IMPACT OF A MAJOR HURRICANE ON SURGICAL SERVICES IN A UNIVERSITY HOSPITAL

Hurricane Hugo struck Charleston, South Carolina, on September 21,1989 . This report analyzes the impact this storm had upon surgical care at a university medical center. Although disaster planning began on Sept ember 17, hurricane damage by high winds and an 8.7-foot tidal surge l ed to loss of emergency power and water. Consequently, system failures occurred in air conditioning, vacuum suction, steam and ethylene oxid e sterilization, plumbing, central paging, lighting, and refrigeration . The following surgical support services were affected.In the blood b ank, lack of refrigeration meant no platelet packs for 2 days. In radi ology, loss of electrical power damaged CT/MRI scanners and flooding r uined patient files, resulting in lost information. In the intensive c are unit, loss of electricity meant no monitors and hand ventilation w as used for 4 hours. In the operating room, lack of temperature and hu midity control (steam, water, and suction supply) halted elective surg ery until October 2. Ground and air transportation were limited by uns afe landing sites, impassable roads, and personnel exhaustion. Surgica l planning for a major hurricane should include 1) a fail-safe source of electrical power, 2) evacuation of as many critically ill patients as possible before the storm, 3) cancellation of all elective surgery, and 4) augmented ancillary service staffing with some, although limit ed, physician support.