02/14/10 843 W, 4 I - + 21 - 8 Yesterday's Mass-Casualty Incident / South Salisbury Street

Saturday morning saw emergency personnel converging on the Raleigh Sheraton. Dozens of students attending a conference were complaining of nausea, vomiting, and diarrhea. Conference rooms were converted to triage and treatment areas. Ambulances lined South Salisbury Street. And by that afternoon, those dozens of students had been evaluated, with many treated on scene.

The first call was reported about 9:30 a.m. as a patient with respiratory distress at 421 S. Salisbury Street. Engine 1, EMS 1, and Medic 94 were dispatched. Upon arrival, they learned of approximately 150 juveniles complaining of stomach and intestinal distress, believed caused by food poisoning. The original call was also determined as a patient with the same symptoms.

Recognizing the scope of the incident, the APP unit requested a third-alarm medical response, which added 13 paramedic ambulances along with three District Chiefs, an additional APP unit, Truck 1, and MD 1 (Medical Director).


The fire department quickly concluded that hazardous materials were not involved, and command was transferred to the first-arriving EMS District Chief, District 1.

Following their Mass Patient Protocol, hotel areas were designated for incident functions, including the command post (first-floor room), triage (second-floor meeting room), and treatment (third-floor ballroom). As the Public Information Officer later explained, EMS made the decision to treat in place, instead of overwhelming area hospitals.

Apparatus and vehicles staged one block north on Salisbury Street, which police had closed. Fayetteville Street, on other side of the hotel, was also utilized as additional staging. The Transportation sector was designated as Salisbury Street, in front of the hotel.

Wake County EMS command staff responded, along with the Medical Director and his staff. Dr. Brent Myers (MD1) served as Treatment Officer. Other roles included Chief 200 (Operations Chief) as Command, Chief 100 (Chief) as Triage Officer, Medic 93 as Staging Officer and District 1 as Public Information Officer.

Additional fire units were requested by command, to provided manpower for treatment and transportation. Engine 1, Engine 13, Engine 3, Ladder 4, and Rescue 2 were dispatched and parked just north of the hotel on Salisbury Street,. Battalion 3 and Chief Car 10 (Division Chief) were also on scene. Engine 26 relocated to Station 1, for coverage. They then reported to the scene for relief, about 90 minutes into the incident, along with Engine 24, Ladder 1, and Rescue 3.

At the command post, a mobile CAD terminal allowed Command to monitor the resources and call volume of the entire EMS system. Command worked with hotel staff to procure rooms, furniture, and supplies. In the treatment room on the third floor, blankets and pillows turned floor and later chair space into comfortable cots. Stretchers were staged on the second floor, and brought to the third floor as needed. Even upturned chairs were pressed into service, as IVs were administered to help with hydration.


Raleigh hospitals were notified and kept aware of pending patient needs by Command. They utilized a second radio channel, the Mass Care talk group Hotel, which is named phonetically. It was chosen as "H" for hospital.

Logistical support was provided by Wake County EMS staff. They helped procure operational supplies, such as the many radios and batteries needed. Cases of bottled water and boxes of snacks were also brought to the scene, in addition to those supplies carried on EMS Truck 1, the Mobile Operations Support Unit. Water and later food was also brought for the personnel on scene, during the extended operation.

Wake County Human Services (Public Health) and Environmental Services (Sanitation/Inspection) were quickly on scene, and were supported by the State Public Health Response Team based in Chapel Hill. The latter provided epidemiological experts to investigate the cause of the illness.

Red Cross, Wake County Fire-Rescue, and Wake County Emergency Management representatives were also present, and ready to make resources available.


Interviews were conducted with all patients. The students ate at a banquet at the Raleigh Convention Center the prior night, and their kitchen was subsequently inspected and cleared to prepare for another banquet Saturday night.

In addition to patient areas, a staging area for parents was established, and a second room was provided for media. Hotel staff provided interior security, directing the hundreds of students and guests toward or away from the treatment and triage areas. Raleigh police officers provided building security, and also closed two blocks of South Salisbury Street.

By mid-afternoon, the last students with symptoms were seen. Approximately 150 medical evaluations had been performed. Some 30 students were treated, and five were transported. The treatment and triage areas were closed. Fire department personnel were released at 3:30 p.m.

EMS units were returned to service as soon as possible, though supplies required restocking. Some units remained out of service as supplies were transported from the EMS warehouse south of Raleigh, to EMS Station 1, located just two blocks from hotel.

Units on scene included:

See more preliminary photos by Legeros.

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