Combined external and internal hospital disaster: Impact and response in a Houston trauma center intensive care unit*

ObjectiveTo increase awareness of specific risks to healthcare systems during a natural or civil disaster. We describe the catastrophic disruption of essential services and the point-by-point response to the crisis in a major medical center. DesignCase report, review of the literature, and discussion. SettingA 28-bed intensive care unit in a level I trauma center in the largest medical center in the world. CaseIn June 2001, tropical storm Allison caused >3 feet of rainfall and catastrophic flooding in Houston, TX. Memorial Hermann Hospital, one of only two level I trauma centers in the community, lost electrical power, communications systems, running water, and internal transportation. All essential hospital services were rendered nonfunctional. Life-saving equipment such as ventilators, infusion pumps, and monitors became useless. Patients were triaged to other medical facilities based on acuity using ground and air ambulances. No patients died as result of the internal disaster. ConclusionAdequate training, teamwork, communication, coordination with other healthcare professionals, and strong leadership are essential during a crisis. Electricity is vital when delivering care in today’s healthcare system, which depends on advanced technology. It is imperative that hospitals take the necessary measures to preserve electrical power at all times. Hospitals should have battery-operated internal and external communication systems readily available in the event of a widespread disaster and communication outage. Critical services such as pharmacy, laboratories, blood bank, and central supply rooms should be located at sites more secure than the ground floors, and these services should be prepared for more extensive performances. Contingency plans to maintain protected water supplies and available emergency kits with batteries, flashlights, two-way radios, and a nonelectronic emergency system for patient identification are also very important. Rapid adaptation to unexpected adverse conditions is critical to the successful implementation of any disaster plan.

[1]  Magyar Cj Salt Lake hospital survives close brush with twister, power outage. , 1999 .

[2]  J Martchenke,et al.  Hospital Disaster Operations During the 1989 Loma Prieta Earthquake , 1994, Prehospital and Disaster Medicine.

[3]  T. Higgins,et al.  Total electrical power failure in a cardiothoracic intensive care unit , 1992, Critical care medicine.

[4]  V. Wills,et al.  Use of an ambulance-based helicopter retrieval service. , 2000, The Australian and New Zealand journal of surgery.

[5]  T Ukai,et al.  Hospital Disaster Preparedness in Osaka, Japan , 1994, Prehospital and Disaster Medicine.

[6]  Michael A. Hatton Tropical Storm Allison Recovery: A Facilities And Operations Perspective , 2001 .

[7]  M. Rosko,et al.  A critical analysis of on-scene helicopter transport on survival in a statewide trauma system. , 1998, The Journal of trauma.

[8]  I Tur-Kaspa,et al.  Preparing hospitals for toxicological mass casualties events. , 1999, Critical care medicine.

[9]  J C Tye,et al.  Complete power failure , 2000, Anaesthesia.

[10]  W. Fawcett,et al.  Complete power failure 2 , 2001, Anaesthesia.

[11]  Special report. When emergency backup power fails: what seven hospitals learned. , 1991, Hospital security and safety management.

[12]  J. Nicholl,et al.  Effects of London helicopter emergency medical service on survival after trauma , 1995, BMJ.

[13]  S. Waring,et al.  Tropical Storm Allison rapid needs assessment--Houston, Texas, June 2001. , 2002, MMWR. Morbidity and mortality weekly report.

[14]  F. Crawford,et al.  Impact of a major hurricane on surgical services in a university hospital. , 1993, The American surgeon.

[15]  O. Wenker,et al.  Principles Of Hospital Disaster Planning , 1999 .

[16]  J Mitchell,et al.  Complete power failure 1 , 2001, Anaesthesia.

[17]  D L Maxwell,et al.  Electrical power failure in a cardiothoracic intensive care unit. , 1993, Critical care medicine.

[18]  F. Amenta The International Radio Medical Centre (C.I.R.M.): an organization providing free medical assistance to seafarers of any nationality world wide. , 2000, International maritime health.

[19]  A. Vohra The role of the anaesthetist: replacement brain , 2001, Anaesthesia.

[20]  R. Rutledge,et al.  A comparison of the association of helicopter and ground ambulance transport with the outcome of injury in trauma patients transported from the scene. , 1997, The Journal of trauma.

[21]  R Aghababian,et al.  Disasters within hospitals. , 1994, Annals of emergency medicine.

[22]  Maxwell Dl,et al.  Electrical power failure in a cardiothoracic intensive care unit. , 1993 .