Hurricane Evacuations: The Georgia Response

When it comes to planning for mass casualty incidents, much of our current focus has been on preparing for terrorist acts that could result in multiple traumatic injuries; however, this year, with increasing frequency, local EMS across the United States has been called upon to perform as major hurricanes hit.

These hurricanes have generated patients who were injured in the impact of the storm, as well as those who were sick to begin with and had to be evacuated from hospitals, nursing homes and other medical facilities in the affected areas. One evacuation that occurred in the aftermath of Hurricane Katrina was from New Orleans to metropolitan Atlanta, GA.

AIRLIFT OPERATIONS
As part of the largest airlift ever on U.S. soil, 1,381 evacuees arrived at Dobbins Air Reserve Base from September 1-5. Dobbins, located in Marietta, GA, 16 miles northwest of Atlanta, is the largest multi-service Air Force Reserve training base in the world. Dobbins supports more than 10,000 Guardsmen and Reservists from the Army, Navy, Marines and Air Force.

A total of 19 flights, including military C-9s, C-17s, C- 130s, C-141s, as well as four Delta Airlines 757 commercial airliners and a Beechcraft King Air, made the evacuation flights from New Orleans to Dobbins.

As evacuees arrived and were deplaned at Dobbins, staff from the Veterans Administration (VA) evaluated and triaged the sick and injured. Of the 1,381 evacuees, 366 were sick or injured and required immediate evaluation, treatment and transport to over three dozen metropolitan Atlanta hospitals. An additional 37 patients were transported to area nursing homes. Local EMS provided treatment and transport for these sick, injured, ambulatory and nonambulatory patients.

The patient load included diabetics who had not had insulin, nursing home patients who had not eaten or drunk for several days, ventilator patients, patients who were in need of intubation and airway support, critical newborns and chronic mentally challenged patients who had been without medication for days.

Key agencies involved in the operation were: FEMA, National Disaster Medical System (NDMS), Georgia Emergency Management Agency, VA, Georgia Department of Human Resources-Division of Public Health, American Red Cross, Cobb County Emergency Management, Georgia Region III EMS, Cobb/Douglas Public Health, United States Army and Air National Guard, Georgia State Defense Force and Dobbins Air Reserve Base.

Pam Blackwell, director of emergency preparedness for Cobb and Douglass Public Health, was operations chief for the evacuation at Dobbins.

"Everyone participated," she says. "That was the key to the operation's success."

Blackwell said that they had practiced an event similar to this, but on a much smaller scale, the week before Memorial Day this year. At that time, the military brought in a C- 130 aircraft with recruits on board to simulate patients. The recruits were deplaned and triaged by the VA, but no transports were done.

"I did not know that a few months later we would be doing this for real," she says.

The EMS deployment involved ambulances and medical helicopters from 28 private and public EMS agencies throughout metropolitan Atlanta and north Georgia. Medi-vans were used for some ambulatory transports. Metropolitan Atlanta Rapid Transit Authority (MARTA) and Georgia Regional Transport Authority Xpress buses were used to transport evacuees who were triaged to go to local shelters. Both Marietta and Cobb County Fire and Emergency Services also assisted in the operation.

Cobb County Fire responded with its mobile command center, as well as its medical operation unit. NDMS staff, along with members of the Cobb County Fire and Emergency Services, lived and worked in these specialty vehicles for the duration of the operation at Dobbins Air Reserve Base. Cobb County Fire and Emergency Services acted in a support role at the base, staffing the mobile command vehicle. Cobb County 9-1-1 communications officers staffed the command vehicle in the role of incident dispatchers.