Orangeville Ontario, 1985 12 dead, 155 injured F3?
Joplin Missouri, 2011 166 dead F5 wind speeds greater than 200 miles/hour
“… On a Sunday afternoon in May, our world turned upside down. Time stood still and nothing would ever be the same again…The forces of nature passed through Joplin, passed through history and in the days that followed Joplin and the four states formed an unbreakable bond beyond time, beyond tragedy, beyond comprehension… ” Advertisement: Zimmer Radio Group
Via Christi Hospital-Pittsburg & SE KS Hospitals: Lessons Learned Medical Surge and Collaboration for the May 22, 2011 Joplin Tornado Karry Moore -Liaison Via Christi Hospital-Pittsburg 1 Mt. Carmel Way, Pittsburg KS 66762 620.704.7200 karry.moore@gmail.com
How long is 30 seconds? http://www.youtube.com/watch?v=asgs3Ky0mJ Y&feature=feedf_more • Keep your eye on the light post as the tornado approaches and passes it to get a feel for the speed of the storm.
www.youtube.com http://www.youtube.com/watch?v=nXjiWaQBXjs&feature=feedf U2 - Where the Streets Have No Name – Joplin Tornado Version KillBoxFilms Released June 9, 2011 Viewed 308 times June 9, 2011 Viewed 38,274 times June 24, 2011 Viewed 80,506 September 21, 2012
Joplin Fire Department, May 22, 2011
Map of the trauma center regions- our proximity to St John’s X 31 miles from St. John’s to Via Christi Hospital, crossing the Kansas/Missouri state line.
This presentation will: • Discuss community hospital (VCH-P) medical surge response and lessons learned • Discuss general lessons learned by the public and area businesses • Discuss the media coverage of the event
1. Self Deployment of Staff VCH-Pittsburg examples Regional Concerns Media examples
Lessons Learned SE KS Regional Hospitals 3 opportunities for improvement: 1. Self deployment, self deployment, self deployment! A. Vulnerability B. Accountability C. Liability
2. Triage System Opportunity for improvement Needed system at every door, multiple entrances, people presenting at many doors, self presenting and ambulance signage
3. Fundamentals “Practicing the plan gets us to the event, adjusting the plan gets us through the event.” Dr. Tim Stebbins
Meanwhile across the state line: • Incident command set up • Patients begin to arrive in personal vehicles • Triage set up at all 3 main entrances • Registration set up (moved servers) • Food set up for staff/EMS/ED • PSU police set up car and flashers at end of ambulance entrance • Call backs for needed clinicians
Via Christi Tornado Response • By 7 p.m., Sunday, May 22, it was all hands on deck at Via Christi Hospital. • An hour and a half earlier an EF5 tornado hit Joplin, Missouri. • The storm cut a swath of damage nearly a mile long. • Via Christi Hospital activated its Incident Command Center and prepared for a medical surge . 26
Via Christi Tornado Response • More than 140 Via Christi employees voluntary showed up to help care for patients currently at the hospital and arriving from Joplin. • Initial reports were unclear about how many patients the Emergency Dept. should expect • Incident Command discussed logistically how many helicopters and ambulances could deliver patients at one time. 27
Via Christi Tornado Response • Once word about the severity of the situation in Joplin and news of the devastation spread, it was clear Via Christi Hospital would have a part in caring for those injured in the storm. The mission of Via Christi came to life, as it was a time to serve as a healing presence with special concern for our neighbors who are vulnerable. 28
Via Christi Tornado Response • After the initial medical surge from Sunday night into Monday morning, additional patients were treated at our ministry throughout the course of the week. • More than 100 patients who were directly affected by the tornado were treated at Via Christi Hospital. • Nine had been patients at St. John’s Regional Medical Center when the tornado hit. 29
Via Christi Tornado Response “In times like these, the character of communities and individuals are revealed,” said Via Christi Pittsburg President & CEO Randy Cason. “I would personally like to thank each of you for the extraordinary effort put forth over the past week. On countless occasions during the week, I have witnessed excellence in care amidst the calamity and tragedy of the tornado.” 30
“ When I look at this tornado, it wasn't an unusual tornado by any means. We get very strong tornadoes like this all of the time. In fact the Picher, OK tornado in 2008 was almost as strong as this tornado. What makes this tornado stand out, is because it tore through a very populated area, which is rare. Chances are it will be in a field or glance towns. But the chances of actually plowing through a city aren't that great. That is what made this tornado stand out. Besides that, I was amazed how fast the tornado developed . Most tornadoes take a good 4 or 5 minutes to go from the beginning stages into a monster, at least 5 minutes. This one was just ready to go and went to a monster in under 60 seconds . This was a big tornado. It was about 3/4 of a mile wide. St. Johns did get hit, but they were on the side of the tornado. If it went directly over the building, I think it would have had even more damage. I hope all of this helps,” Doug DOUG HEADY, CHIEF METEOROLOGIST KOAM TV, JOPLIN MO http://www.koamtv.com/
Before and After Photos http://www.youtube.com/watch?v=s 7Fdsp5YnKE&feature=feedf
The Joplin Globe One month later…Two months later… • $3 billion preliminary damage estimate • 597,500 cubic yards of debris removed • 1,273,471 cubic yards of debris removed • 18,000 cars destroyed • (remove your license plate if it happens to you!) • 6,954 homes destroyed • 5,000 jobs affected • 1,150 injuries • 875 homes damaged • 500 business affected • 155 deaths • 160 deaths • 1,300 animals at the Joplin Humane Society • All tornado animals reunited or adopted out • 10,288 disaster survivors registered with FEMA for Individual disaster assistance
Other related events/concerns: • Identity theft • Looting • Curfews • Officer from KS City, responding to the event, struck by lightening and killed • Responding National Guard vehicle flips injuring occupants when clipped by another driver who left the scene • Mucormycosis (rare fungal infection) developed in wounds of victims and responders • Threats of picketing the memorial services • Numerous resources unavailable in the midwest due to demand, rental cars, freezers, tents… • Tent City
Dr Dodson, Trauma Surgeon St. Johns/Mercy Hospital Notes: • Generator didn’t start • People trying to get in/out of the building at the same time • Many came in to get out of the storm • 183 patients at the time/367 licensed beds • 25 patients were in the Emergency Dept. • Tornado was 45 seconds over head • Other notes……
Via Christi Tornado Response • Via Christi Hospital helped gather and arrange for donations for victims, including hospital patients who arrived with only the clothes they were wearing. • A number of businesses and organizations put together impromptu clothing and supply drives. • Via Christi staff took sizes of clothing of tornado patients to ensure they had clean clothes when returning home, and also put together care packages for them. 39
Via Christi Tornado Response “It’s like staying in a hotel,” one patient from Joplin said. “That’s what it feels like to me; the way everyone looks after me and makes sure I have what I need. I’ve never been treated this well before.” 40
Lessons Learned Via Christi Hospital-Pittsburg 3 things we did well: 1. Stood up Incident Command 2. Staff worked where needed 3. Planned for physician rotation should the event be on going
Lessons Learned Via Christi Hospital-Pittsburg 3 opportunities for improvement: 1. Failure to use job action sheets. We followed many of the rules of incident command designating and handing off positions. We did not use the job action sheets to double check ourselves that we had everything covered. Use of vests – remind staff to hand off positions.
Lessons Learned Via Christi Hospital-Pittsburg 3 opportunities for improvement: 2. Assessing the location of the current selected triage areas-bottleneck issue, needs to have a specific nurse or doctor assigned to triage only-so not to slow down the process by providing treatment.
Lessons Learned Via Christi Hospital-Pittsburg 3 opportunities for improvement: 3. Identification of volunteers and specific positions by vests – beyond those in the ICS (Incident Command System) vest kit we currently own. Identification of patients using standardized triage tags.
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