ON FRIDAY, MARCH 30, 2007, just after 1900 hours, North Hudson (NJ) Regional Fire and Rescue was dispatched to a bus crash with reported persons trapped. The incident occurred when a New Jersey Transit bus exiting the Lincoln Tunnel from New York City struck a center divider, launched over an embankment, and ended up teetering precariously atop a guardrail near the Park Avenue exit of the Interstate 495 helix. The incident details below were provided by North Hudson Deputy Chief Frank Montagne, who served as incident commander at the scene.
Initial response included rescue companies from North Hudson and Port Authority of New York and New Jersey, law enforcement, and the Weehawken Volunteer First Aid Squad. Additional resources included three engines; two ladders; one heavy rescue; one additional transit bus; and nearly 20 ambulances from Union City, North Bergen, Jersey City Medical Center, and Ambucare.
Photos by Ron Jeffers. |
On fire department arrival, multiple priorities were immediately apparent. The bus was unstable, with the front wheels nearly seven feet off the ground. Sixty-three people were aboard with various injuries. Diesel fuel was leaking heavily. An electrical transformer had been torn open, exposing live wires at the front of the bus. Water supply was also problematic, given the location of the incident on an elevated highway.
Firefighters immediately worked to calm passengers in the bus, knowing that panicked individuals could topple the bus. Initially, with the front door damaged and perched nearly seven feet in the air, the bus was inaccessible. Firefighters rapidly deployed cribbing, airbags, and struts to stabilize the bus; electricians were called in to cut power from the exposed transformer box. Firefighters contained the fuel leak and made access through the rear and side windows within 30 minutes of their arrival. Their deliberate and prompt actions coupled with continual communication with passengers calmed the passengers and prevented panic.
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Twenty-five people, including the bus driver, were transported to Palisades Medical Center in North Bergen and Meadowlands Hospital in Secaucus. Most were treated and released. On-scene, most injuries appeared minor (bumps and bruises). Two individuals were treated for chest pain, seven presented with complaints requiring spinal immobilization and extrication, 13 refused treatment and transport, and 18 others were taken from the scene in another New Jersey Transit bus. Fifteen passengers were standing at the time of the crash; they accounted for many of the injuries. A nearby gas station was used as a triage and staging area for EMS.
As massive traffic delays resulted from the incident, the bus was removed, the power was restored, the investigation was completed, and the roadway was reopened in less than five hours. Montagne attributed the success of the rescue efforts to the preparedness of the first-arriving units and frequent interagency drills and combined training programs. Members of the many police, fire, and EMS organizations that responded knew one another from Urban Area Security Initiative (UASI) training programs and, having worked together in the past, had a good understanding of each other’s training and capabilities.
Rapidly assessing the situation and quickly addressing multiple priorities were also keys to the success of this operation.
LESSONS LEARNED
This incident yielded numerous lessons learned.
• Strong command presence.Without leadership, any scene will deteriorate. As incident complexity increases, the need for an effective command and control presence also escalates. With 63 people aboard a teetering bus, the potential for panic was extremely likely. At this incident, command demonstrated clear effectiveness in rapidly setting priorities. Clear visibility and obvious progress in mitigating the many evident hazards helped in reassuring the bus occupants and averting panic.
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• Representation at command post. Each agency participating in rescue efforts must be represented at the command post to ensure clear communication. Without readily available input and consultation, the contributions and resources of departments or services at the scene cannot be fully optimized. No incident commander can possibly have intimate familiarity with all of the equipment, apparatus, and personnel at a scene. Taking time to hunt down representatives at a scene delays the overall operation and can cost the lives of victims and rescuers.
• Interagency training.Having worked and trained together through the Urban Area Security Initiative, many responders who otherwise would not ever have even met the others called to this scene not only knew each other but had worked together sufficiently to become quite familiar with each other’s skills and abilities. Rescuers who have worked with others in the past are familiar with each other’s strengths and weaknesses and can quickly and more effectively plan and execute tactics they have practiced together.
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• Rapid assessment. There is no way to imagine every possible incident that could occur in a given response area. In cases such as the bus crash, hazard assessment and plans for mitigation had to go hand in hand. Crews had to quickly recognize and address potential fire hazards, the fuel hazard, the electrical hazard, and the bus stability hazard with immediate and longer-term solutions. Being able to think quickly, multitask, and continually reassess the scene was absolutely imperative. You can develop, improve, and practice the ability to multitask at complex incidents by including such skills in training and drills.
• Stabilization. Until a vehicle rolls away from us or topples over, the need for stabilization is not often an early priority. In fact, stabilization is scene safety and should be job number one. At this scene, rescuers did not even attempt to gain access to the bus until they stabilized it. Accessing the bus before stabilization likely would have increased movement of passengers inside and potentially compounded injuries had the bus actually tipped.
• Access. Faced with the inability to use the primary egress, rescuers had to find alternate means of obtaining quick access to the bus once they stabilized it. Emergency windows provided this rapid access without the need for extensive cutting or prying at the vehicle frame or structural members. Swiftly making access allowed rescuers to calm the bus occupants and immediately begin triage and treatment of the injured.
• Multiple access points. Panic often ensues when occupants of an enclosed area rush toward a single point of egress. To readily reach numerous injured people and reduce the potential for chaos, rescuers opened multiple access points to the vehicle. Using many access points also prevented delay in extricating victims by allowing many EMS crews to remove victims simultaneously.
• Divisions and groups. Establishing divisions and groups to handle multiple areas of concern shortened the timeline for bringing the operation to a close. Working within the parameters of the National Incident Management System (NIMS) also allowed departments from multiple jurisdictions, including two different states, to speak the same operational language and work effectively together at a large-scale incident. NIMS provides a level playing field for management of incidents of any size.
• Vehicle familiarization. Even though it might not be possible to be familiar with every vehicle that travels through your community, you must have the resources to assist you with unfamiliar situations. In this crash, the transit bus power control switch was located midsection on the passenger side of the bus at waist height. Plan for how you would shut down fuel and power for cars, trucks, recreational vehicles, trains, buses, and aircraft that might crash in your response area. The initial moments of an emergency response are not the ideal time for getting this education.
• Hospital notification. A very commonly neglected step of incident management is hospital notification. Failure to poll hospitals for capacity and make notification of injuries is tantamount to relocating a mass-casualty incident from a roadway to the hospital. Ideally, hospital notification is accomplished during initial scene size-up and assessment, with continued updates as triage and treatment progress. You may discover in the process of making hospital notifications that other incidents are in progress in addition to yours.
MIKE MCEVOY, Ph.D., REMT-P, RN, CCRN, is the EMS coordinator for Saratoga County, New York, and the EMS director on the board of the New York State Association of Fire Chiefs. Formerly a forensic psychologist, he is a patient care coordinator in cardiac surgery and teaches critical care medicine at Albany Medical College. He is a paramedic for Clifton Park-Halfmoon Ambulance, chief medical officer for the West Crescent (NY) Fire Department, and EMS technical editor for Fire Engineering.