That night in March was business as usual in the Children's Emergency Department. We were seeing patients and the volume was steady. It was about 2 am and we had just finished a procedure. We were sitting at the nursing station closest to the secretary's desk finishing our charting when we heard a loud crash. I remember sitting there with the other staff and for a few seconds, we were all looking at each other asking what in the world was that noise? Not long after that moment, we heard screaming over our portable radio that is used for interdepartmental communication for resource needs and room placement that monitors both the CED and Adult ED frequencies. We could not make out anything that was coming over the radio….only screaming.
We were all in awe wondering what in the world is going on when the fire alarm went off announcing the ED fire zone. After hearing the fire alarm, we walked down our long hall leading to the ambulance bay and saw haziness and the back end of a car in the outside wall of the main emergency department. I walked over to investigate. The lobby was trashed with debris everywhere. The air was filled with smoke and haziness and you could smell the airbags and dust. There were both patients and hospital employees walking around trying to make sense of the situation. I found the charge nurse for the main ED in the lobby assessing and putting together her plan of action. I was the charge nurse in the children's ED and offered the help of the CED by taking the main ED lobby patients into our lobby so we would have some accountability for patients and have an organized, safe staging area for the patients so they could still be assessed, triaged, and taken care of. I talked the situation and plan over with our attending physician and agreed that the purple side waiting patients and anyone emergent should immediately be brought back and we would assess and treat them. We had to come up with an alternate plan for the patients due to a computer glitch but the team pulled together to figure the logistics out while we provided great care to the patients and their families. This allowed us to keep track of the patients that came over to us and who may have left without treatment or were left in the main ED lobby. In addition, CED team members went over to the main emergency trauma bay to offer assistance with the critical patients in the resuscitation area. After patients started entering our lobby we took the highest acuity patients and placed them into rooms in the CED to make sure the stress of the event did not cause any worsening emergent cardiac issues that needed to be addressed. We even had a pharmacist that used to be an ED nurse, come over to assist and was put in our triage area to accept any new patients and triage them accordingly. The main ED also sent a senior staff nurse to assist in our lobby to help with triage and sort the patients.
After settling in and planning as things were happening, we decided that having an adult ED triage nurse to check in adult patients would ensure the highest quality patient care, while still balancing our pediatric patients. While accepting patients into our lobby, one of the patients happened to be a victim of the crash itself so that patient was immediately brought back to our resuscitation room and treated. In just a few hours all of the patients had been being taken care of with no significant delays. This could not have happened without the extraordinary teamwork and communication between the staff and management of both departments working together so collaboratively.

Team Members honored with the DAISY TEAM Award:
Samuel Archino, RN
Jessica Wilson, RN
Edie Adams, RN
Angela Jones, RN
Shannon Roberson, RN
Jennifer Styron, RN/Pharmacist
Tina Beaulieu, Care Partner
Margie Young, Unit Secretary
Muriel Carlton, Care Partner/Patient Safety Monitor
Brandy Galloway, RN
Erika Greene, RN
James Fletcher, MD
John Taylor Collins, MD
Brandon Mills, MD