With hurricane season officially under way as of June 1 and continuing until Nov.1, Acadian Ambulance Inc. is planning for the worst but hoping for the best. The National Oceanic and Atmospheric Administration (NOAA) predicts an "active to extremely active" season, with a number of storms expected to reach the East and Gulf Coast. Similar predictions were reported last year, but the season turned out to be mild.
According to Acadian Executive Vice President and Chief Medical Officer Dr. Ross Judice, MD, MPH, MBA, the recent oil spill off the Louisiana coast is also a complicating factor because no one knows for sure how it may affect evacuation plans. Potentially, it could drive oil inland or disperse it further into wetland areas.
Regardless of the severity of the storm season, Acadian is prepared to deploy teams for a sustained operation, with patient evacuation as the top priority. According to Judice, patient evacuation is an extensive two-week, 24-hour-a-day process, beginning about five days before a storm hits. One of the ways Acadian prepares is by not waiting until the last minute to know about patients who need to be evacuated. "We go well in advance to facilities, namely nursing homes, to assess patients and try to understand who'll need to be transported and what their special needs might be to make sure proper equipment is available," says Judice. When transporting two to three patients per ambulance, it's important to know ahead of time who's going where. Not every patient is able to lie flat on a bench seat, for example, so providers must plan in advance, or this type of evacuation could take hours.
Since Hurricane Katrina struck in 2005, the whole Gulf Coast region evacuates, not just the New Orleans area, Judice says. Mutual aid depends on agencies from out of state and inland, and upward of 50 extra ambulances are mobilized during the evacuation period. "It’s an all-hands-on-deck approach," he says, with everyone from ambulance personnel to office staff to support strike teams responsible for specific roles. For example, grocery stores close when a storm comes, so support strike teams feed staff and provide crews in need of electricity with generators.
Judice says that having a good command structure in control and good communication are absolutely critical due to the chaotic nature of disaster mode. "When those two things are in place, you can survive any disaster," he says. Acadian currently uses five different modes of communication: radio, phone, Nextel push-to-talk phone, text messaging and e-mail.
Though many uncertainties surround natural disasters, one thing is certain: Providers and the community should expect the unexpected. Creating a realistic family-care plan will minimize the stress and anxiety EMS providers experience when called to duty during a disaster situation.
The following are some factors to consider when making your evacuation plan:
Remember that some disasters are handled quickly and normal activities are restored within a few hours. With this in mind, create both short-duration and long-duration family-planning scenarios.
Select a durable container that will serve as your family's disaster kit. This kit might contain the following items: first aid supplies, basic food rations, bottled water (enough for three days), a pre-paid credit card, cash, important documents, maps, medications or prescriptions, cell-phone chargers, flashlights, toys for the kids and any other necessary items your family may need. Don't forget to include pets in your plan.
Have supplies for sheltering in place, as well as portable supplies for evacuation.
Evacuate the area early; don't wait until the last minute. Select and agree on three out-of-town host locations: one to the east, one to the north and one to the west. Depending on traffic congestion and other factors, it's important to have several evacuation options. Keep maps of different routes to each location readily available in your disaster kit. When you can, plan to stay with family or friends, so your family will have the support of loved ones while you're at work during the emergency. Don't rely on hotels because they'll most likely be full. Familiarize yourself with the Interstate Highway Contra flow map for your area.
Create a detailed to-do list for tasks that need to be taken care of before you report for duty or before your family leaves the area. For example, you may want to place outdoor furniture and garbage cans inside, install plywood on the windows, put fuel in the family car, pack suitcases, turn off your plumbing, test your home generator and review the disaster plan one final time with your family.
Instruct your family to stay away from your home and the local area until emergency officials say it's safe to return. Just because a disaster seems to be over, electricity and other basic services may be unavailable for several days or even weeks after a hurricane.
In disaster situations, EMS providers can easily become victims as well, says Judice. Several Acadian employees lost homes during hurricanes Gustav and Ike, which struck back-to-back in 2008.
"There are no dull moments; [EMS providers should] expect to work hard," Judice advises.
"I try to take things one day at a time."