Inside Duke Medicine

Living our values: Excellence

A DUHS emergency response team provided excellent care in eastern North Carolina during Hurricane Irene.

In Hurricane Irene, DUHS crisis team driven to excel

Just hours before Hurricane Irene struck the North Carolina coast, a 21-member emergency response team, including a dozen volunteers from DUHS, was focused on anticipating the medical needs of communities in the direct path of the menacing coastal storm.

Responders battled sheets of rain and high winds to make the journey from Durham to Greenville, N.C. Working in a torrential downpour, the physicians, physician assistants, nurses, EMTs, respiratory therapists and law enforcement team members quickly transformed a community building into an emergency field hospital.

Working with a team from Carolinas Medical Center in Charlotte, they set up cots and medical equipment and unloaded essential supplies to serve patients from the hardest hit regions, including Dare and other northeastern counties.

“The team leaders had planned and trained for this type of mission for years,” said Ian Greenwald, M.D., chief medical officer of the Duke Preparedness and Response Center. “Solidarity with the community and health care excellence are guiding principles of the State Medical Assistance Team (SMAT). We are all extremely proud of what they accomplished."

With 11 members based at DUHS and another nine from hospitals within the region, the medical emergency team is part of a statewide emergency response team summoned by the governor when a state of emergency is declared.

Working comfortably with each other and marshaling skills developed in training, the team created a high-functioning field hospital despite winds that knocked out power several times. With back-up generators and a response plan, their success depended on preparation, said Jessica Thompson, director of emergency preparedness at Duke Hospital.

“That’s our mission in these situations,” added Larry Tucker, regional response and recovery coordinator for the Duke region.

As the storm continued into the daylight hours Saturday, leaders worried about supplies and asked team members to use MREs (meals-ready-to-eat) in case fresh food supplies for patients dwindled below reserves.

“We had some concerns about flooding around the building and the storm damage,” Zivica said. “We were not sure when the resupply efforts could get to us. When we saw the water coming up around the building, we felt like an island out there.” As power flickered off, communications to the outside world were limited despite emergency generators ensuring patient safety. “We did not have television to watch 24/7, so we were getting our information from the EMTs and the medical teams showing up with patients.”

Hours of training, in addition to experience in such disasters as Hurricane Katrina, helped the teams sustain a focus on patient care.

With 11 members based at DUHS and another nine from hospitals within the region, the medical emergency team is part of a statewide emergency response team summoned by the governor when a state of emergency is declared. The responders train frequently – as recently as June for the Duke team – and they deploy in emergencies as regional teams from several regions.

About 20 medically fragile patients and an additional 10 family members and caregivers found shelter in Greenville. While the team recognized patient stress, they found ways to reduce anxiety as much as possible. A nurse played a piano in the auditorium at the request of one patient.

Doctors and nurses and EMTs worked together to mop floors, remove trash and clean laundry. “It was an incredible team effort and people were completely focused on the patients – not their traditional roles,” Zivica added.

People who volunteer understand the team’s focus on performance. “From the training to the deployment to the service in crisis situations, everyone makes a commitment to excellent care,” said Claudia McCormick, a nurse and clinic operations director for the Duke Trauma Program.

“This group of employees has set a very high standard in their commitment to excellence,” said Jim Starlin, team commander.

The following team members traveled to the clinic in Greenville, N.C., or provided support roles from DUH:

Janet Keating, M.D., Murdoch Developmental Center

Jonathan Wendell, M.D., DUH

Tammy A. Jones, R.N., Durham Regional

Richard M. Franklin, EMT-Paramedic, Granville EMS

Jason J. Zivica, EMT-Paramedic, Granville County EMS

Betty G. Meekins, EMT-Paramedic, Robeson County EMS

Catherine L. Gaines, P.A., Southeastern Regional Medical Center

Elizabeth J. Albright, Administrative Assistant, Duke Clinical Research Institute

Melanie Watson, N.P., DUH

Michael O. Hill, law enforcement, Durham County Sheriff’s Office

Cheryl F. Satterwhite, R.N., DUH

Amy Marie Lett, R.N., DUH

Thomas J. Mellown, law enforcement, Durham County Sheriff’s Office

Pamela G. Fields, EMT-Paramedic, Robeson County Emergency Medical Service

Jeni L. Hauver, R.N., DUH

Megan N. Lorincz, R.N., Durham Regional

Timothy A. Tyler, EMT-Paramedic, Robeson County Emergency Medical Service

Courtney T. Stuckey, Respiratory Therapist, DUH

Karin T. Winstead, R.N., Durham Regional

Jessica R. Thompson-Melton, Director, Emergency Preparedness and Trauma Program

Claudia McCormick, R.N., clinical operations director, DUH

Danice Tucker, Administrative support

Greg Baringer, Rear area support

View the complete pdf of the  Sept. 2011 Inside Duke Medicine or click through the articles online.