Code Orange. Mass casualties. Be ready for anything. An explosion occurred at the Come By Chance refinery, about 45 kilometers below the Trans-Canada Highway on the isthmus of Newfoundland’s Avalon Peninsula. Eight people were injured, some critically. What followed was an event that experts say had the potential to overwhelm emergency services in even Canada’s busiest cities, but was quickly tackled by a collaboration of paramedics, firefighters, pilots and staff centered around a small emergency department eight bed in Clarenville. Questions remain about what caused the explosion, but one thing seems certain – the actions of those who responded saved lives that night. “It was a humbling experience to be on a ward watching specialist people in action,” said van der Linde, head of emergency services at GB Cross Memorial Hospital in Clarenville. “I think the many teams on our staff are proud of what they accomplished during this event, and I think they have reason to be proud as well.” Dr. Etienne van der Linde, head of the emergency department at the Hospital Dr. GB Cross Memorial in Clarenville, says its staff have reason to be proud after responding to a refinery explosion on September 2. (Ryan Cooke/CBC) The worst-case scenario came to life shortly after 4 p.m. on September 2 — the end of a workday leading into a long weekend. As reports circulated of a possible explosion at the Come By Chance refinery, paramedics from the Fewers Ambulance Service were already on their way to the scene. When Dion Park, the hospital’s senior director in Clarenville, was alerted to the situation, he called a Code Orange – a rare move that is only activated when an unforeseen disaster has occurred and mass casualties are expected. As soon as the call was made, staff began flooding into the hospital. “We had staff writing into work who weren’t supposed to report to work. We had staff staying over from the day shift, staff coming in early for their night shift,” Park said. Dion Park, senior site manager at Dr. GB Cross Memorial, was responsible for calling a Code Orange. (Ryan Cooke/CBC) By 5pm, the first injured workers had arrived at the hospital. Staff are not authorized to speak about their condition, but witnesses at the scene said the workers were suffering from serious burns from the fire. Eight were injured in total and seven had to be put on ventilators. Workers were met by “a total team response,” van der Linde said. Almost every healthcare worker in Clarenville showed up to do their part. “We had three ER doctors, an ER nurse, a surgeon, two general internists, an anesthesiologist, respiratory therapists, a team of about 16 to 20 nurses, x-ray technicians, lab and support staff, all of whom were instrumental.” A Fwers ambulance is parked outside the hospital Dr. GB Cross Memorial. Fwers Ambulance Service was instrumental in rescuing eight workers who were injured at the Come By Chance Refinery. (Ted Dillon/CBC) But as more victims began to arrive, it became clear that fully staffing Clarenville Hospital was not going to be enough. Most of the patients will have to be sent to the Health Sciences Center at St. John’s, a two-hour trip by ambulance, about 30 minutes by helicopter. The Health Sciences Center began moving patients out of the intensive care unit, sending them across town to St. Clare’s Mercy in preparation for the arrivals of the workers.
Call for air support
By 8pm, staff at GB Cross had stabilized three patients to the point where they could fly — but there was a problem. The hospital has only a small helipad, not big enough to land the kind of aircraft they needed to transport the patients along with the medical staff and equipment needed to accompany them. There was an unorthodox solution – the police moved quickly to block off the road around the hospital and block off the Sobeys parking lot next door. Footage here of a Cougar landing in a Sobeys parking lot in Clarenville, preparing to transport injured workers to St. John’s. (via pic.twitter.com/AbyWnRBpKY —@ryancookeNL At 8:45 p.m., a Cougar helicopter was picking up the painted lines between the corrals of carts, followed by a huge Cormorant search and rescue. The first three patients were loaded for transport, flanked by healthcare workers, as dozens of shoppers and passers-by watched. “It was a somber experience. Everyone was thinking of the workers and their families, but the response of the emergency personnel was impressive,” said Peter Troke, a Clarenville resident who was standing nearby. “The cleanup of the Sobeys parking lot was quick and effective, but it also highlights the need for a proper, safe helipad in Clarenville.” A Cormorant helicopter from the search and rescue fleet arrives at the Health Sciences Center in St. John’s, transporting two injured refinery workers. (Ted Dillon/CBC) The patients were in the air by 10 p.m. and headed for St. It’s a moment that will stay with van der Linde forever. “The success of this event involved these teams seamlessly, without question, coming in and being available,” he said. “An important thing for the public – when you need it, the system will spare no resources to give you the care you need.” Paramedics take an injured worker to the emergency department at the Health Sciences Center in St. John’s. (Ted Dillon/CBC) Helicopters landed at the Health Sciences Center around 10:30 p.m., and the patients — attached to machines and covered in blankets — were transferred to waiting ambulances. They were met at the emergency room doors by staff in scrubs, masks and gloves and entered. Two more patients will be transferred during the night. The five injured workers remain hospitalized at the Health Sciences Center as of Friday. Three have been treated and released from hospital in Clarenville.
“Rural Rocks”
Van der Linde says the response from his colleagues signals the potential of smaller hospitals in the province, but also exposes vulnerabilities in areas where these facilities face severe staff shortages. “This is an event that reminds you how important it is to have rural care facilities open and available to take care of you,” he said. Doctor shortages have led to the temporary closure of emergency rooms in towns such as Whitbourne, Baie Verte and Buchans – each near industrial facilities dealing with hazardous materials and machinery. Every second counts in a mass casualty event, van der Linde said, and driving past a closed emergency room could be devastating — especially in places where the next doctor can be more than 100 kilometers away. He hopes these emergency rooms will find a way to stay open and is confident the powers that be will make them a priority. “Rural people matter. They deserve access to emergency care and they have a right to emergency care.”
Come By Chance Refinery Timeline
CBC’s Garrett Barry describes what happened and when at the Come By Chance refinery. Read more from CBC Newfoundland and Labrador
