PRIORITY TRAFFIC Devastation in Katrina’s Wake An initial report on the EMS response to one of the worst natural disasters in U.S. history THE BIG PICTURE without electricity or standard phone serv- bodies added to the already biohazardous mong thousands of apocalyptic images ice for weeks. mess. The heralded French Quarter was Astill surfacing in the wake of Hurricane At first, New Orleans sustained similar spared major flooding, but the rest of the Katrina, one in particular illustrates the al- wind damage but did not flood. Then aging city (largely areas that tourists rarely see truistic EMS response: A lone ambulance, levees began to fail. but EMS crews know well) was inaccessi- taking a hazardous chance, fords through “They’ve been telling us for years and ble to rescuers without boats. floodwaters toward a stranded community. years that this [was] going to happen,” Coast Guard helicopters immediately Ignoring naysaying officials unfamiliar with says Ken Bouvier, a native of New Orleans began hoisting stranded residents, one by the area and its residents, David Hussey, an and president of the National Association one, from the roofs of their swamped EMT-B with Acadian Ambulance Service, of EMTs. “We’d dodged the big storms. homes. But air rescuers were over- found a back way into St. Bernard Parish, We’d gotten lucky before, but now our whelmed: Thousands of residents had La. More rescuers followed his lead, bring- time had come.” lacked the means to leave New Orleans ing aid to one of many stricken areas Within hours, nearly 80% of the city fa- prior to Katrina’s landfall. More than eclipsed by near-anarchy in neighboring mous for its Cajun ambience was deluged 40,000—encouraged by officials—sought New Orleans. with a floodwater roux of sewage, debris shelter in the New Orleans Superdome Even before Katrina slammed into the and stagnating chemicals. Decomposing and Ernest N. Morial Convention Center, Louisiana, Mississippi and Alabama coasts on Aug. 29, 2005, emergency crews knew damage from the Category 4 hurricane would be catastrophic. The below-sea-level city of New Orleans was especially vulner- able, doomed by the same, unique geog- raphy that had sustained centuries of commerce and culture. Initial post-storm attention focused on the ravaged Mississippi and Alabama coasts, where a 20-foot storm surge wiped out entire coastal communities. Major highways disappeared beneath surge-driven sand, and highway bridge decks toppled into water, eliminating hope of quick mu- tual aid from rescuers eager to assist stricken areas. Responding flight crews found few landmarks. The storm had been so vicious that some barrier islands (and at least one lighthouse) were swallowed by the Gulf of Mexico. VICE Katrina’s wrath continued hundreds of CE SER miles inland, where tornadoes and straight- AN line winds shredded trees, peeled the eaves off buildings and left many communities ADIAN AMBUL C Y A An Acadian ambulance traverses the TES floodwaters of New Orleans. OUR C 20 JEMS | OCTOBER 2005 believing that the hurricane itself would be the extent of their nightmare. After winds died down, restless crowds at- tempting to leave either facility found that the city was flooding. They were stranded with lit- tle food or water, no working toilets, no power for lights or air-conditioning—and an already overwhelmed public safety contingent. Promised federal aid did not arrive for days, leaving rescuers to improvise care under the worst of circumstances. Horrifying media images remain impossible to forget: outnumbered rescuers triaging angry masses of dehydrated people, bodies of the dead lying and floating across the city, the days- ARRIE PYNE A victim is evacuated through the O C long wait for evacuation, and subsequent de- T use of a standard kitchen chair. scent into violence. PHO Medical and rescue helicopters, rescuers in boats and hundreds of personnel with EMS, fire and law enforcement agencies found themselves under gunfire, and rescue opera- tions were temporarily suspended until the National Guard and U.S. military were cleared to regain control of the city several days after the hurricane struck. But in the midst of post-Katrina finger- pointing, EMS response consistently is draw- ing bipartisan praise. Hundreds of EMS personnel continued on the job despite losing their own homes in the disaster. Army Gen. Russell Honore, a Louisiana native who minces no words with either military or media, of- fered compliments to civilian EMS. “We’ve got 300 helicopters and some of the finest X EMS workers in the world down there in New O Orleans, and they are making it happen,” Gen. O JESSE C Honore said to a news reporter who had sug- T gested apathy within rescuer ranks. “That’s PHO BS,” he added. “I will say that on behalf of Thousands of hospitalized patients and A military Black Hawk lands to evacuate every first responder down there.” nursing home residents were evacuated by triaged patients. Ironically, days before Katrina struck, ground and air from New Orleans prior to plenty of EMS personnel were in the Big hurricane landfall. Dozens of municipal and Even before the storm made landfall, EMS Easy, attending the annual EMS Expo at the private ambulance agencies descended on the personnel outside the targeted area prepared convention center. When Katrina deviated city and then found the gridlock of ground for the largest mutual aid response in organ- from its initially forecast course and aimed evacuation prevented quick return trips. ized EMS history. Service directors through- straight at New Orleans, Expo organizers As winds rose with the storm’s approach, out the United States were swamped with cancelled Saturday evening activities and calls for evacuation grew more frequent— their own flood of personnel who volunteered urged attendees to evacuate. and frantic. to be part of the rescue effort. Most Expo attendees did leave, but some at “The sense of urgency was huge,” says Mike Knowing they would need to be completely the mercy of airlines were stranded in the city. Burney, operations manager of the communi- self-sufficient in an area left with no electricity A few others volunteered to stay and formed cations center at Acadian, which transferred or running water, rescuers crammed supply their own first response groups within the by air and ground more than 700 patients in trailers with everything from oxygen cylinders city’s hotels. Bouvier, a supervisor with New the 36 hours prior to the storm’s arrival. to sleeping bags, stacks of water bottles, bags Orleans EMS, stayed in his hometown, as did Evacuations were suspended late Sunday night, of beef jerky and thousands of pounds of med- NAEMT Past President John Roquemore, when wind-driven debris made the streets too ical supplies. Once activated by state offices, who works in neighboring Jefferson Parish. dangerous for ambulance crews. hundreds of urban search and rescue crews, WWW.JEMS.COM | OCTOBER 2005 | JEMS 21 PRIORITY TRAFFIC ambulances, and command and support vehi- cles descended in waves upon staging areas. One of the largest staging areas was in Baton Rouge, La., where out-of-state EMS providers filled out paperwork necessary for emergency certification from the Louisiana Bureau of EMS office. Many crews assigned to New Orleans lined up their ambulances on Interstate 10, beneath the Causeway Blvd. South overpass. Coast Guard helicopters ferried people from rooftops, and within hours National Guard and multiple branches of the U.S. military began arriving in the beleaguered areas, although, controversially, they weren’t AIN C immediately deployed to aid those stranded C in the city, nor those in outlying Louisiana, TNEY M Mississippi or Alabama. Houston fire, EMS and police units were OUR pre-staged well in advance of receiving Desperation festered among those remain- O C T evacuated Louisiana residents. ing in New Orleans, where reeking floodwater PHO had risen to waist level in some city hospitals. The situation at Charity Hospital became of the hospital for safety. McSwain e-mailed the Drowning generators fizzled out, cutting so desperate that Norman McSwain, MD, AP for assistance in evacuating Charity and power to the entire facility and every electricity- chief of trauma surgery at Charity, appealed University hospitals. dependent item within it. Staff at Tulane directly to the Associated Press news service “We have been trying to call the mayor’s University Hospital created their own helipad for assistance. Food, water and power were office. We have been trying to call the gov- by knocking over light poles atop an adjacent running out, patients were dying, and re- ernor’s office,” McSwain said in an e-mail parking garage so helicopters could land there maining medical personnel were at risk from obtained by JEMS. “We have tried to use and evacuate patients from nearby facilities. looters. They huddled together on upper floors any inside pressure we can. We are turning Each rescue worker has a continuing, unique story. And more than a few X are shrugging off O the “hero” tag. O JESSE C T PHO 22 JEMS | OCTOBER 2005 PRIORITY TRAFFIC ture of resignation and hope. Following their we’re all kind of camped out together,” initial rescue from New Orleans, evacuees Bouvier said. “Some of our (former) em- joined a complex exodus to nationwide com- ployees who moved away have come back to munities. Most were relieved to be out of the help us. They saved their old uniforms and city but just as desperate to find their families, came back.” who in some cases had been ferried, flown and The topography of every service area has driven to other states. changed. Familiar landmarks and even street One-quarter of those evacuees—nearly signs are gone.