UTHCT responds to looming threat of deadly Hurricane Rita

Monday, October 3, 2005

Each year, employees at The University of Texas Health Science Center at Tyler participate in several disaster drills to prepare them to respond to medical emergencies.

On Wednesday, Sept. 21, 2005, those days of practicing emergency procedures paid off, as the entire state of Texas prepared for the landfall of Hurricane Rita. As the massive storm intensified and began to threaten the Gulf Coast of Texas, hospitals in that area sought to evacuate their patients to facilities outside the danger zone.

Several hospitals contacted UTHSCT for help, including The University of Texas Medical Branch. UTMB officials had decided to evacuate almost all patients and staff from their hospital in Galveston. They needed to transfer their sickest inmate patients to a facility with a secured unit equipped to take care of them.

UTHSCT answered the call for help from its sister institution. Medical and front-line staff prepared to take inmate patients transferred from TDCJ Correctional Managed Care at The University of Texas Medical Branch in Galveston.

Following is a timeline of the major events during the first day of UTHSCT’s response to Hurricane Rita, which began with a Code Yellow alert at 10:31 a.m. Wednesday, Sept. 21.
  • Wednesday, Sept. 21
    • 10:31 a.m. - Code Yellow called. UTHSCT staff are informed that an external disaster (Hurricane Rita) has occurred and patients may be transferred to the Health Center. UTHSCT President Dr. Kirk A. Calhoun already had informed all administrators and department heads that the Health Center might receive approximately 20 inmate patients from UTMB. A Command Center and a separate Media Center are set up in two conference rooms at the Health Center.
    • 11:20 a.m. - Code Red called. Patients are confirmed to be on their way to UTHSCT. Administrators gather in the Command Center, a large conference room with four phone lines, a fax machine and copier, several laptop computers, two large white boards, a television set, and an overhead projector. The Command Center will be open 24 hours a day for as long as UTHSCT is under a Code Red. At least one top UTHSCT administrator will be in the Command Center at all times, and administrators and crucial personnel will be briefed there twice a day.
    • 11:30 a.m. - The Media Center is opened, staffed by members of the Office of Public Affairs and Marketing. It has two phone lines and a laptop computer. A news release about what UTHSCT is doing to help its sister institution, UTMB, is sent out. Journalists from ABC News, the Tyler Morning Telegraph, the Longview News-Journal, the Daily Texan, CBS 19, and KETK-TV call for information and interviews.
    • Noon - Dr. Calhoun holds first briefing. UTHSCT administrators report the status of their preparations to receive the soon-to-be-arriving patients. Dr. Calhoun introduces officials from the Texas Department of Criminal Justice who have arrived to help oversee the inmate patients’ transfer. They are TDCJ Regional Director William Stephens, Warden Todd Foxworth, Warden Paul Pace, Warden Tim Lester, and Sgt. Randy Potts. UTHSCT administrators learn that two helicopters with intensive care unit (ICU) patients are expected to arrive early this afternoon, with others following in ambulances. David Lakey, MD, medical director of UTHSCT’s Center for Pulmonary and Infectious Disease Control, reports on preparations being made at the city of Tyler’s Medical Operations Center (MOC), part of the city’s Emergency Operations Center (EOC). Dr. Lakey is the head of the MOC, coordinating the placement of patients evacuated from Hurricane Rita’s path.
    • 1:30 p.m. - First helicopter arrives with an ICU patient. A second follows about 10 minutes later, carrying two patients. These patients are evaluated, admitted to UTHSCT, and then moved to the ICU.
    • 3:00 p.m. - Three more patients arrive by ambulance. They are evaluated, admitted, and moved to beds in the secured hospital unit on the third floor.
    • 4:00 p.m. - Dr. Calhoun holds second daily briefing in the Command Center. He says six patients have arrived, out of an expected 30. These patients are likely to arrive between 5:00 p.m. and 11:00 p.m. Medical staff report on their efforts to discharge current inpatients who are well enough to go home. They discuss available staffing - physicians, nurses, and other medical professionals - on hand to care for the new patients. Arrangements are begun to house the additional nursing staff coming with the patients. Dr. Lakey reports on the MOC’s preparations to house special needs patients - people who need some medical supervision, but are not sick enough to be hospitalized - in the Ornelas HPE Center at Tyler Junior College. Dr. Calhoun reports on Hurricane Rita, which is still a Category 5 hurricane, with winds of 165 miles per hour. He says Tyler could face extremely heavy rains on Saturday, if the remnants of Hurricane Rita stall out over East Texas. Twenty-two hospitals in the Houston area are transporting many of their patients to facilities outside of Rita’s projected path, and low-lying parts of Houston are being evacuated. Dr. Calhoun sets the next Command Center meeting for 9 a.m. Thursday.
    • 4:30 p.m. - Six more patients arrive by ambulance and are evaluated and admitted.
    • 11:15 p.m. - UTHSCT officials hear ambulance sirens. Kleanthe Caruso, vice president for Patient Care and Chief Nursing Officer, describes the scene: "I was in my office, which has a window that looks toward U.S. 271. On the highway was a caravan of at least 10 ambulances. The ambulances turned into UTHSCT and came down the driveway. I ran down to the emergency room, and there, on one side of the hallway, was a line of UTHSCT volunteers. Here were all these stretchers lined up. Three ambulances were emptied at a time. Dr. Calhoun or Dr. Lakey examined each patient, evaluating his medical condition. Then the patient’s identification was checked, and he was assigned a bed in the secure unit.

"We did that, one-by-one, on almost 30 patients. It was accomplished in less than three hours. It was like a well-oiled machine. It was amazing. I was so impressed with the competence, the professionalism, the camaraderie, and the commitment that people had. We had just 24 hours to organize this, and they did it like it was something they do every day," Caruso said.

  • Friday, Sept. 23
    • 5 p.m. - 18 patients from Tyler County Hospital in Woodville arrive at the Health Center. Seven arrived via an ambulance service from South Carolina that had contracted with the Federal Emergency Management Agency to evacuate patients. Another 18 patients and their health-care providers rode a Texas school bus to the Health Center. Tyler County is under a voluntary evacuation order, and hospital officials wanted to free up its 25 beds for residents who might be injured by Rita’s wrath. Woodville, population 2,500, lies squarely in the projected inland path of Hurricane Rita. It takes about 30 minutes for all the patients to be evaluated and admitted to the Health Center.
  • Saturday, Sept. 24
    • 9:50 a.m. - Code Red All Clear was called. The official state of emergency has ended, though UTHSCT continues to provide care for inmate patients from UTMB in Galveston and patients from the Woodville hospital.
  • Monday, Sept. 26
    • 9:00 a.m. - UTHSCT administrators close the Command Center, after deciding that high level of coordination is no longer needed.
  • Wednesday, Sept. 28
    • 1:30 p.m. - Most of the inmate patients from UTMB begin their journey by ambulance back to Galveston.
  • Monday, Oct. 3
    • 5 p.m. - All but two of the inmate patients have been returned to UTMB, and three nursing home patients who came from Tyler County Hospital have been released to the care of family members or returned home.

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