Fire, Flood, and Fragility: Disasters Through a Geriatric Lens

Dr. Stephen Gamboa is an Adjunct Associate Professor at UNC and medical director of UNC Health Pardee's emergency department in Hendersonville, North Carolina. In today’s GEMCast episode, he shares his first-hand experiences from two major natural disasters: the 2017 Tubbs Fire in Northern California and Hurricane Helene, which hit Western North Carolina in 2024. As he joins host Dr. Christina Shenvi, the two talk about how these events have a disproportionate impact amongst our frail older patients, which can be attributed to age-related comorbidities, reduced mobility, and higher care needs. Tune in and hear a variety of innovative solutions brought about by the various challenges that these major events can pose. The immediate impacts of natural disasters, such as smoke inhalation and needing to rapidly evacuate homes and skilled nursing facilities (SNFs), are just the tip of the iceberg. Older patients with decompensation or exacerbations of chronic conditions made up a large proportion of the increased demand on EDs following these disasters. Coupled with power outages, electricity shortages, no internet connectivity, and pharmacies closing, Dr. Gamboa describes how his team had to adapt quickly and how system-level support from UNC during Hurricane Helene, including staff, equipment and transport, was crucial to providing care to these vulnerable patients. Find more information about this topic at . GEMCAST is a Geriatric Emergency Medicine Podcast created to help clinicians, nurses, or paramedics who take care of older adults, particularly in the Emergency Department setting. GEMCast episodes, show notes and recommended resources can be found on the Geriatric Emergency Department Collaborative (GEDC) website at

You can listen to Fire, Flood, and Fragility: Disasters Through a Geriatric Lens online on Radio and Podcast. Open the player on this page to stream the available audio.

Fire, Flood, and Fragility: Disasters Through a Geriatric Lens is an episode from GEMCAST by GEMCAST.

This episode is 00:33:38 long.

This episode was published on Apr 2, 2026.

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