Gershanick, J. J. (2006). Pediatrics, 117, S265-S268.
The aftermath of Hurricane Katrina is also the focus of this article, especially the flooding of the city and what happened at Memorial Medical Center (MMC), where the process of evacuation was difficult. The day after hurricane landfall, the CEO ordered the hospital to be evacuated, including the 16 infants in the NICU. The situation became chaotic and stressful; the neonatologists had to find placement for the infants, and the staff at MMC had to negotiate for transport. Finding helicopters and getting them to show up for the transport were big problems. A pilot on a small, nonmedical helicopter was convinced to take a neonatologist (the author) and a nurse with two VLBW infants to Baton Rouge, Louisiana. Both the infants were in critical condition and required mechanical ventilation. The incubators did not fit into the chopper, so the infants were wrapped in blankets and held close to the caretakers' bodies. They received ventilation by hand-compression bags during the flight. Assessing their condition was impossible due to lack of space and darkness. A movement of the infant's leg after being pinched by his caretaker was the only sign of him being alive. Amazingly, the infants arrived at the transport hospital in the same condition as when they left MMC, with temperatures and blood gases the same. The heroism of the staff is described, which provides a lesson in caring for all healthcare professionals.
The author points out the lessons to be learned from the experiences, including the importance of planning and preparing for the worst case scenario, the need for a referring physician to get temporary hospital privileges during a disaster in order to continue caring for patients, the need to design hospital buildings so that backup emergency service are not affected by floods or other threats, and the availability of a local or regional central command unit during disasters to organize evacuation and communication. Telephone hotlines are also needed to connect infants with parents/family members.
Sigridur Sia Jonsdottir