Biomedical Engineering Reference
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medications for several days. Another issue was
the fact that some patients could not recall the
names of the medications they had been taking.
The staff also saw some cases of trauma and
delivered several babies who needed resuscita-
tion. At one point, the hospital had 14 venti-
latory patients. Because the patients arrived so
early after the disaster, only a few cases of infec-
tious disease, such as abscesses and cellulitis,
were seen.
When the patients came in such waves, the
primary goal of the medical team was to treat them
as quickly as possible. After the first day, the docu-
mentation process began to take shape and by the
third day, the site had a full medical records system
in place.
As soon as it became apparent that large
numbers of new patients were no longer arriving
from New Orleans, Trevino began to close the
PMAC facility down, recognizing that, as func-
tional as the facility was, it was not optimal for
patient care; however, as of this writing, the LSU
field house remains open as a special-needs shelter
for nursing home patients.
Case Study 4: Empty former retail store in
Baton Rouge, Louisiana
Establishing the surge hospital
Physicians from the University of Texas (UT)
Southwestern University Hospitals took leadership
positions in providing emergency care and mental
health services in the state of Louisiana after Hurri-
cane Katrina struck the Gulf Coast. UT South-
western's Raymond Swienton, M.D., and William
M. Cassidy, M. D., associate professor of medicine
at Louisiana State University Medical Center
(LSU), chose to locate one of the temporary field
hospitals in a building that had formerly housed
a large retail store in Baton Rouge, Louisiana.
They chose the site because it was located just
one half block from LSU's Earl K. Long Medical
Center and because LSU had been in the process
of purchasing the property, which was to be torn
down to make space for the construction of new
clinics. The location proved to be desirable in terms
of management of emergencies, medical staffing,
and supplies.
Cassidy served as medical director of the
facility, but he gave responsibility for the actual set
up to Steven Winkler, MHA, former senior director
of risk management at Baton Rouge General
Medical Center, and Monica Nijoka, MHA, BSN,
R.N., former vice president of patient care services
at the same medical center. The team first arrived
at the site at 4:30 P.M. on Thursday, September 2,
2005. By 7:00 P.M. the next day, they were ready
to provide care to patients.
The neglected site was daunting. The floor was
greasy and layers of dust covered everything. There
was virtually no lighting, the telephones were out
of order, and only one toilet functioned. The inside
temperature reached 100
Fahrenheit. Over 400
volunteers worked to clean the site, remove trash,
fix the plumbing, and install electrical outlets and
emergency power. Winkler and Nijoka designed
the layout of the surge facility and developed a
staffing plan for the professional staff. They super-
vised information systems personnel who installed
a computer system that would allow medical staff
to document information in computerized patient
records.
Some disadvantages
As a university with more than 30,000 students,
LSU presents some disadvantages as a surge
hospital site. For example, housing a medical
facility at a university can be disruptive to student
life. Imagine seeing Blackhawk helicopters full of
evacuated patients landing on the quad. Secondly,
sheltering sick patients and medical personnel on
a university campus holds the potential for trans-
mission of disease. Operationally, it is problematic
to expect a university to essentially shut down its
educational function and take over disaster relief
in an emergency. Other venues, such as an expo-
sition center similar to the Houston Astrodome or
other multiuse facilities, can more easily cancel
events to gear up for an emergency situation
while maintaining logistical and infrastructure
support.
Chris Trevino, M.D., served as the primary
source of information for this case study.
