A visit to Steve Hilley's office shows how much Yampa Valley Medical Center has changed since the Sept. 11, 2001, terrorist attacks.
Masks are inside a filing cabinet, boxes of protective suits sit in a corner, and Hilley can pull out a thick binder explaining the hospital's emergency plan.
Since January 2002, Hilley, the hospital's trauma coordinator, has been helping the hospital upgrade to post-Sept. 11 emergency preparedness levels and has served on a Colorado Department of Health board to prepare hospitals across the state.
Hilley is not the only one in Routt County whose job description has changed as a result of Sept. 11. For Chuck Vale, 90 percent of his energy as Routt County Emergency Services director now goes toward responding to the mandates that have come down since the terrorist attacks.
Although they happened thousands of miles away, Vale said the attacks opened his eyes to how unprepared rural communities were for such events. Before Sept. 11, Vale said, American citizens became complacent in how they prepared for emergencies. It wasn't just governments, but also the average citizen, who wasn't prepared for days without food or electricity, he said.
"There is no question, we are better prepared in Routt County, Colorado and the West. There is just no question. It forced people to work together, and I think take a look at the critical need," Vale said.
Despite Steamboat's remote location, it could be at risk for terrorist attacks, Hilley said. Terrorist attacks can be biological, chemical, nuclear or explosive. He said terrorists could strike small towns for the psychological aspect of making every place in America feel unsafe. Steamboat Springs could be a particular target because it is a destination resort that draws international visitors, Hilley said.
"Just because we are a small town, it doesn't mean we are necessarily safe," he said.
In preparing for the unknown, hospitals are given a two-fold task: being able to treat mass causalities and making sure the hospital is protected for an attack.
"We need to be prepared as much as anyone else," Hilley said.
As a member of the state board, Hilley said he recognized that rural hospitals statewide lacked personal protective equipment. The hospital and Routt County received federal funding to purchase the equipment.
This year, a $7 million grant from the U.S. Department of Heath and Human Services is helping YVMC and other hospitals statewide prepare for possible attacks.
YVMC received $55,000 from the grant, which it used to buy protective equipment for employees, new radios and a decontamination tent.
Protective suits will shield employees if they have to treat patients who are suffering from biological or chemical attacks, Hilley said.
The hospital has suits for 50 employees, which is enough for the first responders, Hilley said. Also, every employee is given a personal mask to wear in case of an emergency. The hospital also has spacesuit-like hooded masks for severe cases of contamination.
Although the suits were bought for treating mass causalities in biological or chemical attacks, the equipment also could be useful in other circumstances.
The personal protection equipment would help if there were a pesticide spill at a ranch, an accident with dangerous chemicals at a concrete plant or an accident with hazardous materials on the highway, Hilley said.
Routt County received a $138,000 grant in 2003 and a $23,000 grant the year before to purchase personal protection equipment for 300 of the county's emergency responders.
Emergency responders include people who are involved with law enforcement, fire service, emergency medicine, emergency management, environmental health, the drug task force and county dispatch, the county coroner, county commissioners and the county manager.
The grant allowed the county to buy gas masks, rubber suits and gloves and other gear that would allow them to continue work in case of a biological or chemical attack. Those were things emergency workers hadn't really thought through before Sept. 11, Vale said.
"So we talked together. How do we deal with it? Are there enough rubber gloves? We pulled together all those needs. It made people be serious about the airborne or disease pieces."
Along with the $55,000 grant, the hospital also received a decontamination tent, which can be set up in the hospital's parking lot, and patients can be sprayed off there.
The decontamination tent can house 50 people, and a trailer can accommodate another 50 people, increasing the hospital's capacity in case of an extreme emergency.
The grant also allowed the hospital to buy new radio equipment, which improves communication with other agencies. The radio will pick up activity from local police and sheriff departments and ambulance and fire crews. If a catastrophe happens, the hospital will be better able to receive information and prepare for incoming patients.
The hospital also purchased a human patient simulator program that allowed it to train for biological and chemical attacks. The simulator will portray the symptoms that victims would have, making it easier for doctors to diagnos the problem and treat the patient.
Along with the purchase of new equipment, the hospital has been revising its emergency plans. Once a pamphlet, the emergency plan has turned into a thick binder with hundreds of pages of scenarios and the steps that should be taken if they occur.
Although Hilley thinks the hospital is as prepared as it can be with equipment, being able to plan for the unknown is harder.
Training is continuous at the hospital, Hilley said, and twice-a-year mass casualty drills are conducted. With the threat of small pox, SARS and terrorist attacks, Hilley said, hospitals across the state constantly are looking at ways to improve their responses to what seemed unimaginable a few years ago.
"We try to be totally prepared for all of them," Hilley said. "There is so much. Where do you stop? You just can't give up."
Vale also has spent time working on plans since Sept. 11. He created a terrorism annex to the community disaster plan. The county also started coordinating more with other agencies. The ingredients of planning for an emergency, from wildfire to tornado to chemical attack, are the same, Vale said.
The county could receive more money in 2005 from a $1.5 million grant that will be spread among 10 counties in Northwest Colorado. Vale said he can not release how that money is being spent.
"I can tell you that money is doing good things to plan and prepare emergencies for large-scale events should they occur somewhere in Northwest Colorado," he said.
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