Sometimes healthcare in the military can be just like civilian care: you churn out patients like an assembly line.

However operational medicine can be extremely exciting and rewarding. For example, there are a number of Navy ships headed to the gulf coast to help out as I'm writing this. You can bet they all have a large contingency of physicians on them. The Navy has a large hospital ship called the USS COMFORT. That ship has everything from an OR to advanced imaging capability. It will be interesting to see if that ship gets mobolized.

Sometimes healthcare in the military can be just like civilian care: you churn out patients like an assembly line.

However operational medicine can be extremely exciting and rewarding. For example, there are a number of Navy ships headed to the gulf coast to help out as I'm writing this. You can bet they all have a large contingency of physicians on them. The Navy has a large hospital ship called the USS COMFORT. That ship has everything from an OR to advanced imaging capability. It will be interesting to see if that ship gets mobolized.


I've spent time on the Comfort....I know about every aspect of its medical capabilities as well as anyone.

By the time it or any other Navy ships get to New Orleans, anyone who is going to die will have already, and anybody else who needs evacuation will have also been evacuated.....

Sending a ship after a disaster is the most ridiculous waste of resources I can imagine.

Patients are easier to transfer to land based hospitals nearby, then to send to a ship via helicopter after waiting a week for the ship to show up....

Typical military silliness...that sound "cool" and "romantic" to the medical student, but in reality is a complete waste of time and money.

Case 19-2005 — A 17-Year-Old Girl with Respiratory Distress and Hemiparesis after Surviving a Tsunami
Kao A. Y., Munandar R., Ferrara S. L., Systrom D. M., Sheridan R. L., Cash S. S., Ryan E. T.

N Engl J Med 2005; 352:2628-2636, Jun 23, 2005. Case Records of the Massachusetts General Hospital

The Mercy took excellent care of this patient. Granted, patients in immediate need of care are out of luck. But patients like this one with aspiration pneumonia can still receive care.

I think many patients will present with various infections in the week after this disaster. Having the comfort could provide assistance albeit at a great cost of fuel to steam the ship there.

I've spent time on the Comfort....I know about every aspect of its medical capabilities as well as anyone.

By the time it or any other Navy ships get to New Orleans, anyone who is going to die will have already, and anybody else who needs evacuation will have also been evacuated.....

Sending a ship after a disaster is the most ridiculous waste of resources I can imagine.

Patients are easier to transfer to land based hospitals nearby, then to send to a ship via helicopter after waiting a week for the ship to show up....

Typical military silliness...that sound "cool" and "romantic" to the medical student, but in reality is a complete waste of time and money.

Some people may think so, but Louisiana is NOT the 3rd world. There are real hospitals nearby...where the above patient would be treated.

Are you proposing, we put these patients on the Comfort, and then transfer them to a real hospital.....Some Navy Admiral might think that's good PR, but lets not be silly.

The third world is a different story.....There, the Comfort/Mercy may deliver better care than they have ever received, even without a natural disaster....but then what do you do with the patients after they survive their inital illness, and then need rehab...like many ICU patients????

In Iraq, these patients were just offloaded.....I suspect most of them died because of the lack of rehabiliattion facilities.

I don't think it's a good idea to chock an effort like bringing in a hospital ship as being futile. There seems to be a desperate need for medical care in LA and MS. These people are taxpayers too. Why can't they receive care from the government?

I think the point is that a navy ship may not be the most cost effective, and just plain effective use of money and man power. Absolutely, send the help, but land based help is probably alot cheaper and fast arriving. But I am not a mass casulalty expert at assessing this either.

I think the point is that a navy ship may not be the most cost effective, and just plain effective use of money and man power. Absolutely, send the help, but land based help is probably alot cheaper and fast arriving. But I am not a mass casulalty expert at assessing this either.

Navy ships sometimes have other abilities, such as drinking water production.

Assuming the Comfort weighs anchor right now and travels at 20 mph...it would take probably 4 days to get there. So in reality, it'll probably be there in 7 days.

What good is a new hospital there in 4 to 7 days????

All the sick and injured can be sent somewhere else in 4 days.

If the Navy wants to do something....send the personnel there RIGHT now on a chartered aircraft. Send supplies on a chartered aircraft. Send transport aircraft there to move people to other regular hospitals in the region.

You know why the Navy won't do that???? It's because we either have idiots in charge or they decide that sending a "hospital" ship is SEXIER

it is obvious whoever made that decision won't get an NCM/MSM/LOM. Not really practical, but it's big navy saying we are trying to do something. Also, there are other ships already in the region that can do some seabee type projects ashore with their current crew.

We do have a big seabee base in that region. If they aren't all deployed, I would expect that they have the most local resources and can be available in the fastest fashion.

Friends (Hull technicians from a carrier) who deployed for Tsunami relief set up fresh water stations ashore on day 2 of relief efforts. They were just aas proud of doing that work, if not more so, than deploying for OIF/OEF because they were able to see the good their welding did.

Hey, I remember back in the 1970-1980's, we sent a coast guerd cutter to the north pole to save a trapped whale..........so in thatcomparison, let's send the 7th fleet to the gulf of mexico.

Friends (Hull technicians from a carrier) who deployed for Tsunami relief set up fresh water stations ashore on day 2 of relief efforts. They were just aas proud of doing that work, if not more so, than deploying for OIF/OEF because they were able to see the good their welding did.

Let me repeat this.

We are not a 3rd world nation

Our infrastructure is not destroyed. Most of the country is still OK. We don't have to build a new water generation plant. We don't have to rebuild an entire nation. A region of our country is destroyed. The areas nearby are not.

Don't let movie style theatrics overcome common sense. Send people and supplies there...move the injured out to hospitals....don't bring the hospital to them.....Moving patients is a lot easier than moving a hospital..

But then, I'm just a simply country doc....not an admiral in the US Navy.

good point. In a related topic, sometimes I felt as if my clinic's admin was "a third world admin"

My midshipman summer cruise in 89 was on a ship that went up for the oil spill. They served as a clean living place for the civilian workers doing the clean up. They could always put her pierside as use her as a berthing barge.

In 1989, warships had all male crews. There was one enterprising civilian female cleanup worker that made a bundle of money by creating her own private business on board the ship while it was in Alaska. That is, until she was put out of business.

Let me repeat this.

We are not a 3rd world nation

Our infrastructure is not destroyed. Most of the country is still OK. We don't have to build a new water generation plant. We don't have to rebuild an entire nation. A region of our country is destroyed. The areas nearby are not.

The deployment of the USNS Comfort from Baltimore is largely symbolic and political. The Governor of LA wants the city of NO evacauated within the next two days. It will take a week for the Comfort to arrive and by that time the City should be evacuated including hospital patients. The Comfort will not be leaving port until this weekend. The ship and crew are preparing for deployment over the next couple of days.

good point. In a related topic, sometimes I felt as if my clinic's admin was "a third world admin"

Funny you should say that, I too often felt that was a third world facility. And compared to the well funded, fully resourced, and efficiently run civilian facilities I have worked with since, that assessment is quite close to accurate.

By the way, I do have personal experience working in a true "third world" medical facility during a humanitarian medical mission to Honduras. The similarities between the two were frightening: Both were understaffed, underfunded, and illequipped.

I think that there's a lot more damage then you guys realize, and the hospitals down there don't have the capacity to handle all of it. You dont' have to be a third world nation for local hospitals not to be able to handle a natural disaster of this proportion.

sending semi-local medical help sounds good.

Here's an article about how bad things are getting down there:

http://apnews.myway.com/article/20050901/D8CB76E80.html

Health Threats Grow in New Orleans


Email this Story

Aug 31, 11:20 PM (ET)

By MARILYNN MARCHIONE

(AP) An airboat pulls up to the Memorial Medical Center in New Orleans on Wednesday, Aug. 31, 2005....
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As a public health catastrophe unfolded Wednesday in New Orleans, hospitals in the Crescent City sank further into disaster, airlifting babies without their parents to other states and struggling with more sick people appearing at their doors.

Dangerous, unsanitary conditions spread across the city, much of which now sits in a murky stew of germs.

The federal government declared a public health emergency for the Gulf Coast region, promising 40 medical centers with up to 10,000 beds and thousands of doctors and nurses for the hurricane-ravaged area.

In a stunning example of how desperate the situation has become, 25 babies who had been in a makeshift neonatal intensive care unit at New Orleans' Ochsner Clinic were airlifted Wednesday to hospitals in Houston, Baton Rouge, La., and Birmingham, Ala. Many were hooked up to battery-operated breathing machines keeping them alive.

Their parents had been forced to evacuate and leave the infants behind; by late in the day, most if not all had been contacted and told where their babies were being taken, said hospital spokeswoman Katherine Voss.

"We actually encouraged them to leave. It would just be more people to evacuate if there was a problem," said Dr. Vince Adolph, a pediatric surgeon.

Helicopters had to land on the roof of the parking garage to get the babies because water covered the helipad at the hospital, one of the few in the area that had been operating almost normally.

"We're getting kind of at the end of our rope," with a skeleton staff of doctors and nurses who have been on duty nonstop since Sunday, Voss said.

Officials were trying to evacuate 10,000 people - patients, staff and refugees - out of nine hospitals battling floodwaters or using generators running low on fuel. About 300 people were stranded on the roof of one two-story hospital in the New Orleans suburb of Chalmette.

Yet even as they tried to evacuate, many hospitals faced an onslaught of new patients - people with injuries and infections caused by the storm, people plucked from rooftops who are dehydrated, dialysis and cancer patients in need of their regular chemotherapy or radiation treatments.

"We have thousands of people who are getting ill ... our hospitals need to be prepared to take care of the incoming sick," said Coletta Barrett of the Louisiana Hospital Association.

Only about 150 patients were able to be evacuated Wednesday from all nine New Orleans hospitals, said Knox Andress, an emergency room nurse in Shreveport, La. He is regional coordinator for a federal emergency preparedness grant covering the state and is involved in helping place evacuees in other hospitals.

"We're ready for patients and we can't get them. We just can't get them out," he said.

The government said dozens of medical disaster teams from nearby states were moving into hard-hit areas.

"We've identified 2,600 beds in hospitals in the 12-state area. In addition to that, we've identified 40,000 beds nationwide, should they be needed," said Health and Human Services Secretary Michael Leavitt.

Storm survivors, particularly in New Orleans where floodwaters remain, face a cauldron of infectious agents, public health experts said.

"You can think of floodwaters as diluted sewage," said Mark Sobsey, a professor of environmental microbiology at the University of North Carolina.

Whatever infections people carry go into sewage and can be expected to show up in floodwaters. That includes common diarrheal germs including hepatitis A and Norwalk virus.

"We are gravely concerned about the potential for cholera, typhoid and dehydrating diseases that could come as a result of the stagnant water and the conditions," said Leavitt.

However, officials at the federal Centers for Disease Control and Prevention and other health experts said cholera and typhoid are not considered to be high risks in the area. CDC officials suggested Leavitt was simply mentioning examples of diseases that could arise from contaminated food and water.

Some experts said worries about catching illnesses from being near dead animals or human bodies are somewhat overblown.

"People who are alive can give you a whole lot more diseases than people who are dead," said Richard Garfield, a Columbia University professor of international clinical nursing who helped coordinate medical care in Indonesia after the tsunami.

Mosquito-borne diseases may start to emerge within days. West Nile virus and dengue fever are both potential risks following a situation like the one in coastal Alabama, Mississippi and Louisiana. Officials also cited carbon monoxide poisoning risks to people using generators and stoves.

"One of the things they have got to do - we've got to plead for - is to make sure that when these hospitals get evacuated, the National Guard or somebody is there putting major security around these hospitals, or they're going to get ransacked. And it's going to make a bad situation even worse," said John Matessino, president of the Louisiana Hospital Association.

He said the four hospitals in New Orleans' central business district - Tulane, Charity, University and the VA hospital - had the worst problem with would-be looters.

Days after the storm hit, many people in key positions to help were still struggling to figure out how.

The Pharmamaceutical Research and Manufacturers Association asked the government to make a public health assessment to guide drug companies.

"Once we know what is required, we can begin to donate and ship in desperately needed medicines," said a statement from Billy Tauzin, the group's president and former congressman from Louisiana.

The American Diabetes Association wants to help get insulin and syringes to diabetics and is working with the Red Cross, but the relief agency "is still very much in 'rescue mode,'" an association spokeswoman said.

Eli Lilly and Co. said it would give $1 million in cash and would match any donations by its U.S. employees to the Red Cross. The company also is donating $1 million in insulin.

The American Medical Association's Center for Public Health Preparedness and Disaster Response was trying to figure out a system to help coordinate doctors who want to volunteer.

"It's going to take years - years - to rebuild the medical infrastructure. There will be continuing health needs," said Dr. James J. James, the center's director.

---

Associated Press writers Melinda Deslatte and Janet McConnaughey in Baton Rouge, La., Mike Stobbe in Atlanta, and Randolph Schmid in Washington, D.C., contributed to this story.

---

the scuttlebutt i've heard around here sounds like the Comfort is being deployed more for its housing capacity than medical abilities. like with 9/11, it's going to be used as a place for workers to sleep, eat, clean up, and recharge. the medical staffing sounds minimal right now.

on the army front, a CSH that some of our personel are PROFIS to has been "notified" that they may be deployed. which would really hit some of us hard because they'll steal our nurses, lol.

--your friendly neighborhood above sea level caveman

Navy ships sometimes have other abilities, such as drinking water production.

exactly. they're not planning on using the "hospital ship" as a hospital-- which is amazingly flexible for an institution like the navy. . . :)

--your friendly neighborhood would rather be deployed to LA than Iraq caveman

I wouldn't argue sending an empty ship to serve as a hotel...although there is probably a cheaper, better way to do it.

I wouldn't argue sending an empty ship to serve as a hotel...although there is probably a cheaper, better way to do it.

Hmmmm. If only there were a type of ship designed to be a hotel ---> wait there is. Arn't they called cruise ships? Maybe it's time to seize a couple of them.

Ed

Hmmmm. If only there were a type of ship designed to be a hotel ---> wait there is. Arn't they called cruise ships? Maybe it's time to seize a couple of them.

Ed

i've heard this idea kicked around, and read it somewhere online early on . . . not sure what became of it though.

with the recent supreme court ruling upholding the government's right to claim property and things "for the public good", this oughta fit in nicely :cool: :D

--your friendly neighborhood imminent domain caveman

Don't let movie style theatrics overcome common sense. Send people and supplies there...move the injured out to hospitals....don't bring the hospital to them.....Moving patients is a lot easier than moving a hospital..

But then, I'm just a simply country doc....not an admiral in the US Navy.

Yeah, the admirals have learned the Golden Rule: appearance is everything.
Of course it's completely unnecessary to sent a hospital ship; but at least it makes people think that someone is doing something.
Thank God I'm not an elected official in Louisiana. Can you say "out of work next election day . . . " And if our illustrious Commander in Chief were up for re-election, he could sure kiss LA goodbye.

By the way, has everyone noted the huge outpouring of international aid from all our "friends and allies"? :laugh: :laugh: :laugh:

RMD 302

By the way, has everyone noted the huge outpouring of international aid from all our "friends and allies"? :laugh: :laugh: :laugh:

RMD 302

A dozen countries have offered aid. Washington is reviewing the offers!

As far as international aid, Greece has offered the use of several cruise ships to be used for evacuation/temporary housing.

The federal govt. is... thinking about it.

Bush and Cronies will certainly go down in history as having one of the worst-run federal administrations in U.S. history.

Who knows what really caused the delay in rescue/medical attention? There is certainly a major outcry (esp. by actors/singers) that the delay was mostly due to... RACISM!

Hard to prove, but you know it's in the back of the minds of everyone.

Of course, it doesn't help that there appears to be a slightly organized band of looters/shooters within the Big Easy making it hard as hell to get aid in and hard as hell to have sympathy for their plight. I know it's a minority of people stuck in N.O. that are committing these crimes, but it sure seems to be getting organized somehow.

misfit

There is certainly a major outcry (esp. by actors/singers) that the delay was mostly due to... RACISM!

Hard to prove, but you know it's in the back of the minds of everyone.


misfit

Bush must be a racist...how else can you explain all those minorities that he appointed to positions of leadership?

Who knows, perhaps he or others are racist. I merely stated that many have blamed the slow emergency response on racism. I have no idea if Bush and Cronies are racist or not, but plenty of people feel that way right now. Merely appointing minorities to govt posts doesn't prove to me that he is NOT a racist, by the way.

I really cannot understand why the federal govt was slow to respond. But, it is ultimately up to the President to allow National Guardsmen and FEMA take action. So, a lot of this blame will have to rest at his feet.

I feel that the Louisiana and Mississippi state governors weren't exactly brilliant with their emergency response plans, either. Somehow, the truth will all come out in the wash...

misfit

I really cannot understand why the federal govt was slow to respond.
misfit


Out of curiosity, what would you have the President do beyond what he did?

Who knows, perhaps he or others are racist. I merely stated that many have blamed the slow emergency response on racism. I have no idea if Bush and Cronies are racist or not, but plenty of people feel that way right now. Merely appointing minorities to govt posts doesn't prove to me that he is NOT a racist, by the way.

I really cannot understand why the federal govt was slow to respond. But, it is ultimately up to the President to allow National Guardsmen and FEMA take action. So, a lot of this blame will have to rest at his feet.

I feel that the Louisiana and Mississippi state governors weren't exactly brilliant with their emergency response plans, either. Somehow, the truth will all come out in the wash...

misfit

the race card if frequently played in politics today. Just my opinion, but what happens sometimes is that in the past (a present) racism DOES occur all too frequently. What then happens is that when something happens against someone/people that have been the victims of racism in the past,they then understandably interpret the most recent event through their past experience with racism, and label the current experiences as racist as well, even when that may not be the case.

There are likely many reasons for the current situation in N.Orleans; poverty, denial, lack of education, lack of political voice, and poor planning to name just a few. Pres Bush being a racist is likely very untrue and not one of the reasons. To think otherwise is a probably a stretch.

I really cannot understand why the federal govt was slow to respond. But, it is ultimately up to the President to allow National Guardsmen and FEMA take action. So, a lot of this blame will have to rest at his feet.

I feel that the Louisiana and Mississippi state governors weren't exactly brilliant with their emergency response plans, either. Somehow, the truth will all come out in the wash...

misfit

Actually, you're only half right in your first paragraph.

The National Guard belongs to the state (unless they are federalized during national emergencies, or called up for Iraq, etc). If the Louisiana National Guard was "slow" in deploying, you have no one higher to blame than the governor of Louisiana.

(I speak as one who was called up a few times for Hurricanes when I was in the Florida National Guard. Our deployment orders came from the governor, our paychecks came from the state treasury.)