Tag Archives: ICS

Controlled chaos: Kaleigh Peil’s leadership at the scene of a bad car crash calmed both patients and bystanders

Kaleigh Peil, administrative assistant for Wyoming Medical Center's disaster department, used the skills she learned on the job to manage the scene at a chaotic car crash on Dec. 23.
Kaleigh Peil, administrative assistant for Wyoming Medical Center’s disaster department, used the skills she learned on the job to manage the scene at a chaotic car crash on Dec. 23.

Emergencies, by nature, are chaotic affairs. Events seem to unfold faster than most of us can process them.  We may wonder if we’d be any help at all if faced with a car crash or other disaster. Kaleigh Peil thinks we’d be surprised with what we could contribute.

She should know. On Dec. 23, she came upon a terrible car crash with multiple casualties. She encountered several bystanders who were eager to help but didn’t know how. All stepped up when given a specific task.

“They may have been teachers or secretaries or anybody. They were just driving by, too. No one there knew what Incident Command was. But that was OK. I could still use them ,” she said.

It happened about 6 p.m. as Peil was driving from Casper to her family’s home in Riverton. About 50 miles out on Highway 20/26, she saw hazard lights and thought someone had hit a deer. She soon realized it was something much bigger. She approached slowly and noticed two vehicles in the ditch – one to the left of the road, one to the right. She had to pick one, so she picked right.

“There was no reason why. It was just a split-second decision,” said Peil, administrative assistant for Wyoming Medical Center’s Disaster Department.

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Kaleigh Peil took this photo of the wrecked SUV she encountered on Dec. 23 on Highway 20/26 about 50 miles outside of Riverton.

Peil first scanned the scene. The SUV in the right-hand ditch was crumbled in on the front driver side with debris scattered for 100 yards. Seven or so people who stopped at the crash stood by, unsure of how to help. Two of the three crash victims were still in the SUV while the driver stood outside. Peil asked the bystanders if law enforcement personnel were yet on scene. None were.

My name is Kaleigh and I’m going to be assuming command, Peil said. I’d like to use you all as volunteers if you think you can help.

A couple of things you should know about Peil before we continue: In person, she’s not what you’d call intimidating. She’s 22 but could pass for a few years younger. She stands 5 feet, 5 inches tall.  But when she took control of that scene, the bystanders were happy to listen.

Peil has high-level training in the Incident Command System (ICS) – a standardized protocol for managing incidents of any type, scope or complexity. It is used by all levels of government agencies and by Wyoming Medical Center. For example, we employed the system the afternoon before October’s winter storm Atlas, checking on resources, assigning specific tasks and making contingency plans for possible power outages and road closures. We also sent representatives to Natrona County’s Central Command Center the day of the storm to serve the county-wide ICS response.

Peil recognized that her right-side crash scene should be managed through ICS.

“My whole goal was not to get tunnel vision,” Peil said. “It’s really easy in that situation to focus on one person or one aspect of the crash. The ICS was useful in reminding me to take a step back and to realize that there were a lot of things going that all need addressed. Knowing what to do in the first couple of minutes and not just focusing on one thing helped me to respond to the whole situation.”

Peil, who is trained as an EMT but is not currently certified, quickly triaged the three patients:

— In the back passenger seat was a woman in her 80s, obviously in pain. She suffered trauma to the head and was passing in and out of consciousness.

— In the front passenger seat was a woman in her 50s or 60s. She was shook up but not as badly hurt as the elderly woman.

— Outside was the driver, a woman in her 40s. She was responding to questions.

Next, Peil delegated the most important tasks. She charged one volunteer with gathering lights, either from flashlights in the stopped cars or from cell phones. She charged another to recall 911 and update them on the patients’ conditions. She assigned two more to monitor the two patients with the less serious injuries and to notify her of changes in breathing or circulation and if they developed signs of shock and hypothermia. Temperatures had dipped to about 15 degrees, and they were working on frozen snow and ice at the bottom of the ditch. When they were almost hit by oncoming traffic, Peil assigned two more volunteers to slow down approaching vehicles with lights and flags.

“They all wanted to help but weren’t sure how. When I gave them a task that they were able to do, they seemed relieved,” Peil said.

Peil took control of the elderly woman in the back of the SUV. Her head injury was bleeding and her coat was filled with blood. She floated in and out of consciousness, and she was scared and confused when she did come to. Peil explained that when the emergency responders showed up, there would be lights and sirens. It would seem chaotic and confusing, but it would be OK.

Law enforcement arrived between 20 and 30 minutes after Peil took command. Riverton’s Air Medical Flight Services came a few minutes later, responding to the crashed car in the left-hand ditch. The first fire truck also responded to the left-hand scene.

Between 40 to 50 minutes after the start, the remainder of fire and EMS were able to relieve Peil of incident command. She briefed the EMS personnel about patient conditions and the tasks she assigned out. She then volunteered herself, assisting in the extraction of the elderly woman via a backboard. She also helped to extract the front passenger using a Kendrick Extraction Device, designed to remove patients from vehicles in the sitting position, while holding the spine and neck stable.

She then asked if there was anything else she could do, and when there wasn’t, she finished her drive to Riverton.

“The first thing that came to my mind was how blessed Wyoming Medical Center is with so many amazing Fremont.Cty.Fire.Letteremployees,” said Mike Magee, WMC’s emergency preparedness coordinator. “To me, it just says that Kaleigh is it. She is the kind of person who we need here.”

A week or so after the accident, a letter arrived at Kaleigh’s desk: “We want to thank you for your excellent assistance on 23 December, 2013 at the motor vehicle crash on highway 20/26,” wrote Dale T. Gibson on behalf of the Fremont County Fire Protection District. “We often find bystanders who are willing, but not trained, to help. It is rare to find a well-trained EMT-B, as yourself, providing good medical assistance at scenes … You made a difference in the outcome of those lives, and we want to thank you in this small way.”

Peil, who plans to stick with disaster and emergency management throughout her career, didn’t expect a thank you, but was touched by the sentiment.

“I felt honored that they saw me as good help to the situation and that they took the time to find me.  For the first couple of days it was easy to wonder if I actually helped or not,” she said. “But after receiving the letter, it eased a few of my doubts.”