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thedrifter
01-31-06, 08:01 PM
Formal event turns into dramatic disaster
By Nancy Thornton, Acantha reporter
Choteau Acantha, MT

Great Falls Clinic-Choteau and Fairfield family physician Dr. Laura Shelton was one of several physicians and other medical providers who came to the aid of carbon-monoxide-poisoning victims in Red Lodge on Nov. 12, 2005.

Shelton gave a 45-minute presentation on the disaster to the Teton County Hospital District board at its monthly meeting on Jan. 23.

After talking about the mass illness, she offered insights about the emergency response that would be necessary if something like that ever happened here.

Shelton and Marine Staff Sgt. Paul Dreyer of Choteau were at the Rock Creek Resort near Red Lodge attending the U.S.Marine Corps 230th Birthday Ball when they both became involved in what state emergency officials called Montana's biggest medical disaster in recent memory.

Dreyer is a member of the Billings-based Co. B 4th Recon BN unit, of whom nearly all were deployed to Iraq over the course of the war. One of the unit's Marines died there.

The Nov. 12 gala was a black tie and formal affair that several hundred Marines outfitted in their finest uniforms and their families and friends attended.

Shelton said things went astray at about 4 p.m. when two Marines at attention wavered and fell during an awards ceremony. The Marines dismissed the symptoms at first, suspecting that the victims had imbibed too much alcohol the night before.

Then five people in the large formation fell ill.

Everyone was in a banquet hall in the basement when it became apparent that the illness was widespread. An ambulance had arrived because several people staying at the resort had passed out.

Shelton described how, at Dreyer's prompting, she changed out of her formal wear and worked to discover what was happening alongside Dr. Green, a cardiologist and Air Force colonel from North Dakota who had attended the banquet in a Scottish kilt. Shelton had not brought her medical kit to the resort, but someone found a "29-cent" pediatric stethoscope for her to use.

The victims told conflicting stories, some had headaches or complained of dizziness, some fell backward and injured their heads, and others had chest pains.

The doctors thought of several diagnoses, including food poisoning, alcohol, terrorism and gas poisoning. Finally, the fire department confirmed carbon monoxide (CO) had infiltrated the building. It registered 279 parts per million when normal is below 35 ppm.

Ambulances responded from all over the region. Forty-two patients were admitted to Beartooth Hospital in Red Lodge; however, about 200 complained of symptoms and lined the halls of the hospital.

A deputy drove Shelton on a harrowing ride in his squad car five miles down a mountain road in snowy conditions so that she could assist in the triage at the hospital.

Three people were treated in a hyperbaric chamber in Billings, having been exposed longer or having been more susceptible to the gas. Carbon monoxide is an odorless, colorless gas that binds to blood cells in place of oxygen. The victims included Shelton, who recalled having a headache that she attributed to the onset of flu earlier in the day.

The fire department determined that a faulty pool heater and boiler were the cause of the carbon monoxide.

Shelton said everyone did an outstanding job in responding to the mass illness, and she cautioned that it could have been worse if it had not been for the fact that the Marines fell ill, before anyone had gone to bed, and followed orders and did not panic.

Shelton listed the challenges she and the other medical providers faced at the hospital and offered suggestions for Teton Medical Center staff and Teton County emergency medical technicians and responders.

Beartooth Hospital was inundated with sick people on a Saturday night. Hospital staff and area medical providers arrived as quickly as possible but their response was hindered by a shortage of staff, a shortage of supplies, (they ran out of oxygen masks and oxygen) and the chaotic environment.

Extra hands were welcome, but providers in these situations must ensure that the extra helpers are trained in what they are asked to do. Shelton recalled that a victim was not getting better and it was determined that someone had not turned on enough oxygen for him.

Shelton noted that EMS rules mandate one EMT for each victim transported. The local hospital had a limited number of people available to travel with victims in ambulances.

On the other hand, a region-wide disaster drill had taken place earlier in the month, and it was fresh in their minds what everyone needed to do when the real thing happened. Ambulances arrived from as far away as Powell, Wyo.

She said everyone should get involved in disaster and emergency services and complimented Teton County EMS Director Justin Grohs for the work he has done here. DES and EMS officials are planning a five-county table-top disaster drill in February.

Shelton recommended that state lawmakers enact a law to require CO detectors in all public places.

She said that people with low body fat are less tolerant of CO gas and the effects of the gas may last up to a year.

She said she owns a sweatshirt stamped with the Marine logo, "Swift, Silent and Deadly," and was glad she was not wearing it when she became part of the disaster, although it was apropos of what happened.

She added, smiling, "I learned to always travel with a stethoscope."