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Maimonides Medical Center NICU Full-Scale Evacuation Exercise

On May 21, 2025 the New York City Pediatric Disaster Coalition (NYCPDC) in collaboration with Maimonides Medical Center conducted a Neonatal Intensive Care Unit (NICU) full-scale evacuation exercise. The goal of the drill was to test the NICU department’s evacuation plan including patient movement and tracking, internal and external communications, incident management, staff capabilities – both clinical and non-clinical (security, facilities management, etc.), and the ability to establish an alternate care space resourced to meet the needs of patients.

Months of preparation between the NYCPDC, NICU leadership, and the hospital’s emergency management team led to a tabletop (discussion based) exercise on May 1st, which served as a dry run and ultimately 10:00am on May 21st brought the real test when an artificial odor of smoke was found in Room D of NICU South. The NICU staff acted immediately putting the evacuation plan in action while security promptly responded to investigate the smoke condition and closed off all local access points. The NICU team was seen wheeling mock patients (infant mannequins) in isolettes to safety for continued patient care. An emergency operations command center (EOC) was quickly established and a Hospital Incident Command System (HICS) Level 2 was declared within 10 minutes of the start of the exercise upon the identification of a mock fire condition in Room D NICU South. Exercise role players from the EMS department took on acting performances such as concerned parents, members of the press, and as bystanders entering unauthorized areas. These injects were intended to challenge staff during a stressful scenario while also reminding them of the potential realities of real-life situations.

In total 6 mock patients were evacuated from the NICU South, over 35 hospital employees participated in the drill as well as members of the New York City Fire Department’s (FDNY) 40th Battalion. A hot wash (debriefing) was conducted at the conclusion of the drill amongst players to discuss the many successes of the response and also to identify opportunities for plan improvement going forward. Special thanks to all the exercise players who dedicated their time to improve the health and safety of our most vulnerable patients.

About the New York City Pediatric Disaster Coalition:

The NYCDC was established in 2008. Founded by Co-Principal Investigators Dr. George Foltin and Dr. Michael Frogel (1950 – 2024), and initially headquartered at Cohen Children’s Medical Center the NYCPDC has called Maimonides Medical Center its home since 2013. The NYCPDC is federally funded by the U.S. Department of Health and Human Services/Administration for Strategic Preparedness and Response/Hospital Preparedness Program via the New York City Department of Health and Mental Hygiene (DOHMH). NYCPDC’s mission is to prepare the city of New York for large-scale disasters and emergencies effecting the pediatric sector. The NYCPDC continually works to enhance the planning and emergency response capabilities of New York City hospitals, agencies, community members, and the healthcare system on behalf of the city’s two million children and their families.

Over the years the NYCPDC has created pediatric disaster planning resources focused on surge and evacuation of pediatric emergency departments, pediatric intensive care units, neonatal intensive care units, pediatric long term care facilities, pediatric outpatient departments, urgent care centers and federally qualified health centers. The NYCPDC has conducted site visits citywide and overseen the implementation of pediatric specific plans at these facilities. Additional planning efforts include the NYCPDC development of a 24/7/365 on call NYC Pediatric Intensivist Response Team (PIRT), the drafting of a citywide pediatric disaster plan for primary and secondary transport, the formation of the NYC pediatric surge annex, NYC pediatric infectious disease, burn, chemical and radiation annexes. These planning efforts have further evolved into a NYCPDC led exercise program to operationalize and revise the facility plans based on lessons learned. The program has included discussion based, functional and full-scale exercises at individual hospitals leading to citywide exercises consisting of all 28 NYC 911 pediatric receiving hospitals. NYCPDC responses to real life emergencies have included Ebola, H1N1, Superstorm Sandy, COVID-19, and a highly fatal 5th alarm fire January 9, 2022 in the Bronx, New York. The NYCPDC has presented posters, workshops, and learning sessions at numerous national and international conferences to highlight the coalition’s work and to share best practices.

For more information or questions about the exercise or the NYCPDC please email John Jermyn at jjermyn@maimo.org.

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Below is an excerpt of a piece written by Celia Quinn, MD, MPH. You can find the full blog HERE.

Preparing for the Worst-case Scenario

Setting the Stage

Imagine this: Explosions across New York City target elementary schools. Hundreds of severely injured and traumatized children, teachers, and parents flood hospital emergency departments in the five boroughs. Municipal emergency medical services (EMS) are rushing to respond.

Fortunately this scenario wasn’t really happening – it was part of an exercise conducted on May 25, 2017. The exercise was designed to test the ability of the New York City (NYC) Healthcare System to respond to a massive surge of pediatric trauma patients, exceeding the usual resources of this large and complex healthcare system.

Identifying the Players

As a CDC Career Epidemiology Field Officer assigned to NYC, I worked with the experts in the Pediatric Disaster Coalition and the Fire Department of New York (FDNY). We designed an exercise that reflected the number of injured children who would need to go to the hospital and the type of injuries they might experience if a similar event really happened.

NYC has 62 acute care hospitals that participate in the 911 system. Of these, 16 are level 1 trauma centers designated by the NYC Department of Health  (this includes three pediatric level 1 trauma centers and 4 burn centers). A total of 28 hospitals care for pediatric patients and have, during the past seven years with the assistance of the NYC Pediatric Disaster Coalition, developed pediatric-specific components of their overall disaster plans to prepare them to receive pediatric patients from an incident like the one invented for this exercise. All 28 hospitals participated in the exercise.

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