'Organized chaos': How a small-town Utah hospital treated 19 bus crash patients


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PANGUITCH, Garfield County — It was just after 11 a.m. Friday when the call came in to Garfield Memorial Hospital. A tour bus carrying 30 Chinese tourists had crashed just 10 minutes away — and most of the passengers, many of them critically injured, were on their way.

The 15-bed critical access hospital in rural Panguitch, population approximately 1,500, typically sees between three and nine emergency patients per day. While the staff had trained for a mass incident of this scale, it was, by hospital administrator estimations, the largest influx of seriously injured patients the hospital had ever seen.

Immediately, the staff leapt into action: preparing rooms, texting off-duty employees to come in to work, notifying larger neighboring hospitals. One local man volunteered his translation skills, and a few nurses from St. George who happened to be visiting the area offered their help as well.

“There was no panicking,” recalled hospital administrator Alberto Vasquez on Monday, three days after the bus crash near Bryce Canyon National Park that killed four passengers and injured more than a dozen others. “There was focus on the task at hand. We know this. We drill this. We anticipate this kind of thing. And people just focused on the patients.”

The crash occurred on state Route 12 near Red Canyon about 11:15 a.m. Friday, according to Utah Highway Patrol, after the bus apparently drifted off the right side of the road and the driver overcorrected. The bus fishtailed and rolled over, police said, rolling into a guardrail before landing on its wheels.

The cause of the crash is under investigation by the National Transportation Safety Board. Investigators said Sunday that the driver of the bus was on his first trip for the company.

Four people, all from Shanghai, China, were declared dead at the scene: Ling Geng, 68; Xiuyun Chen, 67; Zhang Caiyu, 62; and ZhongLiang Qiu, 65.

All in all, Garfield Memorial Hospital saw 19 patients from the crash. Eleven of those patients were transferred to larger hospitals in St. George, Provo, and Salt Lake County. Seven were released from Garfield that day, and one — who has since been released — stayed at the Panguitch hospital.

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By Monday afternoon, 12 patients remained at hospitals across Utah. Three were in critical condition, one was in serious condition, and eight were in fair condition.

In a stroke of good luck, six members of Intermountain Healthcare’s executive team, including executive director of emergency departments and trauma services Rachelle Rhodes, happened to be visiting the hospital on Friday.

Rhodes noted the role telepresence played that day, as Intermountain’s tele-critical care team was able to help notify other Utah hospitals about possible incoming patients. But she also praised the “incredible community that came together” in Panguitch in those crucial first hours, from the Garfield staff to EMS volunteers and other first responders on the ground.

“There was a warm, welcoming, organized chaos,” Rhodes said, as she described watching the scene playing out in the ambulance bay.

“I’m sure inside they were screaming,” Vasquez said of the hospital staff, “but outside they were cool and collected.”

Technology was key to crossing the language barrier, too. After the community volunteer’s initial translation efforts, the hospital used an online service, carrying iPads from room to room to facilitate communication between patients and hospital employees.

The hospital conducts drills about once a year to prepare for such large-scale events, according to Vasquez. While he is proud of Garfield’s response, he said the hospital plans to discuss, going forward, what can be done to “do better” next time.

Both Vasquez and Garfield nurse administrator DeAnn Brown said they believe the hospital’s small size and rural home were strengths, not weaknesses, when it came to mobilizing the hospital and community.

“We know each other; we know what to expect,” Brown said. “I feel like because of that, we were able to plan and kind of know how to respond to each other.”

“It’s a very tight and close community,” Vasquez added. “It doesn’t matter if you’re from China, or Italy, or Panguitch. We’re going to treat you the same way, and that’s why it’s so nice living in a small community. You’re literally caring for your neighbors, even though they may be from across the ocean.”

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