Benefis staff train for mass casualty incidents

Medical staff at Benefis Health System spent Friday learning to prepare for the worst.

The hospital is conducting mass casualty incident training for the non-provider staff, which includes nurses, certified nursing assistants and more.

The exercise was designed to train staff, who deal with emergencies on a daily basis, for a major event such as an explosion, a vehicle driving through crowds of people and mass shootings.

“We’re talking about an overwhelming volume,” of patients, said Kevin Langkiet, director of emergency services and critical care at Benefis.

“This can happen in towns like us,” Langkiet said. “Stop thinking this will never happen. We’ve got to be prepared.”

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Over the course of two Fridays, 387 employees will go through the training.

Half participated on Aug. 2 and the other half will participate next Friday.

The training included lectures and discussions in the morning and a full afternoon of hands-on interactive training outside the emergency department.

During the morning portion, they discussed what medical staff should do with their families in a mass casualty situation, or how to get to the hospital if the incident is between them and the hospital.

“We walk through that to get them in that kind of mindset,” Langkiet said. “I can’t get them to care for patients if they’re worried about their families.”

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Langkiet was in Oakland, California during the 1989 Loma Prieta earthquake that caused 63 deaths and 3,757 injuries in the region.

Langkiet was also in Oklahoma City during the 1995 bombing at the Alfred P. Murrah Federal Building.

He was the triage officer on the scene.

Last year, when the emergency department wasn’t finished yet, there was a crash involving five motorcycles and three vehicles, sending nine patients to the hospital where they were treated quickly, Langkiet said.

They do this every day, he said, but not on the scale of a mass casualty situation.

“I don’t do just in time training,” Langkiet said. “When we go into disaster mode, I want to be ready and have everybody be on board.”

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The scenario for Friday’s exercise was a facility fire with explosions at the refinery that scattered debris across a half-mile radius, significant damage to the refinery infrastructure, the Mountain View Co-Op buildings, the Montana Club, the 10th Street bridge and the garden center at WalMart. In the scenario, roads are impassable, all traffic has been routed to Central Avenue and the 15th Street bridge is being used for emergency vehicles. Fires are burning at the refinery, Montana Club, Mountain View Co-Op buildings and gas pumps in the scenario.

Great Falls Fire Rescue participated with their decontamination tents and hazmat trailer.

Langkiet said in a real world scenario, GFFR would handle the decontamination process before any medical staff would be able to treat patients.


The new emergency department at Benefis has showers, but Langkiet said they wouldn’t be the first line of defense in a mass casualty situation if decontamination was needed. Those showers would be used if medical teams determined a second round of cleaning was necessary.

Patients would go to the first area of the decontamination tent, remove all clothing and anything on their bodies to put in a bag that may or may not be returned, depending on the incident.

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Ambulatory patients would go through one side of the tents and be wrapped in some form of cover when they come out. Non ambulatory patients would go through the other side of the tent either in wheelchairs, on backboards or whatever means necessary assisted by first responders.

After decontamination, the exercise included a triage station where patients would be tagged with the four-color tag system used by first responders and medical agencies throughout Montana.


The exercise included different stations addressing different situations within the scenario: one has a mother than has died, but is laying on top of her baby, suffocating the child; another is a pregnant woman who’s been struck in the abdomen; another was bleeding control, another for airways and what Langkiet called the Grim Reaper station where they exercised how to handle patients that couldn’t be saved.

“There’s a limited amount of resources in a disaster. We have to figure out how to do the greatest good,” Langkiet said.

Participants also practiced securing patients onto backboards and loading them into the Mercy Flight helicopter.

In normal operations, the helicopter would power down before anyone loaded on or off the helicopter, but in a mass casualty situation, they’d keep the blades running and they’d do what’s known as hot loads, Langkiet said.

On Friday, Benefis staff trained on how to safety approach, load and exit a helicopter safely while the blades are running.

Langkiet said Benefis staff had been conducting drills and tabletop exercises with GFFR, Great Falls Police Department, Cascade County Sheriff’s Office, City-County Public Health Department and the Great Falls Clinic

Some Benefis staff members have attended more intensive training in Alabama with the Department of Domestic Preparedness, a component of the Federal Emergency Management Agency.