What we don't yet know about the response (or lack thereof) to Hurricane Katrina in New Orleans will doubtless fill volumes over the next several years. What we do know is this: Acadian Ambulance Services did it right. We're not just saying this because we had the foresight to present them with the EMS Magazine 2005 Gold Award at EMS EXPO just two days before Katrina hit (but we don't mind mentioning it). Their light shone so bright in that first dark week that the whole country noticed.
Based in Lafayette, LA, about 120 miles west of New Orleans, Acadian is the largest private ambulance company in the nation and was dubbed by John Tierney of the New York Times "a lonely island of competence" in the chaos and confusion that engulfed the area. TIME Magazine noticed it, too, pointing to CEO and Chairman of the Board Richard Zuschlag's example of "acts of heroism [that] took the form of mini-rebellions against the bureaucracy."
THE BEST LAID PLANS...
"We started evacuating nursing home patients several days before the hurricane was expected," says Ross Judice, MD, the company's medical director, who a few days later would become known as the guy who took the bull by the horns at the Superdome, coordinating medevac operations with a Disaster Medical Assistance Team (DMAT) situated at the New Orleans Arena next door and helicopters from the National Guard, the Coast Guard, the Army, and numerous private air ambulance companies. Acadian took around 700 patients out of harm's way before the storm arrived. Most nursing homes have mutual agreements with other facilities around the state for such situations, he explained, but hospitals don't tend to evacuate. "They figure they're in big structures and they've got generator power," he says. "They'd been through it before; they figured they'd just ride the storm out."
The New Orleans emergency plan was to use the Superdome and the Arena to shelter patients with special needs who had not been able to leave on their own and as a "shelter of last resort" for the general population.
"The special-needs shelter is run by the New Orleans Health Department in conjunction with the Louisiana Department of Health and Hospitals (DHH)," explains Judice.
There were representatives from the New Orleans Health Department there, including director Julette Saussy, MD, who had lost her own home and dogs; and from DHH, including the secretary of DHH, Fred Cerise, MD, MPH. They were responsible for the special-needs patients and had the Louisiana National Guard Medical Team supporting them.
"They're good people," says Judice, "but without their infrastructure, they were overwhelmed."
As for the general population, they would be given a bottle of water and a bag of MREs twice a day. In terms of medical care for them, however, "I don't think the city's emergency operations plan calls for anybody to be in charge," Judice says. "Basically, they were saying: If you're going to come to the shelter, bring your own medications. The medical care of the general population, by default, fell to us."
Acadian is not a 9-1-1 provider for New Orleans, but they have a contract with the Superdome/Arena complex, handling medical needs that arise at events such as concerts, Saints football and Hornets basketball games.
"Because of our relationship with the Superdome, we felt it was important to have some of our staff there," says Judice.
This plan involved sending Ray Bias, RN, EMT-P, the company's governmental relations manager for the city of New Orleans and member of the board of the National Registry of EMTs (NREMT) and its former chair (1990-91 and 98-99), and "allaround problemsolver," according to Judice, to set up a little Aid Station "like we would at any event."