Storm-hurt poured into hospital

Patients arrived with broken bones, punctures, collapsed lungs

Journeyman technician Grant Pugh of BBC Electric hangs rope to new poles to guide the stringing of power lines Wednesday in Mayflower where Sunday’s tornado tore out the lines.
Journeyman technician Grant Pugh of BBC Electric hangs rope to new poles to guide the stringing of power lines Wednesday in Mayflower where Sunday’s tornado tore out the lines.

Trucks and sport utility vehicles started carrying in tornado survivors before the ambulances did Sunday night at Conway Regional Medical Center.





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Vehicles “began pulling up with people [lying] on doors, using broken pieces of lumber to splint arms and legs,” said Amanda Irby, director of the hospital’s emergency room. “The first SUV had a half-dozen people, just patients piled on top of each other. We just began unhooking the broken bodies and putting people on stretchers.”

Patients were driven in by neighbors, family members and complete strangers, Irby said.

When asked about a victim, one of the drivers said, “‘I have no idea who she is.I’ve never seen her. I just live down the street, but I came here to help,’” Irby recalled.

Conway is the closest medical facility to Mayflower and Vilonia. Many of the injured Sunday night were taken to the 16-bed emergency room there. In all, the hospital treated more than 120 patients.

Irby was one of hundreds of rescue workers, doctors, nurses, emergency crew members and volunteers who helped treat the injured in the hours after the deadly tornado tore through western Pulaski County, Mayflower and Vilonia.

On Wednesday, hospitals and ambulance services reported that they had treated in total more than 150 storm victims since Sunday evening, including several with severe injuries that required hospitalization.

Also, paramedics, doctors and nurses were on standby in Mayflower and Vilonia to treat any injuries that occurred as people cleaned up debris and dug through the treacherous remains of homes and businesses.

On Wednesday, several doctors credited the Arkansas Trauma System - created in 2009 - as well as the National Weather Service’s early warning for saving lives.

“If you’d have done this same event 10 years ago, I think the death toll, and certainly the number of injuries, would be dramatically higher than it is now,” said Dr. Ron Robertson, director of trauma at the University of Arkansas for Medical Sciences, who has been a trauma surgeon there since 1996.

“As far as scale of what occurred, I think this was as large or larger than any event that we’ve had,” he added.

Robertson and several doctors who cared for patients at UAMS Medical Center - the state’s only Level I trauma center for adults - almost didn’t make it to the hospital because they were nearly caught in the tornado as it crossed Interstate40 near Mayflower. The physicians were returning from teaching trauma care to doctors in Fort Smith.

“We were about the last group that got through before they closed the road,” he said, adding that one doctor was stopped when authorities closed I-40 during the storm, but he arrived later.

Injuries to motorists on I-40 - particularly those to children - were among the most challenging that doctors treated Sunday evening, said Dr. Kristin Lyle, the disaster medical director at Arkansas Children’s Hospital, the state’s only Level I trauma center for children.

Doctors and nurses treated children who had been thrown around in cars and suffered head trauma, as well as internal injuries, she said.

Emergency doctors used the hospital’s bedside ultrasounds to quickly diagnose internal bleeding, Lyle said.

“The fact that this tornado crossed a major interstate added a different layer - putting kids in cars and cars up against tornadoes,” she said.

The doctors also saw “blunt trauma from kids being thrown from the impact of the tornado and penetrating trauma from the debris hitting the kids. A lot of crush injuries and long-bone injuries from the collapse of structures onto kids,” Lyle said.

The hospital, which doubled its number of doctors in the emergency room Sunday evening, treated 19 storm-injured children, ranging from infants to teenagers. Eight of them required surgery, she said. Most of those were between 6 months and 10 years old.

After the storm, the first injured children arrived in private cars. Ambulances followed, including one that carried three injured children and a mother, Lyle said.

In Conway, Irby and her staff worked to open a second emergency room with 15 beds. Within an hour, a third emergency room was opened when it became clear that there weren’t many “walking wounded” - patients with minor injuries. Most of the patients were more seriously hurt, and they overflowed the facility.

Outside the emergency room, staff members set up assessment stations equipped with blankets and water for patients with minor injuries. Private doctors, plastic surgeons, orthopedic specialists and primary-care physicians drove to the hospital to volunteer.

At the height of the chaos, Dr. Josh Post said 64 patients with severe injuries were being treated in hospital rooms.

“Most of our injuries were crush-related, head injuries, internal trauma. We had to put in a whole lot of chest tubes for collapsed lungs. Nearly every patient we had had something broken,” he said, noting that more than half of the injuries were life-threatening.

Many of the injuries were from flying debris that had pierced people or was embedded in them. Those injuries were particularly difficult to treat because of caked-on mud and debris, and the need to be delicate, Irby said.

Paramedics and emergency medical technicians with Metropolitan Emergency Medical Services in Little Rock transported 38 people to hospitals in the hours after the storm. Twenty-one went to Conway, 16 went to Little Rock and one went to a hospital in White County.

MEMS Executive Director Jon Swanson said at least 10 of the injured taken to the Conway hospital were later transported to Little Rock for more extensive care.

The ambulance service began preparing for the storm Friday, putting six additional crews on standby. Swanson also deployed special teams in four-wheel-drive pickups.

“Basically, they’re people with chain saws and chains,and ways to help us clear our own pathways through the downed trees,” Swanson said.

The crews helped about 15 ambulances, as well as 17 others from surrounding communities, reach some of the worst damage. The extra assistance was essential, Swanson said, because Sunday was the first time the ambulance service had to manage disaster scenes in two cities at the same time.

“We were watching the weather very carefully to warn our own crews to get out of its path … and then try to fold in behind it,” Swanson said.

“We were very appreciative of the mutual-aid agencies. They were ready to handle whatever we could throw at them, and they certainly did that and did that well.”

As of Wednesday afternoon, there were eight storm-injured patients still at Conway Regional Medical Center. Seven were listed in fair condition, and one remained in critical condition, spokesman John Patton said.

At St. Vincent Infirmary Medical Center in Little Rock and at its hospital in Sherwood, staff members treated 10 patients from the storm, spokesman Margaret Preston said. As of Wednesday, the hospital was still treating one person in critical condition, she said.

About 23 patients were treated at Baptist Health System’s hospitals in Little Rock and North Little Rock, spokesman Mark Lowman said. Six of those patients were still hospitalized Wednesday, he said.

Lowman said the emergency room was prepared for the influx of patients and was fully staffed with emergency personnel in advance of the storm because of the hospital’s internal alert system.

At UAMS Medical Center in Little Rock, 16 storm victims had been treated as of Wednesday, and more were expected. Doctors and nurses were expecting to see people who had injuries lingering from Sunday evening that haven’t yet been treated or new injuries incurred during storm cleanup.

On Sunday, a team of doctors and nurses was designated for treating storm injuries. Another team took care of patients who were already at the emergency room or needed care unrelated to the storms.

“It worked very well. It was kind of like a chaotic ballet,” said Ron Crane, the emergency-preparedness manager at UAMS.

At Conway, there were a few moments of levity between the hours of what Irby and Post called heartbreaking chaos.

A 7-year-old boy with an obviously broken arm asked staff members to let him go home because “he said he wasn’t hurt that badly,” Irby said, explaining that the boy wanted to look for the family’s missing dog, Hershey.

Another little boy arrived wearing his bicycle helmet, telling nurses his mother had made him wear it.

“He had protested because it’s raining outside and, ‘Mama, we don’t ride bikes inside,’” Irby said.

The helmet was cracked through, and the boy had only minor injuries.

“He told staff the wind had picked him up, and when he woke up, he was in a part of the house he had never seen before,” Irby said. “His mama kept saying, ‘You’ve seen it before, just not like that, baby.’ He had all of us smiling.”

Sometimes entire families staggered in through the hospital’s doors. Irby said about five staff members were dedicated Sunday night to getting updates to families separated at different hospitals.

“We had a brave little soldier who was 9. He came in by himself, and he knew his name and birthday,” Irby said. “After about an hour, his grandpa got here. He was hurt pretty badly, as well. His parents and then his sister came in later, and his grandma came in with just a few scratches.”

The family members were split up at different hospitals.The little boy was transferred to Children’s Hospital, but before he left, he spent time telling his grandpa that things would be OK.

“The most tragic situation we saw was a mom and a dad in the emergency room who had lost their two sons,” Irby said, trying to keep her voice from cracking.

She said both parents had serious injuries and were sent to different hospitals.

“That was a broken family, and all you can do is treat their wounds … you wish there was more.”

Front Section, Pages 1 on 05/01/2014

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