Strong Memorial Hospital debriefs on emergency response to steam pipe rupture near ER entrance

Hospital debriefs after steam pipe burst

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ROCHESTER, N.Y. — Strong Memorial Hospital held a debriefing Tuesday on how its team handled a major steam pipe rupture last week.

You’ll remember the dramatic video of steam pouring into the air right in front of the Emergency Department. A steam pipe under the ambulance bay ruptured, and it took about an hour to get the steam turned off.

“In our world, the first thing you think of sometimes is an act of violence and the first thing I was thinking is, is everyone okay,” recalls Dr. Andrea Miglani, Vice Chair of Operations for Emergency Medicine at URMC.

The steam line broke right in front of the temporary structure in the parking lot, which is almost always full of patients. It was also feet away from where ambulances park to transport patients inside. Thankfully, the EMS crews who were in the parking lot at the time were all inside with the patients because the force in which the steam shot into the air could have been deadly.

“There was certainly rock and grit being flown in every direction but really, nobody got seriously hurt, some people got a little raining of rock on them but that was about it,” Dr. Miglani says.

Emergency department staff immediately evacuated the temporary structure and sealed it off. Patients were transferred inside and once all of the staff was accounted for, the emergency plan was activated —something the hospital regularly runs drills on.

“One of the scenarios or one of the things we do plan around are utility failures, whether it be infrastructure related to the internet or computers like we had with the Crowdstrike situation or about a more traditional infrastructure like electrical service or on this case, a stream line,” said David Chafetz, Chief Administrative Officer of Emergency Medicine at URMC.

The registration area of the ED was moved into the waiting room and incoming patients were re-routed to the main entrance of the hospital for triage. “Our ED is always, always operating at what feels like 150% capacity and everyone is always firing on all cylinders and to add this additional load or challenge on top of it, I have to give everyone a lot of credit … all of these drills and it’s not just the drills, it’s the act of talking through what would we do … if,” Dr. Miglani says.

With the parking area torn up and steam spewing out of a pipe for about an hour, Strong did have to go on diversion for about 2.5 hours during the incident. While it didn’t turn away any patients or ambulances, it did ask EMS crews to choose another hospital to transport to, during that time.

“What we were able to identify because of this was another alternative entrance for EMS crews, that’s how we were able to get off of diversion very quickly. They did have a little bit of a long walk through the hospital but we were able to identify that entrance, be able to take all of the patients, not make EMS crews think, “where else can I take this patient,”” Dr. Miglani says.

Being the only level 1 trauma center, it’s rare for Strong to ever go on diversion, “it’s really critical that we keep our doors open,” Chafetz says.

As for what triggered this burst, “this was an aging steam line, as best as we understand, it was not related to the new construction project although we can appreciate why people are asking that because it’s in such close proximity,” Chafetz said.

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