Lesson From Katrina: Fighting for the Tiniest Survivors

As floodwaters rose, medical staffs performed small miracles to keep preemies alive

MONDAY, May 8, 2006 (HealthDay News) -- Dr. Juan Gershanik stood on the roof of Memorial Medical Center in New Orleans a day after Hurricane Katrina hit, and watched as the flood waters mounted around him.

Those waters, he realized with growing dismay, could soon inundate the back-up generators that were keeping 16 tiny babies alive. Helicopters were flying overhead, but none stopped for these smallest survivors.

"It's hard to guess how much time you have left," recalled Gershanik, medical director of the neonatal intensive care unit at West Jefferson Medical Center in Marrero, La.

That same day, about two miles away, Dr. Brian Barkemeyer, head of neonatology at Louisiana State University Health Sciences Center, waited for a boat to take two preemies to a waiting fire truck. The boat never showed.

Instead, Barkemeyer entrusted the babies to three orthopedists who arrived by chance in a canoe. Barkemeyer gave them precise instructions on how to care for the tiny lives. "The babies should stay pink," he said. "Without monitors, that's your one gauge to see if what you're doing is effective." The babies made it to the fire truck.

But Barkemeyer still had more than 20 infants to evacuate. At one particularly low point, six nurses holding six babies left by boat to meet a helicopter, which never materialized.

Most of the mothers had been discharged, and there was no way to contact them. In fact, Barkemeyer learned later, officials believed there were no babies left to be evacuated.

In reality, the number of babies needing to be rescued was growing. Several women gave birth in the hospital that week without electricity or running water.

Friday morning, one woman delivered her baby three-and-a-half months premature. The newborn probably weighed about one-and-half pounds, Barkemeyer said, but there was no way to know for sure since all the hospital scales were electronic.

The baby needed to get to the neonatal intensive care unit immediately. "We ran the baby through darkened hallways where people were sleeping, and jumped over extension cords," Barkemeyer said. "We got the baby there, and we put the breathing tube in and medicine into the lungs. We inserted catheters. We did the best we could, but there were no X-rays to see where the catheters were going internally. We had no measurements of oxygen in the blood. We were, in a primitive way, flying by the seat of our pants. We estimated the doses of medicine and the IV fluid and waited."

By that time, the water had risen to the point that "there was no real way of getting out other than boat or helicopter," Barkemeyer said.

Eight hours later, Barkemeyer and his staff heard the clanging of metal being hurled off the roof. It was the welcome sound of debris being cleared so helicopters could land. The preemie just born was wrapped in cellophane and blankets, and evacuated.

For Gershanik, evacuating by helicopter was easier said than done.

Both doctors were among many who told their harrowing health-care tales in a special Katrina supplement to the May issue of Pediatrics.

In Gershanik's case, the heliport was located on the roof of the parking garage. But the first floor of the hospital, which connected to the garage, was flooded. Doctors and nurses finally found a way to the second floor of the garage.

But now the transport incubators had to be pushed to the eighth floor and up three flights of narrow stairs. "When we reached the stairs, I thought the incubator would tilt to the side, and there they would go with the babies," Gershanik said. "There were so many frightening moments."

At the heliport, the back-up generators were still working so the incubators could be plugged in. "For these critically ill preemies, temperature conservation is major," Gershanik said. "If they get cold, you lose the battle for survival."

But when the helicopters finally came, there was no room for the incubators.

Gershanik took the sickest baby in his lap. "They called me the Argentine kangaroo," he said. "We wrapped them in a lot of blankets, and put them so close to our bodies that it was like a unit, like the kangaroos."

"I thought this would be the only chance that these babies would make it," he continued.

By now, the sun was setting and there were no lights anywhere in the city. Gershanik could barely see the baby, nor could he hear it: "The only way I could figure out he was alive, I feel bad about it, but I pinched his foot and he moved his foot and we knew he was alive."

After about 10 minutes in the air, the pilot had to stop to refuel, which turned out to be a blessing. The baby was running low on oxygen, and Gershanik had to switch the tank.

"I guarantee if I had run out of oxygen while we were in the air, I never would have been able to do the switch," Gershanik recalled.

They ascended again, and flew towards the lights of Baton Rouge.

"I had already told myself that if this baby makes it, I never, never will complain about anything in life," Gershanik said. "With babies, it's not a life you're talking about. It's a lifetime."

More information

For more on preemies, visit Premature Baby, Premature Child.

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