title: EDs credit drills, community engagement with helping them manage casualties from tornado crises.
abstract: Emergency department leaders at DCH Regional Medical Center in Tuscaloosa, AL, and Cullman Regional Medical Center in Cullman, AL, credit their regular practice drills with helping them deal with unprecedented demand when deadly tornadoes swept through the South this past April. Both facilities used the hospital instant command structure (HICS) to mobilize the resources needed to care for the surge in patients, and say the approach worked well in helping them meet the needs of their communities. However, the crises also showcased opportunities for improvement. The ED at DCH Regional Medical Center saw more than 600 patients on the day of the storm, a three-fold increase in the hospital's typical volume. CRMC treated 99 patients in the seven hours immediately following the storm when it usually treats 114 patients per day. In addition to a big surge in patients, both hospitals dealt with power outages that limited access to some services such as radiology. Triage proved particularly challenging at DCH Regional Medical Center, as patients flowed into the hospital from numerous access points. The hospital plans to assign coordinators to each area of the hospital to better manage the influx in the future. When reviewing emergency operations plans, Joint Commission reviewers often find deficiencies in hazard vulnerability analyses as well as the processes used to determine the emergency credentials of licensed independent practitioners.
mesh_terms: D000407:Alabama; D003159:Community-Institutional Relations; D004189:Disaster Planning; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D054527:Mass Casualty Incidents; D055872:Surge Capacity; D055869:Tornadoes; D014218:Triage / Q000458:organization & administration