Hurricane Katrina-

New Orleans
August-September 2005
Ken Miller MD PhD
FEMA US&R Incident Support Team
FEMA US&R CA Task Force 5
 Hurricane Katrina-New Orleans
„ Monday, August 29, 2005.
„ Eye wall moves east of New Orleans.
„ US&R resources staged in Shreveport, LA, Saturday,
August 27 and Sunday, August 28.
„ IST-A, TX TF-1, MO TF-1, TN TF-1.
„ TX Type I TF, MO & TN Type III TFs.
„ Other operations: IST-A, OH TF-1 & IN TF-1 staged at
NAS Meridian for Biloxi & Gulfport, MS; NDMS DMATs
staged in multiple gulf states.
„ Intelligence gathering, caches configured for water rescue.
„ Maps, internet, impact region infrastructure, news media.
„ Moved briefly to Baton Rouge Monday, confer with LA State
EOC & move on to New Orleans, arriving around midnight.
•Wind
•Storm surge

•Debris in
storm surge
•Flooding
 The First 5 Days
„ Day 1: Tuesday, August 30
„ Temporary BoO in Metairie, LA
„ FEMA BoO began to attract locals looking for shelter

„ I-10/I-610 used as boat launches for operations into west

New Orleans: primary search & rescue operations
„ Provide FEMA US&R water rescue
„ Task Force boats, US EPA contractor boats
„ Support LA Dept. of Fish & Game, local/regional fire &
law enforcement, USCG, local volunteers, any others
 The First 5 Days
„ Day 1: Tuesday, August 30
„ Evacuee numbers overwhelm resources
„ High medical acuity, no operational EMS, limited hospitals
„ Ambulance strike teams staged for Superdome evacuation

„ All hands enter operations

„ Approximately 350 evacuees rescued by boat
„ BoO moved to New Orleans Saints Training Facility that
night
„ No utilities or services
„ Perimeter and access controlled by local law enforcement
 The First 5 Days
„ Day 2: Wednesday, August 31
„ Return for water operations at I-10/I-610
„ Huge numbers of volunteers with boats

„ Local EMS marginally operational

„ Buses available to move evacuees
„ Reconfigured FEMA US&R Medical Teams
„ Created Medical Branch by consolidating Medical Teams from all
Task Forces (Type I TF 2 MDs + 4 EMT-Ps,
Type III TF 1 MD + 2 EMT-Ps, IST 2 MDs)
„ Placed Medical Team member at each boat launch site for
primary triage
 The First 5 Days
FEMA ESF-9 Leader

US&R IST Leader

IST Operations Chief IST Plans Chief IST Logistic Chief

Branch

Division
TFs, SWRTs

Division
TFs, SWRTs

Branch

Division
TFs, SWRTs

Division
TFs, SWRTs

Medical Branch

Task Force
Medical Teams
 The First 5 Days
„ Day 2: Wednesday, August 31
„ Return for water operations at I-10/I-610
„ Realization that all of the evacuees rescued the previous
day were still on the freeways, some local medical
resources providing care but overwhelmed
„ Communications impossible: satellite & cellular
telephones with no signal, continuously busy or drop calls
„ UHF radios are only local communication
 The First 5 Days
„ Day 2: Wednesday, August 31
„ Coordination improved between boat operations
and initial triage, evacuee movement to Medical
Branch, limited essential medical care & evacuation
off-site by bus
„ Evacuated patients from downtown NO hospitals
among boat evacuees, NOPD & NOFD among
evacuees
„ Improved coordination and communication with
local EMS (Jefferson Parish EMS)
 The First 5 Days
„ Day 2: Wednesday, August 31
„ Evacuees still being massed along freeway,
helicopters from downtown NO hospitals delivering
evacuated patients making problem worse
„ Shelters being formed in Baton Rouge but no coordinated
transportation
„ NO International Airport evolving as central receiving
point
„ 5 DMATs completely overwhelmed
„ Over 2500 evacuees rescues by boat
„ Medical acuity noticeably dropped
 The First 5 Days
„ Day 3: Thursday, September 1
„ Tactical stand-down
„ Unvalidated reports of unchecked violence & lawlessness
„ Ultimately largely overstated and ‘urban legend’
„ Security of response forces could no be assured
„ Local law enforcement overwhelmed
„ State & federal law enforcement still arriving
„ Regroup US&R resources and tactical plans
„ Conditions in FEMA BoO
„ Low on water, food and fuel
„ Hygiene and waste management marginal
„ Population increasing
 The First 5 Days
„ Day 4: Friday, September 2
„ Moved operations to I-10/SR-90, east New Orleans
„ More resources:
FL TF-1, NM TF-1, CO TF-1, AZ TF-1,
NV TF-1, CA TF-2, 3, 5, 6, 8
„ CA OES SWRTs 1-8
„ Anticipated evacuating neighborhoods, 2 hospitals
„ Discovered Lafon Nursing Home
„ Evacuated 55 patients, 19 fatalities
„ Evacuees still being left on freeways, NO Int’l Airport
overwhelmed, evacuation of Superdome political priority,
no coordinated transportation
 The First 5 Days
„ Day 4: Friday, September 2
„ Helicopter evacuations to NO Int’l Airport
„ Non-ambulatory ground-transported evacuees
turned away at airport by law enforcement
„ Change in US&R rescue strategy

„ Rescue when necessary

„ Shelter-in-place where possible

„ Water, ice, MREs
„ Approximately 2000 sheltered in place over next few days
 The First 5 Days
„ Day 5: Saturday, September 3
„ Operations in multiple Branches and Divisions
„ Medical Branch moved to strategic collection points
„ Over following days medical acuity and numbers of
victims rescued decline
„ Medical operations returned to individual Task Forces
„ Medical evacuation coordinated through IST Medical Unit
„ Air evacuation to FEMA BoO helibase
„ Ground transport via local EMS to predetermined hospital
„ Ochsner Clinic Foundation
„ East Jefferson General Hospital
 Continued Operations
„ Multi-Branch, multi-division, multi-Task Force
„ Primary to secondary search transition
„ Door-to-door, room-by-room search in approximately 22,000
residential structures based on census data and known
flooding
„ Forcible entry permission
„ Management of deceased
„ Mark location: GPS, address
„ Access, technical operations
„ Contractor, DMORT, DPMU, local ME
 Continued Operations
„ Rescuer health & safety
„ Urban flooding
„ Coliforms, other bacteria, enteric viruses from sewer

„ Volatiles from fuel tanks

„ NG leaks and fires

„ Hazardous materials sites

„ Homes
„ Industrial & commercial sites
„ Respiratory, dermatologic, gastrointestinal sx surveillance

„ Hygiene vs. ‘decon’

 Continued Operations
„ Rescuer health & safety
„ Atmospheric & water quality monitoring
„ 5-gas meters upon attic breaches
„ O2, LEL, CO, H2S, VOCs
„ US EPA, CDC, state
„ Interior searches
„ Molds
„ Trauma & immersion
„ Heavy-lift helicopter safety
„ Cooling vests
„ Useful for about 2 hours; refrigeration source for renewal
„ Therapeutic use in heat stress
 Continued Operations
„ Rescuer health & safety „ Challenges
„ CA OES SWRTs
„ BoO Medical Unit
„ Military
„ IST Medical Officer
„ Non-US&R federal
„ Incident medical
responders
operations
„ State & local
„ Care of IST members
responders
„ Task Force Medical Team „ Contractors
„ Victim care
„ Rescued animals
„ Task Force member
„ Solutions
care
„ NDMS DMAT strike
„ Initial search canine
team
care
„ Federal Occupational
Health
„ Military medical unit
„ VMAT
 ‘Internally Displaced Persons’
„ Evacuation of Gulf states population.
„ Houston, Atlanta...
„ Orange County, CA.
„ Approximately 700 self-evacuated persons.
„ 41% Vietnamese.
„ Approximately 300 requiring medical resupply or care.
„ Challenging medical economics.
„ Multi-agency coordination: government & NGO.
„ OC HCA, OC SSA, OC ARC, ‘Operation OC.’

„ Issues with populations returning to LA, MS.