As reporters crowded into the emergency room, one woman rushed through the crowd holding a baby doll close to her chest as if it were a real child.
“Trauma five,” she told the waiting doctors. “He’s the sickest.”
The doctors, placed the doll on top of a mannequin — another simulated patient they’d been working on until just a few minutes ago. Then they began working on the doll.
“If the child’s attached to the parent,” explained Charles Reneau, “even if the parent’s dead, that attachment will have a positive effect on the health of the child.”
Reneau is the director of the Noble Training Facility, a part of the Department of Homeland Security’s Center for Domestic Preparedness, where 19 health care workers and hospital officials from around the country trained Friday for real-life battle with highly infectious diseases such as Ebola or Middle East Respiratory Syndrome.
That’s a slightly different take on what the CDP does every week. The center routinely brings first responders from around the country to Anniston to prepare for large-scale disasters and terrorist events.
In a press release about this week’s training, CDP officials noted that Africa is once again dealing with an outbreak of Ebola — a deadly viral hemorrhagic fever that infected a handful of victims in the United States during a 2014 outbreak. Still, the center’s invitation to reporters to watch the training may have had less to do with Ebola concern and more to do with their desire to show off a newly-refurbished wing of Noble Training Facility, a former Army hospital that now deals only with simulated emergencies with the CDP, which has long been an Ebola training center.
“We want them to have their worst day here so they can have their best day elsewhere,” said Richard Brewer, a spokesman for the CDP.
The training is realistic enough to look like a movie set — in this case, the classic film “E.T. the Extra-Terrestrial.” Medical workers in white protective suits unloaded mannequins from simulated ambulances and sealed them in little plastic tents — known as “iso pods” — before spraying pod and gurney down with disinfectants.
“No diarrhea?” asked one worker, talking loud to be heard over the sound of ambulance sirens.
“No diarrhea,” said another.
“Is he able to speak English?” said the first worker.
“Some,” said the second.
Training at the center closely mimics military training and exercises — with students attending classes and then working through a realistic simulation at the end of the training. Friday’s event left little to the imagination. The mannequins on the gurneys were robotic, with chests that heaved as they breathed. Actors played the roles of patients.
Trainees weren’t told what diseases to look for as patients came through the door. On a news broadcast playing throughout the hospital — actually a trainee on camera answering questions from a pretend reporter — there was mention of a single confirmed case of Ebola. Reneau later confirmed that an Ebola outbreak was part of the simulation.
“Ebola, and maybe a little something else,” he said.
Asked about their accomplishments, CDP officials typically point to recent disasters and the first responders who trained in Anniston before those disasters happened. Seven people died last month in the crash of a historic B-17 bomber in Hartford, Conn.; Brewer said officials from a nearby hospital trained for a mass-casualty event not long before the crash.
Grant Bissey, who was in charge of Friday’s exercise, said the training forces first responders to think of things that might not occur to them until a disaster.
“What do we do with people who’ve passed on?” he said. “If we have a morgue that will handle only six people, what do we do?”
Trainees also confront some grim math. If the hospital has more patients in need of respirators than it has respirators, who comes first? Reneau said he often asks doctors to choose between an elderly patient, now on a respirator with a good chance of living, and a 12-year-old with an acute illness who’s very likely to die.
“Emotion always prevails,” Reneau said.
“They’ll let the old guy die to save a kid who’s dying anyway,” added Bissey.
Both were quick to follow up by saying that there’s no right or wrong answer, and that instructors don’t judge students’ ethical choices.
Tiny innovations, developed or championed here in Anniston, were visible around the hospital. The robot patients in the emergency room had color coded “triage tags” around their necks, meant to help doctors remember who needs urgent care. The tags used here were designed by CDP, with input from trainees. Bissey said they’re now used around the country, with more than 10,000 distributed to hospitals.
Some rooms in the hospital are bathed in the purple glow of an ultraviolet light — something that allows workers to spot spills of biological material, Bissey said, because protein tends to show up in black light. That’s something hospitals could easily adopt, Bissey said.
No one at the center said they’re expecting to have to deal with Ebola any time soon. Still, the CDP does sometimes train security officials for large pre-planned events, officials say. They expect to soon train the officials who’ll deal with both the Democratic and Republican 2020 conventions and for the Super Bowl.
Reneau said the training is always tough, on purpose.
“We push them to the point of failure, but we don’t let them fail,” he said.