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Community Spotlight: Elevated Motor Vehicle Crash Death Rate
Tioga, North Dakota:
Last fall, 20 high school students participated in a hypothetical situation where an oil
rig semi-truck crashed with a school bus. The students were caked with makeup to resemble blood and bruises,
which added to the experience. Each student wore a sign that detailed their injuries and enabled emergency crews
to practice their triage skills.
This mock event stemmed out of a Community Health Needs Assessment from Tioga Medical Center (TMC), which had
identified "Elevated motor vehicle crash death rate" as a prioritized community health need. While this need is
not surprising given the increase in traffic from oil rigs, it falls outside the scope of the hospital and its
To address this need, TMC spearheaded an initiative to host a mock motor vehicle mass casualty incident. They
partnered with Williams County Emergency Preparedness, North Star Helicopter Services, Guardian Helicopter
Services, Tioga Fire Department, Tioga Ambulance Department, Ray Ambulance Department, Powers Lake Ambulance
Department, and Tioga Public School.
According to Ryan Mickelsen, VP of TMC, the purpose of this exercise was “to test the abilities of the local EMS
as well as Tioga Medical Center in the event of a mass casualty incident, with the goal of successfully reducing
the number of casualties and ensuring patients receive definitive care as timely as possible.”
One of the aims of the Community Health Needs Assessment is to promote community engagement by assessing the
strengths and gaps of the community. As part of the Affordable Care Act, identified needs must be addressed, but
hospitals are often left with scarce resources to implement activities. The emergency drill is an example of a
community program that is making a difference and fostering collaboration and cooperation among community
It took months of planning to implement an activity of this magnitude, but all community stakeholders wanted to
participate to test their capacity and improve their systems. Lessons learned stemming from this mock event
include improving the field triage process. As an all-volunteer emergency squad, this event highlighted the need
for more training to better prioritize patient load and assess which patients to treat first and which, among
the walking wounded, could wait for treatment. Additionally, it underscored the need for more EMS education
regarding diverting less seriously injured patients to neighboring hospitals to decrease patient loads.
The mock test also revealed strengths in the current health communication system with an "all hands on deck"
page going out to all employees. Employees who did not receive the page were flagged as needing to update their
While the cost for emergency planning and preparation drills like this can be high, the only money TMC dispensed
was for make-up and the pizza and pop for participants to enjoy afterwards. The amount of in-kind contributions
from local businesses and community organizations—in the forms of equipment supplied from the oil company,
schools, fire and ambulance departments—conveys their commitment to community health.
One year later, Tioga Medical Center is realizing the benefits from this mock event in the form of more cautious
driving which in turn has led EMS responding to fewer vehicle crashes involving the youth. Additionally, there
are improved relationships and a more open dialogue among the EMS crew, hospital staff and flight crews.
"In general our medical center feels more confident in the abilities of our local EMS in managing a mass
casualty scene appropriately," said Mickelson. "Our EMS providers are more confident in the medical center to be
able to manage the patients that are brought to them as well as the decisions to divert patients to other
Future plans for continued training and commitment to community health are witnessed by Mickelson’s willingness
to host another event every couple of years to keep everyone sharp in their responsibilities.
For more information about this mock event, contact:
Tioga Medical Center