By A.J. Plunkett
Review your emergency preparedness plans to ensure you have contingency plans for emergencies within an emergency, and drill staff on evacuating patients up or down stairwells.
Most hospitals in Louisiana were forced to shelter in place as category 4 Hurricane Ida swept in from the Gulf of Mexico Sunday, August 29, because there was no place to go with evacuated patients as another COVID-19 surge filled normally available facilities to capacity, according to several media reports.
Louisiana Governor John Bell Edwards told the Associated Press that hospitals in the state were already caring for more than 24,000 COVID-19 patients and face weeks without power because of the magnitude of the storm.
At Thibodaux Regional Health System in Lafourche Parish, a partial loss of a power generator forced staff to use disposable ventilator bags on patients in intensive care as they were being carried on stretchers to a separate floor where emergency power still worked.
Ochsner Medical Center in Kenner, Louisiana, had to move patients to hallways after hurricane winds peeled away part of the hospital’s roof. Other hospitals within the Ochsner Health system were ready to switch to using emergency well water after public systems were compromised.
Meanwhile, in California where another COVID-19 surge has also claimed vast hospital resources, a South Lake Tahoe hospital had to evacuate almost all patients and staff as flames from a wildfire threatened. Barton Memorial Hospital remained open only for emergent care.
Evacuation drills are crucial for preparing staff for what they will need to do and also exposing potential problem areas, particularly if the evacuation is through stairwells.
The staff at the University of Texas Medical Branch in Galveston found that out the hard way when they had to evacuate 110 patients after a fire was set in a waiting room in 2017. Staff had drilled for horizontal evacuations—from one unit to another on the same floor—but were unprepared to take patients down 12 flights of stairs.
Other hospitals have learned to use the TRAIN matrix to triage patients in an evacuation.
Emergency preparedness requirements call for all-hazard risk assessment and exercises should include emergencies that happen within another emergency, say experts.
Here are some links to articles on the Accreditation & Quality Compliance Center that offer lessons learned from other hospitals:
- Hurricane Harvey—https://www.accreditationqualitycenter.com/articles/harris-health-system-vs-hurricane-harvey-0
- Multi-vehicle traffic accident—https://www.accreditationqualitycenter.com/articles/work-local-healthcare-coalitions-successfully-manage-mass-casualty-surge
- Back-to-back-to-back emergencies—https://www.accreditationqualitycenter.com/system/files/issues/IJC_03-21-16_web.pdf
- Winter storms—https://www.accreditationqualitycenter.com/articles/winter-storm-texas-tests-concept-‘all-hazards-planning’