USA: Hospitals Evacuating High-Risk Patients

WASHINGTON POST, September 1, 2008: By David Montgomery and Philip Rucker, Washington Post Staff Writers NEW ORLEANS, August 31, 2008: A steady stream of elderly patients, infants in incubators and others among the city's most vulnerable ill residents left this weekend via a fleet of ambulances, underscoring the effort by local health officials to avoid the missteps that occurred during Hurricane Katrina three years ago, when some critically sick people were left virtually abandoned in flooded, powerless medical facilities and nursing homes. The ambulances ferried patients to the airport for transport to hospitals farther east, in Florida and North Carolina. The effort is not without risk: Gov. Bobby Jindal (R) said in a news conference Sunday evening that officials have received unconfirmed reports of three patients dying in transport, one from New Orleans and two from Lake Charles. At the same time, hospitals here were trying out new systems put in place to keep out the water, keep the lights on and keep family members in touch with loved ones being dispatched hundreds of miles away. "We're getting a dry run," said Robert Lynch, chief executive of Tulane Medical Center downtown, standing in the emergency room's waiting room, where Katrina blew in three feet of water in 2005. "We're hoping we're not going to get a wet run." The hospital's count of about 200 patients last week had been reduced to fewer than 90 by Sunday. Some will stay for the storm, Lynch said, but far fewer patients and staff members will ride it out than during Katrina. During Katrina, about 1,500 patients and staff members remained at the hospital. During Gustav, a total of about 500 will be there for the storm. "It'd be nice to get to zero [patients], but I don't think we will," Lynch said. "We're moving the patients most difficult to move if they have to be moved in a crisis." Those included premature babies and elderly patients from the intensive care unit. Complicating matters was the reality that a handful of very sick people were still being admitted to the hospital Sunday, and some smaller facilities were sending a few of their patients to Tulane, the largest downtown hospital. The devastation of Katrina was so severe it took six months for Tulane Medical Center to reopen. Now, its power generators are on higher ground and are protected by "submarine doors" to keep the water out, Lynch said. The glass windows and doors of the hospital entrance were covered with plywood Sunday. Most hospitals appeared to be taking the same approach: Moving the most critically ill patients, cutting the number of staff members still on duty compared with Katrina, but keeping the doors open and some patients in hospital beds. Not all went smoothly. Eleven ambulances -- some from as far away as Pittsburgh -- spent much of the afternoon waiting to take patients from Tulane to the airport, but several departed empty, apparently because of trouble with flight connections, according to a paramedic with one of the ambulances. Some patients were not pleased about being discharged with a hurricane bearing down. After being released from University Hospital, another facility in downtown New Orleans, James Hardy hobbled on crutches, his broken left leg in a bandage, making his way toward one of the last buses taking evacuees out of the city before dusk. "I ain't got nowhere to go," the 49-year-old painter lamented from under the brim of a black New York Yankees hat, sweat dripping from his forehead and his gray T-shirt drenched after an afternoon in the hot sun. "I just want to get . . . away from here." Three years ago, Hardy said, he was incarcerated in a New Orleans jail, trapped for three days as the city flooded. This time, he almost got stuck in the hospital but was released. "I want to go somewhere safe," he said, carrying only a white plastic bag with bottled water and personal items. But other patients or their family members were pleased with the institutional response to Gustav. "It's been going well," said Carla Arpin, as her ailing husband was loaded on a stretcher into an ambulance at Tulane for a late-afternoon trip to the airport. They were flying to North Carolina, she said. Health officials do not know how many patients are being moved for the storm, said Michelle Clement, a spokeswoman for the Louisiana Hospital Association. But judging from counts at some hospitals contacted by reporters, the number appeared to be in the hundreds. After Katrina, the association's Web site added a patient locator feature -- found at http://www.lapatienttrack.com-- allowing families to learn where a relative has been relocated, Clement said. This is the first time the system is being activated, Clement said. Louisiana State University Health Care Services, which operates seven hospitals in the southern part of the state, completed a 48-hour evacuation procedure Sunday. All of its at-risk hospitals were fully evacuated, except the facilities in downtown New Orleans and in Bogalusa. At least 120 patients were transferred to hospitals in northern cities, while pregnant women and infants were sent to a women's hospital in Baton Rogue, said Michael Butler, chief executive of the hospital system. "This is our biggest evacuation, and it's gone very smoothly," Butler said. "We've done our post-Katrina planning, and it's gone very well." In the city, a trauma center will remain running at University Hospital. About 79 patients will stay there, and 49 were evacuated, said Cathi Fontenot, interim chief executive of University Hospital. About 486 employees will stay at the hospital, including 83 physicians, to support urgent needs after the storm. "We have extra water and nonperishable food, extra pharmaceuticals for an extra week," Fontenot said. © Copyright 1996-2008 The Washington Post Company