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Lessons Learned From the Evacuation of an Urban Teaching Hospital
Christine S. Cocanour, MD;
Steven J. Allen, MD;
Janine Mazabob;
John W. Sparks, MD;
Craig P. Fischer, MD;
Juanita Romans;
Kevin P. Lally, MD
Arch Surg. 2002;137:1141-1145.
Hypothesis Valuable lessons can be learned from the emergent evacuation of a large urban teaching hospital because of flooding.
Design Case report.
Setting Four hundred fifty–bed adult and 150-bed children's tertiary referral teaching hospital.
Case Summary Massive rainfall from tropical storm Allison caused extensive flooding. Emergency power came on at 1:40 AM. Complete power loss occurred at 3:30 AM. The decision to begin evacuation of patients was made at approximately 10:30 AM. All 575 patients were either discharged from the hospital (169 patients) or evacuated (406 patients) to 29 other facilities by both ambulance and helicopter by 3 PM the next day. Six deaths occurred, none of which could be attributed to the conditions created by the flooding.
Conclusions The lessons learned from this experience included the following: (1) flooding will occur in a flood plain; (2) electrical power outages are not necessarily temporary—begin evacuation; (3) appoint a triage officer from those available; (4) have a reliable in-house communication system not dependent on telephone lines or electricity; (5) have a reliable telephone system for contacting outside facilities; (6) have flashlights available on all units; (7) have battery-operated exit signs and stairway lights; (8) maximize use of volunteers when they are available and fresh; (9) maintain a paper record of all patient transfers; (10) coordinate loading of ambulances and helicopters for patient transfer; and (11) reassign staff as necessary to care for transferred patients. Emergent evacuation of a large, tertiary hospital requires extensive effort from both the hospital staff and the community.
From the Departments of Surgery (Drs Cocanour, Fischer, and Lally) and Pediatrics (Dr Sparks), University of Texas Health Sciences Center at Houston, and the Memorial Hermann Hospital, Houston (Dr Allen and Mss Mazabob and Romans).
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