How the ice storm raised the stakes for patient triage at Sunnybrook

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This is part of The Globe's months-long series on the challenges facing Canadian hospitals. All of our published material has been reported with permission from staff.

Hospitals are like cities in which emergency, surgery, general medicine and other departments are neighbourhoods linked by corridors or thoroughfares. Usually, they exist in isolation, unaware of the human dramas playing out on the other side of the medical street.

All of that changes when an overwhelming force, such as the Christmas ice storm, threatens the viability of the metropolis.

When the two main power lines into Sunnybrook failed around 8 p.m. on Saturday, Dec. 21, its five diesel-powered backup generators kicked into gear, according to Ru Taggar, whose titles include vice-president of quality and patient safety.

But early the next morning, the lights started flickering in the Neonatal Intensive Care Unit (NICU). That's when the hospital decided to send six of its premature babies to other neonatal units. The sickest ones, who were on ventilators, went to Mount Sinai and the Hospital for Sick Children; Moses and Alexander (twins born on Nov. 3 at just under 24 weeks), who were robust enough to breathe with the help of CPAP machines, were sent to nearby North York General.

Their mother Roselyne Shipendi was awakened around 5:30 by a phone call from Sunnybrook. "I was shocked," she said in an interview, adding she was "scared" and "frustrated." An hour later, she had a phone call from North York saying the babies had arrived safely. The "move was a big thing for them," she says, but "they are getting better and they are used to North York now."

Back at Sunnybrook, the hospital had long since activated its emergency plan and opened up a command centre. "We knew that the NICU was fine," said Taggar, "so we moved to checking out the other systems." The immediate issue was running the radiation machines, which require too much power to operate on backup generators; so appointments in the cancer clinic were cancelled on Monday morning.

Then, the unexpected happened. Ambulance volumes across the Toronto system were rising and patients relying on the Community Care Access Centre (CCAC) for home care were in distress because of hypothermia or the failure of their electronic medical devices.

That's when the province, the CCAC, the Emergency Medical Assistance Team (EMAT) and other essential services banded together to deploy a mobile emergency unit at Sunnybrook, to cope with an anticipated surge of patients. In the end the EMAT facility, set up in the hospital's auditorium, saw fewer than a dozen patients before full power was restored on Dec. 23.

Instead of causing a city-wide medical disaster, the ice storm gave the system a valuable real-time exercise in emergency planning with the key players helping out like good neighbours should.

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