Earlier this year, a New Orleans blogger noted on his Web site that a mobile hospital deployed to Mississippi last September to care for victims of Hurricane Katrina was now en route to New Orleans for Mardi Gras.
“Does that mean they are planning for Mardi Gras to be a disaster?” he asked.
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Not quite. North Carolina's MED-1, a one-of-a-kind hospital on wheels, was sent to New Orleans at the request of the US government to boost the number of hospital beds available during Mardi Gras, when the population of the devastated city was expected to swell temporarily.
Last fall, after Katrina slammed into the Gulf Coast, MED-1 — an acronym for Medical Emergency Department — treated 7500 patients on its debut mission to Waveland, Miss. One of the few success stories in the bungled response to the deadly storm, MED-1 took over for area hospitals knocked out by Katrina's floodwaters and violent winds.
MED-1 began as the brainchild of Dr. Tom Blackwell, medical director for the Center for Prehospital Medicine at Carolinas Medical Center in Charlotte, NC, who set out in 2000 to create a mobile hospital sophisticated enough to serve areas paralyzed by terrorist attack or natural disaster.
The US Department of Health and Human Services and several other nations' governments have expressed interest in purchasing a MED-1.
Blackwell's self-contained hospital, built over several years at a cost of $1.5 million to the US Department of Homeland Security, fits into 2 standard-size tractor trailers. Slide-out walls expand 1 trailer into a 90-square-meter hospital that includes 7 general care beds, 4 critical care beds, a dental chair and a 2-bed operating room.
The unit, which is self-sustaining for 48 hours, has complete lab, radiology, ultrasound and pharmacy facilities, and satellite communications for off-site consulting.
A special filtration system allows MED-1 to operate in biologically hazardous conditions. An attached air-conditioned tent, carried in the support truck, accommodates 88 additional cots.
Designed for speedy, 1-hour setup, MED-1 can handle a wide range of medical and dental emergencies, including cardiac arrest, orthopedic stabilization, burn treatment, wound repair, and management of multiple medical problems.
To Blackwell's knowledge, it is the first full-scale hospital treatment facility on wheels. “We call it the ultimate house call,” he says.
MED-1 was awaiting its first field test when Katrina struck last Aug. 29. Just 5 days later, it left Charlotte, NC, for the Gulf Coast.
The volunteer staff of more than 80 doctors, nurses, paramedics and support personnel cleared trees and other debris from a Waveland Kmart parking lot, and got to work for the next 7 weeks.
Initially, patients had cuts from storm debris, and rashes and skin infections from wading through contaminated floodwaters. The staff also treated car-crash victims and provided follow-up care to patients who had recently undergone surgery. But the seriously ill patients they expected didn't turn up. Finally, they realized that perhaps many diabetics and cardiac patients hadn't survived without their medications.
The rotating staff, drawn from North Carolina hospitals and trauma centres, slept on cots, and initially took cold showers and lived on ready-to-eat meals.
But there was an upside: “We got back to old fashioned medicine — touching people, talking to people, spending more time at patients' beds,” says Blackwell. “It was life-changing. People begged to come back.”
Six months later, a crew of 15 did return to the Gulf Coast to back up New Orleans' gutted hospital system during Mardi Gras. The city had lost nearly two-thirds of its hospital beds and had just 2 functioning emergency departments.
MED-1 pulled into a parking lot near the Superdome late one evening and, with the help of more than a dozen local healthcare workers, it was ready to receive patients the next morning. At the time, only 4 hospital beds were free in the city. It stayed 2 weeks.
The blogger who had wondered if officials were expecting a Mardi Gras disaster added a final comment. “At least,” he wrote, “they are planning.” If he only knew.