Monday, September 12, 2005

Paramedics' Perspectives

Hubby has a fellow motorcycle friend who was called up as part of the Texas Task Force to go to Louisiana. He tells his unique story on the motorcycle forum under his nickname of txmedic. He has an understanding of how the emergency response system works that many people aren't familiar with. He was part of the real deal, one of the paramedics on the famous I-10 overpass. What I'm posting here is merely the introduction. He has a play-by-play and pictures of what happened to him on the days there. I started highlighting the important info but there's too much! Go read it. It's enlightening.


It's no secret that Hurricane Katrina is probably the biggest single natural disaster since Galveston Hurricane almost 100 years ago. Let me set the stage for the enormity of this event.

New Orleans has a metro area of about 1.3 million people. It has a majority black population and an unemployment rate of about 25%. The eastern 3/4ths of the city are below sea level and surrounded on three sides by water. All that keeps New Orleans dry are a series of levees holding back Lake Ponchartrain, and the Mississippi River. Prior to the storm, the mayor issued a mandatory evacuation order for the entire city of which about 250,000 failed to heed. Most cite the inability to leave as lack of transportation or money. What was left was the poor, elderly, infirm or not very bright. Judging from the abandoned vehicles everywhere, many ran out of gas in the middle of the city and could not get anymore.

On Sunday night/Monday morning, Hurricane Katrina made landfall just a few miles east of New Orleans as a category 4 to 5 storm with winds of up to 170 mph. Two of the levees failed immediately, and several more failed in the coming days. 85% of New Orleans was under water. Help was sent as soon as the request was made by the mayor (necessary for FEMA to take action officially). FEMA arrived and requested the details for the emergency plan, only to find out the city has none. Period. 30 % of its police force never showed back up, most of its fire apparatus were lost rendering the firefighters as casual observers. The EMS service was vastly understaffed and under funded. They call all their assets to bear, but lack the manpower, resources and training for mass casualty response. The Mayor appears on TV bashing the government for an ineffective response.

Chaos reigns supreme as FEMA sets a plan in motion. They headquarter in the relatively undamaged, but utilityless headquarters of the New Orleans Saints. Help is requested from a series of state run task forces specializing in disasters. The mobilization begins, and help starts to arrive within hours of the request. Texas Task Force 1 was on the road within 90 minutes. By Wednesday, there are thousands of State Task Force members, law enforcement officials, military and medical assets based out of FEMA HQ. Like the fiasco in constructing the Tower of Babel, no one can communicate because they all have different frequencies on their radios. The circus begins, and it is a race against time, people will start to die from dehydration and exposure within a couple of days.

Rescue Operations are to run from 0630 until dark due to concerns about the remaining citizens. Shots are heard regularly but are later determined to be signals for help, not attacks on rescuers. The citizens are however, pretty hard on themselves. Eleven hours of daylight should be pretty good, but remember the tower of Babel. The rescue effort for one location involves boats from numerous agencies as well as volunteers, medical resources, manpower staff, law enforcement from dozens of different agencies, military, aircraft, and supply logistics people. All of which have to be informed every day what they are supposed to do and whom they are working with. It takes hours to get offsite, convoy and then construct an actual plan with all the commanders you meet for the very first time while standing on an elevated roadway.

This leads us to my particular group. Austin and Travis County sent a medical strike team composed of 40 firefighters and paramedics from all over Travis County and one from Sam Bass Fire. They ranged in abilities from paramedics, to flight nurses, to EMT's. Preparation for the trip began the week before Katrina hit the coast, and all we had to do was wait for a request for service from either FEMA or the state of Louisiana. Neither came until Tuesday when Acadian Ambulance service called and asked us to help. The call came at 2100 so a decision to delay until the following morning was made.

There's also another account of paramedics from the perspective of the New Mexico team, who were stationed at the Superdome. Now this is VERY interesting because of the timeline they describe. They were at the Superdome and in communication with FEMA while the worst of it was going on. The medical groups were all ordered to evacuate when the flood came but the New Mexico team stayed, even into the days without water.

Hesch was dumbfounded by what he saw around him. Disaster teams from otherstates evacuated.

"It was very unique because they were yelling for us to get on the bus," Hesch said.

But Mike Richards, an Albuquerque doctor who heads the team, replied, "No! New Mexico isn't going anywhere!"

....Alone, the New Mexico team -- and one doctor from New Orleans -- set up a full-scale acute medical-care clinic by 11 a.m. in the basketball and hockey arena, which is connected to the Superdome by a causeway. The sick and injured from the Superdome came to them. Some had head injuries. Some had gunshot wounds. Some had cuts on their bodies from walking through the water-filled streets. Some had gone cold turkey off their medications.In the space of 40 hours, the staff treated 800 to 1,000 patients. Hesch said he sutured wounds under the light of his headlamp.

I highly recommend reading the whole thing at Medpundit, another of my favorite bloggers. The good doctor talks about the oddities in this report compared to what we understand from the media.
Does this sound right? They brought 20 tons of supplies to the Superdome on Tuesday, the day after the hurricane? That's a fast response, and lots of supplies. So what the heck was going on in that Superdome, anyway? All this time I thought people were stuck in there because of the flood waters, but the media and volunteers seemed to be coming and going. And if the media and volunteers were coming and going, why couldn't they get supplies to them? Why did they make people stay there? Crowd Control?

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