Louisiana's medical system consumed by people in need of treatment

Patients shipped out of New Orleans

Katrina's Wake

September 02, 2005|By Robert Little | Robert Little,SUN NATIONAL STAFF

BATON ROUGE, La. - Every five minutes the scene repeated: An ambulance or bus pulled up to the arena at Louisiana State University and a crowd of men and women in green scrubs and rubber gloves closed around it.

Then another nursing home resident snatched from the dark, or another dehydrated child or another potential heart attack victim disappeared into a makeshift emergency room, which reached its theoretical capacity of 200 the instant it opened Sunday.

Emergency workers at the LSU campus estimated the patient load to be in the thousands yesterday, and state officials don't know when the flow of patients would stop.

As rescue workers in New Orleans struggled to evacuate all the city's powerless hospitals and nursing homes, doctors say the crush of those in need of treatment has consumed Louisiana's medical system, if not overwhelmed it. Officials estimate that every hospital bed within 100 miles or more of the city is full.

At LSU, displaced doctors and nurses and local volunteers have set up an emergency triage center that fills two large arenas, and say they are desperate to find transportation to move patients deeper into the state.

The entire LSU medical school is expected to be relocated here from New Orleans in the next day or two, offering relief to the doctors and nurses staffing the center during time off from their regular jobs.

Most patients are given a cursory evaluation by medical technicians as soon as they leave New Orleans, and then are shipped to Baton Rouge for more definitive evaluation. The most serious patients are moved quickly into emergency rooms west of Hurricane Katrina's strike zone; others are treated and sent to one of the state's "critical needs" shelters for people who need constant but not emergency attention.

Doctors say that at least a few patients have died inside the LSU arena and that some emergency cases requiring resuscitation or surgery have arrived. But a more typical patient is 16-month-old Jacob Leicher, who got his first helicopter ride from the roof of his house Monday and his second one to Baton Rouge on Wednesday after he was diagnosed with dehydration. He was treated and released to walk the campus with his father, Mark.

"God takes care of fools, drunks and children, and I was a fool for staying in that house," Leicher said, squatting in his donated clothes against a vent in the arena that was blowing cold air.

Among the first patients to arrive at LSU were roughly 100 nursing home residents rescued from a rooftop in St. Bernard Parish. "They come in sick, dehydrated, no meds, no records, and every time you move them, some of them are going to die," said Dr. Robert V. Blanche, a geriatric psychiatrist whose services have been in particular demand.

The influx has scarcely abated since the hurricane, and doctors say they are seeing more patients in a day or two than they would typically see in a month.

State officials think the system is handling the volume. Donated medical supplies and a drug formulary donated by pharmaceutical companies have been more than adequate, they say. And a flood of volunteer nurses and doctors has staffed the center with virtually every medical specialty available in a permanent hospital.

No one is certain what will happen when the volunteers leave and the supplies dwindle, however. And doctors treating the patients say they would be reluctant to alter the system regardless of whether it is effective because of the dire need to move patients and the elderly out of New Orleans.

People arriving from nursing homes without power and supplies have symptoms of dehydration and neglect rarely seen in modern hospitals, certainly not on such a large scale, they say. Doctors recounted second-hand stories of ventilators failing because of drained batteries, patients whose medication was washed away and people with dementia who wandered off into the flood zone.

State officials say they don't have a death count, but medical officials in Baton Rouge say they are certain some patients have died in New Orleans.

"I can't tell you first hand, but from what everyone is telling us, it won't be surprising when they announce that people have died because of the conditions," said Dr. Dale Leleaux, an internal medicine specialist.

State officials agree that the situation is critical and deteriorating. "We're using buses, ambulances, helicopters, boats, anything we can find to evacuate nursing homes and hospitals," said Kristen Meyer, a spokeswoman for the Lousiana Department of Health and Hospitals.

The situation has enveloped one corner of the LSU campus, already overflowing with students expecting to begin classes next week. Students in flip-flops walked through a blur of sirens, Federal Emergency Management Agency vans and police barriers yesterday as gurneys clanked down the sidewalk and doctors clutched their stethoscopes while they ran from building to building.

Leleaux had a patient whose blood pressure was 198 over 90 and hadn't taken his medication in three days. Dr. Mark Mouton, another internal medicine specialist, had a patient whose blood was coagulating and was at immediate risk for a blood clot or a stroke.

Blanche, the psychiatrist, kept thinking about the woman who sat on her rooftop as floodwaters rose and listened to her eight relatives screaming until the screaming stopped.

"They're sleep-deprived, exhausted, malnourished, washed out and just plain scared," Blanche said. "God knows what's going to happen next. It's extraordinary we've gotten this far."

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