Post-storm scenarios challenging
And then the storms pass, or begin to die down, and a
whole new set of issues emerge. For instance, before
and after Harvey, specific types of patient issues
became critical throughout the Houston area.
“As the physical hardship progressed, we managed
issues like community dialysis, which almost came to a
standstill, and renal patients out of desperation began
filling up ERs and hospital beds,” Dr. Merkle says.
“Transporting patients who needed sophisticated levels
of care—premature babies or severely injured trauma
patients—was problematic. It was very difficult to
discharge patients from medical beds because nursing
homes and pharmacies were shut down.”
In Florida, the same logistical challenges presented
themselves, Dr. Schwartz adds. “After the winds get to
about 45 miles an hour, EMS stops transporting,” he
explains. “[Draw] bridges get opened and don’t get
close again. There’s no transportation of critically ill
patients once the winds get over that level. Once the
winds die down and the bridges are brought back
down, then everybody who needs help and can get to
the hospital, gets to the hospital. The post-storm
environment, in a lot of ways, is more challenging than
the pre- or during-storm management and requires
different resources. It also requires an attention to
who’s now fatigued and needs relief and how do we
get that relief to them.”
But what no one could have been truly prepared for,
Dr. Merkle says, was the post-hurricane rains and “the
magnitude of the flooding; we had many willing workers
and resources who were simply unable to leave their
homes/neighborhoods to help.
“We expected surges in patient volumes for at least
two weeks after roads started to become passable,”
she says. “Patients who came in were sicker due to
being unattended for several days. Trauma tends to
increase during this type of situation. Patients who are
well enough do not want to be discharged out into the
uncertainly around their homes and transportation.
And although they were tough, I know our team
members worked on through concerns about their
own homes and families.”
As in Florida, team relief was an issue not because
there weren’t willing workers, but because they were
unable to get to and from facilities.
“The sites that brought in two shifts of workers at day
one was well positioned during the crisis, but it
depleted their relief pools,” Dr. Merkle explains.
“People couldn’t get home, and thus the teams wore
out faster. So, there was a tradeoff.”
But, she adds, “I was awed by the sustained outpouring
of offers of help from our own Houston team
members and from TeamHealth team members from
around the nation. When Gov. Abbott allowed any
clinician with a license in good standing to help in
“As the physical hardship progressed, we managed issues
like community dialysis, which almost came to a
standstill, and renal patients out of desperation began
filling up ERs and hospital beds. Transporting patients
who needed sophisticated levels of care—premature babies
or severely injured trauma patients—was problematic. It
was very difficult to discharge patients from medical beds
because nursing homes and pharmacies were shut down.”
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