ASA Member from Oregon’s Disaster Medical Assistance Team reports
in from the center of the devastation in New
Orleans.
Anesthesiologist Reports on Treating Victims
in the Midst of Katrina’s Devastation
ASA member James “Judge” Hicks, M.D.,
MMM, of Portland, Oregon, serves on the Disaster Medical
Assistance Team, part of the National Disaster Medical
System (NDMS). His team from Oregon arrived in the
New Orleans area on September 1, where their bus joined
a caravan of 11 vehicles taking medical aid to victims
of Hurricane Katrina. The team includes approximately
35 physicians, nurses, other health care personnel
and support experts in communications and logistics.
Dr. Hicks offered to keep in contact with ASA to provide
information about the conditions and medical needs
in the area.
Epilogue from Dr. James “Judge” Hicks
September 16, 2005
Our team was relieved on Friday (September 10), and
we returned via convoy to Houston and then home on Saturday.
I’ve been extremely impressed with the response
of Dr. Sinclair and ASA in taking the response to this
disaster as a serious responsibility of its own. From
one who has seen its effects close up, I can say that
this response is necessary and warranted.
I see the greatest need for volunteer efforts at this
point as the need to give of our time to work with organizations
that are helping the victims to rebuild their lives.
The people that I saw in New Orleans do not have the
means to do this for themselves. For example, I’d
like to give some time to Habitat for Humanity and my
goal is to have a part in rebuilding at least one home.
I know that there are thousands of my colleagues who
wanted to do the same thing that I was able to do in
being one of the first responders giving medical help
to these victims. I was fortunate to have the training
and to be part of an organized team that enabled me to
do this. I thank everyone who wanted to give their help
as physicians, and hope that I represented you well.
I was not so much an anesthesiologist in this scenario
as I was simply a physician, and it was a good experience
(although I will never be able to look at Baggage Carousel
Number 8 in the New Orleans airport the same way again!).
To any of my colleagues who are interested in joining
a disaster medical assistance team in order to be ready
for future situations, I encourage you to contact one
of your local or state disaster response organizations.
I would be happy to field questions from anyone who is
interested in this type of service at hicksjim@ohsu.edu
Days 5 and 6
September 5 and
6, 2005
We are still performing triage and early treatments,
but the flow of patients has diminished markedly. Searchers
are bringing in people they find who were still in their
homes. We had 1500-2000 patients the first few days,
and today we are seeing about 150-200.
Most of the people we’re seeing now are suffering
from dehydration or the effects of standing in water
for a long time. Intestinal disorders are emerging. Many
of those who are being treated here are having chest
pain and other exacerbations of existing cardiac disease.
They’re under so much stress.
Things are improved. From the viewpoint of our acute-care,
makeshift facility, there is not a great need for surgical
treatment or anesthesiology services at the moment. This
could become more of an issue in the longer term in regular
facilities.
The evacuation of patients from the airport went very
well. There are currently seven or eight Disaster Medical
Assistance teams in the area but we expect we will be
demobilizing in the next few days, barring the emergence
of any unforeseen health situations.
Day 2— Kenner Airport, New Orleans
September 2, 2005, 2:30 p.m. CT
Dr. Hicks calls in after a brief sleep following 48
hours awake. He reports that the situation at the airport-cum-medical
treatment unit is looking up, although at this point
it is still a “seething mass of desperate humanity.” He
calls it a “modern version of Andersonville.”
Kenner Airport is under heavy security, but there have
been no outbreaks of violence. “It’s strange
to walk around an airport so freely,” Dr. Hicks
says, telling of walking out onto the tarmack to unload
stretchers.
Late yesterday, after arriving at the makeshift medical
center at the airport, Dr. Hicks and his Oregon DMAT
colleagues dug into the work of helping the patients
and refugees. About 3,000 people are there, mostly refugees
waiting for transport out of the area, but also about
500 patients. All are from the most vulnerable groups:
elderly, infirm, obese, developmentally disabled, and
without the means or capability to evacuate. Many are
on stretchers.
“It’s like walking through a nursing home.
People reach out to you and they need something and you
try to stop and help somebody. This is not on my assigned
task list, but it’s why we’re here,” Dr.
Hicks says.
Last night, many patients had to be hand-ventilated,
as that’s all they had. This morning they got some
mechanical ventilators—a big relief.
“Patients keep coming in as fast as they can move
them out…they are coming in by helicopter, by
ambulance—we had some come from Charity Hospital
in a boat and then a pickup truck.”
He reports that the voluntary and government agencies
are working well together in a coordinated effort, sharing
supplies and coordinating tasks. President Bush visited
the airport for about an hour today.
Dr. Hicks reports that in his venue there is enough
food and water. He remarks that the Forest Service is
particularly adept at setting up mobile food and water
stations for such situations, as they have done here.
“Sanitation is marginal, but the airport has small
cleanup crews. They have bathroom facilities for us,
and they brought in a shower trailer, so I got to take
a shower,” he says with appreciation. “And
I had a whole bologna sandwich and it tasted mighty good.”
“Things are working, and efforts are happening.
People are being taken care of.”
September 1, 2005, 10:40 am CT
Day 1 in New Orleans
“I believe we are headed to Kenner Airport, which
has been set up as a medical treatment center,” said
Dr. Hicks in a phone call from the bus. He explained
that first responders who are treating victims at makeshift
centers will have certain critical care, pulmonary and
resuscitation equipment as well as oxygen, but will not
have access to diagnostic equipment or surgical facilities.
When asked what the team had been told about conditions
at the airport, Dr. Hicks answered, “They are on
emergency power, no air conditioning, so it’s about
100 degrees in there. Patients are being triaged according
to the seriousness of their injuries. The Transportation
Security Administration is screening everyone for firearms.
We expect to find some people with gunshot wounds and
other violent injuries.”
Ten of the Oregon team members had been dispatched to
New Orleans approximately 36 hours before with the Disaster
Medical Assistance Team from Washington state.
Dr. Hicks has served in the Army Reserve, and was called
to active duty in 1990 for Operation Desert Shield/Storm.
He also commanded the 396 th Combat Support Hospital
in Vancouver Barracks, Washington, in 1994. He retired
with rank of Colonel in 1997 and was awarded the Legion
of Merit. He currently serves as Director of Obstetric
Anesthesia at Oregon Health and Science University.
“At ASA we hope for the safety of the anesthesiologists
and all of the first responders who are working to help
relieve the suffering of these victims,” said ASA
President Eugene P. Sinclair, M.D.
Many anesthesiologists have training and experience
in crisis and battlefield situations, making them especially
qualified to respond in times of disaster. (See “On
the Front: Anesthesiologists in Operation Iraqi Freedom” at http://www.asahq.org/Newsletters/2005/07-05/mongan07_05.html)
The National Disaster Medical System (NDMS) is a section
within the U.S. Department of Homeland Security, Federal
Emergency Management Agency, Response Division, Operations
Branch, and is responsible for supporting Federal agencies
in the management and coordination of the Federal medical
response to major emergencies and Federally declared
disasters.
Members of the NDMS join all of the health care providers,
including many anesthesiologists, who stayed in the hurricane-ravaged
areas to care for patients under extremely challenging
and unstable circumstances.
Physicians who wish to serve as part of a Disaster Medical
Assistance Team for response in future disasters
can find out more at the National Disaster Medical System’s
Web site at http://ndms.dhhs.gov .
Members of the team must be in place before the
disaster strikes in order to facilitate rapid deployment.