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MGH-based disaster teams meet the challenges of September 11

BOSTON — March 1, 2002 — When the first International Medical and Surgical Response Team (IMSuRT) of the National Medical Disaster System was formed in 1999, its members anticipated they would travel to locations around the world to respond to terrorism or other disasters affecting American citizens. Instead the team, based at Massachusetts General Hospital (MGH), was first called into action in the aftermath of the September 11 attacks on New York City.

"No one thought that the team would experience its inaugural deployment on American soil," writes MGH pharmacist Ronald Gaudette, BS, MBA, in an article in the March issue of the journal Pharmacotherapy. Pharmacy team leader for the MGH-based disaster team, Gaudette describes the challenging, sometimes harrowing situations facing the specially trained health care workers after their arrival at Ground Zero.

The New York site was, Gaudette notes, "one of the first disasters where we could not even place search and rescue teams into the area because of the twisted steel barrier created by the collapse." He describes how what was planned as an effort to care for those injured in the initial attacks changed into a mission to support and care for the rescue workers.

The National Disaster Medical System of the U.S. Department of Public Health, Gaudette writes, is made up of state-based Disaster Medical Assistance Teams (DMATs), staffed by volunteers from a variety of medical fields. Four DMATs are based in Boston and staffed by health care workers from the MGH and other area hospitals: one general medical DMAT; a pediatric DMAT; a burn DMAT, directed by Robert Sheridan, MD, of the MGH and Shriners Burns Hospital; and the IMSuRT, directed by Susan Briggs, MD, MGH trauma surgeon. Briggs also was overall commander of the four Boston DMAT teams.

The MGH-based IMSuRT arrived at Ground Zero on the evening of September 13, not long after a collapsing building had fallen on the site initially chosen for the medical station. An alternative site was designated and, as Gaudette describes, the team set up the first of what would be five medical stations throughout a cold and rainy night. Before 7 a.m. the next morning, the team had treated its first patient, beating the readiness goal it had established. Among the medical needs met by the team was providing needed medications to rescue workers with chronic conditions such as asthma, diabetes and hypertension and dealing with a wide variety of injuries. The MGH IMSuRT and the other Boston disaster teams treated more than 5,000 workers during the first 11 days following the disaster.

Gaudette notes that of all the clinical and personal skills the team members brought to Ground Zero, creativity, flexibility and true teamwork were probably the most valuable. Among the nonmedical challenges met by the team: getting themselves to New York when all air transport in the country was suspended; using sandbags to support the tents because stakes could not be pounded into the city concrete; and adapting a delicatessen's shelves and counter to serve as a supply depot and examination table. He describes combining antibacterial and anesthetic creams to treat the blistered feet of a firefighter who refused to stop working and treating another rescuer with a history of heart disease who insisted on returning to work after his chest pains subsided.

"We thought we knew what we were going to find until we got there, and then our worst nightmare didn't even come close to reality," Gaudette writes. "What was particularly frustrating is that we, as a country, have the best medical care available and yet at Ground Zero, we could not save people. What is also important to realize is the strength that a disaster like this gave to us, and the fact that the MGH team, like the other teams and our federal system, really worked." Gaudette’s co-authors on the Pharmacotherapy paper are Jay Schnitzer, MD, PhD, pediatric surgeon, MassGeneral Hospital for Children; Edward George, MD, PhD, MGH anesthesiologist; and Briggs.

Massachusetts General Hospital, established in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $300 million and major research centers in AIDS, the neurosciences, cardiovascular research, cancer, cutaneous biology, transplantation biology and photomedicine. In 1994, the MGH joined with Brigham and Women's Hospital to form Partners HealthCare System, an integrated health care delivery system comprising the two academic medical centers, specialty and community hospitals, a network of physician groups and nonacute and home health services.

Media Contact: Sue McGreevey , MGH Public Affairs
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