When emergency back-up generators at New York University Langone Medical Center-Tisch Hospital failed Monday night during Hurricane Sandy, nurses and first responders improvised. These heroes used their instincts, and relied on training exercises to dramatically save the lives over 200 patients, 20 whom were babies in the hospital's neonatal unit and 45 of whom were patients in critical condition. Some were on battery-operated respirators.
When the hospital's elevators ceased to function, nurses carried babies down nine flights of stairs in the dark, insulating and ventilating them, often manually pumping oxygen into the babies. Some nurses asked to be carried down in stretchers so they could keep the newborn babies close to their skins to ensure they were warm.
"It's a challenging situation," NYU Medical Dean Robert Grossman told WCBS-TV Monday night. "We drill all the time for this kind of thing. But this isn't a drill. This is the real thing."
According to Fox5 New York, patients were transferred from the adult critical unit, neo-natal intensive unit, pediatric critical care unit and obstetrics. Some patients were battling cancer. Patients were moved to Memorial Sloan-Kettering Cancer Center and Mount Sinai.
Jonathan LaPook, M.D., a medical correspondent for CBS, arrived on the scene last
and observed the hospital's lobby "was filled with doctors, nurses, police officers, firefighters, and a command team of medical center personnel headed by Dr. Robert Grossman, the Dean and CEO of the medical center":
They were all racing against time to try to transfer approximately 200 patients out of the Tisch Building. That included 20 newborns - four with breathing tubes - in the intensive care unit, or ICU. Those infants were swaddled in blankets and carefully carried with intravenous lines, oxygen, and monitoring devices attached. I saw a 29-week-old premature being held by a nurse who held an oxygen mask to his face. Anxious faces of parents and family members dotted the lobby.
A member of the NYU response team told LaPook that "water water flooding over the FDR Drive had taken out not only the backup generator but the backup to the backup generator" and many patients were too sick to even walk down the stairs:
They were painstakingly carried on plastic sleds - one by one - by teams of four to five people from as high up as the 17th floor. I went to several of the floors with Dr. Mark Pochapin, the director of the Division of Gastroenterology at NYU. He was one of a team of people making sure that communication flowed and that everybody was accounted for. The intensive care unit was already evacuated when I arrived. Lit only by my flashlight, filled with crumpled blankets and other evidence of a hasty retreat, it appeared eerie to me - like a scene in a movie where a cup of still-warm-coffee tells the detective that somebody had been a room only minutes before. But this was undeniably real life and the clock was ticking as the team of workers raced to evacuate the patients.
"Due to the severity of Hurricane Sandy and the higher than expected storm surge, we are in the process of transferring approximately 215 patients within the medical center to near by facilities," NYU Langone said in a statement on Monday night. "We are having intermittent telephone access issues and for this reason the receiving hospital will notify families of their relatives arrival."
New York City officials said many of those patients, roughly 45 of whom were critical care patients, were eventually moved out of NYU "via private ambulance with the assistance of the New York Fire Department."
According to Fox5, gusts of wind blew the blankets insulating the patients and "nurses and staff huddled around the patients, some holding IVs and other equipment," as ambulances came from around the city.
According to ABC, the hospital had 800 patients two days ago, but some were discharged before Hurricane Sandy.
Here are some tweets that captured the drama at NYU and the heroism of the nurses and the first responders:
After Hurricane Katrina disabled many emergency generators in hospitals across New Orleans, hospitals across the nation have taken extra precautions with their power sources before impending storms. In light of this, New York Mayor Michael Bloomberg's comments before Hurricane Sandy may have given some of the city's hospitals a false sense of security. Bloomberg said:
Although we’re expecting a large surge of water, it is not expected to be a tropical storm or hurricane-type surge. With this storm, we’ll likely see a slow pileup of water rather than a sudden surge, which is what you would expect from a hurricane, and which we saw with Irene 14 months ago
Many hospitals in New Orleans learned the importance of having reliable backup generators after Katrina -- some hospitals in New Orleans were sued for negligence for not having backup generators that contributed to the deaths of some patients.
While some hospitals in New Orleans that installed generators above flood level were lauded after Katrina, many others had to apply the harsh lessons learned from hurricane. And when Hurricane Issac struck the Gulf Coast this summer, hospitals in New Orleans, nearly all of which applied recommendations given to them after Katrina, responded well.
In September of 2006, a Joint Commission published an alert to help hospitals in their planning for hurricanes or severe storms. The Commission put additional emphasis on the importance of emergency power generators:
All hospitals must have an emergency power testing program that includes generator load testing and emergency power supply system maintenance
Healthcare facilities should strive to exceed minimum National Fire Protection Association requirements for emergency power
Hospitals must conduct thorough hazard vulnerability analyses of their utility systems
The alert recommends that facilities ensure “engineering staff communicate the capabilities and limitations of the emergency power supply system to the organization's management and clinical leaders.