Puerto Rico’s entire infrastructure was wiped out by the Category 5 hurricane and one of the many urgent matters requiring immediate attention was finding a place for the territory’s patients, since the few hospitals still in operation were running on generators and unable to provide for the basic safety of the people in their care.
In a complex and ambitious logistical undertaking, emergency responders and hospital systems throughout the Southeast, aided by federal agencies, swung into action in response. In South Carolina, the statewide National Disaster Medical System’s Patient Reception Team was more than ready.
“We formed after [Hurricane] Katrina in 2005,” says Jeff Straub, Emergency Manager & Safety Officer at Spartanburg Regional Healthcare System and lead coordinator of the team. “A lot of the folks on this team have been here every year [training], so over time we’ve figured a lot of stuff out. Where to put arrows on the floor [to help traffic flow], how far and wide do you disperse the stretchers, putting cards on the floor [in front of beds] so we can communicate more easily. It all comes from training and practice.”
Straub’s team got the call on a Saturday night and were on site in Columbia at 9 a.m. on Sunday to set up the reception area. While much of his team is pulled from Spartanburg, other medical staff are from hospitals across South Carolina. Other responders, clinical staff, nurses, doctors, respiratory therapists came from around the state, with the State Guard, Army, Red Cross, Salvation Army, and Incident Management Team from the Forestry Service also sending people.
For someone like Straub, who served as a hospital corpsman in the Navy before getting into emergency response and management, there’s a clear passion that drives this work, something which is also true of his partner-in-crime, Chris Lombardozzi, MD and Chief Medical Officer at Spartanburg Regional Medical Center. Lombardozzi doesn’t have the same military background as Straub, but he did volunteer as a flight physician during his residency and has traveled to sites with urgent medical needs—like Houston in the wake of Hurricane Harvey—to volunteer his services.
For Lombardozzi, it’s important for the team to draw clear lines around their role.
“We've been talking about this for 12 years [now],” he points out. “We sit down and hash things out all the time. Is it a medical shelter or patient reception area? There’s a huge difference.”
As the latter operation, the goal is to provide immediate short-term care and facilitate the transfer of patients to hospital beds using the Joint Patient Assessment Tracking System, which has its own staffing table in the hangar.
“When that patient gets from A to B to C, we know where the bed is going to be for that patient,” Straub explains. “If [the patients] are extremely sick, we get them in the ambulance immediately—but this isn't a hospital by any stretch, and we don't want to take on the risk. But we have things we can do. We have ALS gear, drugs, medicines—we can get them stabilized. We just can't sustain long-term care.”
The attention to detail that the team now has is fairly stunning, with everything from a specific spot for gloves and hand hygiene products to specifically-assigned code beds already pre-arranged. Straub says the team has rehearsed at least once a year since Hurricane Katrina, with many members carrying over from year to year.
“We train the way we play,” adds Lombardozzi. “Every time an issue occurs, it kind of rolls into the new plan.”
Off to the far end of the hangar, meticulously organized supplies emphasize the degree of preparedness—including such unlikely items as cat litter (for “messes”) and more standard medical items.
There’s a lot of ‘hurry up and wait’ to the process, with uncertainty around the timing and number of flights and patients that anyone reception site will see, but Straub, Lombardozzi, and their assembled team don’t seem to mind. After all, Lombardozzi points out, they are all here voluntarily, with no funding for much of the training and practice they do, although FEMA will eventually reimburse the costs things like the Hurricane Maria response.
Their work occurs behind the curtain in many ways, particularly given that the devastation is occurring hundreds of miles away. But South Carolina hospitals and healthcare workers are doing what they always do—responding to those in need.