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At least 19 recordsLinked to original sources

Tornado injuries related to housing in the Plainfield tornado.

BACKGROUND: On 28 August 1990, a tornado in Will County, Illinois, caused 29 deaths and more than US $200 million in damage. Risk factors for impact-related morbidity and mortality were studied. METHODS: A case-control study was conducted of 26 people hospitalized or killed, and 116 injured, randomly selected people who were in houses damaged by the tornado. To obtain information on study subjects, telephone interviews were conducted, and hospital records, coroners' reports, and American Red Cross records were abstracted. Structural details on houses were collected from tax assessor records. RESULTS: Cases were more likely than controls to have been in multistorey houses than in single-storey houses (OR = 3.9; 95% CI: 1.2-13.2). The risk associated with houses built after 1972 (OR = 7.9) and those built from 1962 to 1972 (OR = 2.2) was greater than for those built before 1962 (OR = 1.0; chi 2 for trend = 12.1; P < 0.01). Being in the basement when the tornado hit was protective (OR = 0.1; 95% CI: 0.0-0.4). CONCLUSIONS: One-storey houses were safer than multistorey houses, and basements were safer than other rooms. The association of risk with the construction date of the house is a new finding and should be examined in further studies.

Adult↗

Risk of tornado-related death and injury in Oklahoma, May 3, 1999.

On May 3, 1999, powerful tornadoes, including a category F5 tornado, swept through Oklahoma. The authors examined all tornado-related deaths, hospital admissions, and emergency department visits to identify important risk factors. Data on deaths and injuries directly related to the tornadoes and information obtained from a survey of residents in the damage path of the F5 tornado were used in a case-control analysis. The direct force of the tornadoes caused 40 deaths, 133 hospital admissions, and 265 emergency department outpatient visits. The risk of death from the F5 tornado was greater for persons who were in mobile homes (odds ratio (OR) = 35.3, 95% confidence interval (CI): 7.8, 175.6) or outdoors (OR = 141.2, 95% CI: 15.9, 6,379.8) when the tornado struck than for those in permanently anchored houses. Risk of severe injury was also greater for persons in mobile homes (OR = 11.8, 95% CI: 3.4, 51.7) or outdoors (OR = 34.3, 95% CI: 4.4, 1,526.2). However, the risk of death (OR = 0.0, 95% CI: 0.0, 9.9), severe injury (OR = 0.0, 95% CI: 0.0, 2.0), or minor injury (OR = 0.8, 95% CI: 0.1, 3.1) was not greater among persons in motor vehicles than among those in houses. The risk of death (OR = 0.6, 95% CI: 0.1, 1.7), severe injury (OR = 0.2, 95% CI: 0.1, 0.6), or minor injury (OR = 0.3, 95% CI: 0.2, 0.7) was lower among those fleeing their homes in motor vehicles than among those remaining. Recommendations involving the relative safety of motor vehicles during a tornado should be evaluated using experience from recent tornado events.

Adolescent↗

Get off the bus: sound strategy for injury prevention during a tornado?

INTRODUCTION: On 08 May 2003, a tornado categorized as an F-3 on the Fujita Tornado Scale (the "F Scale") struck an Oklahoma City, Oklahoma commuter bus carrying 24 passengers. The driver evacuated several passengers before the tornado struck. The tornado rolled the bus, and pelted it with debris. METHODS: A case-series investigation of tornado-related injuries was conducted among passengers who were evacuated to a ditch and those who remained on the bus when the tornado struck. RESULTS: Nineteen of 24 passengers sought care for injuries at hospital emergency departments (injury rate = 79.2%). While a greater number of passengers who were outside the bus when the tornado struck (11) sought care for injuries than did those who remained on the bus (8); passengers outside of the bus suffered fewer injuries than did those who remained on the bus (median number of injuries 3 versus 4), and their injuries were less severe (median injury severity score (ISS) 1 versus 4). CONCLUSION: For persons caught in motor vehicles during tornado events, this study supports currently accepted recommendations to immediately evacuate and lie in a low-lying area away from motor vehicles if other shelter is unavailable. However, generalizing the experience of bus passengers to automobile drivers might be inappropriate because buses lack the safety features that might protect automobile drivers from tornado-related injuries.

Adolescent↗

Predictors for people's response to a tornado warning: Arkansas, 1 March 1997.

On 1 March 1997, powerful tornadoes touched down in Arkansas (USA) on a Saturday afternoon. Twenty-six fatalities and 400 non-fatal injuries were reported. We performed a population-based cross-sectional study to determine factors associated with appropriate responses to tornado warnings. Of 146 survey participants, 140 (96 per cent) knew the difference between 'tornado watch' and 'tornado warning' and were aware of when the warning was announced. Of those 140 participants, 64 (45.7 per cent) responded to the warning by seeking shelter, and 58 (90.6 per cent) of those 64 acted within five minutes of hearing the warning. Four factors were positively associated with those seeking shelter: having graduated from high school (OR = 4.2, 95 per cent CI = 1.1-15.5); having a basement in one's house (OR = 3.8, 95 per cent exact CI = 1.1-17.1); hearing a siren (OR = 4.4, 95 per cent CI = 1.3-18.9); and having prepared a household plan of response when tornadoes occur (OR = 2.6, 95 per cent CI = 1.1-6.3). On the basis of these findings, we recommend: first, that people who live in tornadoprone areas have a personal plan of action to help them respond immediately to warnings; second, public-health education officials in areas with frequent tornadic activity should do more to educate the public about what they can do to protect themselves from a tornado; and third, that emergency-management officials planning protection measures for vulnerable communities should consider that most people have limited time (our study documented five minutes) in which to respond to a tornado warning. Thus, shelters in tornado-prone areas should be quickly accessible by residents.

Arkansas↗

Direct estimation of the cost effectiveness of tornado shelters.

This article estimates the cost effectiveness of tornado shelters using the annual probability of a tornado and new data on fatalities per building struck by a tornado. This approach differs from recent estimates of the cost effectiveness of tornado shelters in Reference 1 that use historical casualties. Historical casualties combine both tornado risk and resident action. If residents of tornado-prone states take greater precautions, observed fatalities might not be much higher than in states with lower risk. Estimation using the tornado probability avoids this potential bias. Despite the very different method used, the estimates are 68 million US dollars in permanent homes and 6.0 million US dollars in mobile homes in Oklahoma using a 3% real discount rate, within about 10% of estimates based on historical fatalities. The findings suggest that shelters provide cost-effective protection for mobile homes in the most tornado-prone states but not for permanent homes.

Journal Article↗

Human holistic and energetic responses following a tornado.

After an F-4 tornado destroyed a large section of our town, I gave 50 complementary energy treatments to tornado victims. I discovered that the same energetic, physical, emotional, mental, and spiritual disruption occurred in people directly and indirectly exposed to the tornado, and that the damage did not repair spontaneously over time. This article describes the energetic damage people sustained from the tornado and their physical, mental, emotional, and spiritual responses. It also describes the energetic treatment that effectively eliminated the trauma, returning the tornado victim to a stable state. The article concludes with clinical and research implications and relates the treatment of the tornado victims to holistic nursing. The treatment holds promise for victims of posttraumatic stress disorder.

Anecdotes as Topic↗

Disaster planning: meeting the challenge of 'killer' tornadoes.

In many areas of the country, tornadoes represent a major concern for hospitals in preparing disaster plans. Like all such plans, the hope is that they will not have to be put to use. But last spring, in areas of Arkansas and Texas, damage and casualties from twisters made national headlines and put the disaster plans of a number of hospitals to the test. For example, as part of the country's worst tornado outbreak since March 1994, twisters that tore through Arkansas from southwest to northeast on the afternoon of Saturday, March 1, killed 25 and injured hundreds. The tornadoes left a path of damaged buildings and downed trees more than 200 miles long. Three persons died in the Little Rock suburb of College Station. Warning sirens and TV and radio broadcasts a few minutes before the tornadoes hit were able to give area residents time to take cover, reducing the number of casualties. On May 27, tornadoes that hit three central Texas counties killed 32 people and left hundreds homeless. The small town of Jarrell was flattened by winds of up to 270 mph. In Cedar Park, about 20 miles south of Jarrell, a grocery store was demolished and a nearby shopping center had roofs torn off. Fortunately, there were relatively few injuries. In the area immediately around Jarrell, hospitals reported 33 casualties treated. The small number of injuries may have been the result of a large number of deaths, one official speculated. In this report, we'll give details on how nine hospitals in the affected areas dealt with tornado emergencies and how their disaster plans were carried out.

Arkansas↗

Comparing reactions to two severe tornadoes in one Oklahoma community.

The authors compared the effect of the 3 May 1999 F5 and 8 May 2003 F3 tornadoes on the community of Moore, Oklahoma, by canvassing damaged areas after both tornadoes and surveying residents. Significantly more 1999 than 2003 residents reported property damage and injuries. Television and tornado sirens were the most common warnings each year, however, more 1999 residents received and responded to television warnings. Importantly, storm shelters were used more frequently in 2003. Fifty-one per cent of residents who experienced both tornadoes took the same amount of protective action in 2003 as they had in 1999; 22% took less; and 27% took more. Residents who took less action said that the reason for doing so was inadequate warning and shelter. First-hand experience of tornadoes prompts people to heed warnings when adequate notification is received and to take effective protective action when adequate shelter is available.

Disaster Planning↗

Risk factors for death in the 27 March 1994 Georgia and Alabama tornadoes.

Field surveys were made one week after tornadoes killed 40 persons and injured over 300 in rural regions of Alabama and Georgia, USA, on 27 March 1994. Surveys were completed for samples of 20 persons who were killed and 31 persons who were in the paths of the tornadoes but survived to determine whether there were differences in personal characteristics, behavior or location between the two groups. Persons who died were significantly older than persons who survived, more likely to be in mobile homes or in rooms above ground with windows, less likely to be watching television before the tornado, and were aware of the approaching tornado for less time than survivors. There was no difference in gender, race, marital status, education, disability or previous experience with tornadoes between those who died and survivors.

Adult↗

The human ecology of tornadoes.

This paper offers an empirical test of the impact of human ecological patterns and other known correlates on tornado occurrence. It uses the National Severe Storms Forecast Center's information on tornadoes from 1950 through 1990 and employs ecological data from the U.S. Bureau of the Census and the Environmental Protection Agency. The results show that metropolitan and other urban counties have higher odds of tornado occurrence than rural counties, and that the probability of occurrence of tornadoes increases with increases in the number of previous tornadoes. The paper assesses the meaning of this finding for demographers, atmospheric scientists, engineers, and disaster managers.

Disasters↗

Tornado-associated fatalities--Arkansas, 1997.

On March 1, 1997, approximately nine tornadoes originating from two separate thunderstorms swept across Arkansas, from Hempstead County in the southwest to Clay County in the northeast (approximately 260 miles). The tornadoes caused 26 deaths and an estimated $115 million in property damage, reflecting damage to residences, nonresidential buildings, bridges, and roads and agriculture and timber losses. The strongest tornadoes touched down southwest of Little Rock in Clark, Saline, and Pulaski counties; the estimated widths of the tornado paths ranged from 1/2 to 1 mile, and wind speeds were > 200 miles per hour (National Weather Service [NWS], unpublished data, 1997). This report summarizes circumstances of the tornado-associated fatalities from information collected by the American Red Cross (ARC); 14 of the 26 fatalities occurred among persons who were in mobile homes.

Adolescent↗

Human health concerns from pet ownership after a tornado.

INTRODUCTION: Although 50% to 60% of North American households own pets and many of these pets are considered family members, there is little information on the impact of pet ownership on pet-owning families affected by disasters. METHODS: This case report describes some of the effects of a tornado on 17 families whose dwellings were destroyed. The setting was a typical urban trailer park. RESULTS: After a tornado at the Sagamore Village Trailer Park in north central Indiana, 104 families were evacuated. Seventeen (16.3%) of these families owned pets. For 14 families (13.5%), pet ownership had an important impact on the families' recovery from the tornado. Public- and mental-health concerns that arose from pet ownership included failure to evacuate a dangerous site, attempts to re-enter a dangerous site, separation anxiety leading to psychosomatic disturbances, and the need for additional animal care. CONCLUSIONS: In urban disasters, the behaviors of families with a human-animal bond are likely to pose a significant risk to their own and others' health and safety in urban disasters. In this small study of families affected by a tornado, the most prominent public-health concerns were failure to evacuate because of a pet and attempts of re-entry to save a pet; the most common mental-health concerns resulted from separation anxiety from a pet and refusal to accept medical treatment until a pet's well-being can be assured. These are thought to be typical issues that will arise out of the human-animal bond in urban disaster situations and differ considerably from traditional public-health concerns over dog bites, spread of zoonotic diseases, and human food contamination. Medical disaster preparedness planning should consider the substantial effects that the human-animal bond is likely to have on human recovery from large-scale urban disasters.

Adult↗

Transcatheter occlusion of patent ductus arteriosus using tornado platinum coils.

BACKGROUND: The purpose of the present study was to develop a method to occlude a patent ductus arteriosus (PDA) using a tornado platinum coil, which is compatible with magnetic fields. METHODS: Twelve patients with a PDA (5 boys and 7 girls; 0.6 to 7 yrs; 6.5 to 22.1 kg) were enrolled. The minimum size of the PDA ranged from 0.2 mm to 3.6 mm. Either the anterograde or retrograde method was applied using a retrievable system that consisted of a 5-Fr multipurpose catheter and a 3-Fr bioptome. Three to 3.5 loops of the larger end of a tornado platinum coil were placed in the aortic ampulla and the remaining 0.5-1.0 loop of the smaller end of the coil was placed in the main pulmonary artery. RESULTS: In 11 patients with minimum size of PDA </= 2.8 mm, the PDA was successfully occluded using one to five tornado platinum coils and, in 10 of 11 patients, an echocardiogram confirmed complete occlusion up to 6 months after the procedures. In the remaining patient with a relatively large PDA (3.6 mm), the PDA could not be occluded because of instability of the coils. CONCLUSIONS: It is feasible to occlude a relatively small PDA (</= 2.8 mm) using tornado platinum coils, but further study is warranted to evaluate the safety and efficacy of this method.

Child↗

Risk factors for tornado injuries.

Tornadoes in North and South Carolina on 28 March 1984 caused 252 people to be injured seriously enough to require hospitalization and 59 to be killed. To evaluate risk factors, we gathered information on 238 (94%) of those hospitalized and 46 (78%) of those killed. Those hospitalized or deceased had statistically significantly more deep cuts, concussions, unconsciousness and broken bones than those with them at the time of the tornado who were not hospitalized or killed. People living in mobile homes were more likely to be hospitalized or die than people occupying conventional houses. Other risk factors for hospitalization or death included advanced age (60+ years), no physical protection (not having been covered with a blanket or other object), having been struck by broken window glass or other falling objects, home lifted off its foundation, collapsed ceiling or floor, or walls blown away. More awareness of the tornado risk before it strikes and better adherence to tornado protection guidelines could reduce injuries and deaths in the future.

Adolescent↗

Tornado disaster in rural Georgia: triage response, injury patterns, lessons learned.

Our objective was to characterize the medical response and injury patterns from a recent tornado disaster in rural southeastern Georgia. We conducted a retrospective review of 11 patients treated at a Level I trauma center after sustaining injuries due to an April 9, 1998 F3 tornado. Data were obtained from trauma registry and medical records. Of 11 victims, 8 (73%) were male. Ages ranged from 5 to 54 years. Two patients were triaged directly by military helicopter, six arrived as secondary triage from local rural hospitals (2 by air, 4 by ground), and three arrived by delayed secondary transfer. Six patients were thrown by the tornado, and five were struck by flying debris. All victims were either in exposed areas or mobile homes. Injuries by anatomic region included the chest (45%), abdomen (27%), extremity (91%), and head (45%). Nine (82%) of the patients required surgical intervention. These included three laparotomies, one thoracotomy, six orthopedic procedures, and one neurosurgical procedure. The average Injury Severity Score (ISS) was 23. Among patients who were thrown mean ISS was 31; among those struck by debris, mean ISS was 12. Hemodynamically significant pelvic fractures occurred in three patients (27%). The major complication, sepsis due to Serratia marcescens was seen in three patients, all of whom had been thrown and had clinically significant wound contamination. Both patients who died had Serratia sepsis and multiorgan system failure. The injuries and inclement weather characteristic of tornado disasters stress regional trauma triage responses, cause significant injury, and disrupt communities. Injury patterns involve multiple systems and require coordinated efforts among caretakers. Infectious complications are common and frequently involve Gram-negative bacilli and are associated with soil-contaminated wounds. Trauma severity increases if the victim is thrown rather than struck by flying debris.

Adolescent↗

Tornado disaster--Kansas, 1991.

On April 26, 1991, 54 tornadoes swept across six midwestern states, causing 24 deaths and more than 200 injuries, requiring disaster-relief services for more than 8000 persons, and causing property damage of more than $250 million. In Kansas, one tornado, with wind speeds exceeding 260 mph, caused 17 deaths. The 46-mile path of the tornado led through Andover, Kansas (Butler County) (population: 4300), where the town's only outdoor warning siren failed. A mobile-home park (MHP) in Andover with 244 homes and one community storm shelter was struck by the tornado, resulting in the destruction of 205 (84%) of these homes. This report summarizes a poststorm survey, conducted by local health departments, the Kansas Department of Health and Environment, the American Red Cross, and CDC, to identify risk factors for injury and death among persons in the MHP.

Adult↗

Tornado disaster--Alabama, March 27, 1994.

On Sunday, March 27, 1994, a series of severe thunderstorms and tornadoes moved across Alabama, Tennessee, Georgia, North Carolina, and South Carolina. These storms accounted for injuries to at least 422 persons, including 47 fatalities. Twenty-three fatalities were associated with a tornado that cut a path across St. Clair, Calhoun, and Cherokee counties in northeastern Alabama from 10:55 a.m. to 11:39 a.m. (Figure 1). This tornado damaged or destroyed three churches while services were being conducted. This report provides a summary of the injuries and deaths associated with this tornado based on information from death certificates from coroners' offices in the three counties and from emergency department and inpatient medical records from eight area hospitals.

Alabama↗