'Code orange': How first responders react to a tragedy

Dr. Hassan Masri hadn’t heard the news about the crash involving a Saskatchewan junior hockey team bus when he went into work on Friday night. But when the hospital went into "code orange," he said it worked like a well-oiled machine.

Post-traumatic stress disorder can be a risk for first responders

The wreckage of a fatal crash outside of Tisdale, Sask., is seen Saturday, April, 7, 2018. A bus carrying the Humboldt Broncos hockey team collided with a truck en route to Nipawin for a game Friday night, killing 15. (Jonathan Hayward/Canadian Press)

Dr. Hassan Masri was scheduled to work at Royal University Hospital in Saskatoon at 8 p.m. on Friday. The intensive care unit doctor had dinner, and then went to work feeling relaxed, expecting a regular shift.

He hadn't heard the news about the crash involving a Saskatchewan junior hockey team bus.

"When I arrived I heard there [had] been a potentially mass casualty going on," he said.

The hospital went into "code orange," allowing them to tap into additional personnel resources, materials and equipment.

"Within the hour, the teams were assembled, and each team's job was to take care of an individual patient that comes in," said Masri.

The teams were organized and colour-coded, and even though Masri says code orange is so rare — you'll only see it once in 10 years — everyone worked like "well-oiled machines."

The father of one of the injured players posted this photo on Twitter. From the left are Derek Patter, Graysen Cameron and Nick Shumlanski. (Twitter/rjpatter)

He said he looked at his watch around 10:30 p.m. and before he knew it, it was 6:30 a.m.

"When we were taking care of the patients initially, you're very much focused on the task at hand, but after everything has settled down, a lot of the emotions rise to the surface, and you start to think, oh my God, what did I just go through?"

'Emotion gets set aside'

Jennifer Chouinard runs the peer support group for PTSD Saskatchewan, and is a masters student at the Johnson Shoyama Graduate School of Public Policy, where she studies mental health policy for first responders.

She said Masri's reaction is typical for many first responders.

"Sometimes the emotion gets set aside for the clinical performance, and then after everything's come down, then you're going, 'OK, now I have to process this.'"

First responders are not just police, fire and paramedics, said Chouinard.

"There will be tow-truck drivers, there will be clean-up crews, coroners sometimes go on scene. Crisis workers. There's such an array of emergency services that goes into supporting and intervening in a situation like this."

Jennifer Chouinard studies mental health policy for first responders. She says it's important for people to talk about their reactions to tragic events. (Jennifer Chouinard/LinkedIn)

Feeling horrible is normal

She said tragedies like these, where the victims are young and there are multiple casualties, can be especially difficult for first responders.

"Another thing that really impacts paramedics is the innocence, when there's a perceived innocence to a loss of life."

Chouinard said one of the best things family, friends and the community can do for first responders is to normalize their response.

"Feeling horrible about this event is a normal reaction and it's not a pathological reaction," she said.

"I don't think we say often enough that it's going to hurt really bad but you can be OK and you can be resilient and you can grow from this."

Praise for first responders

In the case of the Humboldt Broncos crash, that conversation is already happening to some degree. Officials and the public have been praising the first responders from the beginning, lauding their brave role in the tragedy.

Premier Scott Moe thanked first responders, naming the RCMP, ambulance crews, firefighters, STARS air ambulance and medical teams.

"Their response was immediate, their response was comprehensive and compassionate. Their response was Saskatchewan at its very best."

I don't think we say often enough that it's going to hurt really bad but you can be OK and you can be resilient and you can grow from this.- Jennifer Chouinard, PTSD Saskatchewan

Doug Dahl, communications officer for the Saskatchewan Health Authority in Prince Albert, also expressed his gratitude to first responders in a letter to media.

"Many physicians and staff members were called away from their families and friends to deal with the significant number of patients, many with very serious injuries," he said in his message. "I commend all involved for their quick and selfless actions."

The Saskatchewan Health Authority has sent counsellors to the affected sites, including offering mental health support to first responders.


Ashleigh Mattern is a reporter with CBC Saskatoon and CBC Saskatchewan.