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NAEMSP 2018 Quick Take: Hurricane Harvey lessons shared with EMS physicians

Disaster response experience at the federal and local level in a 10,000-person emergency shelter shared at NAEMSP


Hurricane Harvey brought record rainfall to southeast Texas in August 2017.

Karen Warren/Houston Chronicle via AP

SAN DIEGO – Hurricane Harvey brought record rainfall to southeast Texas and south Louisiana in August 2017. Along with the deluge came an unprecedented number of local and federal emergency responders.

Kevin Schulz, the assistant medicine director for the Houston Fire Department; and Kevin Sirmons, the medical officer for NDMS/MN-1 DMAT, tag teamed to present at the 2018 National Association of EMS Physicians Annual Meeting on their experiences operating a 10,000-plus person emergency shelter at the George R. Brown Convention Center (GRBCC) in downtown Houston post Hurricane Harvey.

Memorable quotes on operating a 10,000-person shelter

Here are some memorable quotes from their talk:

“We had two days to prep for a five-day storm, rather than five days of prep for a two-day storm.” —Schulz

“We had a few things, but that wasn’t going to fly for 10,000 people.” —Schulz

“As with any disaster, we needed help from the community.” —Schulz

“Someone local maintained control.” —Sirmons

“The first night that DMAT was running the show, we had 20 patients on ‘kush’ come through. That was once the dealers figured out where everyone was.” —Sirmons

“These are seasoned professionals; I entrust them to do whatever they need to do to take care of a patient.” —Sirmons

Disaster response lessons learned

At the end of their presentation, Schulz and Sirmons shared a well-articulated list of lessons learned:

  1. Regroup and reframe – Disasters create a state in which information evolves by the hour. As such, it is critical to regroup on a daily basis, if not more often, so that everyone is on the same page across the various shifts and organizations working in tandem.

    The DMAT saw 260 patients within the first 12 hours of being operational, and another 300 the following day shift. Even though patient volume tapered with time, being flexible was an absolute necessity for smooth operations.

  2. Reorganize and redistribute – The influx of wanted (and sometimes unwanted) supplies and materials will require attention. In other cases, resources will be made available and actions must be taken to ensure they can be appropriately utilized.

    As Houston is home to the Texas Medical Center, the largest medical complex in the world, volunteers from a number of affiliated healthcare facilities came to the shelter to offer their services. A few of the larger hospitals granted full immunity and liability coverage to their employees that were volunteering in the shelter.

    By expanding the on-site healthcare resources available to patients, the shelter was able to continue to focus on one of its primary aims, protecting the hospitals from any inappropriate influx of patients from the GRBCC.

  3. Redesign – Every disaster is unique, thus the flow of supplies, resources and patients must be adjusted accordingly. In the case of the GRBCC, it was immediately obvious that zero tolerance was needed for any patient causing a disruption. This included patients with the same complaint within a 24-hour period as well as those patients high on “kush.”

A unique public-private partnership was also quickly created when Uber and Lyft built a geo fence around the convention center. This made trips booked from the area free, helping ease the transportation burden created by the shelter.

Additional resources on disaster management

Catherine R. Counts, PHD, MHA, is a health services researcher with Seattle Medic One in the Division of Emergency Medicine at the University of Washington School of Medicine. She received both her PhD and MHA from Tulane University School of Public Health and Tropical Medicine.

Dr. Counts has research interests in domestic healthcare policy, quality, patient safety, organizational theory and culture, and pre-hospital emergency medicine. She is a member of the National Association of EMS Physicians and AcademyHealth. In her free time she trains Bruno, her USAR canine.

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