It has been… a week.  I know I’m not alone.  I want to say to those who are without power – either personally, or in their centers – or both… I hope life returns to normal soon.  I also hope you are all safe and well as we add more dramarama to this year that has been anything but… well, clear, despite the “2020” title.

I have an ASC that I work with in New Orleans.  I had a site visit scheduled this week and was oblivious to the impending weather – who watches the tropics the week of Halloween?! I decided to drive vs. fly since I’m still on the fence about flying right now – especially when the time gain is minimal. So, my plan was to drive down from Atlanta Monday, work on-site Tuesday and possibly Wednesday morning if needed, then drive back on Wednesday night.  I had visions of yummy car snacks, a good book on tape, and sunny cruise control weather.

Halfway through my eight-hour drive, I learned that Zeta was looming.  I decided to abbreviate my visit to midday Tuesday and get some return miles in Tuesday night.  I figured it would get me ahead of the storm and get me home sooner, since home seemed to be in the path as well.

All went as planned through mid-afternoon Tuesday, as I loaded up and started to head home.  The book was interesting, the weather was fair, and the GPS was mapping the way.

The rain bands began hitting pretty soon after my travel started. Travel, that I should mention, included large, tall bridges.  Having grown up in Florida – large tall bridges were commonplace for me, but I’ve never been fond of them – especially after seeing the Sunshine Skyway immediately after it fell as a kid (You can learn more here:  The further I drove, the better the weather, so I decided to push through – all the way home.  Eight hours later, I found my front doorstep – exhausted, over-tired and wired, but safe.  I thought the worst was behind me.

I got a fitful night’s sleep, and awoke to my regular tasks, but with a new concern.  We were now in a Tropical Storm warning.  As evening approached, I remember thinking that we were pretty prepared, and went to bed Wednesday evening without major concern.

The torrential rain and wind woke us at about 4:00 a.m.  Living on a hill in a two-story house with a daylight basement, we sit pretty high up.  We started hearing trees breaking almost immediately.  We didn’t lose power (although we later learned that many did) and got through relatively unscathed. We lost some beautiful huge trees in back – one was over 100 feet tall.  It was scary.  Many centers lost power and had to cancel cases.  We all went into recovery planning mode.  Here are some of the issues they faced and what helped:

Cancelling and resuming cases:  What is your facility’s decision-making plan (who/when)?  Does your emergency plan outline these tasks?  If patients require an immediate post-operative follow up, consider that impact as well.  It may be appropriate to perform the procedure, but if the physician’s office is closed for post-op care, these patients may need to be postponed as well.

Communication Plan:  Decide who will communicate (staff, patients, physicians, anesthesia providers), how (alternate communication plan).

Power outages:  Consider medication storage; sterile supply manufacturer guideline temperature parameters; generator use and limits; and facility resumption preparation (cleaning, sterilization, communication, staffing).

Transportation: Is gasoline available due to power outages, impacting staff, supply availability and service vendor travel?  Consider these limitations in planning.

Facility Assessment:  Who will evaluate facility return readiness?  What service vendors may be needed? Where is their contact information kept?  Maintaining cloud-based lists (and paper back-ups if internet is out) in a “bug-out” binder will help.

My New Orleans colleagues are safe but are still without power and navigating all that goes with it.  They are great at what they do, so they are making it happen.  I hope to see them again soon, after I get a little rest.

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