West

West, Texas is a misnomer. West is the name of a small community in central Texas 20 miles north of Waco with a population of about 3,000. To get there you drive through peaceful rolling hills and pass vibrant green pastures, dotted with bluebonnets, evidence of recent spring rains. 

West, Texas is where the terms EMS and firefighter are interchangeable. Firefighters serve as EMS and EMS back up the firefighters. There is a real sense of communal spirit, love and honor in small rural areas of Texas. Those feeling were deeply tried and tested in West on April 17, 2013.

EMS  RESPONSE

When the West Fire Department got toned out for the initial fire, the department’s EMT students were practicing skills and studying for their final exam. Rick Coleman, an EMS instructor with the Texas Engineering Extension Service (TEEX), was conducting an EMT class. His students were scheduled to graduate one week later, April 24, 2013. 

April Conaway, an EMT, and her husband, Coil, a paramedic, were serving as EMS volunteers that night. They were hanging out at the station, with no idea what was about to happen. Coil walked outside to take a phone call and saw smoke rising just a few blocks away. He shouted to April, “We have to go! There is a fire! We have to provide rehab and mutual aid for the firefighters.” 

April and Coil ran to the ambulance, joined by Kevin Saunders, an EMT student who had finished practicing for the exam. Kevin wanted to ride out. The three mounted up and headed toward the fire.

Dorene Strickland, volunteer and self-appointed mother to the personnel of the nearby Abbott, Texas department, was participating in the same EMT course when the bell rang. Her son Russell Strickland, together with Cryus Reed, and Jerry Chapman, all firefighters from Abbott, and Perry Calvin, an EMT from the neighboring town of Mertense, were also practicing with the class. Dorene observed Cyrus as he jumped up with his usual wide-eyed smile, running towards his personal vehicle to respond to the fire. Chapman and Calvin responded in their own vehicles too. 

Dorene and Russell responded Code Three, returning the six miles to Abbott to get equipment and pick up available personnel. They made the trek there and back, in less than five minutes, determined to help their neighbors in West.

Chief Bradley Matthys of Abbott Fire responded directly to the scene in his personal vehicle. Chief Tom Marek of West EMS, also an Abbott firefighter, responded to the Abbott fire station to pick up one of the engines, then made his way to the fire. 

April, Coil and Saunders were the first arriving EMS crew. When approaching the fire, they found hose stretched across the railroad tracks entering the plant. Firefighters had not charged the line yet and waved the ambulance over the hose and closer to the blaze. Water was shuttled by various apparatus as a permanent water supply had yet to be established. Cryus Reed, pulled in behind the ambulance, jumped out, donned his bunker gear and sauntered confidently up to April, grinning ear to ear, “Don’t worry, April. I got this.” 

April nodded and smiled back saying, “Be careful, Cyrus.” As he walked toward the fire, Kevin Saunders, wearing only jeans and a T-shirt, was determined to go with him. April warned him, saying “You are here as EMS with no bunker gear. Stay with us.” Saunders kept following Cyrus towards the fire. 

There was so much smoke and radiant heat coming from the fire that Coil became concerned about air quality. He radioed back to the EMS station, requesting the EMT students evacuate patients from a nursing home just 200 yards from the fire.

Dr. George Smith, the EMS medical director, and Mike Reed, the EMS supervisor, were already taking action. The EMT students began moving the nursing home residents to the west side of the building away from the radiating heat and choking smoke. Towels were stuffed under doorways to limit smoke entry. EMS students were ordered to shelter the patients in place with preparations to begin evacuations if needed. 

Chief Waylon Price of the Whitney, TX, Fire & EMS Services, 22 miles away, was responding to the fire, too, when the unthinkable happened.

EXPLOSION

The energy from the super-heated ammonium nitrate was volatile, blazing and lethal.  The eruption from the West Fertilizer Company spewed outward in all directions. To the west, the positive pressure wave from the blast rocketed toward the railroad berm, turning millions of jagged rocks into shrapnel. With that came chunks of concrete, metal buildings, tanks, silos and rails. The pressure wave continued to the nearby apartments, nursing home, middle school and neighborhood homes, lifting roofs and turning the wooden structures below them into toothpicks and splinters.  

In a split second, the unbelievable positive pressure reached its limit and the negative pressure instantly began the reverse with the same force and fury, pulling a vacuum back towards the center of the explosion. The roofs that had lifted up came crashing down. The nursing home began to collapse around the residents, EMT students and their supervisors. 

Thankfully, the earlier precaution of moving residents to the west side of the nursing home, which suffered less damage, saved many lives. The east side of the nursing home completely collapsed.

 Everyone in the area was knocked to the ground. Some were thrown under vehicles or hit by chunks of flying concrete, rocks and shrapnel. Eleven of the 24 EMT students and many of the 127 elderly residents inside the nursing home were injured. More than 200 nearby citizens were home when the blast occurred. Most suffered trauma from flying debris or collapsing structures, including: cuts, scrapes, lacerations, bruises, fractures, head and some crush injuries. Many were deafened by the blast and some could not see.

Cyrus Reed, Saunders, Calvin and Chapman were among the responder fatalities.

EMS RESPONSE TO EXPLOSION

The EMS station took a heavy hit, including the EMS radio repeater mounted to the roof. With no radio communications, several dead, many injured and two of West’s three ambulances damaged, EMS was now facing overwhelming complications.

Smith dug his bloodied face out from under the collapsed nursing home structure but had no time to lick his wounds. He was faced with more than 300 patients, a tidal wave of tears from shaken citizens and a plume of thick smoke that boiled into the sky and now rained jagged rocks and shrapnel. Smith boldly shook off his own fright and began the process of evacuating his patients and EMS personnel.

When Chief Price arrived from Whitney, he found Kert Wines of the West Fire Department at the explosion site. Wines’ stunned statement to Price was simple and to the point — “Somebody needs to take charge. We’ve got dead first responders.” 

Chief Price, Chief Marek and Chief Matthys circled the wagons, setting  up a command post and sectoring the initial incident. With radio communications impaired, responders used their cell phones to call for back up. Mike Reed took command of the EMS sector with Smith leading the patient treatment area. EMS personnel, put aside their own injuries and the unknown fate of their families to begin the unbelievable task at hand.

EMS ACTION

EMS leaders knew the only open area west of the blast site was the football field approximately 400 yards away. Despite widespread power outages, a coach from the school district turned on the lights. On the east side of the railroad tracks, the high school was used for a short amount of time for triage and treatment, but that was moved to the with the football field since most of the EMS resources arrived there first. Furthermore, the three-year-old, $14 million high school was almost immediately declared unstable and is now reportedly scheduled to be torn down in the near future.

Triage and treatment was set up as surrounding area responders started to arrive with more equipment and supplies, including a mass casualty apparatus capable of treating up to 100 trauma victims and a rescue apparatus with special equipment for extrication and shoring up unstable structures. The arduous process of extricating and evacuating patients began.

COMPLICATIONS

It was now dark as midnight under a skillet. First responders who survived the initial blast continued to serve, despite being victims both physically and emotionally. When they could see each other through the heavy smoke or darkness communication was mainly through hand signals.                                                                 

No one could control the water rushing up from the ruptured pipes below street level. Water was a bigger issue near the fire and blast site. With no permanent water source, firefighters were helpless to extinguish any of the burning structures at the fertilizer plant, the middle school or the nearby neighborhood.

Chief Marek, commanding the fire sector, said, “We had water everywhere, but none to put on the fire.” The fires basically burned themselves out over a period of days.   

Tracking the numbers triaged, treated and transported was difficult as many citizens were transported via private vehicle. More volunteers arrived with pickup trucks, vans and 15 wheelchairs commandeered from the nursing home. Volunteers cleared debris — rocks, concrete, metal — to create a path to safety. It took more than four hours to begin moving patients through darkened, flooded, wreckage-filled streets.

To make things more frightening, the underground rumble from the explosion continued long after the initial blast, causing renewed fear on the faces of the victims and rescuers. 

Helicopters transported the patients tagged red with critical injuries. The West helicopter, parked 500 yards away from the explosion, could not be used at all, as the explosion blew out its Lexan windows. Personal vehicles and ambulances from across central Texas transported patients tagged yellow with moderate injuries. Buses were commandeered for those tagged green with minor injuries.  

Once patients started making their way to the football field, the incident had been sectored into fire, EMS and search and rescue. The incident commander assessed the situation. With the continued rumbling sound underfoot, he made the determination that there was a possibility of a secondary explosion. The football field was no longer deemed safe. In the darkness of night, the citizen’s pilgrimage towards safety changed direction.

EMS SERVICES

A community center on the opposite side of town was designated as the next treatment and triage area. Patients tagged red who had not been air lifted out were treated inside the community center, where lights, equipment and supplies were available. Traffic around the area became chaotic as rescuers trying to enter crossed paths with citizens desperate to get out. At one point, rescuers checked on imagined victims who turned out to be other rescuers. 

Due to the quick and efficient evacuation of the victims of this tragedy, together with so many responses from neighboring towns, the most critical patients had been rescued, moved to safety, treated and transported to hospitals within an hour. The surrounding hospitals began to fill with injured arriving by personal vehicle or ambulance. Eleven critical patients were transported by helicopter. One elderly man from the nursing home made it safely to the community center, then suffered a cardiac arrest and later died. 

Chief Marek said that “Within an hour and 15 minutes of the explosion nearly every rescue was complete and most of the patients who needed transportation had left the scene.”

The community center remained open for many days. Doctors’ offices inside West filled up the next morning with minor injuries from the blast that were never accounted for in the total number of injuries. 

Dallas firefighters serving on Urban Search and Rescue (USAR 19) arrived shortly after midnight. They were assigned to do a primary search of 75 houses west of the fire and explosion. Part of the team was assigned to search the nursing home. 

“It was eerie to walk through the nursing home as puddles of blood where found in almost every direction,” said a responder with Dallas Fire Rescue.   

Each rescuer had a compelling story to tell. They showed unyielding courage during the fire and subsequent explosion. Their eyes filled with tears and throats tightened with sorrow a month after the event when sharing the events of that fatal night. The pain expressed seemed to translate into some kind of survivor’s guilt among those EMS and firefighters left standing. However, the story of each rescuer included a renewed human spirit that spoke “that which does not kill me, makes me stronger” without actually saying it.

AFTERMATH

Shortly after midnight, when relief companies from larger cities began to arrive, all the initial rescuers pulled together at the community center for the first of many critical incident stress management (CISM) meetings. These structured debriefings and defusings allowed rescuers to vent and hopefully to release stress after an incident of this magnitude. In the old days, responders returned to their stations, cleaned and prepared their equipment, washed their uniforms and nourished their bodies. Until CISM was created, no program existed that allowed responders the freedom of self-expression to clear their minds. CISM is like taking a bath when you are dirty. It cleans and releases some of the pain from the event.

The stress of losing fellow rescuers, personal homes, cars, jobs and equipment continues. Smith lost his medical office, the nursing home, the assisted living home, his EMS station and all his patients who were transported out of town. He also lost his own personal home and cars. He is thankful for his family’s safety and amazingly smiles with delight when talking about the EMS response to this incident. 

“The town of West is blessed to have amazing volunteer service that did an awesome job, including the EMS students,” Smith said. “We had a lot of help, and I can’t help but acknowledge the response from the surrounding communities and all the people that showed up to help was truly inspiring.  I am proud to be from West, Texas.”

One month after the incident, responding members continue to display signs of post-traumatic stress. Tears still permeate the room when these responders are together. Broken sentences betray problems concentrating. Trouble sleeping is common. Many are haunted by thoughts of fellow responders lost that night. But the survivors are improving, a slow victory for the warriors and winners.

The community is rallying behind the city of West and its neighbors. The Texas Forestry Service is arranging to replace some damaged equipment. Willie Nelson, who was raised in Abbott, donated $46,000 to the Abbott Fire Department. Governor Rick Perry and Greg Abbott, the state attorney general, responded to the incident within a few days, promising not to forget what happened and to help the community become vibrant again. 

The once relaxed way of life in West is a dichotomy to the experience of talking to rescuers and seeing the aftermath. In the face of this horrible event, lost loved ones, damaged equipment and resources, these responders hold up their heads. Looking forward and shaking off thoughts of the past, they are triumphant and professional. As one professional to another, I stand in awe of who they are and what they did.