Charity Hospital evacuates its healthiest patients, deeming those remaining too sick to move.

Hospitals appear to survive hurricane without major damage. Although power is out, backup generators initially keep essential services going.

Water from the levee breach Monday afternoon floods lowest floors of New Orleans hospitals, and knocks out generators. Several hospitals are now in trouble.

With no power, cardiac monitors don't work. Ventilators don't work. Dialysis machines and IV pumps don't work, to name a few. Anyone who requires mechanical ventilation now needs a person to pump a football-sized plastic bag, 12 times a minute, every minute, every hour, every day. After 4 minutes without ventilation, these people will die.

Every IV now must be watched by a person and adjusted frequently, especially for those drugs where accuracy is crucial so as not to over or underdose. Machines do this far better than a person turning a simple dial - some drugs are simply to dangerous to give without a pump. The staff must now do much more with much less; at this point, it is only a matter of time before the staff is exhausted. Once the generators fail, it is obvious patients must be moved out or new generators - with adequate fuel - brought in.

No running water poses an equally serious problem. Doctors and nurses now can't wash their hands: a sure prescription for the spread of disease. The supply of drinking water is now crucial.

CNN reports:

U.S. Health and Human Services Secretary Mike Leavitt  said 2,500 patients would be evacuated from hospitals in Orleans Parish.

Police were working to get more generators to Charity and its 300 patients. The most critically ill would be evacuated first, with the rest to go later this week.

Outside Charity, water was waist-deep in the street. Inside, halls were dark and slippery. Workers ferried supplies up and down darkened stairs. Everyone needed flashlights.

The article goes on to mention patients continuing to arrive. The first good news for Charity: 25 babies are successfully evacuated via helicopter, a drop in the bucket.

As a doctor, the picture is vivid in my mind. The staff has lost the primary way of monitoring patients - their appearance. Skin pale? Gray? Jaundiced? Difficult to tell, by flashlight. You can hear with a stethoscope in the dark, but you can't examine wounds, look for swelling or signs of infection. Laboratories run on electricity; only the most basic results from battery-operated devices (such as home glucometers) are now available. Tasks for one person now need two: a second person to hold a flashlight.

The predictable consequences:

At Charity Hospital, the city's major trauma center, two intensive care patients died Wednesday morning as a result of the lack of electricity and water, doctors said.

"We have salvageable patients we are going to lose because we can't get these people out of here," said Dr. Jeffrey Williams, who works in the intensive care unit. "They are human beings, after all."

Meanwhile, other local hospitals had their own problems. Memorial Medical Center and Lindy Boggs Medical Center belong to Tenet Healthcare, which began evacuations.

Tulane University Hospital, privately owned by HCA, had only minor wind damage. HCA hired helicopters and arranged resupply and evacuation, anticipating a two-day process for patients, longer for staff.

Charity Hospital and University Hospital put out an SOS to Associated Press:

saying they were nearly out of food and power and had been forced to move patients to higher floors to escape looters.

The same article notes that Tulane University Medical Center is nearly finished with evacuation. From the NYT,

HCA, which operates Tulane, started making arrangements to move people a week ago, said Ed Jones, a vice president.

The USA Today article goes on to say

Late Thursday afternoon, the U.S. Surgeon General's office told the AP that five private helicopters had been secured to start taking patients out of Charity Hospital.

Private helicopters generally can only take one patient at a time. Charity Hospital has 250 patients and the public University Hospital has 110. The math is not encouraging.

At Charity evacuation begins, but stops when the helicopter is fired on.

The NYT again:

At Touro Infirmary Hospital, two private buses were able to get the last of its 2,000 employees and patients out of the hospital by the end of Thursday, Stephen Kupperman, the hospital's chairman, said. The hospital also hired private air ambulances to transfer patients.

"We could not get any assistance from the government at first," said Mr. Kupperman, who said about 80 patients transferred from the hospital were moved by government helicopters the last day.

Additional troops and supplies arrive in New Orleans. Evacuation of Charity Hospital resumes. Tulane completes evacuation.

 

Evacuation of Charity Hospital complete.