Report from the rear area, Hurricane Katrina

I have spent 12 1/2 of the most exciting and rewarding hours of my life. As most of you know, evacuees from Hurricane Katrina have been relocated to Texas, including approximately 4,000 who are temporarily residing in the Austin Convention Center. Our Austin/Travis County Emergency Operations Center issued the request for medical assistance on a regional basis.
I would like to relate my experiences to you. The medical and public safety communities from the Austin area united to provide an absolutely seamless care environment to the evacuees, most of whom have gone several days without their routine medicines or any medical care, beyond that necessary to stabilize any immediately life-threatening conditions. Upon my arrival at the convention center this morning (after dealing with some well-intentioned Red Cross volunteers who believed that they had an official role in screening EMS providers who were scheduled to work), I was quickly oriented to the facility, particularly the medical areas. We had a triage area staffed by nurses and EMS providers who obtained vital signs and a basic assessment prior to referring the patients to a physician. Our transport section was ably staffed by EMS agencies from surrounding counties as well as both private services here in Austin. In addition, our medical area had a section reserved solely to provide insulin shots and tetanus boosters. Another room was a mental health area staffed by counselors and clergy. This room also had an "assisted living" area where medical staff could pay closer attention to those who were deemed unable to maintain themselves. We also had a pharmacy trailer provided by a local drugstore chain.
After a short time in triage, several of us who are EMTs, mostly those affiliated with Travis County fire departments (along with some nurses and nursing students), were organized into two-person "medical strike teams." These teams were assigned to roam the main areas where evacuees were located. Our job was to stop and talk to almost every person there, ensuring their immediate, as well as ongoing, medical and psychological needs were met. We encountered many people with chronic medical conditions that were unaddressed, particularly hypertension and diabetes. We also encountered many cases of diarrhea and rashes. Many of these people were referred to our medical area well in advance of their medical needs becoming acute. We also encountered several acute cases that might not have been observed without the presence of the medical strike teams, notably a severe eye infection and a case of hypotension. In my opinion, the strike teams are a NECESSITY for the shelter environment. I would submit that failure to include the strike teams in the shelter setting only ensures that the triage areas will be overwhelmed later with much more serious conditions.
The only observation for improvement that I would recommend would be to provide for optometry (many of the evacuees needed new eyeglasses) and dentistry (I personally encountered several people with dental complaints.).
For those medical personnel working in the strike team setting, I would make the following recommendations for supplies.
1) An EMS-style fanny pack for supplies.
2) Stethoscope and blood pressure cuff.
3) Gloves.
4) Drug guide. (Many of us in EMS may not always be familiar with the maintenance medications that we will be encountering.)
5) Neosporin along with basic bandaging supplies.
6) Any such OTC meds as your medical control will authorize.
My hat is off to each and every medical provider and public safety provider who I worked with today. While several so-called "rival" agencies were working in the same confined area, egos were absent as we all focused on providing the best possible health care (both physical and mental) to some very scared, very tired evacuees. Thank you each for being there.
I truly am indebted and honored that I had a small opportunity to be a part of these people's lives. At the risk of sounding cliche, this was a life-changing experience. The tears I've been holding back today are tears of joy and compassion. I will always treasure the friendships I made, however brief the contact, with each and every evacuee and professional at the shelter.