KATRINA / Grim Triage for Ailing and Dying at a Makeshift Airport Hospital

Authorities said 8 to 10 people an hour were dying at hospitals in New Orleans.

FELICITY BARRINGER and DONALD G. McNEIL Jr.
The New York Times

KENNER - Some were being given water by soldiers. Some had small spasms as they lay on their stretchers. Some psychiatric patients chewed their lower lips or babbled quietly. Some tried to wander out the doors where buses dropped off more patients. Some were dying; one corpse in a wheelchair, not far from the Delta counter, lay covered by a blue blanket.

On the day that a fleet of military helicopters and buses with military escorts finally succeeded in emptying the exhausted and darkened hospitals in the city's flooded zones, the departures concourse of the Louis Armstrong New Orleans International Airport had become the newest and most chaotic hospital in the New Orleans area.

By evening, all the patients in the flooded zone had been moved out, though hundreds of medical personnel and frightened city residents who had sought shelter in hospitals from rising water were still hoping someone would come get them, too. Left behind were an unknown number lying dead in flooded morgues and sometimes in spare corridors.

As the nation watched long lines of obviously fragile patients being wheeled down the tarmac, it was clear that some patients had died in transit - the airport hospital has its own morgue - and there were worrying hints that the forgotten nursing homes of New Orleans might ultimately be found to be worse charnel houses than the stranded hospitals.

The head of a Louisiana ambulance service said he had been told of one home in lower St. Bernard's Parish where 80 patients had been found dead and of an apartment home for the blind where the staff had abandoned the residents. The reports could not immediately be confirmed.

A Web site set up by The Times-Picayune newspaper in New Orleans at www.nola .com to encourage people to tell their stories had numerous detailed pleas from family members of elderly New Orleans residents saying they believed their relatives were trapped in nursing homes or apartment buildings, unable to make contact because they were bedridden or too senile to ask fleeing neighbors for help.

Nonetheless, the situation for hospital patients had suddenly improved dramatically.

Early on Friday morning, the scene at the airport looked "extremely desperate" in the eyes of Dr. Ross Judice, medical director for Acadian Ambulance Service, which even before Hurricane Katrina landed had contracts to evacuate many private hospitals.

In a 4:30 a.m. phone call to his wife, Robin, in Lafayette, he described a chaotic situation in which the area meant for 250 already had 2,000 sick and injured patients, more were arriving every hour and the Federal Emergency Management Agency had no plans to evacuate any of them.

It was hard just to move patients across the tarmac from helicopters, and Dr. Judice asked his wife to send out a plea for gurneys and medical golf carts with beds. He also asked her to recruit volunteers willing to fly in and act as stretcher bearers.

"Somebody's got to get this thing rolling," his wife reported him saying.

By 9:30 a.m., Mrs. Judice said, he had called back and "there was tremendous relief in his voice." The military had arrived with transports and chartered commercial jets were landing. "Patients were being moved out and he felt that there was definitely a plan," she said.

By Friday afternoon, there were only a few hundred patients at the airport.

With hundreds of National Guard troops spreading out in the city streets, it was finally easier for small boats to approach embattled hospitals, some of which were surrounded by six feet of floodwater and had little or no electricity and no running water. At the same time, the fleet of helicopters evacuating patients from rooftops had grown from a handful of single-patient civilian ambulances just after the storm to about 100 military medevac choppers.

The evacuations came in the nick of time for several hospitals, where doctors had been working by flashlight and helping patients breathe with manual ventilators, waiting helplessly for news from the outside. Some staff members were so hungry and dehydrated that they were reported to be feeding themselves intravenous sugar solutions.

Although helicopters had delivered food and water to some hospitals, it was limited and rationed.

Richard Zuschlag, the president of Acadian Ambulance, described a hellish week for his helicopter and ambulance crews from his command center in Lafayette. Mr. Zuschlag said he had begged the governor, senators, Pentagon and FEMA officials for more help as the crisis deepened.

The evacuation was so chaotic, he said, that "At Touro Infirmary, these mothers were just giving my medics their little day-old babies. They were just looking at us with fear and horror on their faces. We would put four of them in an incubator and just fly them out. They're scattered all over the country now. We couldn't keep track of where everyone was going."

All the babies, he said, had identification bracelets on, so that their mothers would presumably be reunited with them. A spokesman for the hospital later said he had little idea where the evacuated patients were.

At Charity Hospital, which was not evacuated until Friday evening, Mr. Zuschlag said, "When we first tried to get medics there, in Fish and Wildlife boats, people shot shots at us, tried to turn our boats over. It would be O.K., and then there'd be pockets of thugs where it was terrible."

Early on Friday morning, at University Hospital, a public institution with many patients on welfare, Dr. Joan James, an obstetrician, said in a telephone interview that it was getting harder and harder to take care of the patients. Dr. James was among the last to be evacuated from the hospital by airboat.

Only four of the eight floors were usable, and the water outside was so deep that fish were cruising past, she said. Intensive care and dialysis patients had been evacuated earlier in the week, but each had to be taken out by boat to another nearby hospital with a helicopter landing pad.

The hospital was out of running water, had no ventilation and food that had been had been airlifted in was limited. Backup generators powered only the operating rooms and a few other areas, so the staff was using flashlights and stethoscopes to diagnose patient problems.

"We can't tell a lot from monitoring a fetal heartbeat," Dr. James said. "People are starting to get frustrated. Luckily, we haven't had anyone get too violent."

Don Smithburg, the chief executive officer of the Louisiana State University Hospital, which oversees the public hospitals, told The Associated Press, "Our morgue at Big Charity is full and it is under water." The basement morgue had 12 bodies and another five were stacked in a stairwell, also under water, and other bodies were left elsewhere in the hospital, he said.

At Touro Infirmary Hospital, two private buses were able to get the last of its 2,000 employees and patients out of the hospital by the end of Thursday, Stephen Kupperman, the hospital's chairman, said. The hospital also hired private air ambulances to transfer patients.

"We could not get any assistance from the government at first," said Mr. Kupperman, who said about 80 patients transferred from the hospital were moved by government helicopters the last day.

"My view is that the government was totally unprepared for something of this size," he said.

By this morning, Tulane University Hospital had been able to evacuate some 1,400 patients, employees and others, largely by leasing 20 private helicopters.

HCA, which operates Tulane, started making arrangements to move people a week ago, said Ed Jones, a vice president. The company has also been able to move some 50 Charity patients, many of whom are critically ill.

Tenet Healthcare hired five private helicopters to try to get 3,000 patients and employees out of four of its hospitals , said a spokesman, Steven Campanini.

Among the few hospitals still operating in the area is the Oschner Clinic Foundation, which is not flooded. But after several of its generators failed, the clinic had no clean water and chose to transfer about 200 of its 45o patients to Houston. Oschner now has power and supplies, allowing it to reopen its emergency department, according to Dr. Joseph Guarisco, the department's chairman. "The crisis is clearing up rapidly," Dr. Guarisco said.

Now hospitals and public officials face the daunting task of trying to locate patients. "Our patients are scattered," said Mr. Kupperman of Touro Infirmary. " We don't really know where they are."

At Kindred Hospital, an acute-care center in the Garden District, workers and patients were taken out in four tour buses on Friday morning. Hospital workers said they had been told that they would be evacuated several times this week but the buses never arrived. On Thursday morning, three dozen patients were brought to the hospital lobby but then had to sleep on the floor.

Bridget A. Jatho, who worked in the psychiatric ward, said that the 11 patients in her unit frequently grew restive during the week but that only one fight broke out.

At the airport, Jack Rimp, who retired to New Orleans after a career in theatrical advertising in New York, surveyed the scene in a wheelchair, his hospital gown neat around his knees, a green oxygen tube beside his chair, a card hanging over his neck identifying him as an emphysema patient. Mr. Rimp was evacuated by helicopter from Memorial Medical Center on Wednesday, and been at the airport ever since.

"After three nights, it's really fine," he said.

Felicity Barringerreported from Kenner, La., for this article, and Donald G. McNeil Jr. from New York.James Dao contributed reporting fromNew Orleans,and Reed Abelson and Jennifer 8. Lee from New York.