The evacuation of 21 critically ill infants down nine flights of stairs at New York University Langone Medical Center the night of Monday, October 29, 2012, is a lasting image of the effect of Hurricane Sandy.

Because data on evacuating neonatal intensive care units (NICUs) are sparse, Michael Espiritu, MD, and other neonatologists and pediatricians from New York University reconstructed and evaluated exactly what transpired as Sandy struck.

Looking back, the primary challenges were finding beds, arranging transportation, and maintaining chain of command and communication. The authors also highlight “situational awareness,” such as not wasting time contacting facilities that would obviously be unable to help because they, too, were in the direct path of destruction.