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In the aftermaths of Hurricanes Katrina, Rita, Irene, and Sandy, as well as other natural and technological disasters (wildfires, tornadoes, tsunamis, earthquakes, and terrorist attacks), University health systems have led the way in both continuing to care for inpatients, as well as working to triage those affected by both forecasted and “surprise” events. As a result, medical manpower is stretched thin, and those working in predominately research units within University health systems experience a shift in responsibilities away from credential specific (simply MD or RN) to being “jacks of all trades,” and taking on responsibilities of orderlies, lab techs, emergency technicians, life-flight paramedics, and ICU doctors and nurses. In such a scenario, the most critical patients in the ICU are those who require the most supervision, and who fall prey to the greatest consequences when University health systems (e.g., New York University Health System, Tulane University Hospital, and Louisiana State University Health System) lose power and must move patients to other facilities that can take over responsibilities for providing critical care.

This presentation draws upon data from Hurricane Sandy and her impact on New York University’s Health System (which lost power during the storm), and examines the impact of the transfer trauma experienced by patients who must be moved away from a top research hospital to a secondary facility. Given that the greatest ramification of transfer trauma is mortality, I will discuss this risk with regard to the Changes in Health, End-Stage Disease and Symptoms and Signs (CHESS) measures. Further, I will provide recommendations for greater disaster preparedness and mitigation for University Health Systems, so that critical care patients will experience greater health outcomes by being able to remain at these Hospitals without compromised care.