« Update on the Cajun Dome Relief Effort, Labor Day, 2005 | Main | 3 Days in Louisiana: A PA Reports »

September 06, 2005

Physician Report from the Astrodome

Amy is an MD who volunteered at the Houston Astrodome.  Here is her on-the scene-report.

Makeshift_er_and_clinic_9205_1

I don’t even know how to explain how bad it is down here for those of you who aren’t here.  It’s just unreal that so many people are here in Houston,  and it seemed like the Red Cross was unprepared for the onslaught of refugees, even though they knew ahead of time they were coming. 

Well I was watching the news Thursday night as over 100 buses were headed to the Astrodome from New Orleans  and it seemed like all hell was breaking loose. With about 60 people on each bus, that meant that about 6000 people would need to be processed, registered, and settled into the Astrodome. Then I heard that they were also triaging everyone medically too, since so many people on the buses were very sick- so many hadn’t had their medications since the hurricane, hadn’t eaten or drinken anything, had gotten cut or badly hurt in the flood waters, or were simply sick for other reasons. Then, one of the volunteer doctors came on the TV and begged any doctors, nurses, paramedics, PAs, volunteers, etc to come down and help get these people some medical care because they were getting overwhelmed in the ER/clinic they had set up in the AstroHall.

I was only one of about 6 doctors for hundreds of patients, so there was just such a sense of urgency to get these patients seen. So I dusted off my white coat, unpacked my scrubs, and found my stethoscope and drove at 1 am to the Astrodome to help in any way I can. I wasn’t sure what I could do since I don’t have my Texas license yet, but I was willing to hand out Band-Aids if that’s all they’d let me do. I explained my situation to the head MD, and he said since I was a doctor, he didn’t care. They needed help so badly that I saw all my own patients, decided my own treatments, transfers, follow-ups, etc, and just ran it by the attendings if needed. They simply signed off on my charts and prescriptions at the end of the cases, so that I’d be protected in the state of Texas, not that I cared at that point.

Anyway, the patients were so sick. It became routine to see blood sugars over 400 and blood pressures way over 200/100. They hadn’t had their medications for days, along with no food and water. But they were so thankful for the treatment they were getting and were so patient about having to wait so long. They were just so grateful to be in Houston.

I had to hold back tears so many times at how horribly these people had been ravaged by this storm and what it had done to their lives.

My toughest patient of the night was a young man who began seizing in the waiting area -- where he had been waiting for over 12 hours after getting off his bus. He had a grand mal seizure for over 3 minutes, hitting his head hard on the concrete floor when it started. I was the only doctor around at the time, so I had to step up to the challenge. There was no patient chart, no family with him, and no one knew anything about him. His finger stick glucose reading was so high it was off the charts, so we went from there, injecting whatever insulin was available. Then we had to hand hold 2 IV bags wide open while he was still lying on the floor in the waiting room, because we didn’t have enough help to get him up and into a bed yet. Finally we got him into a “room” on a stretcher and he told us that he’s diabetic and epileptic and had been off all his meds since the hurricane. He also hadn’t had anything to eat for 4 days. Since we didn’t have any lab services at that time and our only “EKG” was off of the defibrillator machine, I still had no idea if he was in ketoacidosis or just seizing from his lack of meds. Luckily his sugar came down, he stabilized, and we were able to transfer him to the VA, since we had no Dilantin to load him with, he needed to be ruled out for a possible head injury, and he obviously needed more intensive care. It’s amazing what you can do with so little when you have to. The teamwork and camaraderie around here among the healthcare personnel is awesome, and I think that’s why so much is getting done with so little.

For you orthopods- I also saw a horrible case of tibial osteomyelitis with a draining sinus- the med students were so interested in it. They’re literally seeing things they would only see in a third world country. I had to transfer him to the VA for his pending below knee amputation before he became septic, it was so bad.

The medical set up is pretty impressive and ever evolving. When I got there, it was just a large square area with about 20 curtain rooms, no lab services, no x-rays, no monitors, and very limited medications. The only IV antibiotic was Ancef, which some of you know doesn’t cover the brackish water organisms. There were a few other oral antibiotics, but not many. We had no pain meds, no diuretics (and everyone had edema on their legs!), only a few anti-hypertensives, and one or two types of insulin. There was a free pharmacy that was able to get more home medications, but they had to come back the next morning to pick them up, so who knows if they’ll do it. By the time I returned the following night, it had evolved to where there was an area for each specialty, an xray area, a lab trailer, an area for the ambulances to pull in, fast track and emergent care. And by then there were so many more medications and supplies. I’m so impressed by the way the Harris County Hospital District has handled this. They are really organized and proactive. Most of the medications, supplies, doctors, nurses and other personnel, stretchers, wheelchairs, etc are from Harris County Hospital District so it’s just an amazing effort by these guys to help out in any way they can.

Anyway, I urge everyone just to do whatever you can to help. There’s no way to explain how devastated these people are. But they still have their spirit and dignity and faith.

I included some pics I took. I didn’t take as many as I wanted to, because the people getting off the buses were so fragile. They didn’t need some doc snapping their pic.  The photo here is from inside, where you can see some of the treatment area and the waiting area.

Take care and lots of love. God bless the victims of Hurricane Katrina.


September 6, 2005 in Hurricane Katrina: Nurses and NPs Help | Permalink

Comments

It is very Balancing & wonderful entry. Coloring of this very reasonable and useful.

Posted by: Fogia | Sep 9, 2009 4:26:40 AM

I'm a RN that has been licensed in the State of Texas for the past 15 years. I have 5 years of ICU experience at a major trauma center, and have been a Home Health Nurse for the past 12 years. I registered with the Conroe, Texas Red Cross. I also registered with Nurse Ready Texas through the Texas Nurses Foundation. I had arranged through my employer to take time off to go down and help.

I had my own place to stay as I have relatives in the area. I have my own medical equipment. I could pack my own food and water. I was ready to go. I live 3 hours from Houston.

No one called me. I called the Red Cross back and was told I could not volunteer for them until I had completed a training course and could show proof of licensure (which is available online 24 hours a day and can be verified almost instantaneously). They told me that it would be a legal liability for me to just show up and start working.

Nurse Ready Texas never called me. I attempted to contact someone hooked up with the Houston Astrodome, couldn't get through. Meanwhile, they are running ads begging medical professionals to come help.

So it's quite distressing to me to find out that a physician that isn't even licensed in the State of Texas could just show up and other MDs are even willing to sign off on their notes/treatment orders and such with no questions asked. I'm appalled actually. Is this a bias on the part of the medical profession?

I ended up donating online eventually. Sad.

Posted by: Karen Eilert, RN | Dec 30, 2005 1:54:21 PM

Your account of the Astrodome conditions echo those of other Red Cross workers I have sent down there from my Chapter. I would like to make it very, very clear though that the Astrodome was NOT a Red Cross Shelter. It was staffed by the Red Cross at the request of Harris County. The person who was placed was in complete charge of the shelter was responsible for coordinating with local authorities and goverment the arrangment of suitable shelter and medical care for the evacuees. It has been repeatedly reported in the media as a Red Cross shelter, and I simply wish to correct that. You did a wonderful job and may God Bless You for your unselfish service to those in such dire need.

Posted by: kathy letts | Sep 7, 2005 2:38:09 AM

Why are these people being referred to as "refugees" instead of "evacuees"? I thought a refugee was someone excaping political unjusts from another country or to escape persecution. I do know it also means "one that flees", it just seems more appropriate and respectful to refer to them as evacuees.
Also wanted you to know there is a Mississippi Medical Battallion that has only had a few organizational meetings and has begun training as an emergency response team to set up a field hospital. They responded immediately and went down to the Mississippi Gulf Coast. Considering their infancy, I found this to be exceptional. Dr Anita Batman is first in command of this organization.

Posted by: Joan Hamilton | Sep 6, 2005 3:13:13 PM

The comments to this entry are closed.