Hospitals scramble to treat tornado victims

Treating injuries from tornadoes is a well-established job in Oklahoma, but healthcare providers say the twister that carved a 17-mile-long path of destruction through central Oklahoma Monday produced surprising injury patterns and unusual flows of patients.

Trauma clinicians at two hospitals in Oklahoma City, just north of the hard-hit city of Moore, saw far fewer head injuries than they had expected given the strength of the storm, which packed winds as strong as 200 mph. But the stream of broken bones and degloving injuries—in which skin is ripped from the underlying tissue—was heavy at area hospitals.

“When you see these monster storms come through that have significantly more energy associated with them, things are different,” said Dr. David Hogan, an emergency physician and disaster-medicine specialist at 305-bed Integris Southwest Medical Center.

Integris Southwest, which treated 91 patients and had one fatality as of Tuesday morning, turned out to be one of the closest hospitals to Moore after the tornado shredded the second story of the city's downtown hospital, Moore Medical Center, a campus of Norman Regional Health System.

Thirty patients were transferred from the Moore campus to Norman's other hospital sites to the south, and all of the Moore patients and staff were all accounted for, the system said.

But the tornado blocked Interstate 35, which runs north-south through the city, forcing some residents on the north side of town to flock to Oklahoma City hospitals such as Integris and 750-bed OU Medical Center.

Internists at OU Medical Center worked long into the night to discharge patients and give the hospital the capacity to care for the incoming flood of victims. Staff treated 94 patients, including 51 children, between its main campus and Children's Hospital of Oklahoma, hospital officials said at a news conference. No fatalities had been reported at the hospital.

As of Tuesday afternoon, the death toll stood at 24, including nine children, though the number has been rising and falling since the tornado struck.

Patients who did find their way to the hospitals seemed to have less-severe head and blunt-force injuries than would have been expected based on past storms, doctors at Integris Southwest and OU Medical Center said. However, the sheer volume of patients was the medical staff's biggest challenge.

But the hospitals in the area have handled that volume well, largely as a result of the state's trauma planning after a severe tornado hit the state in 1999, said Dr. Bob Letton, OU Medicine's pediatric medical director. Patients needing treatment have been transferred to hospitals and treated faster than 1999, he said. Without that planning, the death toll would have been “much higher.”

Both hospitals experienced loss of water pressure Tuesday, which Hogan said was in some ways more crippling than a power failure because of hygiene concerns.

Hogan said that in coming days, the care for tornado victims will shift from emergency to primary care, especially as people who have spent the past 24 hours digging relatives and neighbors out of rubble discover that their injuries also require medical attention.

In those cases, physicians should expect to see wounds highly contaminated with grime from the Oklahoma countryside.

“Tornadoes have a tendency to pick up what they pass by. Dirt, rocks, clay, sand get picked up and accelerated to 200 miles an hour. You have that combined with a lot of moisture,” Hogan said. “Basically, they're a mud ball when they come in, if they were exposed to that.”

Executives and staff at the hospital in Joplin, Mo., that was destroyed by a tornado in May 2011 said Oklahoma City area hospitals can also expect to see patients with injuries related to digging through the debris of their homes.

“Our hearts go out to those folks in Oklahoma,” said Gary Pulsipher, president of Mercy Hospital Joplin. “Those pictures look so much like what we saw in Joplin two years ago.”

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