Time to stock up on the antidote for rattlesnake bites and boost blood supplies.

More than 1 million visitors are expected to flood the state for the solar eclipse Aug. 21 and hospitals in its path are ramping up for the massive influx.

For hospital systems from central Oregon to the coast, it will be all-hands on deck in the run-up and aftermath of the eclipse.

Without a precedent, planners have turned for advice to their counterparts in Sturgis, a town in South Dakota that attracts about a half a million people for a yearly motorcycle rally in August.

"One of the key things that we learned was that the need for acute care services oftentimes just mimics the increase in the population," said Dr. Jeff Absalon, executive vice president of St. Charles Health System in Bend.

That means more patients with food poisoning, broken bones, strokes and heart attacks. It also means more emergency surgeries for traumatic injuries.

Here's what's planned:

CENTRAL OREGON

St. Charles Health System, with hospitals and clinics in Bend, Redmond, Prineville and Madras, has an emergency plan for Aug. 16 to 23. It expects the local population to increase by 280,000, more than doubling.

To meet the demand, the hospital system has canceled elective surgeries, such as hernia operations and joint replacements. It has limited time off and contracted to bring in nearly 60 traveling nurses. Administrators have also moved staff around, shifting doctors and nurses from nonclinical positions to the emergency room.

The hospital system has stocked up on supplies, buying everything from extra gauze and saline solution to pharmaceuticals. It also received extra blood from the Red Cross in Portland, nearly doubling its supply.

The Red Cross declined to provide any details about its contingency plans but said it would have the need for blood covered.

St. Charles Health System also purchased extra antidote for rattlesnake bites.

"It's a little tricky because it has a short shelf life, said Lisa Goodman, spokeswoman for the hospital system.

Clinics in Bend, Redmond, Prineville and Madras will welcome walk-ins, with hours extended from 6 to 10 p.m.

Madras, home to about 6,700 people, is expected to be ground zero.

"It is largely considered to be the very best place in the country to watch the eclipse because of geography and weather patterns," Goodman said.

Hospital staff expect a sixfold increase in patients in the Madras ER around the eclipse.

The hospital will have five physicians, nurse practitioners or physician assistants on duty at the hospital instead of the usual three. But the hospital has only 25 beds.

That means patients will have to be transported to other hospitals in the area or out of the region and the roads are expected to be clogged.

Usually, two air ambulances serve the area. Two more will be added during the eclipse period, Absalon said. The Oregon Army National Guard also will make a Black Hawk helicopter available to transport patients.

Administrators will open hospital parking lots to staff, allowing them to camp out in their recreational vehicles to be closer to work.

Providers have urged pregnant women due around the eclipse to be prepared but the hospital isn't altering due dates by inducing labor or doing C-sections

"There will be some instances where people may need to make alternate living arrangements," Absalon said. "We won't be delivering babies outside the standard time for delivery."

SALEM AREA

Salem Health administrators have been planning for a year for an expected 500,000 visitors to their vicinity.

"We're expecting everything to be up by 25 percent," said Wayne McFarlin, emergency preparedness administrator for Salem Health, with hospitals in Salem and Dallas and clinics in Marion and Polk counties.

The hospital system has increased supplies across-the-board, hired contract nurses, moved staff from nonclinical positions and shifted schedules to ensure that more physicians, physician assistants, nurse practitioners, nurses and technicians are available.

"We've increased our emergency department and hospital staff," McFarlin said. "We've boosted nurses in every unit that has in-patients."

In concrete terms, that means an extra 10 professionals in the ER, compared with 65 to 70 usually, to treat perhaps an extra 100 extra patients a day at Salem Hospital.

Administrators will allow staff to sleep onsite if they choose. Salem Hospital has about 70 cots; half have been reserved so far.

The hospital also has available floor space, if needed, for doctors and nurses to sleep over.

Elective surgeries haven't been canceled but only about a third the usual number are booked because patients and providers have selected other dates, McFarlin said.

On the Wednesday before the eclipse, Salem Hospital will set up three air-conditioned tents outside the ER to handle the demand. They will be used as triage centers and sobering stations. Patients will also be treated in the tents, as appropriate, and discharged.

A command center will be set up in the hospital to track patients and to work with 11 other hospitals in the region.

CORVALLIS TO THE COAST

Samaritan Health Services has five hospitals -- in Corvallis, Newport, Albany, Lebanon and Lincoln City – and expects more patients at each.

There could be 150,000 visitors on the coast and as many as 300,000 in the Willamette Valley. Administrators hope to shift demand to urgent care clinics when possible to save ERs for more complicated care.

The hospital system is closing dozens of specialty clinics to move staff to 18 urgent and family care clinics from Sweet Home to Albany to Depoe Bay. From Friday through Monday, some of those clinics will have extended hours. Of the 18, 15 will be converted to walk-in clinics. Details are posted online.

The hospital system has asked staff to work extra hours if possible. They'll be able to sleep overnight at the hospitals or camp in parking lots, provided there's space.

Administrators are also hiring contract nurses.

But with so many other hospitals in need of professionals, there's a limit to how many extra professionals they can hire on a temporary basis, said Joseph Hutchinson, director of emergency management, safety and security for Samaritan Health Services.

"Would we like more? Absolutely," Hutchinson said. "Can we get more? No."

Samaritan Health Services has canceled elective surgeries and bought more food, medications and other supplies.

Like central Oregon, the area serving Samaritan Health facilities will have four air ambulances instead of the usual two and more medical transport vehicles on the ground.

Providers have urged pregnant women to be prepared. But the hospital system has refused requests by women who want to deliver the day of the eclipse.

"If a person is ready to deliver – they will deliver a baby," Hutchinson said. "We are not encouraging or accommodating anyone who wants to have a baby born on the eclipse."

Emergency managers are stationing extra security guards at clinics and they're activating emergency communications, with satellite phones and a network of volunteer ham radio operators.

Planners have tried to think of everything as if they were preparing for a major earthquake or disaster.

"It's an invaluable exercise," Hutchinson said. "You can't get better training for emergency preparedness."

-- Lynne Terry