Drill time: Managing an airplane crash

[Allina Newsroom, May 27, 2024] It was a beautiful day for a disaster. Drill. Just a drill. As a part of Federal Aviation Administration guidelines, the Minneapolis-St. Paul (MSP) International Airport is required to test and update their emergency plan every three years. On May 8, our EMS team participated in a drill to test the plan.

The scenario was this: an engine detached from an airplane during take-off which caused the aircraft to crash into a taxiway, slide through the perimeter fence of the airport before coming to a rest in the airport dog park, where it was engulfed in flames. Traveling on the plane were 130 people between crew and passengers. Buses were arranged on the field to represent the plane.

EMS crews were assembled and briefed before responding to the event, which is an opportunity for EMS to put their own response plans into place. Each ambulance carries an Incident Response Plan, a trifold, which easily fits into the cargo pants pocket on an EMS uniform and provides basic planning and guidance on priorities when responding to a significant incident.

Typically, the first arriving ambulance will be the last one to leave. The crew splits up, taking on roles in command and control of the event. It's practiced on a smaller scale each day when responding to car crashes where more than one person is injured, and more than one ambulance is needed. However, a plane crash will quickly overwhelm the first EMS crew and require a Mass Casualty Incident (MCI) declaration, with multiple ambulances needed for transport.

The MCI declaration begins a series of notifications within our EMS team and to mutual aid agencies along with Medical Resource Control Centers (MRCC). Supervisors and EMS Medical Directors responded and began roles within the incident command structure and triage area. Hennepin EMS responded as mutual aid partners. The Incident Response Plan trifold was developed by Metro EMS leaders and is carried by mutual aid partners so we can work off of the same plan.

For a real event, we may have assistance from multiple agencies, and we all use different radio channels due to the high volume of radio traffic within each agency. Within our own EMS dispatch center, we can begin to coordinate a radio patch, which merges channels together so agencies can talk to one another without changing channels or radios.

With this type of incident, injuries can be wide-ranging and, unfortunately, in the scenario, many did not survive the crash. Patients were represented by a long wooden board with a paper listing injuries for triage purposes.

After crews received patients from triage, they would contact MRCC to advise of where they are transporting to based on the severity of injuries. Each hospital has advised what number of beds they can provide care for if an MCI were to occur and it is stored within a tracking sheet through the Minnesota system for Tracking Resources, Alerts and Communication (MNTrac). MRCC keeps track of the number of beds available at each hospital and can alert crews to choose another hospital if one is overwhelmed. MNTrac is monitored by dispatch centers and hospitals throughout the state.

With more than 400,000 flights in 2023 and approximately 34 million people traveling on the grounds, MSP airport is its own city, with a police and fire department, land and air operations crews and a hotel directly attached. In 2023, our EMS crews responded to the airport and the surrounding grounds more than 2600 times.

The need for this type of drill is imperative as many agencies need to collaborate if a disaster were to occur. It was the result of eight months of pre-planning meetings and a tabletop exercise before the outdoor drill took place.