Doctors emerging as heroes of Katrina

Good article (requires annoying but free registration): AP Wire | 09/09/2005 | Doctors emerging as heroes of Katrina.


Disasters always spawn heroes.

On Sept. 11, 2001, many of them wore dark blue uniforms that said FDNY.

On Sept. 1, 2005, many wore hospital scrubs that said MD, RN and EMT. Thousands of health care workers stayed with patients in devastated hospitals after the storm struck. Thousands more rushed in to help.

They are people like Dr. Norman McSwain, a legendary, 68-year-old Tulane University trauma surgeon who on Sept. 1 waded through fetid floodwaters to get out word that thousands of people were trapped in hospitals running out of food and water.

And Dr. Rich Tabor, a 38-year-old Bethlehem, Pa., emergency medicine physician who got partners to cover his shifts and paid $520 out of his own pocket for a plane ticket to Louisiana, where he climbed into an airboat and went door-to-door with rescue workers.

And Barry Albertson Jr., 42, a paramedic from Easton, Pa., who missed his 7-year-old son’s first peewee football game to join a caravan of ambulances making the 30-hour trip to New Orleans.

And Dr. Lee Garvey, 48, an emergency room doctor at Carolinas Medical Center who dropped everything to staff a state-of-the-art mobile hospital that provided the only trauma care for seven devastated counties in rural Mississippi.

"We’re here because this is what we live to do," Garvey said, "trying to offer something to these people."

U.S. Lawmakers Vow Expanded Health Coverage for Hurricane Victims

via MedScape News: U.S. Lawmakers Vow Expanded Health Coverage for Hurricane Victims.

WASHINGTON, (Reuters Health) Sept 08 – Democrats in the U.S. House and Senate are pushing legislation that would dramatically expand federal funding for the Medicaid health program for the poor, both to states that suffered damage from Hurricane Katrina last week, as well as states that are now hosting tens of thousands of evacuees.

Currently, states share in the cost of Medicaid with the federal government. "But the states directly affected by Katrina, and those hosting the survivors, will not be able to put up their match payments due to the fiscal crisis that Katrina has created," said Sen. Blanche Lincoln, D-Ark. "This is a critical issue that’s got to be addressed immediately," she said.

Lincoln offered an amendment to an unrelated bill in the Senate to do just that. Her proposal, originally offered by Senate Minority Leader Harry Reid, D-Nev., as part of a broader hurricane relief proposal, would make it easier for states to enroll eligible people in Medicaid, and would expand Medicaid eligibility to all people below the poverty line. In many states, individuals must have incomes well below poverty to qualify for Medicaid coverage.

The measure would also have the federal government pay the full costs of Medicaid in Louisiana, Mississippi, and Alabama — the states hardest hit by Katrina — as well as the full costs of individuals from those states who enroll in Medicaid in other states where they are living temporarily.

Polite Dissent – Triage

First-hand reporting: Polite Dissent – Triage.

Last night, I was one of two physicians on hand as a plane full of New Orleans evacuees landed at our small airport. Our clinic provided 5 people (2 physicians, a physician’s assistant, a nurse, and a medical assistant) and our senior physician was in charge of the medical operations on site. Our job was primarily one of triage – deciding which patients need medical care and how quickly – rather than hands on medical care.

People straggled off the plane one or two at a time, clutching plastic bags filled with toiletries and other belongings. Several people held on to their cats and dogs tightly as well. As they stepped into the terminal, we’d give them a quick medical look-over and make sure they were doing OK. Volunteer greeters came up and directed each passenger and family to food and water and helped them fill out the necessary forms. After that was accomplished, they were taken to the first floor for more food and then loaded on buses to take them to their lodgings.

Read, as they say, the rest.

CPR-bot: And The Beat Goes On – MedGadget – www.medgadget.com

MedGadget found one of my favorite gadgets, an automatic CPR-giver: CPR-bot: And The Beat Goes On – MedGadget – www.medgadget.com.

I was an EMT in an ED before I went to med school, and I’ve done my share of CPR.  Doing it right is hard work, and isn’t nearly as easy as it looks on TV.  Mechanical widgets like this are not just better from a mechanical performance standpoint, but they’re force-multipliers: your techs or nurses can now be doing something other than hard manual labor.

And now that I’ve said that, your rescue squad isn’t going to show up with one of these.  Please take a basic CPR course.

Blogborygmi has Katrina First-person posts

Go over to Nick’s at Blogborygmi, and read the two first-person accounts from the Katrina effort.

Emergency Department Dirty Words

In any Emergency Department there are a couple of words whose utterance will immediately earn the speaker social disapprobation at minimum, and quite frequently half-joking threats of physical violence.

These are not your average, run of the mill profanities, though one is a four-letter word. No, we’re quite immune to ‘Sailor speech’, and most of us don’t even bat an eye when those pedestrian words are spoken. No, not those words.

The power of the words is inextricably linked to most ED workers’ innate superstition, else these words wouldn’t have the impact, and engender the cold sweat and dread way out of proportion to their intended meanings.

Brace yourselves. The words are “Quiet” and “Slow”. Don’t look very fearsome, do they? Right now you’re saying ‘this is just silly’, and you’d be right, unless you uttered them in a slow or quiet ED, then you’d be a pariah, for the next happening will be the blare of the ambulance radios and a bus-station line at the triage desk.

So, you’ve been warned. Ban them from your vocabulary. Then start on the sailor talk, too.

State Bar of Texas Health Law Section

Katrina Questions and Answers for Texas Healthcare Providers, Patients and Attorneys: State Bar of Texas Health Law Section.

This has some excellent information.

Tulane Hospital CEO’s account of Katrina

This is a letter from the CEO of Tulane Hospital, Jim Montgomery.  I think they’re to be commended.  It’s long, so keep going into the extended entry.  And his post-script should be a wakeup call for all of us.

I thought it might be easier to compose an email to all of you at once
that
tells some of the story of the past few days.  First and foremost I
felt your
prayers and heard your concerns that were registered with
Donna and others
and they comforted me and kept me calm which was
essential in this time.

This storm as of noon Friday the 25th didn’t seem like it would be
much
of an event, but by 5pm things began to look different.  We met as
a
group on Saturday to begin our routine preparations for a hurricane.

Donna left for her brother’s home and I went home to put things
together
there.  I started to think what do I absolutely not want to lose in
case
the house would be swept away and the answer only revealed the photos of

the family thru the years so that and few clothes was all I took.

The
Storm:  God’s Natural World has an awesome power.  From the small
observation
windows from our tallest floors, we observed awnings being
blown off, a
blinding rain and a general sense if God’s ever angry we’re
going to lose
big.  Our first inspections revealed little damage.  A few
broken windows and
some roof damage but the building held up well.  In
fact, if you were in the
inner core of the facility you only vaguely
heard it.  We even walked around
late in the afternoon since there was
only limited flooding no worse than a
heavy thunderstorm.
Overconfident, we even stated we had absorbed the best
punch that nature
could throw and we seemed intact.

At 1:30 am on
Tuesday morning began the biggest crisis and challenge of
my life and in the
life of Tulane and no doubt New Orleans.  I was
awakened by my COO who told
me the water in the boiler room was rising a
foot an hour since midnight and
if it continued at that rate at best we
had only another two to three hours
before we would lose all power since
we already were on emergency power since
early Monday morning.  We had
only 7 ventilator patients whose lives would
be in jeopardy, and we had
to move fast to get them out.  We had no boat and
no helicopter pad.
Houston we have a problem.

[Read more...]

Jessica’s Well Lives!

They’re baaack: Jessica’s Well.  It’s about time.

Eject! Eject! Eject!: TRIBES

If only I could write like this: Eject! Eject! Eject!: TRIBES.

And, yes, I like to think I’m a sheepdog.  Woof.

Medical Insight from the Astrodome

via Code: the Web Socket.  Alwin has 5 days of communications from the medical director at the Astrodome, and it’s worth reading.  I have no idea why they’re out of order.  Maybe that’s how he got them.

I predict he’ll write a book when this is over, and it will be required reading by everyone in my specialty of Emergency Medicine.

USATODAY.com – Reporter’s notebook: Treating those left behind

A story I highly recommend: USATODAY.com – Reporter’s notebook: Treating those left behind.

He’s a reporter now, but his Paramedic backgroud both got the better of him, and provided him with a richer story, and he was able to help.

Hurricane Katrina Medical Relief Effort Status Report

FYI:this color is my emphasis.

Hurricane Katrina Medical Relief Effort Status Report


Sunday, Sept. 4, 2005, 4 pm

Dear Dr. :

Katrina Rescue Shelters Increase: Rescue shelters are growing across Texas. Most available space
in Houston and the Dallas-Fort Worth metroplex has been filled.
Katrina evacuees
are being sent to rescue shelters in Amarillo, Austin, Corpus Christi, El Paso,
Lubbock, and San Antonio on Sunday. Please check with your local county medical
society (CMS) to volunteer.

TMA Working with Louisiana State
Medical Society:
TMA has been in contact with the
Louisiana Medical Society (LSMS). TMA sent LSMS our roster of the names and
e-mail addresses of all the physicians who have volunteered to help. Over the
next few weeks LSMS or your local county society may call you. Please stay in
touch with your local CMS as the need for medical services is growing in many
Texas urban areas.

Bring Your Medical License: Louisiana Governor Kathleen Blanco has issued an executive order
waiving licensure requirements as long as a physician holds a current valid
license from another state. Read the complete executive order on the TMA Web
site Katrina Relief Resource
Page
 
If you go to
Louisiana, please bring your medical license, valid photo ID, DEA license, and
prescription pads.  (ed: I would have forgotten the Rx pads).

Toll-Free Number for Medicaid
Beneficiaries:
The toll-free number (800) 473-2783 has
been set up for health care providers to verify Medicaid and Children’s Health
Insurance Program (CHIP) enrollment information and procedures to process
claims.

For Current Information Visit the TMA Web Site: The TMA Web site Katrina Relief Resource Center at http://www.texmed.org/Template.aspx?id=4292
is updated daily. Please refer to the
site for up-to-date information on the Hurricane Katrina crisis.

Sincerely,

Robert Gunby,
MD

President
Texas Medical Association

 

TCU football beats Oklahoma :: Frogs hold the Sooners to 225 yards of offense

Oh, yeah: Go Frogs!

TCU football beats Oklahoma :: Frogs hold the Sooners to 225 yards of offense.

I didn’t attend TCU, but am more than glad to root for the Home Team.

Use of Former (?Shuttered?) Hospitals to Expand Surge Capacity

via MedPundit, the Government (Motto: "We’re Here to Help") has released some guidance for re-opening shuttered hospitals in the even of a disaster, here.

I spent some time looking these guidelines over, and they look pretty good.  This document also points out an incorrect statement I made recently: actually there are empty hospitals waiting for patients.  Nearly every major city has one or two closed hospitals sitting empty, but they’re empty of everything: beds, medicines, but mostly the skilled people who make them run.

The guidance gives several hints for who should staff these places, like DMAT’s, which make sense, especially if it’s a local DMAT and the credentialling is already in place.  The planners state the best way to handle this would be for the ‘surge capacity’ hospital to be considered a satellite of an existing hospital, which makes sense from an organizational standpoint.