Field care during disasters | 09.20.2006 | 07:45:20 | Views: 4815 | ID: September 20 '06: As Hurricane Rita bore down on the Gulf Coast last year, medical responders in the area had to use inventive and varied ways to make sure patients and those injured by the storm were cared for even when supplies and basic necessities were low or non existent. An editorial originally published in August of this year in the Annals of Internal Medicine details some of the methods used by medical responders in the field during the storm. The authors of the report - doctors in the US Public Health Service - "received orders to leave their regular jobs and go to the Gulf Coast, where they served as physicians, nurses, pharmacists, dentists, engineers, administrators, environmental health officers, veterinarians, mental health experts, and mortuary experts." The authors were stationed in Alexandria, Louisiana. The influx of evacuees from more southern areas of the state caused surge capacity problems in the medical care centers. In order to alleviate crowding, the doctors turned a local YMCA gymnasium into an evacuation center for patients while "Anticipating the need for structure, leadership, and organization, the PHS implemented an incident command structure in Alexandria," the editorial read. Logistical problems that arose included the loss of power, water, sewage, air conditioning, and supplemental oxygen, so the doctors "improvised backup systems. ... How does one provide supplemental oxygen to patients with chronic lung disease in shelters that lack wall-based central oxygen?" The result was that local sources of oxygen were found and the doctors "strung together H-tanks to create reserves ... and used T-pieces to distribute it from a central tank." Water reserves were created in case systems failed; the Louisiana National Guard installed portable 60-kilowatt generators; and master electricians were on call to repair damaged and failed electrical systems. "We had had hands-on experience in other disasters," the doctors wrote, "such as 11 September 2001, anthrax attacks, immunization crises, and natural disasters. Our broad clinical skills were necessary in Alexandria but would not have been sufficient without practical training and experience in organization, communications, logistics, and operations."
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