HAP Blog

Tornadoes and The Terrifying, Teachable Moments for Hospital Emergency Managers

Past storms provide invaluable lessons for EM teams

May 30, 2024

On May 8, an EF-2 tornado ripped a path through a residential area in southern Michigan.

On May 9, nine tornados rated EF-2 and EF-3 cut through portions of Tennessee caused at least three deaths and major damage to structures.

On May 10, a line of storms with at least three tornados moved across Tallahassee, Florida, cutting power to more than 66,000 residents.

And, during a four-day stretch during April, 130 tornados were confirmed or spotted across the Great Plains, the Midwest, and portions of the Southwest.

I’m sure you’re noticing the trend. If you work as an emergency manager in a health care facility—wherever you are—you need to be ready to respond to tornadoes and other severe weather threats. Here’s a look at how health care teams have risen to the challenge, their harrowing stories, and what you can learn from their response.

A threat everywhere

We think of places within Tornado Alley like Texas, Oklahoma, and Kansas as the top areas of concern. Yet, during 2023, Illinois saw the most tornados with 136. Alabama followed up with 101. Ohio broke into the top 10 with a recording of 53. Average yearly counts for Pennsylvania (18), Michigan (15), New York (9), Maryland (9), and West Virginia (3) show there’s a diminished risk but certainly a lingering threat.

During April, an EF-4 cut through Marietta, Oklahoma, near the Texas border. In its path was a small community hospital, Mercy Health Love County.

Moments before the storm’s 11:12 p.m. impact, staff acted quickly following weather notifications, moving patients to designated safe areas. Staff were trained and prepared. There were no fatalities or injuries, even though the hospital “sustained significant damage, rendering the building unsuitable for patient care.” After a long night, when the sun rose, the facility transferred its patients to other hospitals. Then, they turned their focus toward recovery.

This situation isn’t all that uncommon. Acute care, post-acute care facilities, and post-acute care services like rehabilitation, dialysis centers, and pharmacies are vulnerable to these events—and we must learn from their experiences.

Sobering storm

On May 22, 2011, an EF-5 struck Joplin, Missouri. Mercy St. John’s Hospital took a direct hit to the point that the “building shifted off its foundation.”

A hospital report detailing the incident has sobering details: Gas lines were blown and sewer lines were destroyed, resulting in raw sewage seeping into the facility. Doors ripped from hinges; windows blew out; glass shattered; liquid oxygen discharged from a damaged tank; and water from the fire suppression system flooded the halls.

The impact was so severe that the structure was no longer safe. “Everyone in the facility thought they were going to die,” the report notes.  With no other options, the facility had to be abandoned and patients evacuated.

Lessons from history

The report is a must-read for health care leaders and emergency managers.

It highlights the immediate response, evacuation, special considerations, recovery, lessons learned, and much more. Joplin lost more than 160 lives, and 1,300 more were injured. Thousands of homes were destroyed. Apartment complexes were left uninhabitable. And business and large retail stores were devasted and shuttered.

The storm’s destruction made continuity of care and operations nearly impossible. As the damage was assessed, complex challenges appeared over and over throughout the following hours, days, and weeks. Faced with the daunting mission of mending the community’s health care system, health care providers and community partners overcame the most devasting and unimaginable event.

Doing the “impossible”

Just a few short miles from Mercy, Freeman Health System also was affected, but in different ways.

Damaged but operational, Freeman staff and providers—unaware of the storm’s magnitude and the evacuation of Mercy St. Johns—assessed their own environment as victims began to arrive. Critical needs mounted. There was a high demand but a huge lack of communications, supplies, and ventilators. Low water pressure and the limited potable water hampered efforts. Fuel for generators and morgue space became a greater necessity.

Within the first two hours, about 180 patients presented to Freeman’s ER with penetrating wounds, amputations, and other traumas. Because of the storm’s Sunday evening arrival, surgical and OR staff were not in the building. Navigating the roadways provided many obstacles. A normal two-minute drive into work for one physician became a difficult 20-minute journey.

Miraculously, as the four-hour mark after impact approached, surgical suites were at 100 percent capacity and fully staffed. Twelve hours after impact, about 1,000 patients had presented to the hospital and were triaged.

Communication issues remained. Radiology had limited operability, and the portable units needed recharged. Water pressure was still a concern. Yet, the labor pool was established, and volunteer registration was well underway.

During the storm, post-acute care services and facilities also were affected. Retail stores and businesses that usually supported incidents with just-in-time supplies were offline. Tragically, sixteen residents from Greenbriar Nursing Home were either killed or lost due to fatal injuries. Pharmacies were destroyed. Infrastructure—power, gas, water, roadways, food and grocery, home improvement stores—all shattered. The people of Joplin, while challenged and taxed, overcame and rebuilt.

“Trust your staff, have confidence in them. An emergency operations plan cannot possibly include every contingency for a disaster,” said Jeff Carrier, Chief Clinical Officer, Freeman Health System, in a report. “Your staff, if trained, will be calm and will create solutions on the fly. They will do what is humanly impossible, and they will do it with compassion.”

Strength in teams

A few years ago, staff members at Rolling Fields Elder Care in Northwest Pennsylvania went through a similar response as an EF-2 tornado approached.

Staff pulled curtains closed in hopes of containing breaking glass from windows. Everyone huddled in the hallways as the violent and loud storm struck.

Nurses and aides sang songs to help maintain calm. Doors slammed open and shut again. Glass broke. Portions of the roof were missing. Then, there was the strong smell of natural gas that burned the back of throats.

After the storm passed, 160 residents relocated to a local school gymnasium, which served as temporary shelter until more adequate placement could be arranged. Twenty-one of the residents with memory challenges posed the greatest risk and concern. Eight children from the onsite daycare were another worry, yet staff managed to keep everyone safe. Volunteers arrived.

A local landscaping company, equipped with chainsaws, cut limbs and debris; they made roadways passable. They unloaded the lawnmowers and other equipment from their trailers and trucks and reloaded them with med carts, linen carts, beds, nightstands, chairs, and so much more. The challenge of relocating the residents took hours, but there were minimal injuries and no loss of life.

The destruction and disruption of these severe weather events can be massive. The stories and accounts can be gut-wrenching and harrowing, but they offer important lessons.

Health care providers—while shaken and bruised—find solutions amid colossal devastation. They dust themselves off, push aside the debris, tend to the injured, and rebuild. They are the hardiest of the hardy. Trust your staff. That might be the greatest lesson learned.


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