in disaster response, particularly when managing a large number of decedents. This presentation focuses on three key objectives: controlling rumors by sharing verified facts about the incident, clarifying the proper procedures for handling mass fatality events, and explaining the role of the Disaster Mortuary Operational Response Team (DMORT) in this response. Specifically, it highlights the distinction between a full DMORT deployment and the partial team that was utilized, detailing the functions and limitations of the assets deployed. By addressing these aspects, this report aims to provide transparency, enhance public understanding, and ensure trust in the disaster response process.

Ryan Jury –  NC Division of Public Health - Acting Senior Deputy Division Director 

This presentation will provide an in-depth overview of MAHPC's coordinated response to Hurricane Helene, both regionally and as an integral part of the State Medical Response System. With seventeen out of eighteen counties in our region receiving major disaster declarations, the impact of this hurricane on Western North Carolina was unprecedented. The discussion will cover the complex challenges faced during the response, including logistical obstacles, resource allocation, and interagency coordination. Lessons learned from this experience will be analyzed to highlight opportunities for improving future disaster response efforts. Additionally, we will share best practices developed during this response to enhance preparedness and resilience in the face of similar emergencies. This presentation aims to provide valuable insights into effective disaster management in unique and challenging geographic contexts.

Mark Stepp –  Mountain Area Healthcare Preparedness Coalition - Regional Healthcare Preparedness Coordinator

On the early morning hours of December 3, 2024, the Duke Medicine Pavillion, an 8-Floor facility with 160 critical care rooms and 16 operating rooms at Duke University Hospital experienced a total loss of oxygen supply. This unprecedented event posed a significant threat to patient safety and required immediate and coordinated action from multiple departments to prevent patient harm from occurring.

We will highlight the pivotal role that emergency management plays in the development of plans and procedures to respond to such an event.  We will also discuss the critical roles of the engineering and maintenance teams in swiftly identifying and rectifying the root cause of the oxygen failure and how early relationships with these teams create an atmosphere for transparency and quick response.

Equally important was the collaboration with the respiratory therapy team, whose specialized knowledge and quick thinking were instrumental in managing the patients' respiratory needs during the crisis. Their ability to adapt and provide alternative oxygen delivery methods was a key factor in mitigating the impact of the oxygen loss.

This presentation will underscore the importance of interdepartmental relationships and effective communication in crisis management as well as discuss changes to the Duke University Hospital- Loss of Medical Gases plan learned from this event. By examining the successful collaboration between engineering, maintenance, and respiratory therapy, we will provide valuable insights into best practices for handling similar emergencies in healthcare settings.

Jason Zivica –  Duke University Health System - Assistant VP, Workplace Violence Prevention  & Emergency Preparedness

Learn how the North Carolina Healthcare Systems regularly collaborate to support state level decision making for patient movement before, during, and after emergencies and disasters. Since 2018, a group of dedicated healthcare professionals have worked together to coordinate the policies and procedures that are utilized during various types of emergencies and disasters that have required state supported patient movement. This group collaborates on the levers available within their health system to support patient surge. Join a panel of these experts to learn about the processes utilized and the lessons learned during real world incidents.   

Kimberly Clement (Moderator) –  NCOEMS- Healthcare Preparedness Program Manager

Brian Langston - Cape Fear Valley Health, Corporate Director of Patient Logistics & Mobile Integrated Healthcare

Kevin Corbin - UNC Health, Associate VP of Operations

Marcy van Schagen - WakeMed, Director System Capacity & Patient Placement

Since the start of the 21st century to 2022, Florida has been impacted by 79 tropical and subtropical cyclones.  On September 28, 2022, Southwest Florida sustained a direct hit from a category 5 hurricane, Hurricane Ian.  Hurricane Ian was to date, the most deadly hurricane to impact Florida in this time frame. Due to the loss of water pressure government agencies mandated the evacuation of three local hospitals.

One of the hospitals, Golisano Children’s Hospital, was included in the evacuation. Evacuating critically ill neonates provide added vulnerabilities due to their complexity and can be difficult to safely and efficiently evacuate in a disaster.    In 2017, the Florida Neonatal and Pediatric Transport Network Association, being experts in the state for the safe transport of neonates, developed a disaster response plan.  This plan was used in 2019 to evacuate 5 neonates from the West Coast of Florida.  This disaster plan is now a part of the Florida Ambulance Deployment Plan. 

No one imagined using the disaster response plan to the magnitude we did on September 29, 2022.  Golisano Children’s Hospital evacuated a total of 81 patients to 15 out-of-county healthcare facilities throughout the state in a 36-hour period.  The neonatal intensive care unit (NICU) census on September 29 was 68, which decreased to zero.  Seven babies were discharged to their parents and 61 babies were evacuated, one neonate was delivered in the middle of evacuation, stabilized, and evacuated. Of the 62 evacuated babies, 21 were categorized as level 3/ critical care and the others were intensive care level 2 patients.  The other patients included eight from the pediatric intensive care unit, six from the pediatric medical unit, three from the pediatric oncology unit, and two from the pediatric emergency department. There were no reported adverse events.

Nichole Shimko – Golisano Children's Hospital- Manager Transport Team

On December 27, 2024, Duke University Hospital, a Level I Trauma and Pediatric Center, experienced a catastrophic water line failure that resulted in significant flooding and extensive damage to critical areas of the facility. This unprecedented incident necessitated the immediate relocation of the Emergency Department and triggered a complete EMS diversion, redirecting emergency medical services to nearby hospitals. The water line failure disrupted not only the ED but also numerous critical services throughout the hospital, challenging the institution’s capacity to maintain operations and patient care.

This presentation will provide a detailed account of the incident, including the initial response, mitigation efforts, and the collaborative strategies employed to ensure continuity of care across the healthcare system. Key lessons learned, including the importance of robust emergency planning, interagency coordination, and communication with regional partners, will be discussed. Attendees will gain valuable insights into managing large-scale infrastructure failures in healthcare facilities and preparing for similar events to enhance resilience in their own organizations.

David Marsse – Central Carolina Healthcare Preparedness Coalition - Regional Healthcare Preparedness Coordinator

Shawn Rozalez - Duke University Health System - Emergency Management Coordinator

Any large gathering of people is one critical incident from becoming a disaster.  In some instances, that step is closer than others.  Factors such as expected attendance, basis for the gathering, weather, or environmental factors all play roles in the likelihood of increased demand for patient care both on-site and the impact on local/regional EMS as well as hospitals.  Proper preplanning and deployment must balance anticipated event characteristics against available resources and tolerances of patient-centered metrics such as time to defibrillation for cardiac arrest.  This presentation will discuss the approach to event medicine from both the planning and response perspective.

Jeff Ferguson - Henrico County Division of Fire, Medical Director

"The next pandemic is a plane ride away", David Weber, Medical Director of Infection Prevention and Associate Chief Medical Officer for UNC Hospitals. 

UNC is one of 13 Regional Emerging Special Pathogens Centers (RESPTCs) that will accept and treat these high-consequence patients up until discharge. Readiness and preparedness are crucial to the positive outcome and safety of our patients and personnel. Learn the necessities of an effective special pathogen response program in your facility.

Brooke Brewer – UNC Hospitals, Program Manager - UNC SPARC

Paula Hoyle - UNC Hospitals, Nurse Educator - UNC SPARC

Natalie Schnell - UNC Hospitals, Nurse Educator - UNC SPARC

Impacts from Hurricane Helene were immediate, unimaginable, and extremely impactful on healthcare facilities and their workers. This session will overview the mission of the NC OEMS Healthcare Assessment Teams and the critical information they were able to provide back to the state EOC. This presentation will also realign what we think of as the “worst case scenario” and how to prepare your leadership to recognize the potential of extreme impacts on your operating environment. 

Jason Zivica –  Duke University Health System - Assistant VP, Workplace Violence Prevention  & Emergency Preparedness