Biomedical Engineering Reference
In-Depth Information
the Gulf Coast, the Joint Commission is consid-
ering the development of a set of standards with
which surge hospitals would need to comply. These
standards would assure the public that the care
received in a given surge hospital—or in the health
care system as a whole—is safe. If the develop-
ment of these standards moves forward, the Joint
Commission will work with health care organiza-
tions that are developing plans for surge facilities
so that these standards can be implemented quickly
and with minimal cost.
into spaces that could be used for patient regis-
tration, triage, exam rooms, and a pharmacy.
Tables, computers, photocopiers, and telephones
were gathered from around the site and brought
to the clinic, which had the benefit of full elec-
trical power, working toilets, and potable running
water. The team acquired a number of donated
X-ray machines from a national medical supply
corporation and a major pharmaceutical company
sent a mobile laboratory on an 18-wheeler truck.
Two national drug store chains set up pharmacies
at the site, one housed in two mobile homes. Many
local businesses donated medical supplies and the
Red Cross provided cots. For the most part, the
100,000-square-foot clinic was prepared to provide
care to patients by midnight.
Supervised by medical director Thomas
Gavagan, M.D., MPH, vice chair for community
health in the Department of Family and Commu-
nity Medicine at BCM, the clinic processed 150
patients per hour over 15 days—or a total of more
than 10,000 people.
Originally equipped with 20 examination rooms,
the clinic quickly ballooned to 65 exam rooms. The
medical staff members worked 36 hours straight
after the clinic opened, and were finally relieved
after a call for medical volunteers produced
about 2,700 responders. For the rest of the time,
25 physicians were assigned to work per each
12-hour shift. The staff administered thousands of
immunizations—10,000 tetanus shots alone—and
filled a similar number of prescriptions. The site
remained an outpatient facility; acutely ill patients
were sent to local hospitals for treatment.
Paul Sirbaugh, M.D., Director of Prehospital
Medicine at Texas Children's Hospital, oversaw
a special pediatric clinic at the Astrodome so
that children could be seen by a physician
without having to be separated from their parents.
Mental health needs were seen as crucial to the
care of hurricane survivors, so psychiatric staff
from BCM stepped in to provide mental health
counseling.
The clinic's medical staff treated patients with
broken bones, chest pain, and withdrawal from
drug addiction, but most of the patients had
chronic conditions, such as asthma, diabetes,
Case studies
This section examines several surge hospitals that
were set up after Hurricanes Katrina and Rita
devastated the Gulf Coast. They illustrate the
variety of forms the concept can take as well as the
variety of responses medical personnel were able
to coordinate in response to the recent disasters.
Case Study 1: “Katrina Clinic,” Houston,
Texas
The Houston Astrodome served as a shelter for
more than 25,000 of the people who fled the
levee breaches that followed Hurricane Katrina's
destruction in New Orleans. In response to this
onslaught of evacuees in crisis, many of whom
had lived in appalling conditions for days, Baylor
College of Medicine (BCM) in Houston set up
“Katrina Clinic” in Reliant Arena, a building adja-
cent to the Houston Astrodome.
Three days after the storm hit, Harris Country,
Texas Judge Robert Eckels and Houston Mayor
Bill White asked George Masi, chief operating
officer of the Harris Country Hospital District, to
coordinate a facility that could manage the health
needs of the arriving multitudes. The Houston
Astrodome in Reliant Park, in ordinary times
used as a livestock exhibition hall, had been long
designated a shelter by local officials involved in
disaster planning. The team from Baylor College of
Medicine had roughly 15 hours to prepare before
the first busload of patients arrived.
The set-up team employed stored rods and
curtains used for exhibitions to separate rooms
