Practicing Neonatology in a Blackout: The University Hospital NICU in the Midst of Hurricane Katrina: Caring for Children Without Power or Water

Barkemeyer, Brian

doi:10.1542/peds.2006-0099f

Cited by 43 publications

(50 citation statements)

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“…Reviews of health care operations during Hurricane Katrina emphasized the lack of basic training in disaster preparation and response by physicians as a contributing factor to the adverse patient outcomes (1)(2)(3)(4)(5)(6). Other research underscores the need for resident subspecialty training, in particular, in Emergency Medicine, Anesthesiology, Family Medicine, Pediatrics, and Surgery as critical to the future success of local emergency preparedness plans (7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Disaster 101: A Novel Approach to Disaster Medicine Training for Health Professionals

Scott

Carson²,

Greenwell

2010

The Journal of Emergency Medicine

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Section: Introductionmentioning

confidence: 99%

Disaster 101: A Novel Approach to Disaster Medicine Training for Health Professionals

Scott

Carson²,

Greenwell

2010

The Journal of Emergency Medicine

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“…Despite all efforts at preparedness, one cannot predict every eventuality. Although we were fortunate not to have had to improvise methods of evacuation to the degree of those heroic neonatologists and nurses involved in Hurricane Katrina, 4,6 on-the-spot thinking was crucial in determining how to safely transport our patients down 9 flights of stairs without transport isolettes or infant-sized evacuation equipment. Areas of future development of regional disaster preparedness planning could include creation of a central bed management authority or system to facilitate mass transfers of patients.…”

Section: Figurementioning

confidence: 99%

“…2 Bagaria et al 2 found only 69 cases of hospital evacuation published globally between 1979 and 2009, 15 of these occurring in response to hydrometeorologic events. The published data on evacuation of NICUs are even fewer and have come almost exclusively from experiences during Hurricanes Katrina [3][4][5][6] and Rita 7,8 …”

mentioning

confidence: 99%

Evacuation of a Neonatal Intensive Care Unit in a Disaster: Lessons From Hurricane Sandy

et al. 2014

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NICU patients are among those potentially most vulnerable to the effects of natural or man-made disaster on a medical center. The published data on evacuations of NICU patients in the setting of disaster are sparse. In October of 2012, New York University Langone Medical Center was evacuated during Hurricane Sandy in the setting of a power outage secondary to a coastal surge. In this setting, 21 neonates were safely evacuated from the medical center' s NICU to receiving hospitals within New York City in a span of 4.5 hours. Using data recorded during the evacuation and from staff debriefings, we describe the challenges faced and lessons learned during both the power outage and vertical evacuation. From our experience, we identify several elements that are important to the functioning of an NICU in a disaster or to an evacuation that may be incorporated into future NICU-focused disaster planning. These include a clear command structure, backups (personnel, communication, medical information, and equipment), establishing situational awareness, regional coordination, and flexibility as well as special attention to families and to the availability of neonatal transport resources.

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“…3 Hurricane Katrina caused extensive flood damage and electrical power loss to hospitals caring for critically ill newborn infants and resulted in mass evacuation efforts that were suboptimally coordinated. 4 Although all neonates in the affected hospitals survived, and many hospitals received evacuated neonates, there was a surge in NICU patients at the hospital receiving the most transports from the affected area, from 55 to 125 patients in 3 days.…”

Section: Introductionmentioning

confidence: 99%

Disaster Preparedness in Neonatal Intensive Care Units

Barfield

Krug

Newborn³

2017

Pediatrics

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Disasters disproportionally affect vulnerable, technology-dependent people, including preterm and critically ill newborn infants. It is important for health care providers to be aware of and prepared for the potential consequences of disasters for the NICU. Neonatal intensive care personnel can provide specialized expertise for their hospital, community, and regional emergency preparedness plans and can help develop institutional surge capacity for mass critical care, including equipment, medications, personnel, and facility resources. CLINICAL REPORT Guidance for the Clinician in Rendering Pediatric CareDisasters, whether natural or man-made, are especially threatening to the lives of people who are technology dependent. This is particularly true in the NICU. During a disaster, the provision of highly skilled and specialized care for preterm and critically ill newborn infants can be compromised by the loss of electrical power, physical facilities, specialized equipment, personnel, and other resources that can occur as a result of environmental disruption or large-scale illness, injury, or trauma. There is a paucity of data regarding the effect of disasters on the NICU population and practice implications for providers within the health care system. 1This clinical report first briefly reviews disasters that have affected NICUs in the United States and then examines how organizing concepts of mass critical care in pediatrics can be applied to the NICU, including the role of regionalized perinatal systems; disaster-based drills; and training, equipment, medication, and personnel needs. The objective of this report is to help neonatologists and other NICU providers and administrative leaders understand these organizing concepts and develop response plans within their units, hospital institutions, and geographic regions. This report builds on existing American Academy of Pediatrics policies concerning children in disasters, with a focus on the extremely vulnerable NICU population, and also discusses ethical issues related to surge capacity, altered standards, and atypical locations of care, evacuation, triage, and transport.

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Practicing Neonatology in a Blackout: The University Hospital NICU in the Midst of Hurricane Katrina: Caring for Children Without Power or Water

Cited by 43 publications

References 0 publications

Disaster 101: A Novel Approach to Disaster Medicine Training for Health Professionals

Disaster 101: A Novel Approach to Disaster Medicine Training for Health Professionals

Evacuation of a Neonatal Intensive Care Unit in a Disaster: Lessons From Hurricane Sandy

Disaster Preparedness in Neonatal Intensive Care Units

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