RSMH response to tornado event relied on earlier disaster training

Cherrystone Family Camping & RV Resort, a 300-acre playground of swimming pools, mini-golf, pier fishing, crabbing and other activities, is located in Northampton County, on the peaceful and historic Eastern Shore of Virginia. The Campground, founded in 1964, is located just 11 miles north of the 17-mile long Chesapeake Bay Bridge Tunnel that separates the Shore from the mainland.

On the morning of Thursday, July 24, 2014, more than 1,300 campers were preparing to enjoy another day in the natural beauty of the campground when the National Weather Service issued a tornado warning for the area at 08:20 valid until 09:00. The tornado had begun in the Chesapeake Bay, a few miles west of the Campground. Described as an EF1 with winds of 86 to 110mph on the Enhanced Fujita Scale, the tornado struck the Campground with devastating force at 08:40, with both tornadic and straight-line wind and hail.  Preliminary reports described multiple trees downed or snapped, with many camping trailers overturned and damaged and several more destroyed.

Seventeen miles away in Nassawadox, Riverside Shore Memorial Hospital, with 60 operational beds and part of the Riverside Health System, had already begun to prepare for possible mass casualties when they heard there was a tornado approaching. As soon as the tornado alert was issued, a Code Purple was called, alerting the Emergency Department and other medical staff to stand ready to receive patients. At the time, no one knew how many patients to expect.

Mark Rath, Riverside's System Director of Emergency Management was at RSMH that morning for a meeting with the Eastern Shore Medical Director. Rath immediately activated an Incident Command Center to coordinate medical staff and supplies, to assess and respond to needs in the Emergency Room and to monitor communications with first responders and EMS in the field.

Response at the hospital was immediate. Within minutes, every local off-duty Emergency Department physician was on site, quickly joined by general surgeons, anesthesiologists, and practitioners of pediatrics, orthopaedics, pulmonology, cardiology, neurology, family medicine, obstetrics and gynecology and ENT. Hospitalists assisted with evaluation, as well as nurses and advance practice providers from the hospital, the physician offices and respondents from home. A psychiatrist with the Eastern Shore Community Services Board and a Chaplain for Hospice came to offer family support and pastoral care to the victims.  Additional medical personnel from RHS Newport News responded quickly to support the Shore team.

The first tornado related patient was triaged at 09:17. In all, 26 patients came through the ER within 90 minutes of the incident, and one later in the afternoon. Of those, the majority suffered lacerations and cuts, and were treated, sutured and released. Three were admitted to RSMH, one required surgery for a hip dislocation and fracture. Two others were observed overnight, one older female with a history of underlying medical problems with elevated cardiac enzymes and a second pediatric patient who required additional imaging after the initial study showed an abnormal lumbar spine;  both were released the next day.

Four patients were transferred to other facilities: one adult, who sustained a lumbar vertebral fracture with encroachment on the spinal canal, was transferred by ground to a Richmond hospital for neurosurgery when wind restrictions prevented helicopter transport to the nearer Level One Trauma Center in Norfolk. Three children were taken to Children's Hospital of the King's Daughters in Norfolk – two were treated at RSMH and then transferred to CHKD to be with other members of their family.

The importance of disaster training cannot be overstated. Riverside Shore Memorial Hospital regularly holds planning exercises for various scenarios. Its last tornado drill was held in February of 2014.

The tornado on Virginia's Eastern Shore on the morning of July 24, 2014, demonstrated the intense and violent power of nature: in addition to the damage and injuries noted, a couple from New Jersey lost their lives when a tree fell on their tent as they tried to escape the storm. Their son survived, but sustained severe injuries.

The July 24th tornado demonstrated something else as well: the ability and commitment of this small community hospital to respond to a disaster of enormous proportion with the same level of skill, expertise and professionalism as is expected of a larger major medical facility. The administrator of RSMH remembers the level of calm in the emergency room, especially during the initial surge of incoming patients. There were no cross words, no egos anywhere apparent, nothing but professional healthcare providers focused on the immediate and urgent goal of assessing the next patient, responding with compassion and a genuine desire to help –to practice medicine at its highest level.

There were many indications that the Eastern Shore community appreciated that Riverside Health System and Riverside Shore Memorial took the time and mandated a disaster preparedness program of preparation, planning and practice that allowed this small community hospital to be ready for this natural disaster and quick response. The realization that this type of disaster can happen at any time to any community without significant warning only reinforces the importance of disaster training and practice.

Published: August 7, 2014



 

Bookmark and Share   E-Mail Page   Printer Friendly Version