Federal EMS: A Lesson Learned From Katrina

On the evening of August the 26th I was privileged to sit in on an Open Forum at the 2005 EMS Expo in the great City of New Orleans. The question posed to the distinguished panel and arguably the brightest minds in pre-hospital medicine, was "Does EMS Belong in the Department of Homeland Security?"

I believe this forum was prophetic since it took place less than 48 hours before Hurricane Katrina hit land in a city that suffered the most damage of its effects.

I would like to start off by saying that members of the Emergency Medical Service have done an outstanding job of dealing with the disasters of the past month or so. Whether they are members of local first aid squads who packed up their kits and headed south or Army 91 Whiskeys, Navy Hospital Corpsmen or Air Force Medics at the Federal level, they have all made us proud.

Certainly the City of New Orleans medics, EMTs and first responders, the "regulars" have borne the brunt of 30-plus days in the middle of an MCI. Add to that the Emergency Medical Personnel of Galveston and Houston, Mississippi, Alabama and the surrounding Gulf States and I am proud to say the personnel of the NYPD and FDNY and brother and sister medical personnel from all over the country, continent and the world. Although they are not often acknowledged in the headlines, they are writing another page in EMS history. The way that EMS has conducted itself throughout this disaster is a credit to the service at large and its individual members.

It is no surprise to anyone who has ever occupied a seat in an ambulance. EMTs and medics are all self-starters, who can think independently and are experts trained to use the resources at hand. EMS managers are made of the same stuff since they were once in the driver's seat of an ambulance and know what needs to be done when the spit hits the fan.

That being said, the gift, and also the problem of our own resourcefulness are that we are able to function in impossible situations with or without a central command structure, which can be problematic.

I am sure that the individual units in the field had a varying amount of support and command leadership. Realistically, there is no central command and support system in place adequate to support such an enormous project.

On the federal level, EMS is tucked away in 14 different government agencies. The budget for the newly created Federal EMS Department is about one percent of what is allocated for either fire or police although it is mandated to perform a mission on the same scale.

Anyone who worked the great MCI of September 11th 2001 in New York City understands the frustration of not being able to treat the victims.

A similar frustration occurred when New Orleans and parts of the great American Gulf Coast were ravaged by Hurricane Katrina.

On September 11th after the initial rush of patients to local emergency rooms and hospitals, makeshift triage centers and the backs of ambulances, we searched for patients and none were found.

In the Gulf Coast, there still are many who are in need long after the flood waters have subsided.

The very real possibility of diseases such as West Nile, Tuberculosis, Influenza, Cholera, Leptospirosis, Norovirus, and Vibrio vulnificus looms in the horizon.

In the emergency medical service, we wake up in the morning to help the sick and injured. Watching our fellow Americans suffer is pure anxiety to those of us who most times call an ambulance our home.

The morning of September 11, 2001, I was working the end of the night shift with my partner in lower Manhattan.

The night before Katrina hit the Gulf States, the same medic partner and I were boarding a plane back to New York. I am a registered nurse and paramedic. My partner Steve works for the City of New York as a paramedic. Both of us served in the Marine Corps at the same time and were partners since medic school.