Kevin Kikta, an EP on duty during the Joplin tornado, recalls the first harrowing moments, and Michael Lohmeier, an EP from St. Louis, recounts the first hours of Missouri DMAT’s recovery effort.
That’s the only way that I can describe what we saw as I emerged from the room where I had taken shelter during the tornado. Patients were coming into the ED in droves. It was absolute, utter chaos. They were limping, bleeding, crying, terrified, with debris and glass sticking out of them, just thankful to be alive. The floor was covered with about three inches of water and the power outage left the ED eerily dark. The frightening aroma of methane gas leaking from the broken gas lines permeated the air; we knew, but did not dare mention aloud, what that meant. I redoubled my pace.
We had to use flashlights to direct ourselves to the crying and wounded. Where all the flashlights came from I’ll never know. There was no power, but our mental generators, were up and running, and on high test adrenaline. We had no cell phone service in the first hour so we were unable to call for backup.
I remember a patient in his early 20’s gasping for breath, telling me that he was going to die. After a quick exam I removed the large shard of glass from his back and diagnosed his pneumothorax. I gathered supplies from wherever I could locate them to insert a thoracostomy tube. I’ll never forget his courage; he allowed me to do the procedure without any local anesthetic since none could be found. I knew he was running out of time, and it had to be done. Quickly. Imagine my relief when I heard a big rush of air, and breath sounds again.
I immediately moved on to the next patient, an asthmatic in status asthmaticus. We didn’t have the option of trying a nebulizer treatment or steroids, but I was able to get him intubated using a flashlight that I held in my mouth. A small child of approximately 3-4 years of age was crying; he had a large avulsion of skin to his neck and spine. The gaping wound revealed his cervical spine and upper thoracic spine bones. I could actually count his vertebrae with my fingers. This was a child, his whole life ahead of him, suffering life threatening wounds in front of me, his eyes pleading for me to help him. We could not find any pediatric C collars in the darkness and water from the shattered main pipes was once again showering down upon all of us. Fortunately, we were able to get him immobilized with towels and start an IV with fluids and pain meds before shipping him out.
We felt paralyzed and helpless ourselves. There were no specialists available – my orthopedist was trapped in the OR. We were it, and we knew we had to get patients out of the hospital as quickly as possible. As we were shuffling them out, the fire department showed up and helped us to evacuate. Together we worked furiously, motivated by the knowledge and fear that the methane leaks could cause the hospital could blow up at any minute.”
-Kevin Kikta, MD