Thursday, September 01, 2005

Medicine in the flood and coping

After Hurricane Katrina and the breaking of two levees the day after that resulted in 80% of the city being under water, New Orleans hospitals are in crisis conditions, with no power, flooding, and a serious shortage of supplies, plus even the apparent threat of looters. Worse, emergency generators are running out of fuel, worsening the situation. Only the Ochsner Clinic, at 8 ft. above sea level, remains unflooded.

What do you do as a doctor or nurse in conditions like this? Many of the tools of modern medicine and surgery require electrical power. At the very least, light is needed, and in the sweltering summer weather of New Orleans (over 90 degrees, 90% humidity), air conditioning is about close to a necessity as you can get. Running water and toilet facilities are also needed, but not available.

I remember one time when I was on call as a resident one Saturday night. There was a rather nasty thunderstorm, and the power went out. Surprisingly, for some reason, the emergency backup generators didn't kick in right away, and the power remained out for around 20-30 minutes before the generators finally started up. Nurses and every available resident on call scrambled to the ICUs to manually bag patients on ventilators. Fortunately, most of the monitors had battery packs; so monitoring the patients wasn't a problem. Also fortunately, there were no respiratory or cardiac arrests to deal with. We also didn't have the lower levels of our hospital flooded or have to worry about looters, as at least one New Orleans hospital apparently did. My experience was nerve-wracking enough for me.

Now imagine trying to deal with such a situation in a blighted city for three days and counting while waiting seemingly endlessly for help to come to evacuate patients to inland medical facilities. Consider the difficulties involved in actually getting to these hospitals and transporting hundreds of patients. And donate to the hurricane relief charity of your choice. A place to look for charitable organizations involved is here.

Personally, I recommend Catholic Charities (I've had personal experience with their competence in providing services to my indigent patients) or the American Red Cross.

UPDATE: The New York Times has more on the desperate conditions in New Orleans hospitals, and GruntDoc is blogging about it as well.

7 example(s) of insolence returned:


At 8/31/2005 11:51 PM, Blogger Dr. Charles said...

it would be like field medicine in war i suppose. i have no experience in the nonelectric world of hospital care, but for 'outpatient' medical needs i think palpable supplies are the most helpful, and i'm giving to the red cross, too.

 

At 9/01/2005 1:33 AM, Anonymous Anonymous said...

"....On Tuesday, that included two near-fatal electrocutions of people who tried to return to flooded areas, and others who were injured by flying glass when wind and water smashed their shelters.

Even at the clinic, broken glass littered some areas, and patients and staff alike had fallen on floors slick with hurricane waters. With electricity and air conditioning out, generators were providing the only power.

But there was ample water, food, blood and medical supplies to do everything needed, and enough power to keep medical machinery humming, hospital officials said, crediting the plans and preparations made before the storm hit.

"I'm proud to tell you that, things are going — under the circumstances — really well," said nurse Jackie Lupo, director of labor and delivery.

Several women gave birth during the ordeal, each baby announced with a tune over the loudspeaker.

"Nobody named one Katrina yet," said clinic spokeswoman Katherine Voss."

From what I've seen, though Jehovah's Witnesses don't get alot of credit for it, they are frequently the first on the scene after the big guys (like the red cross and the army), and they are very well organized and low key. They distributed water for Coors - or some big company - in Florida after a big hurricane, can't remember which one. Their people do tons of volunteer work to help many people rebuild their houses as soon as they can get in there after a disaster.

 

At 9/01/2005 10:31 AM, Blogger Kristjan Wager said...

One of my friends went to Afghanistan together with the Danish military to work as a doctor. He did work within the military compound, but also volunteered his work to Afghan clinics. His mails were very humbling to read, and he did a great job of explaining the problems facing the medical teams due to the primitive conditions and lack of resources.

I am in awe of people working in these conditions saving lives.

 

At 9/01/2005 11:11 AM, Anonymous Dianne said...

Are they in need of medical personnel? I haven't heard a call for any yet, but if the need is there, I'd be willing to volunteer to head down there. In the mean time, I'm donating to the Red Cross. I'm sure they can find something useful to do with the money.

 

At 9/01/2005 3:07 PM, Blogger Wade Rankin said...

Thanks for a thoughtful post, Orac. My family and I are currently refugees in Texas, having gotten out of Louisiana in time. The news we're getting from home is not terribly good. This morning, we heard that Chalmette General Hospital, just to the north of the City, was completely submerged. There is no word of the approximately 200 staff members who were in there at the time. I have a feeling we're going to be getting a lot of bad news in the next several weeks.

 

At 9/01/2005 4:19 PM, Anonymous Dianne said...

From the NYT article: " And the Navy has announced that it will send the hospital ship Comfort to the Gulf of Mexico. It is expected to arrive Sept. 8."

WTF? Why is it taking a WEEK to get ONE hospital ship to the Gulf of Mexico? Aren't there any that are close enough to get there today or tomorrow? And is one going to be enough given the scope of the disaster? For that matter, couldn't the Navy or maybe the Coast Guard ferry people from the Superdome to Houston via ships? (Yeah, I know the Superdome isn't right on the ocean, but water is lapping at its doors, so why can't small boats be sent up there to carry people to the ships?) It just seems like the fed's response has been sluggish.

 

At 9/02/2005 1:05 AM, Anonymous ebohlman said...

AIUI, the Comfort has to travel from San Francisco to New Orleans, and the trip takes about a week in addition to the four-day lead time needed to fully deploy it. Why the process didn't start at the end of last week, when it was easily predictable that Katrina would cause major damage, is anybody's guess. The number of balls that have been dropped seems to be increasing exponentially.

 

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