Evacuation of a neonatal intensive care unit in a disaster: lessons from Hurricane Sandy.
NICU patients are among those potentially most vulnerable to the effects of natural or man-made disaster on a medical center. The published data on evacuations of NICU patients in the setting of disaster are sparse. In October of 2012, New York University Langone Medical Center was evacuated during Hurricane Sandy in the setting of a power outage secondary to a coastal surge. In this setting, 21 neonates were safely evacuated from the medical center's NICU to receiving hospitals within New York City in a span of 4.5 hours. Using data recorded during the evacuation and from staff debriefings, we describe the challenges faced and lessons learned during both the power outage and vertical evacuation. From our experience, we identify several elements that are important to the functioning of an NICU in a disaster or to an evacuation that may be incorporated into future NICU-focused disaster planning. These include a clear command structure, backups (personnel, communication, medical information, and equipment), establishing situational awareness, regional coordination, and flexibility as well as special attention to families and to the availability of neonatal transport resources.
Division of Neonatology, Department of Pediatrics, New York University School of Medicine, New York, New York michael.espiritu@nyumc.org.
Michael
M
Espiritu
Division of Neonatology, Department of Pediatrics, New York University School of Medicine, New York, New York.
Uday
U
Patil
Division of Neonatology, Department of Pediatrics, New York University School of Medicine, New York, New York.
Hannaise
H
Cruz
Division of Neonatology, Department of Pediatrics, New York University School of Medicine, New York, New York.
Arpit
A
Gupta
Division of Neonatology, Department of Pediatrics, New York University School of Medicine, New York, New York.
Heideh
H
Matterson
Division of Neonatology, Department of Pediatrics, New York University School of Medicine, New York, New York.
Yang
Y
Kim
Division of Neonatology, Department of Pediatrics, New York University School of Medicine, New York, New York.
Martha
M
Caprio
Division of Neonatology, Department of Pediatrics, New York University School of Medicine, New York, New York.
Pradeep
P
Mally
D000046:Academic Medical Centers; D003299:Cooperative Behavior; D055867:Cyclonic Storms; D004189:Disaster Planning; D004190:Disasters; D011211:Electric Power Supplies; D060447:Emergency Shelter; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D033183:Interdisciplinary Communication; D009518:New York; D010348:Patient Care Team
Hurricane Sandy; NICU; disaster preparedness; neonates; neonatology; power outage; vertical evacuation