By BETSY TAYLOR
As families sorted through the ruins of their homes and volunteers assisted with clean up the day after a deadly, 1.3 mile wide tornado hit Moore, Okla., killing 24, Mercy Hospital Oklahoma City set up a medical tent at the edge of a large debris field.
Over the next days, doctors and nurses treated patients with injuries such as lacerations caused as they picked through storm rubble and skin irritations caused by fiberglass insulation scattered by the EF5 tornado that struck the Oklahoma City suburb the afternoon of May 20.
Mercy clinicians working out of the tent treated asthma patients and dispensed insulin and blood pressure medications to get storm victims through the first few days of the recovery efforts. "We went through about 45 tetanus shots in about five minutes this morning," Dr. Dustan Buckley said on the second day of the medical tent's operation. "We've ordered 600 more."
Buckley is chief of staff at Mercy Hospital Oklahoma City, part of the Chesterfield, Mo.–
based Mercy network. She said she was gratified to be able to provide some comfort and care to tornado victims. "I hope if it were my family, someone would be there to help as well," she said.
St. Anthony Hospital, which is part of St. Louis-based SSM Health Care, initially treated 36 patients with tornado-related injuries, including 14 children, at its three Oklahoma City emergency rooms located at its main campus, Healthplex East and Healthplex South locations.
Marti Jourden, St. Anthony vice president of performance improvement, served as incident commander during the tornado preparation and its aftermath. Severe weather had been forecast in the area, and Jourden said that when the National Weather Service issued a tornado watch for the county and surrounding areas, the hospital issued a "code black watch" over the hospital's announcement system, letting staff know of the potential for a tornado.
"Some of the things we do to get ready are to identify which patients could be discharged, what staff are here, what vacant beds we have," she said. The hospital didn't need to discharge patients, and while it might free up beds if they were needed, it wouldn't discharge patients into severe weather, she explained. Dr. Chad Borin, medical director of the emergency department, was given a walkie-talkie in case he needed to quickly communicate with a triage nurse, though it ultimately wasn't needed, Jourden said.
St. Anthony President Michael Beaver said that, before the tornado hit, off-duty staff contacted the hospital to see if their help was needed. Others stayed past their shifts. "We had probably 50 people in the emergency department, ready. Doctors staying late, just lingering, waiting to help."
St. Anthony was ready for patients when the tornado struck Moore, about 3:20 p.m. Jourden said as incident commander she coordinated with the hospital's telecommunications staff to issue a text message to more than 75 people at the hospital, letting them know a tornado had touched down in the area. Among the patients seeking treatment were a person with a skull fracture; another patient had a pulmonary injury. Many people had cuts and bruises from debris. Emergency room staff triaged patients at the hospital, using color-coded tags to indicate the severity of injury. None of those treated at St. Anthony were critical, they said. Jourden said the hospital also gathered the names of patients brought in, and coordinated with the area's Medical Emergency Response Center to reunite injured children with their parents.
St. Anthony did not admit any storm victims overnight. It did transfer three children to other hospitals.
Two employees, one at St. Anthony Oklahoma City and one at St. Anthony Shawnee, had family members who died of storm-related causes. Beaver said, "Some of the staff that were here, who were working past the end of their shifts, were people who were pretty sure their own homes had been damaged, just because of the neighborhoods they live in. And they were willing to stick around and help the hospital and help our patients in any way they could."
Twenty employees of St. Anthony Hospital lost their homes with another 18 suffering severe damage to their residences.
Mercy Oklahoma reported 25 employees significantly impacted by the tornadoes, with a few experiencing the death of a family member, as well as those whose homes were destroyed or damaged.
The day before the tornado struck Moore, another twister touched down nearby in Edmond, Okla., damaging an $88 million Mercy outpatient medical complex under construction. The two employees who generally staff a fitness center in the complex, located about 14 miles north of Oklahoma City, were not on site; and the complex was otherwise vacant. "The roof was peeled back, and there were about 40 broken windows," said Mercy Oklahoma spokeswoman Rachel Wright. Mercy now estimates that repairing the storm damage will delay the opening of the complex by six months.
Wright, speaking from the medical tent in Moore, said she was inspired to see people coming together to help in the storm's aftermath. "It is so uplifting to be out here. Everyone is just wrapping their arms around each other. It's obviously a tragedy but people are pulling together and getting it done."
Mercy builds storm-hardened replacement hospital in Joplin, Mo.
Two years after a devastating tornado tore through Joplin, Mo., killing 161 people, including five patients and a visitor at St. John's Regional Medical Center, Mercy is building a "storm-hardened" permanent replacement hospital. The building plan incorporates design elements and strengthened construction materials to protect patients, staff and the facility in severe weather, including the strongest twisters.
St. John's took a direct hit from the EF5 tornado. Window glass rained down in patient rooms, part of the roof peeled away, pipes burst and the emergency generator was sucked loose from its moorings, casting the hospital staff, visitors and 188 patients into darkness. The experience cemented a commitment at Mercy to investigate what materials held up well and what more could be done to build hospitals that can continue to operate in a time of natural disaster, explained John Farnen, executive director of strategic projects at Mercy.
The $450 million Mercy Hospital Joplin is being built with a precast concrete exterior, which Mercy officials said will provide a building shell tougher than the brick, metal or plastered walls of many commercial buildings. Every floor of the 200-bed hospital will include a hallway with reinforced walls, and ceilings with tiles and lights secured as they would be in an earthquake zone. Heavy storm doors with hardware that penetrates into the cement above will secure these safe zones. Passenger elevators will reach the basement, where wide corridors will allow people to shelter during severe weather. And after seeing how much glass blew out and in at St. John's in 2011, hospital planners worked directly with consultants and a vendor to develop specialty window systems, with glass and frames designed to withstand winds up to 250 miles per hour.
"We've had a lot of smart people working on coming up with tornado resistant design," said Farnen. After the 2011 tornado, he said there was as much damage to the inside of the building as there was on the outside. Engineers on-site learned from the disaster as they saw what materials held together, like the strengthened glass located in the behavioral health unit, where it had been installed to keep patients from hurting themselves or others.
Due to open in March of 2015, the permanent replacement hospital will have three types of windows. In areas like lobbies where it's anticipated people will be able to move to more protected areas, windows will be installed with a rating to withstand 110 mile per hour winds. Patient rooms will have laminated glass designed to withstand 140 mile per hour winds. The strongest windows, in intensive care units, have passed tests where 15-pound, two- by-four boards are shot at them at 100 miles per hour, which is the speed debris is typically flying at in a tornado with 250 mile per hour winds, according to Mercy officials. Farnen said the windows must hold up even when battered twice, and the windows in their frames have been tested to make sure they flex properly when the air pressure shifts suddenly, as it does during a tornado.
Mercy, which has 32 hospitals and 300 outpatient facilities, said in a statement that it has added strengthened windows to other buildings under construction, including an orthopedic hospital in Springfield, Mo., and a rehabilitation hospital in Oklahoma City.
At the new Joplin hospital campus, a storm-hardened utilities building will be built with half its exterior walls buried below grade. Utility lines will run through a reinforced underground tunnel. Two lines for power, water and data communications will be installed and enter the hospital from different directions, with the plan being that even if some utilities are knocked out, operations could be shifted to parts of the hospital that retained them.
Hallways and stairwells will have battery-operated safety lights. Ventilators and neonatal intensive care unit bassinets will have backup battery systems, with up to two hours of power. Flashlights, batteries, first aid kits, even gloves, shovels and crowbars, in case they're needed to clear debris from hallways, will be stored throughout the hospital, according to Mercy.
Mercy cannot outsmart Mother Nature, Farnen said, but in the event of severe weather, "Certainly we feel we should be able to ride it out and hopefully be a place where people can come for shelter, or can come after an event like that, and we can take care of them." He said many of the new features will make the hospital safer in the event of an earthquake. He said the storm safety features, including the wind-resistant windows and storm-hardened utility plant, account for about $8 to $10 million of the hospital's overall cost.
— Betsy Taylor
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