The Situation:

On July 1, 2015 at approximately 11:50 PM a tank derailed on a 57 car freight train on CSX Railroad near Maryville, Tennessee (a city of 30,000 people just south of Knoxville, TN).  The crew reported seeing a fire near the rear of the train.  Of the 57 cars, 27 contained hazardous chemicals.  After safely stopping the train, they found that the 37th car was derailed with the bottom of the car completely engulfed in flames.  The car that derailed and was in flames was hauling 24,000 gallons of acrylonitrile.

Acrylonitrile is a flammable, toxic and colorless liquid used in the manufacture of plastics.  It’s considered carcinogenic.  Exposure can burn the skin; inflame the lining of the lungs, throat, and nose; and cause headaches, nausea and dizziness.  Most concerning in this incident was that cyanide is a byproduct of burning cyanide.

Mandatory evacuations started around 12:30 AM.  The evacuation zone stretched to a 1 1/2 mile radius from the scene (in three jurisdictions:  Maryville City, Alcoa City, and Blount County), with about 5000 people and businesses affected.

KET HCC Communications and Initial Response:

Wanda Roberts, the Regional Hospital Coordinator for the East Region, was notified of the event by Blount Memorial Hospital (BMH) around 3:00 AM, with an initial notification as the hospital had only received a courtesy notification from the scene at that point.  As the event unfolded and the extent of the hazard was realized, BMH made a follow-up notification to Wanda Roberts at 5:00 AM that they were starting to receive patients.  This second notification kicked off the response from the Knox/East TN Healthcare Coalition member organizations.  Regional Hospital Coordinators responded to the Regional Medical Communications Center.  An event was activated in the Healthcare Resource Tracking System (HRTS) and Tennessee Health Alert Notification (TNHAN) was sent to notify area hospitals and EMS.  Also during this period, the East Region EMS Consultant was dispatched to the scene and the East Regional and Knox County Emergency Response Coordinators were dispatched to the East Tennessee Regional Health Office’s Regional Operations Center, which had been activated.  Additionally, the local chapter of the American Red Cross established a shelter at Heritage High School.  Finally, the East Region Ambus was deployed to the scene to support operations.

The event page on HRTS as well as the message board served as the primary source of information between the Regional Hospital Coordinators and the area hospitals.  Additionally, communications were regularly flowing between the scene and the Regional Medical Communications Center, Tennessee Emergency Management Agency, Tennessee Department of Health State Health Operations Center and East Tennessee Regional Health Operations Center.

Blount Memorial Hospital’s All-Star Response:

Ultimately, Blount Memorial Hospital received 157 patients during the event (a majority of them in the initial response period), with 49 admissions.  Utilizing their permanent on-site mass decontamination system, they successfully decontaminated 132 patients!  Early on, the medical staff at the hospital realized the potential need for cyanokits to treat patients expose to cyanide gas, so they quickly made a very early request to the Regional Hospital Coordinator for support.

KET HCC and Neighboring Support:1005090224_10181100

Following the request for cyanokits, the East and back-up Knox County Regional Hospital Coordinators immediately started reaching out to hospitals in the Knox/East TN Healthcare Coalition.  Additionally, kits were requested from neighboring Healthcare Coalitions (Northeast/Sullivan County and Southeast/Hamilton County)and the cache held by the Tennessee Department of Health’s Central Office in Nashville.  Ultimately a total of 41 kits were identified and were transported to Blount Memorial Hospital via Tennessee Highway Patrol.  Most of the kits were received at BMH within 2 hours; and, within 8  hours all of the kits had been received.

Partnerships Built To Last:

This event served to demonstrate how a tight-knit community of Coalition Members can quickly respond to support one another without a moment’s hesitation. Communications flowed quickly throughout the event, resources were provided in a timely manner, and poor outcomes were mitigated.

We couldn’t be more proud of ALL the Knox East TN Healthcare Coalition Member Organizations that responded to this event including area hospitals, area EMS organizations, Regional Medical Communications Center (MEDLINK 2), American Red Cross, Tennessee Emergency Management Agency, Tennessee Department of Health EMS and Emergency Preparedness, East Regional Health Office, and Knox County Health Department.

More Information:

First Responders Decontaminated at Blount Memorial Hospital

CNN Coverage

Blount Memorial Chief Medical Officer Early Update