Sweating It out in a Level III Regional NICU: Disaster Preparation and Lessons Learned at the Ochsner Foundation Hospital

Abstract

Preparations: In New Orleans, Louisiana, we had been through the drill many times before. Annually, disaster preparation is undertaken in conjunction with our Office of Emergency Preparedness when an imaginary hurricane strikes our city and causes catastrophic damage. Sometimes life imitates art. When Hurricane Katrina crossed the state of Florida and entered the Gulf of Mexico, New Orleans had a metropolitan population of 1.3 million, with 484000 inside the city limits. Much of the city lies slightly below sea level, whereas the level of Lake Pontchartrain typically is 1 foot above sea level. The Alton Ochsner Foundation Hospital is a 531-bed teaching hospital that is situated on the east bank of the Mississippi River, just west of New Orleans in the Parish of Jefferson. Providing incalculable benefit, the first floor of our hospital stands approximately 6 feet above sea level—12 feet above some of the lowest parts of the city of New Orleans. The NICU, located on the 10th floor of this 11-story hospital, was supporting 25 neonates, many of whom were on mechanical ventilation as Katrina approached the Gulf Coast of the United States. One infant was requiring extracorporeal membrane oxygenation (ECMO). The institution had established an emergency-management manual that, although remaining a perpetual work in progress, is currently 122 pages in length and addresses many topics including responses to loss of utilities, external and internal disasters, and severe weather conditions. The Ochsner model of medical care includes many satellite clinics and a closed medical staff for the hospital. Preparing for a natural disaster involves having a facility that would withstand the storm (externally and internally) and having a staff that can care for patients, their families, and all personnel on campus. According to our procedures, after deciding the “essential staff,” “A” and “B” teams are created. The A-team … Address correspondence to Harley G. Ginsberg, MD, FAAP, Neonatal Intensive Care Unit, Alton Ochsner Foundation Hospital, 1514 Jefferson Hwy, New Orleans, LA 70121. E-mail: hginsberg{at}ochsner.org