Emergency Physician Shares Story and Lessons Learned from Wildfire Evacuation

Here’s what I remember most: watching the last bus pull away from the KP Santa Rosa Medical Center at 6 a.m. and realizing we safely evacuated 122 patients in two and a half hours.

Not a bad night’s work.

Our work didn’t end there, of course. It would take more than three weeks until the hospital and clinics were fully back up and running. Even now, things are not back to normal, given that more than 200 of our staff and physicians lost homes and entire neighborhoods in our community are gone.

Things will never be back to normal. Instead, we have a new normal, one that is wiser, stronger, more realistic, and, most of all, kinder and more cooperative.

Dr. Fitzgerald is an emergency physician at Kaiser Permanente Santa Rosa in Santa Rosa, California.

Lessons Learned

Not all disasters happen at 10 a.m. on Monday. A disaster that occurs at 3 a.m. on Sunday presents increased challenges in terms of personnel availability and functionality.
Keep your medical ID with you at all times.
Some of your key responders may not be able to get to the hospital in a disaster event.
Evacuation is a parallel process. The resources needed to evacuate the adult ICU and NICU patients are different from those needed to evacuate the patients on the floor. For those who can walk, buses and private cars are your new best friends if the situation is urgent. If you even think you might have to evacuate, start preparation immediately, including making plans for how you will track your patients and the supplies, patient care information, and medical personnel you will send along with them. You can determine and practice much of this in advance.
When evacuating patients or when handling a patient surge, assign one staff member to each patient to monitor, track, and help transport. Having direct eyes on every patient, whether by someone medically trained or not, is invaluable during chaotic disaster events.
Practice makes perfect when it comes to disaster response and infrequently used plans such as evacuation plans. Talk through and drill your plans as often as you can. Muscle memory will prove extremely helpful when the time comes.
The concept of the “disaster brain” is real, though the extent to which it dictates behavior in a disaster varies. We may not even realize our brains are not 100 percent until much later. It’s like they used to teach us for codes, “Take your own pulse first.” Call a huddle; do a quick time-out. Make sure everyone is on the same page. If the situation gets worse or more chaotic, repeat this sequence, just like you would repeat the ABC’s in a difficult or extended code. Drill under time pressure to grow more resilient.