Houston's medical disaster response to Hurricane Katrina

Following the devastation of Hurricane Katrina and an official request for Houston to shelter evacuees, thousands of exhausted, dehydrated, injured, and acutely ill Gulf Coast residents were bused to Houston's Astrodome/Reliant Center Complex (ARC). Houston's regional disaster plan was quickly activated. The Harris County Hospital District and Baylor College of Medicine were charged with the organization of the ARC medical response. The ARC mega-shelter was opened to house 30,000 evacuees. Primary and secondary triage operations were developed to evaluate the health status of arriving evacuees at bus offload and within ARC for special needs evacuees. Emergency Medical Service (EMS) transfers for seriously ill/injured evacuees were deployed using contract ambulances vectored by the Catastrophic Medical Operations Center (CMOC) to area hospitals with near real-time capability/capacity to treat. The Katrina Clinic, organized within 12 hours of the initial request to shelter evacuees, soon expanded to include 65 examination rooms with defined areas for triage, adult medicine, pediatrics, obstetrics and gynecology, orthopedics, emergency psychiatry, eye and dental care, and services for special needs patients. Medical record, pharmacy, patient tracking, and public health services, including immunizations and disease surveillance/response, were arranged. The presentation will include data regarding EMS transfers by date and presenting complaint, EMS transfer rates, total patient clinic visits plotted against date in hourly intervals, the distribution of illness/injury by date, and the distribution of patient triage by date. Lessons learned, including the CMOC model; medical staffing and patient tracking and confidentiality challenges, and recommendations for future disaster preparedness will be discussed.