On September 16, 2017, Hurricane Maria, a massive storm with winds topping 170 mph, slammed into Puerto Rico, leaving behind over 60 dead, hundreds injured, and the entire island without power. Even 45 days after the storm, power had been restored to only 41 percent of the island, leaving thousands in the dark.¹
Natural disasters can wreak havoc—not only on towns and cities, but also on the responders tasked with caring for the injured and the dead. Imagine responding to a major storm, a powerful earthquake, or a cyber-attack that knocks out main power grids, and you can appreciate the challenges first responders must overcome in providing essential services. The key is preplanning: having detailed plans in place, staging practice scenarios involving response agencies from across the board, and ensuring your equipment needs are met in the event of a mass casualty incident. And one of the most essential pieces of rescue equipment is your battery-powered aspirator.
The Role of Aspirators During MCIs
Emergency field medicine is all about improvising. And when you are faced with the added burden of an MCI, improvisation can be extreme. The scene itself may have to serve as the triage area; standing structures may serve as field hospitals; and cooling trucks may be commandeered as morgues. In a natural disaster, you must make do with what is available.
But when it comes to your battery-powered aspirators, there is really nothing that can take its place. Which is why you must strategize when planning for an MCI. The following list provides some essential considerations.
- What Type of Unit: Begin your plan by selecting the best battery-powered aspirator to meet your needs. This includes:
- Reliability—ensure you choose a brand that has a proven track record in quality construction and function.
- Durability—especially when selecting for MCIs, you want a durable unit that can withstand extreme temperatures, weather, and rough handling.
- Portability—the unit must be lightweight and easy to transport.
- How Many Units: Depending on your agency's size and budget, you must decide how many units to purchase. If your service is part of a large community, where there are numerous mutual aid agencies available for MCIs, you may not require as many units as a more rural agency where backup would be delayed or nonexistent.
- Catheters and Adjuncts: Don't forget to include extra catheters, tubing, and canisters when preparing for MCIs. Since the units may operate for long durations on a successive number of patients, be sure you have plenty of replacement adjuncts available (and be sure to decontaminate the unit between patients).
- Power Sources: It’s a given that you will need batteries for your battery-
powered aspirators. This is especially true during MCIs caused by natural
disasters, since electricity may be in short supply. Have plenty of extra
batteries, or include aspirators capable of utilizing alternative power sources,
such as defibrillator batteries. Your units are of no use if they don't have
power. Consider devices that run on commonly available batteries, such as
disposable alkaline batteries. Devices powered in this way can run
indefinitely.
- Maintenance Is Essential: MCI trailers and their contents may sit for long periods between events. Equipment must be inventoried and up to date. As for your battery-powered aspirators, good maintenance will ensure they are ready when needed. Here are some considerations:
- Check batteries regularly—replace old or damaged batteries and have plenty of backups available.
- Power units up—to ensure they are operational.
- Check for wear and tear—inspect for dry rot, cracked tubing, rust, and damaged parts/accessories.
- Keep units clean—do not let dust or debris accumulate while units are in storage.
Preparing for multi-casualty incidents requires careful planning, intra-agency cooperation, and ensuring you have the appropriate equipment and supplies at the ready. And no piece of equipment is more critical than your battery-powered aspirator. Visualizing the cords during intubation or maintaining airway patency can only be accomplished through effective suctioning, so be sure your units are prepared for the next disaster.
¹ Federal Emergency Management Agency, Statistics: Progress in Puerto Rico.,2017. https://www.fema.gov/hurricane-maria.