Hurricane Katrina: medical response at the Houston Astrodome/Reliant Center Complex

On September 1, 2005, with only 12 hours notice, various collaborators established a medical facility--the Katrina Clinic--at the Astrodome/Reliant Center Complex in Houston. By the time the facility closed roughly two weeks later, the Katrina Clinic medical staff had seen over 11,000 of the estimated 27,000 Hurricane Katrina evacuees who sought shelter in the Complex. Herein, we describe the scope of this medical response, citing our major challenges, successes, and recommendations for conducting similar efforts in the future.     

IMERT deployment to Baton Rouge, Louisiana in response to Hurricane Katrina, September 2005.

An Illinois volunteer emergency response team was deployed to assist in the disaster care efforts following Hurricane Katrina. The team joined local care providers to establish a field hospital on the campus of Louisiana State University in Baton Rouge, Louisiana. The team worked to support local providers, establish order, and assist more than 3000 evacuees. The challenges and lessons learned from this deployment are identified.     

Combined effects of Hurricane Katrina and Hurricane Gustav on the mental health of mothers of small children

Few studies have assessed the results of multiple exposures to disaster. Our objective was to examine the effect of experiencing Hurricane Gustav on mental health of women previously exposed to Hurricane Katrina. A total of 102 women from Southern Louisiana were interviewed by telephone. Experience of the hurricanes was assessed with questions about injury, danger and damage, while depression was assessed with the Edinburgh Depression Scale and post-traumatic stress disorder using the Post-Traumatic Checklist. Minor stressors, social support, trait resilience and perceived benefit had been measured previously. Mental health was examined with linear and log-linear models. Women who had a severe experience of both Gustav and Katrina scored higher on the mental health scales, but finding new ways to cope after Katrina or feeling more prepared was not protective. About half the population had better mental health scores after Gustav than at previous measures. Improvement was more likely among those who reported high social support or low levels of minor stressors, or were younger. Trait resilience mitigated the effect of hurricane exposure. Multiple disaster experiences are associated with worse mental health overall, although many women are resilient. Perceiving benefit after the first disaster was not protective.     

Hurricane Katrina – one hospital's experience

Hurricane Katrina came ashore in Louisiana at approximately 07:00 hours on Monday, 29 August 2005. The storm washed away a swathe of the Louisiana coastline, destroyed large portions of the city of New Orleans, and forever changed the state of Louisiana. Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana was one of the receiving hospitals for evacuees from the New Orleans area. This commentary briefly describes the hospital's preparation before the storm and the activities during and immediately after the storm came ashore. Author commentary of the process is included to cover anticipation of the patient surge, transport of critical patients, and communication across all agencies – interhospital, local, state, and federal. It is beyond the scope of this report to judge the performance of agencies outside Our Lady of the Lake Hospital.     

Evacuation of a maternal-newborn area during Hurricane Katrina

On August 29, 2005, Hurricane Katrina made landfall and inflicted devastation across the Gulf Coast. The catastrophic hurricane and flooding from failed levees in New Orleans made this event the most destructive natural and man-made disaster to occur in the United States' history (White House, 2006). Such a massive disaster challenged survival for everyone in its path, including patients and healthcare professionals. This hurricane challenged the usual standards of care and disaster management strategies well beyond what we had ever prepared for or experienced. The city of New Orleans was under 8 to 12 feet of water. Memorial Medical Center, located in one of the lowest sections of the city, quickly became isolated from everyone and everything. The challenges that nurses faced during the 6 days after the disaster were arduous and multifaceted. Nurses had no choice but to be creative and flexible and improvise by using what limited resources were available. Nurses were not able to provide care in the typical patient care environment because patients were relocated to multiple areas of the hospital, the ER ramp, and the parking garage to await evacuation. The temperature soared to 110 degrees F, and evacuation efforts were chaotic and disorganized. This article describes the heroic efforts of a strong and cohesive nursing team in caring for our patients and providing for the evacuation of 16 critically ill newborns from the Level 3 regional neonatal intensive care unit and 5 well newborns and their mothers.     

An exploration of post-traumatic stress disorder in emergency nurses following Hurricane Katrina.

INTRODUCTION: As a result of Hurricane Katrina on August 29, 2005, ED nurses were faced with chaos during and after the storm. The purpose of this pilot study was to determine if emergency nurses have experienced signs and symptoms of post-traumatic stress disorder (PTSD) as a result of working in an emergency department of the New Orleans metropolitan area during and immediately after Hurricane Katrina. METHODS: The research identifies if the nurses perceived satisfaction with measures administrators took to provide Critical Incident Stress Management (CISM). To combat burnout, absenteeism, emotional difficulties, and health problems in nurses, administration must offer adequate crisis management for those affected by a traumatic event in the workplace. Data were captured through a cross-sectional research design using self-reporting questionnaires. A questionnaire captured demographic information as well as information regarding satisfaction with CISM offered by management. The Post Traumatic Checklist (PCL) was utilized to assess PTSD symptoms in the nurse. An emergency department located approximately 40 miles north of downtown New Orleans, Louisiana, served as the setting for this study. The sample included 21 registered nurses who worked in the emergency department. RESULTS: Twenty percent of the nurses has symptoms of PTSD. In addition, 100% of the nurses reported that administrators did not offer CISM. DISCUSSION: To combat consequences of long-term effects of PTSD, hospital administrators must offer adequate treatment to employees. Further research is needed to expand the sample and gain a wider perspective on PTSD symptoms in nurses who worked during the Hurricane.     

Mass medical evacuation: Hurricane Katrina and nursing experiences at the New Orleans airport.

Hurricane Katrina, a category 4 storm, struck the U.S. Gulf states in late August, 2005, resulting in the most costly and second most deadly natural disaster in recent United States history. The storm and subsequent flooding due to levee failure necessitated the evacuation of 80% of the city of New Orleans' 484,674 residents. Most of the city's hospitals and other health care resources were destroyed or inoperable. The hurricane devastated many communities, stranding people in hospitals, shelters, homes, and nursing homes. Nurses and other health care providers deployed to New Orleans to provide medical assistance experienced substantial challenges in making triage and treatment decisions for patients whose numbers far exceeded supplies and personnel. This article describes the experiences and solutions of nurses and other personnel from 3 Disaster Medical Assistance Teams assigned to the New Orleans airport responsible for perhaps the most massive patient assessment, stabilization, and evacuation operation in U.S. history. As the frequency of disasters continues to rise, it is imperative that the nursing profession realize its value in the disaster arena and continually take leadership roles.