CA CNA Katrina Volunteers

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Wednesday, September 28, 2005

We thought we had it rough: read on

In the Wake of Katrina: A Surgeon's First-Hand Report of the New Orleans Tragedy
Posted 09/19/2005

Scott E. Delacroix, Jr., MD

Federal Emergency Mis-Management Agency (at Least Until Saturday Post Storm, Day 5)

Was in Madisonville, Louisiana, for the storm. Took 2 days to cut out of St. Tammany Parish because of all the trees down.

Wednesday: Post Storm, Day 2
While cleaning up after the storm in Madisonville, I heard Dr. London Guidry (surgery resident at Charity Hospital) put out a call for help over Clear Channel Radio. Decided to leave and try to get into New Orleans. The Causeway Bridge was not open nor was I-10 (Interstate 10) from Slidell into the city. Decided to go to Baton Rouge and then take I-10 in. After multiple, failed attempts, found gas at a Shell station near LSU's [Louisiana State University's] campus and got on I-10. Really wasn't sure where I was going. Rumors abounded about looting and bridges being blown out. Evacuees wandering the city. A levee break and the "bowl filling with water." Decided to try a back way into New Orleans through Destrehan. Got off the I-10 at Laplace and headed to Airline Highway. I met multiple police officers but was wearing scrubs and a white coat. Guess I didn't look like a looter. Laplace police, State police in Norco, and Destrehan police -- no one knew how to get into the city. All communication was down. No army or national guard anywhere. Made it down to Destrehan where Airline Highway was under water and blocked by 3000-lb sandbags. Spoke with a local police officer who had lost everything and was out working security on the highway. Told me to go back to 308 and get back to I-10. The stories of looting in New Orleans had caused everyone to be on the alert. A cop had been shot? All the gun stores had been looted and criminals were heavily armed? I was very nervous driving up to roadblocks with police officers on high alert. I learned that in my old truck in the pitch black with my lights on, every police officer had a gun drawn as I pulled up. I started to turn my lights off about 100 yd prior to roadblocks and turning the lights on in my car. This allowed them to see me in a white coat and alleviated me from breaking out in a sweat every time I had a gun pointed at my driver's seat. With my 38 in my lap, I was now back on I-10 from Highway 308. One more roadblock, and after giving a couple more bottled waters to state troopers, I was on I-10 at Kenner heading into the city. It was eerie. No lights anywhere. No police. No people. Couldn't see anything but what my dim headlights were illuminating -- a complete blackout. As I neared Causeway and I-10, I could see a mass of police cars and people.

I parked my car and walked into a sea of people. It was overwhelming. Helicopters were landing on the Westbound circle and having evacuees walk from the helicopters across the I-10 median, and people were placed behind barricades. Nonambulatory patients in stretchers were being placed on the 2 inside lanes of the inbound I-10. There were about 20 state police officers, 2-3 small trailers, of which one was loaded with medical supplies. As I walked up and viewed the scene, 2000-3000 people on the edge of the Interstate: standing, sitting, or lying down behind barricades. Between them and the highway lanes were barricades and state troopers. Two of the 4 traffic lanes open for passage. The remaining 2 lanes and the inside shoulder of the Interstate were crowded with a site out of a bad dream. Patients were laying on broken gurneys, were laying on cardboard boxes, were laying in the street. Some were extremely old and decrepit appearing -- unable to speak. Nursing homes and hospitals had somehow been evacuated to the I-10 and Causeway Interchange. Patients were laying on the ground and in small cots with their medical charts used as pillows. They numbered in the hundreds. On top of these, evacuees of all ages began to succumb to the elements and horrible conditions in which they were being held. A steady flow of elderly persons with chest pain and shortness of breath streamed across the barricades and into our "triage" area. Children ages 4-6 with seizure disorders began having seizures. Asthmatics and evacuees with emphysema began to come to triage seeking oxygen and respiratory treatment. Dehydration was apparent, especially in the elderly and mentally retarded patients who were laying in the streets. It was myself (a urology resident) and ER [emergency room] resident, Pat Dennis; a neurologist; 2 psychologists; and several nurses (Kelly Tourere and Danny Dickson); and some staff from Acadian ambulance. One FEMA [Federal Emergency Management Agency] official was on the ground and helping to coordinate transportation, although for the first hour there was none. Supplies were very low. I was wiping off ventilation masks and reusing them to save supplies. There were sick people in need everywhere you walked. A highway of patients. The helicopters continued to land. Patients continued to come to our triage with their entire medical charts from whatever hospital they had been in -- a postoperative knee replacement, a postoperative coronary bypass, a mentally retarded nonambulatory lying there in diapers. What was going on in their minds? Someone's mom or dad who earlier had been in a hospital was now in our care lying on a highway. We had 3 oxygen tanks -- people had to wait to receive oxygen therapy. Triage became a 15-second read of a patient's medical chart and allotting people into a general 1, 2, or 3 category for priority transport onto one of the few ambulances. Around 2:00 am, a line of Acadian ambulances arrived to transport ill patients. That was the toughest part -- choosing who goes. "I've been laying here for 24 hours now." "Don't separate grandma or mom from us." I split up families, and sent mom with one epileptic child who had decreased consciousness for the past hour and left the other 3 kids with their 70-year-old grandmother to fend for themselves. There was nothing we could do. One family member with each medical patient. Buses did show up to take the "healthy" patients but short of causing a riot; there was no way to get the women and children or the elderly onto these buses. The weak had given up trying to get onto the buses. The young and strong pushed their way onto the buses without concern for the weak. It was sad to see. I met a gentleman who had recently finished his EMT [emergency medical technician] training -- Nick Pieper. He was bagging a ventilator-dependent cystic fibrosis child whose battery-powered ventilator had run out of juice. The child did end up getting onto one of the ambulances around 3:00 am, but to where I did not know. I spoke with someone who said that FEMA was setting up a hospital at the airport, and some would be going to Baton Rouge. The transport was slow. There was no central command. No definite place for these people. Didn't know how many more were coming, but that they just kept coming -- helicopter after helicopter. Supplies low, one of the psychologists contacted EOC [Emergency Operations Center] or DHH [Department of Health and Hospitals] in Baton Rouge and placed me on the phone to give a description of the supplies that we needed. Pedialyte, formula, oxygen, aspirin, IV [intravenous] sedation, and transportation. This chaos went on into the next morning. There were several bodies placed in the median behind our trailers.