viernes, 31 de agosto de 2012

After Isaac dies down, health care is trying to get back to normal -

As weather conditions improved after Hurricane Isaac, the New Orleans health care system was in a process of restoration Thursday. Nursing homes, many of which were without city power, were of particular concern to health officials. "I worry a lot about them," New Orleans health commissioner Dr. Karen DeSalvo said.

At Poydras Home in Uptown, residents were moved several blocks away to Lambeth House at Uptown Square on Thursday afternoon after an overnight incident left them without much backup power. On Thursday about 3 a.m., a tree apparently fell on a generator that had been providing backup power, CEO Jay Rive said.

The parts to fix it weren't available Thursday, and a smaller generator was being used to power some lights and fans. At around 5 p.m., residents were moved in vans to Lambeth House, which still had power. More than 25 nurses and support staff were to go with the residents, whose belongings and personal items, supplies and medical charts were packed into a Penske rental truck for the short trip to Lambeth House. 

Overall, 21.5 percent of the state's nursing homes were operating on generator power after losing electrical service, state officials said. Across the state on Thursday, at least 59 nursing homes housing 6,366 residents, along with 36 hospitals, were operating on generator power. Officials were planning to evacuate six more nursing homes across the state that were endangered by floodwaters.

At St. Luke's Medical Center on Woodland Drive in Algiers, one of the facility's backup generators was not working after the loss of city power. St. Luke's CEO Larry Stansberry was not on site and refused to comment on the condition of the center's vulnerable residents and whether the facility had air conditioning.

A young woman in a green Girl Scouts T-shirt answered a knock on the center's locked entrance on Wednesday evening. "We're fine, I promise," she said, refusing to identify herself.

Another concern for health officials was what to do about residents who rely on home medical equipment, many of whom did not evacuate the city and lost power during the storm. A medical special needs shelter was set up in New Orleans on Thursday to provide electricity and support with the help of federal disaster medical teams. Residents can call 504.658.2500 for information.

City officials worked well into the night Wednesday for a third night to help bring back a range of healthcare assets that, DeSalvo said, "often get forgotten." Those included dialysis units, psychiatric hospitals, and substance abuse and mental health living programs.

The city's homeless shelters took in hundreds more residents than usual during the storm. The New Orleans Mission had no power throughout Wednesday. It was sheltering around 250 people. Resources were brought in to run refrigerators. Mental health crisis response teams were a high priority for Thursday, to provide residents options in addition to visiting emergency rooms.

The storm highlighted the way in which the pieces of the city's health system are interconnected. With clinics and other services shut for the storm, the city's emergency rooms saw an increase in patients even as tropical storm force winds continued to buffet the city.

The emergency room at Ochsner's Baptist campus on Napoleon Avenue was on backup power and partially lit. The hospital's inpatient services were closed and hospital leaders were assessing roof damage. The small team of medical workers on duty was working hard. New patients arrived, walking up an emergency room ramp full of broken glass. Ambulances pulled up one after another. "It looks like we're going to be swamped with EMS," an intake worker said.

Tulane Medical Center opened its emergency room to ambulances on Thursday morning after having diverted them on Wednesday. Many of the hospital's operating rooms and intensive care unit beds had to be closed because of water intrusion. Hospital workers and an outside remediation crew placed blowers in wet areas and planned to sample drywall before reopening them.

Tulane's emergency room remained open to walk-in patients throughout the storm. Doctors and nurses treated a woman who had injuries from a fall, and a child who fell out of a window. City residents who needed dialysis and relied on electric-powered oxygen concentrators also came to the emergency room for help. Those in need of dialysis can call 800.472.8664, officials said.

Disaster "A" team workers were still on duty on Thursday for a third day at Tulane and at many of the city's other hospitals. They worked 12-hour shifts and were provided with food and sleeping accommodations as relief team members began returning.

"Our first priority is making sure our patients are covered," chief operating officer Jennifer Eslinger told hospital leaders at a meeting on Thursday morning.

Even after three days on duty, hospital officials cracked jokes as they worked to solve problems. The room erupted in applause for the head of food services. "Great teamwork," Eslinger told her colleagues.

At Touro Hospital, hospital leaders also kept the emergency team in place throughout the crisis. "It's been a really calm and organized process," said Christine Albert, associate vice president of marketing.

At the Interim LSU Hospital late Wednesday, a small area in the center of the emergency room waiting room was surrounded by yellow "wet floor" sandwich boards and yellow caution tape. CEO Dr. Roxane Townsend said despite some leaks and a temporary power outage to one MRI machine, all the hospital's services were functioning and the response to Isaac was "very controlled, very calm."

Townsend said a mission-driven attitude and experience in dealing with frequent budget cuts had made her staff resilient and creative in solving problems. "One of the things we learn in the public health system is how to manage, how to make do," she said. "That probably carries the day when you're dealing with adverse conditions."

At Baton Rouge General Hospital, power was fully restored after a problem with one Entergy feed, according to spokeswoman Nicole Kleinpeter. The hospital had lost power and air conditioning during Hurricane Gustav, but this time air conditioning continued to function. After Gustav, the hospital invested in a generator system capable of running air conditioning during emergencies.

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