First In: Report from Tennessee Task Force One

Contrary to all the media reports that it took the Federal Emergency Management Agency (FEMA) five or six days to reach New Orleans after the devastating Hurricane Katrina, Tennessee Task Force One (TN-TF 1), the Urban Search and Rescue (USAR) team sponsored by the 1,800-member Memphis Fire Department, was in the waters of New Orleans conducting rescues within hours of the levees breaking.

TN-TF 1 is one of 28 federal USAR teams located across the country and is made up of not only Memphis firefighters but other firefighters, medical personnel and specialists from the Memphis area. The Tennessee team has been pressed into service many times in its 10-year history, including the Pentagon on 9/11, the space shuttle disaster and numerous hurricanes. The team was deployed three times in 30 days for Hurricanes Katrina and Ophelia, and later was located in Lake Charles, LA, for Hurricane Rita.

TN-TF 1 was notified by FEMA and deployed on Saturday, Aug. 27, two days before Hurricane Katrina roared ashore. By 5 o'clock Sunday morning, they had reached their initial staging area, out of harm's way in Shreveport, LA. On Sunday, members of the team watched news accounts as Hurricane Katrina reached Category 5 status.

On Monday, FEMA moved TN-TF 1 and task forces from Missouri and Texas to Baton Rouge, LA, after the storm had moved through. As they arrived, Katrina was still wreaking havoc on southern Mississippi. At the rally point, the Louisiana State University fire training academy in Baton Rouge, task force leaders and members of the Incident Support Team from FEMA to put together their strategy.

After the strategy was devised, the first three FEMA vehicles with USAR team members made their way into New Orleans. The three FEMA vehicles were provided with an escort and as they made their way through the suburbs of New Orleans, they saw what had not been yet reported by any of the cable TV networks. The damage was far-reaching, although initial reports on TV reported the New Orleans area had escaped the worst of the storm. As the team entered the city, it was met with road blockages, looters and building fires that were burning unattended. At one point, the convoy was halted and sent to a secure staging area while the Louisiana State Police chased looters who had shot at them.

On the morning of Tuesday, Aug. 30, the team had little knowledge that it would be the first of federal assets into the waters of New Orleans to conduct rescues for what would turn out to be the largest natural disaster and rescue mission in the continental United States.

Members of the team describe the first day of operations as "organized chaos." By that point, 80% of New Orleans was under water, so the team established its first area of operations at the intersection of Interstates 10 and 610. This turned out to be one large boat ramp where helicopters and rescue boats continued to drop off those who had been rescued from rooftops, attics and the tops of cars. Members of the team described the people as coming in "droves." They were the elderly, the sick, the hot and the tired.

At one point during the operation, announcements were made on the radio that this was not a "normal" search and rescue operation. FEMA teams are designed to handle search and rescue operations involving the collapse of structures or other specialized rescues. Never had a FEMA team been thrown into a water rescue operation of such a magnitude.

Although rescues from helicopters and boats continued unabated, the reality was that this operation was turning into a medical and humanitarian mission. Those who were brought to the Interstate 10 and 610 interchange were exhausted from hanging onto what they could in the flood waters. Some had chronic illnesses. Others had not eaten nor taken their medications in over 24 hours. Still others had lost their home oxygen supplies or were just mentally zapped from what they had endured.

As it became clear that the intersection of Interstates 10 and 610 was turning into a mass-casualty event, the decision was made to begin a triage, treatment and transport of the victims. The challenges were many for the team. Besides heat indexes of 100 to 105 degrees, human and material resources were in short supply. The primary purpose of the medical team for TN-TF 1 is to provide medical support to the members of the team who conduct search and rescue, and then any victims who are found. The medical mission of the team changed dramatically that first day as an initial 368 patients were triaged, treated and transported. The team even had to work several cardiac arrest victims.

The team had no triage tags, no way of designating red, yellow, green and black areas, and initially no ambulances. The START triage system was utilized and worked effectively. A medical director from a local ambulance service was contacted, but the team was told it would be four or more hours before ambulances could be sent to them, since they were fulfilling their contractual obligations to the hospitals and were moving those patients. Eventually, the most serious of patients were moved.

The next day brought more of the same. Hundreds more patients were brought to the interstate intersection. By that time, the team had the system down and was working well with other local, state and federal agencies. Unfortunately, the patients they were seeing were sicker and more emotionally drained after being in the water for two days. Many were suffering dehydration.

On Sept. 1, the FEMA task force team was told by radio to "stand-down." Rescues for the day had been canceled as a result of chaos and violence in the streets of New Orleans. Reports were coming in of shots being fired at rescuers and boats being turned over as people fought to get into them; there even was a report of one person cutting another with a knife as the two fought for a spot in a boat. The team could not go back in without protection. Their protection came from members of the New Orleans Police Department who had stayed.

On Sept. 2, the task force reached a nursing home staffed by a Catholic nun, a licensed practical nurse and three aides. They had carried their 85 patients to the second floor of the nursing home as the water rose to seven feet in just a few hours. Trapped there for four days, they had cared for the patients in horrible conditions in the hallway on the second floor. Many of these patients under "normal conditions" required extensive care and nursing. They had been kept alive for nearly a week with spoiling food and limited water by the nursing home staff. Eventually, all the patients would be triaged and organized for evacuation. Some were already dead and others died while waiting for evacuation. Of the original 85 patients, 57 were evacuated from the nursing home, along with the staff.

As the violence increased, the force of protection surrounding the task force got larger. Members of the team were now being inserted in the hostile waters to conduct rescues by Blackhawk helicopters.

One area the team worked was Chalmette, which contained many oil refineries. The leaked crude oil, chemicals and toxins in the water were visibly obvious to all. But the team pushed on and many more rescues were made, including one of a woman who had stood in water up to her neck for almost a week.

After a 10-day deployment, TN-TF 1 was rotated home for rest. The members were physically and emotionally drained, but still had the will to continue.