CA CNA Katrina Volunteers

This is the link to a public photo album http://cakatrinarn.blogspot.com/

Sunday, September 11, 2005

The "Medical Center" takes up almost the entire Arena. The sleeping area is now empty; they moved evacuees to the Dome a few days ago.
We triage four levels:
1) Life threatening: respiratory distress, seizures, chest pain with cardiac hx.
2) Immediate medical attention: Diabetes - hyper or hypo glycemia, dislocation/fracture with neurovascular compromise
3) Medical Care - Needs work up: Abdominal pain -(nausea, vomiting) These patients go directly to Hydration Clinic; Hypertension, Diabetics needing assessment. The Diabetic Clinic was set up daily from 2 - 4 pm. Otherwise sent to Adult Medical.
In Medical Care, our choices were Adult Medical, Ortho, Pediatric, OB-Gyn, Eye, ENT, Nephrology and General Surgery. Also Mental Health Clinic. There is a Mobile Dental Unit but was closed on Sat/Sun. Also an Optometic Dispensary; the Lions Club showed up on Sat/Sun. Not all clinics were open at the same time.
4) Fast Track: Sore throat, Lacerations/rashes; Isolated limb injuries, prescriptions, Pregnancy Testing.

We had several cases of patients who needed critical medical attention who should have been sent a hospital emergency room but we try to handle what is presented. About half of the patients coming in have nausea/vomiting/abdominal cramps/ diarrhea and get moved directly to "Hydration." This clinic was named " 24 hour Isolation" at first and was changed to hydration because people did not want to go into a place where they would have to stay any length of time. We also had a large Isolation area where numbers of people were actually living who had communicable diseases. It was closed on Sunday, dont know why. Some of our nurses volunteered there and maybe they can tell us.

Another 25% of our patients have infected lacerations/wounds of the feet and lower legs. Many have already been incised and drained; on antibiotics, with fevers, return visits to redress the wounds. Babies especially have skin rashes from being exposed to dirty water.

I spoke with Kelly Weller, a teacher for EMT's who was circulating around the clinic supervising her volunteers. She said that she was working in the Dome doing triage last weekend - processing approximately 400 people per hour. The EMS parameters were: 1) Dead 2) Fixing to die 3) Breathing.

SWIFT, a local agency that handles Senior Citizens issues requested RN's to sweep the different living areas here and find seniors needing medical care and/or housing. Nurses found old people who were dead on their cots and some who did not know who they were or where they were. We triaged several they sent in by EMT transport who were in diabetic coma, and some that were just generally confused/demented. One old guy told us he was trying to cut his toenails sitting on his cot, and was bleeding from his big toe. He said that he has no feeling in his foot due to diabetic neuropathy, and did not realize he was cutting himself. The nurses chastised his, saying "you know better than to cut your toenails yourself." I said "why did you do this when you had pretty nurses waiting here to help you with that." He just smiled and said he was happy that we were here for him now.

The nurses found another elderly woman (85 years old) who was incontinent, needed her clothes changed and a bath. She had a grandson here, but he could not be found. SWIFT found a placement for her in a Board and Care facility that day but could not take her out of the Dome because of the layers of bureaucracy here. She needed to be cleared by an MD, and discharged by the Command Center. An RN for SWIFT moved some mountains and made it happen.

More later