title: Get off the bus: sound strategy for injury prevention during a tornado?
abstract: BACKGROUND
  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).
  
  
  CONCLUSIONS
  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.
authors: The Ohio State University, College of Medicine and Public Health, Department of Pediatrics, Columbus, Ohio 43205, USA. comstocd@pediatrics.ohiostate.edu
authors: R Dawn
authors: RD
authors: Comstock
authors: Sue
authors: S
authors: Mallonee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001924:Brain Concussion / Q000453:epidemiology; D015984:Causality; D002648:Child; D004189:Disaster Planning / Q000379:methods*; D004190:Disasters; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018986:Motor Vehicles; D009825:Oklahoma / Q000453:epidemiology; D016019:Survival Analysis; D014947:Wounds and Injuries / Q000453:epidemiology / Q000517:prevention & control*