Fake blood. Real drama. Steelworkers practice for mass casualty

A Nebraska industrial plant stages disasters to hone its emergency response

It's the type of industrial accident everyone dreads.

As workers unload a delivery of wooden beams from a flatbed truck, the forklift driver pushes the load too far. The stack of 4x4s tumble forward, crushing two men under the load. Their screams could be heard over the din of the steel plant where they work.

Within minutes a small group of men in hard hats rushed toward the pile of wood.

"Has anyone called 911 yet?" asks one.

Another kneels next to a man caught under the lumber.

"What hurts the worst?"

The pinned man gasps, "the waist down," as his voice trails off.

"Okay, quit moving your arms and legs around, and just try to lay still as you possibly can, okay?"

Nearby, a tall, bearded man in well-worn overalls held his bleeding arm. A long steel band dangles out of the wound. Someone urges the man to sit, so his sleeve can be cut away, revealing a nasty wound underneath.

The whole scene is theater, staged by the Nucor Steel plant outside of Norfolk, Nebraska to train 24 members of the volunteer Quick Response Team (QRT).

Fellow employees portray the anguished victims. Make-up artists provided them with ghoulish injuries that looked like they needed immediate first aid.

The extensive theatrical trial is necessary because Nucor's sprawling complex is several miles from the nearest, fully equipped fire department. Those first responders could take up 20 to 30 minutes to respond, which is far too long. Instead of waiting for help, Nucor trains and equips its own group of emergency medical practitioners.

When the injuries are real, a delay could cost a life.

The recent training was the first exercise of this type since the pandemic. "Some of these guys have never had this kind of incident before," said Josh Mattson, Nucor's local safety coordinator. "It's good to pull everyone together."

A staged mass casualty event like the lumber loading accident gives the response team the opportunity to work with first responders in the area and to hopefully "get these patients out of here faster and keep them healthier," according to Mattson.

The plant falls within the boundaries of the Hoskins-Woodland Park Volunteer Fire Department, which has 35 members. The paid firefighters in the city of Norfolk routinely respond to calls from the plant when necessary.

"We have to make sure our guys and gals are trained up enough to just take care of their patients and recognize what's going on," Mattson said.

The firefighters realize the workplace hazards facing more than 500 employees at this plant pose unique issues for anyone providing help in an emergency. There are warning signs around the complex cautioning visitors about the transportation of molten metal.

When working a shift at the Norfolk department, Lt. Brock Soderberg said, "everybody holds their breath for a minute" when an alarm is sounded at the Nucor plant "because they usually know if we're coming out here, it's something that's going to be pretty bad."

The company claims its recent safety record has been good. According to 2021 filings with the Security and Exchange Commission, its injury rate has been the lowest in the company's history for two consecutive years.

During the fictional disaster concocted by Mattson, the complications multiplied as the incident unfolded.

The incident commander, Brad Hilfiker, rushed to the scene and found "a very realistic scenario" that demanded he and his group determine which of the three injured by the lumber needed fast transport to the hospital.

One of the Quick Response Team members suspected one of those pinned may have punctured a lung, so Hilfiker calls in the LifeNet medical helicopter to get him to Faith Regional Hospital.

Then another complication — the stressed-out forklift driver collapses from an apparent heart attack. A fourth person needs transportation to the emergency room.

The stress is part of the plan.

"I was watching the people as they come, and they sort of had that pucker factor when they come up here," said Mattson, who detailed every element of the exercise from the timing to progression of each patient's blood pressure.

"You know it's a drill, but you get on scene, and you start seeing the patients, and you hear them yelling, and your mind goes, 'this is real. We got to keep going to get these patients out of here," he said.

During the drill, the Nucor first responders kept their interactions calm.

"We apply a tourniquet on both legs?"

"Yeah. How bad is arterial bleeding?"

Hilfiker said the crews take the responsibility seriously, even knowing it's a drill.

"You treat it like a real-life scenario as much as we can," he said.

"One of the guys even said he felt helpless sitting here waiting for Norfork fire to show up," even when no lives were actually at stake.

The crews also know they are being assessed and scored by observers watching their every move. There will be a blow-by-blow review of the day's exercise. Hilfiker said the goal is to improve their response, including "effective triage, identifying the critical patients and treating them correctly right away," adding "one of the biggest parts that we struggle with is communication."

One welcome improvement to the team was updating Nucor's two-way radios, allowing teams to talk with neighboring departments on emergency channels.

Cooperation and coordination with the responding fire departments get special attention.

"We rely on mutual aid very, very heavily," Hilfiker said.

When the volunteer emergency crew from nearby Hoskins-Woodland Park arrives, it is only staffed with a single EMT. Rules require a second EMT to accompany a patient during the run to the hospital. Because the steel mill's responders had comparable training, they could ride with a patient on the run.

Lt. Soderberg of Norfolk acknowledges volunteer fire departments all over the state are short-handed, but they routinely provide important assistance.

"They're trying their absolute best, and we try to support them as best we can," he said as the drill wrapped up. "They have the heart. Volunteering their time leaving their full-time jobs, I mean, that's dedication."

A crew loaded the most critically injured patient aboard Nucor's on-site ambulance and drove him to one of the two helipads on the plant's huge acreage.

The others made the trip to the emergency room in the rescue squads sent by Norfolk and Hoskins.

In a larger emergency, the mutual aid calls could have been answered by half a dozen other volunteer departments working cooperatively.

After the drill was finished, the victims peeled off the fake blood and bandages while the observers with clipboards prepared reports on what went right and wrong.

Nucor's disaster planner, Josh Mattson, liked what he saw.

"There might be a couple of things we got to sort of work on with some equipment issues, but I think we're good. I'm proud of everybody.

There is another, often overlooked advantage to the training. Many of the Nucor QRT team members serve on their local fire departments. These are skills all of them could be pressed to rely on in emergencies closer to home.