First In: Report from Tennessee Task Force One

Contrary to all the media reports that it took the Federal Emergency Management Agency (FEMA) five or six days to reach New Orleans after the devastating Hurricane Katrina, Tennessee Task Force One (TN-TF 1), the Urban Search and Rescue (USAR) team...


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As it became clear that the intersection of Interstates 10 and 610 was turning into a mass-casualty event, the decision was made to begin a triage, treatment and transport of the victims. The challenges were many for the team. Besides heat indexes of 100 to 105 degrees, human and material resources were in short supply. The primary purpose of the medical team for TN-TF 1 is to provide medical support to the members of the team who conduct search and rescue, and then any victims who are found. The medical mission of the team changed dramatically that first day as an initial 368 patients were triaged, treated and transported. The team even had to work several cardiac arrest victims.

The team had no triage tags, no way of designating red, yellow, green and black areas, and initially no ambulances. The START triage system was utilized and worked effectively. A medical director from a local ambulance service was contacted, but the team was told it would be four or more hours before ambulances could be sent to them, since they were fulfilling their contractual obligations to the hospitals and were moving those patients. Eventually, the most serious of patients were moved.

The next day brought more of the same. Hundreds more patients were brought to the interstate intersection. By that time, the team had the system down and was working well with other local, state and federal agencies. Unfortunately, the patients they were seeing were sicker and more emotionally drained after being in the water for two days. Many were suffering dehydration.

On Sept. 1, the FEMA task force team was told by radio to "stand-down." Rescues for the day had been canceled as a result of chaos and violence in the streets of New Orleans. Reports were coming in of shots being fired at rescuers and boats being turned over as people fought to get into them; there even was a report of one person cutting another with a knife as the two fought for a spot in a boat. The team could not go back in without protection. Their protection came from members of the New Orleans Police Department who had stayed.

On Sept. 2, the task force reached a nursing home staffed by a Catholic nun, a licensed practical nurse and three aides. They had carried their 85 patients to the second floor of the nursing home as the water rose to seven feet in just a few hours. Trapped there for four days, they had cared for the patients in horrible conditions in the hallway on the second floor. Many of these patients under "normal conditions" required extensive care and nursing. They had been kept alive for nearly a week with spoiling food and limited water by the nursing home staff. Eventually, all the patients would be triaged and organized for evacuation. Some were already dead and others died while waiting for evacuation. Of the original 85 patients, 57 were evacuated from the nursing home, along with the staff.

As the violence increased, the force of protection surrounding the task force got larger. Members of the team were now being inserted in the hostile waters to conduct rescues by Blackhawk helicopters.

One area the team worked was Chalmette, which contained many oil refineries. The leaked crude oil, chemicals and toxins in the water were visibly obvious to all. But the team pushed on and many more rescues were made, including one of a woman who had stood in water up to her neck for almost a week.

After a 10-day deployment, TN-TF 1 was rotated home for rest. The members were physically and emotionally drained, but still had the will to continue.


Gary Ludwig, MS, EMT-P, a Firehouse contributing editor, is deputy chief of EMS in the Memphis, TN, Fire Department. He has 28 years of fire-rescue service experience, and previously served 25 years with the City of St. Louis, retiring as the chief paramedic from the St. Louis Fire Department. Ludwig is vice chairman of the EMS Section of the International Association of Fire Chiefs (IAFC), has a master's degree in business and management, and is a licensed paramedic. He is a frequent speaker at EMS and fire conferences nationally and internationally. He can be reached through his website at www.garyludwig.com.