The document describes a storm chasing physician's first-hand account of responding to the deadly EF5 tornado that hit Joplin, Missouri on May 22, 2011, which killed over 150 people, including at local hospitals, provides safety tips for storm chasing and responding to disasters, and discusses the physical and mental health challenges faced in the aftermath.

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
http://stormdoctor.com/
Acknowledgements
• The People and the City of Joplin
• Tim Vasquez
• The Chasing Community
• Robert Balogh, MD, and Bill Hark, MD
• My Family

2. About Me

3. StormDoctor.com
904-343-4325
Free Service
Confidential
Always Available
In-Season Available
in the Field

4. Storm Chasing
Storm Chasing

5. Updraft
Clear Slot
Rain-Wrapped Wall Cloud
Vault
RFD
Condensation Funnel
Horizontal Swirl
Debris Cloud
FFD
Inflow Jet
Cow
“Suck Zone”
Tornado
Near Republic Cty, KS, 5/24/04. Photo by Jason Persoff, M.D.
Sometimes It’s Hard To Know

8. 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

9. 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.”

11. 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

12. May 22, 2011
May 22, 2011
• The tornado intensifies, bearing down on St. Johns Hospital

13. May 22, 2011
May 22, 2011

14. 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

15. St. Johns Hospital
Photos copyright Google
and Michael Schiefenbaum
St. Johns Hospital

16. 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

17. 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

18. 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?

19. 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?

20. 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)

21. 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

22. Recommended Equipment
• Personal Protection • Trauma Bag
– Gloves (box) – Emergency Medical
– Gowns Products
– Face masks http://www.buyemp.com/
– 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

23. 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