Whakaari/White Island: Gas masks shielded lungs, surgeon believes

Thursday, 19 December 2019

Gas masks protected the lungs of people caught in the Whakaari/White Island eruption, a surgeon believes.

Waikato Hospital took in eight critically injured patients on the evening of the disaster.

Gas masks, such as the one pictured, were supplied to those on tours to Whakaari/White Island.

'We thought there would be a lot more lung injuries, as well, from inhalation,' trauma director Grant Christey said.

'What we learned later, from the people who went out there, was most of [the tourists] had gas masks on,' he said. They put their gas masks firmly on their faces and closed their eyes and tried to get through it.'

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'We really didn't know early on what was going on, how many patients we were going to get,' Waikato Hospital director of trauma Grant Christey says.

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'Some of them did get [lung] injuries, but not as bad as we were expecting.'

The gas masks given to those on White Island tours have been described as little more than props, with a health and safety expert saying a full-face mask would be more appropriate.

Whakaari/White Island erupted on Monday, December 9.

'The half masks do not protect the eyes from gas,' the expert said.

Natural hazards on the island included corrosive sulphur dioxide (SO2), deadly hydrogen sulphide (H2S) and superheated steam, Stuff has reported.

On the day after the eruption, large volumes of sulphur dioxide and hydrogen sulphide were being released hourly, GNS data said.

For Waikato, information on potential patients was patchy in the immediate aftermath of the eruption on Monday, December 9.

'It was so chaotic, we didn't know how many people were injured - ranging from two to 100,' Christey said.

The patients were 'in severe trouble' when they arrived at Whakatāne Hospital, Christey said. Waikato aimed to get the patients through the ED resus rooms in 20 to 30 minutes.

'We really didn't know early on what was going on, how many patients we were going to get.'

Nearby Whakatāne Hospital received more critical patients in 12 hours than it normally would in 12 months, it has been reported.

Once patients were transferred, Waikato Hospital took on the largest load: eight critical patients.

Whakaari is probably the biggest mass casualty event Christey has seen in his time at Waikato - even the 2008 Tamahere coolstore explosion was relatively minor in comparison.

Helicopters were landing, operating theatres were temporarily turned into intensive care spaces, and hours of surgery were ahead.

Waikato's first patient arrived within an hour of medical leaders declaring a mass casualty response.

'These patients were in severe trouble when they arrived at Whakatāne Hospital,' Christey said. 'They would have been given big doses of pain relief.'

'Whakatāne had teams of people, anaesthetists going around intubating [putting breathing tubes in] them one after another.'.

That's because the risk with burnt lungs is swelling airways, which can cut off breathing, said Christey, who also runs the Midland Trauma System.

During Waikato's wait for patients, staffers turned a couple of operating theatres into intensive care beds, and made space in its emergency department and intensive care unit.

Teams of medical staffers were at the ready and all the hospital's training and emergency simulations were about to be tested.

All the Whakaari patients were hypothermic when they arrived; damaged skin means heat is lost fast.

Some patients were identified, some had toe tags, and each was assigned their own doctor and nurse to follow them through the hospital as they were treated.

The aim was to get them out of the ED resuscitation rooms within 20 to 30 minutes, Christey said, and they were also checked for any non-burns injuries from the eruption's blast.

It was up to Christey, an ED lead and an anaesthetics consultant to prioritise patients and work out where they needed to go, and they held conferences every few minutes.

Four operating theatres - cranked up to about 35 degrees to protect patients - ran until the wee small hours, and a fifth was added for a while.

'They just kept going until those eight patients were done,' Christey said.

He can't remember when he finished, but had a 7am debrief to attend on Tuesday morning.

'I didn't sleep that much, so it wasn't a big hardship.'

Two patients in critical condition remain at Waikato Hospital.

Some video courtesy of RNZ