When St. John's Regional Medical Center in Joplin, Missouri, took a direct hit by an F-5 tornado on May 23, staff and EMS crews quickly evacuated patients from the twisted, mangled structure. In 90 minutes, they had evacuated 183 patients from their debris-strewn rooms. Another 30 waiting for care in the emergency department also were assisted in leaving the building.
Patients were hauled in the backs of pickup trucks, as well as ambulances, and were taken to a number of facilities, including the city's other Level II trauma center, part of the Freeman Health System, and hospitals in other regions.
"Sadly, five patients in the ICU, located on one of the top floors of the hospital, and one visitor were killed," says Dr. Sean Smith, an emergency physician at St. John's and the county's EMS medical director. Smith credits local EMS crews and hospital staff for the quick and efficient evacuation that Sunday evening.
"They (hospital personnel) had 9-12 minutes' notice (that a tornado was possible)," he says. "They did what they could to move patients out of their rooms, away from windows, but there was so little time."
Medical records and equipment were sucked up by the tornado and deposited throughout a wide area around Joplin. Hospital officials sent messages via the local media on how to return documents.
Smith said when you see the amount of destruction, it's amazing how many patients, staff and visitors survived. Windows were shattered, medical equipment and devices were destroyed, water poured from broken pipes, patients' beds were tossed around. The power was out, and the backup generator failed due to the horrific conditions.
Smith was in a storm room in his house with his wife and sons when he received a text about the hospital taking the hit. "I sent some texts to others, but knew everyone would be heading in," he says.
Debris blocked streets and roads, and the usual 22-minute trip took Smith more than 90 minutes.
"I had to walk for the last mile," he says, "and I wasn't the only one who abandoned their car."
Smith said he can't say enough about the EMS crews from Jasper and Newton counties. "Our EMS crews here are superb and work together all the time.They have the same protocols. They work as a team every day, not just on big incidents. There aren't any territorial issues between them."
Mutual aid companies throughout the region also sent crews to assist; however, getting to the hospital wasn't easy for them either because of the roads.
Personnel knew Freeman Health would be overwhelmed with the influx of transfers and people injured by the tornado, so they headed to a nearby civic center two blocks away to set up a makeshift clinic.
"Our staff scavenged anything they could that was still OK and ran up the street to Memorial Hall," says Smith. "They were incredible. We treated more than 125 patients there. We had a cardiac arrest and a number of other priority 1 patients, as well as people with head and chest injuries. Some needed to be intubated."
One helicopter based at St. John's was destroyed. The other, based abut 30-40 miles away, was OK. Medical personnel also set up temporary clinics in other areas in Joplin.
Smith, a former paramedic in Oklahoma, says he still can't get over the amount of destruction. "I've seen tornadoes and their aftermaths before, but nothing compares to what happened here. It looks like a nuclear bomb went off. It tore bark off trees. You can't tell the make or models of some vehicles because they're that smashed. It pulled asphalt out of the road."
It wasn't the first twister to hit the area. On Mother's Day four years ago, a tornado killed 27 and left more than 200 injured. And another about eight years ago hit the northern part of town. "Little did we know that one would be a dress rehearsal for the big one," Smith says.
He spoke of his pride and admiration for Joplin's entire medical community who pitched in that day. "St. John's is blessed," he says.