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Emergency Preparedness Parts 1 & 2 - Joplin - Persoff


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Emergency Preparedness Parts 1 & 2 - Joplin - Persoff

  1. 1. First Response Mode A Storm Chasing Physician’s First Person Account of the Deadliest Tornado in US History: May 22, 2011 Jason Persoff, M.D., S.F.H.M. Assistant Professor of Internal Medicine University of Colorado School of Medicine Acknowledgements• The People and the City of Joplin• Tim Vasquez• The Chasing Community• Robert Balogh, MD, and Bill Hark, MD• My Family
  2. 2. About Me
  3. 3. 904-343-4325 Free Service Confidential Always AvailableIn-Season Available in the Field
  4. 4. Storm ChasingStorm Chasing
  5. 5. UpdraftClear Slot Rain-Wrapped Wall Cloud Vault RFD Condensation Funnel Horizontal Swirl Debris Cloud FFDInflow Jet Cow “Suck Zone” Tornado Near Republic Cty, KS, 5/24/04. Photo by Jason Persoff, M.D. Sometimes It’s Hard To Know
  6. 6. May 21, 2011• 18z NAM – Surface—intense 990mb low in South Dakota with long draping cold front – Intense pooling moisture along the front in SE KS with associated CAPE >5000 J/kg – Left exit region at 250mb over KS/MS/OK areas – Target: Coffeyville, KS
  7. 7. May 22, 2011 May 22, 2011• 12z RUC – Suggests mesolow formation over SE KS by 21z – Very large dewpoint depressions throughout the region (80s/60s), but with forecast increase in dewpoints in advance of front• 21z Analysis – Prominent intersects the cold front (draped ENE to WSW)• “This storm will do amazing things.”
  8. 8. May 22, 2011• 1:30pm--NWS issues Tornado Watch 325 May 22, 2011• 5:17pm a Tornado Warning is issued for Joplin• 5:41pm the first tornado touches down
  9. 9. May 22, 2011 May 22, 2011• The tornado intensifies, bearing down on St. Johns Hospital
  10. 10. May 22, 2011May 22, 2011
  11. 11. May 22, 2011• St. Johns Hospital emergency response for MCI – “Anticipate Condition Gray” (organize for MCI) – “Execute Condition Gray” (MCI imminent, patient safety)• Shortly before 6:00pm, the tornado intensifies to EF5 strength – Staff busy at St. John’s moving patients to hallways – Five patients and one visitor killed when tornado hits• St. John’s became a wind tunnel – Similar to Ft. Worth tornado in 2007 St. Johns Hospital
  12. 12. St. Johns Hospital Photos copyright Googleand Michael Schiefenbaum St. Johns Hospital
  13. 13. St. John’s Hospital May 22, 2011• All MCI drills in Joplin involved mutual aid of 2 hospitals• Cell service, phone service, and power all down• St. Johns issues SOS and all call for mutual aid• Several fire stations and ambulances hit by tornado
  14. 14. May 22, 2011 May 22, 2011• Staggering immediate death toll – 162 dead • Deaths in healthcare facilities unprecedented: – 21 killed at Greenbriar Nursing Home – 15 killed at St. Johns Hospital – 2 killed at Meadows Healthcare Facility • 1 officer killed in line of duty • 23 killed outside – Source: NIST• Staggering immediate injuries – >1500 injured, trapped, or dying
  15. 15. Are You Ready?• IMPACT…THIS IS A LIFE THREATENING SITUATION. YOU COULD BE KILLED IF NOT UNDERGROUND OR IN A TORNADO SHELTER. COMPLETE DESTRUCTION OF ENTIRE NEIGHBORHOODS IS LIKELY. MANY WELL BUILT HOMES AND BUSINESSES WILL BE COMPLETELY SWEPT FROM THEIR FOUNDATIONS. DEBRIS WILL BLOCK MOST ROADWAYS. MASS DEVASTATION IS HIGHLY LIKELY MAKING THE AREA UNRECOGNIZABLE TO SURVIVORS First Response Mode• Storm Chasing: A Hard Duality – Desire to see intense, rare atmospheric phenomena – These phenomena must occur somewhere – Disproportionate representation of populated areas due to road/infrastructure – What exactly is a chaser’s role?
  16. 16. First Response Mode• First rule: your safety is paramount – Driving is the single most dangerous activity chasers engage in • ~1.8 deaths/million miles driven—US DOT • Average storm chasing year ~2,000-5,000 miles • Livestock, deer • Water on roadway, hydroplaning – Multitasking increases risks of car accident – Glare from electronics obfuscates view – Hail fog Are You Ready? • Are you dressed for being outside? • What equipment do you have? • What communications do you have available? • Who do you treat and where do you start?
  17. 17. First Response Mode• Don’t just do something, stand there! – Pull over—stop driving • Stop your car • Stop filming (you can resume it later) • Stop your chase – Capture GPS location, know where you are before you call – Call 9-1-1, then attend to victims• Every person can save lives First Response Mode Take Command Assess Impact ONE PERSON ONE SUPERVISOR Triage Area Surveyor (Team) Responder (Team)
  18. 18. First Response Mode• DO NOT: – …Send rescuers in solo—always in groups – …Use chainsaws or other electric gear unless you have experience with rescues • Gas leaks are common and potentially can ignite – …Attempt to enter debris-filled structures or move debris without safety equipment • Utility gloves, masks, goggles – …Leave the area until relieved of command • Once relieved, define your role and check in First Response Mode• DO: – …Take down all names of rescuers and where they are going (check-ins) – …Map the area and what you know about it – …Perform basic first aid in the triage area • Splinting, bandaging, but limit CPR in MCIs – …Have rescuers use spray paint to mark areas where imminent rescue is needed – …Know your limits – …Know who’s doing what – …Stay put—don’t move unless necessary
  19. 19. Recommended Equipment• Personal Protection • Trauma Bag – Gloves (box) – Emergency Medical – Gowns Products – Face masks – Sharps • Communications• Utility Gloves – Amateur radio• Ropes • Waterproof Paper /• Axe Marking Pens• Blankets • FOOD, MEDICATIONS, and WATER for you for• Spray Paint 2+ days• Torches / Flares • Bug Spray• Rescue Knife • Regular (Non GPS) Maps Recommended Safety• Hunt in packs• Hunt where you know the terrain• Don’t hunt at night• Wear seatbelts• Live life outside your viewfinder—pay attention• Have a back-up plan for communication failure• Prepare to be isolated
  20. 20. Ready.Gov Post-Trauma• No rest for the weary – Stress cardiac syndromes (Tako Tsubo, “Broken Heart”) – Medication shortages – Severe wound infections (days) – Atypical aerosolized wounds / inhalation injury (mucormycoses)• Posttraumatic Stress – Let’s talk