One discarded triage tag in the American Legion Hall parking lot on May 16 was one of the few remaining pieces of evidence of the incredible job by first responders the night before.
The building was used as an initial triage site to quickly provide medical attention to about 200 people who had been injured in the May 15 tornado that struck practically next door, in the Rancho Brazos subdivision. Of the 200, about 30 had critical injuries, Texas EMS Executive Director Verne Walker said.
Teamwork and skill enabled 22 Texas EMS personnel to process the injured with a high degree of efficiency, Walker said.
“We triaged and moved people in less than a minute per person,” Walker said. “We had almost every single employee working that night.”
Texas EMS Operations Manager Cliff Montemayor said, “A lot of it is the training we do and the people we had with experience in those types of scenarios. It was absolute teamwork. Everybody had their assignment, and they did their role and they did it efficiently.”
A secondary triage site was set up north of the American Legion building at Oak Woods School, also on Davis Road. Most of those injuries were not as severe, and only four patients had to be taken by ambulance to hospitals from that location.
“From looking at regional events that have occurred around us, I’m very impressed with the way our county disaster plan worked,” Walker said. “Less than one minute per person is phenomenal.”
Only seven of the 22 Texas EMS personnel had been on duty before the time the tornado first touched down in Rancho Brazos – believed to be at 8:02 p.m.
“We got our first call at about 8:14,” Walker said, noting that a quick request for mutual aid from surrounding counties also helped because Texas EMS has only four ambulances. That outside help included 28 separate companies. There were 42 pieces of equipment – mostly ambulances – that flowed into the county from other areas.
That initial call reported nothing about a tornado, just that a 10-year-old boy had suffered an arm laceration from a broken window – not a life-threatening injury. When Texas EMS Shift Supervisor Clint Perkins was the first to arrive in Rancho Brazos, it was obvious by then that the injured the boy was only a tiny part of the overall picture. The neighborhood had been devastated, and Perkins and the rest of the paramedics who arrived realized that multiple fatalities were likely.
The triage tags, used in the immediate aftermath of a disaster where there are mass casualties, also helped save time in triage.
After an initial medical assessment, each injured person had a color-coded tag placed around his or her neck.
“You’re assigned a color based on your condition. You don’t have time for date of birth or name,” Walker said. “If you can walk, you’re green. If you’re severely injured but stable, you’re yellow.”
The next two tag colors are even less desirable – red for critical or life-threatening condition, and black for fatal injuries, Walker explained.
There were 41 who fit in either the red or yellow tag category, Walker said.
In normal situations, paramedics will “do everything for everybody until there’s no hope left,” Walker said. But with limited personnel and time, difficult decisions must be made using mass casualty criteria – not unlike war scenarios. In those extreme cases, attention must be diverted from one who obviously won’t survive for the sake of others who can be saved if they get prompt attention.
“This creates an emotional burden … stepping away from that person,” Walker said. “It really was a military type of situation. We were doing the best we could with limited resources.”
Only one of the injured tornado victims died at the American Legion triage site, officials said. Medics saw that the man’s dire condition was hopeless and turned their attention to someone else, who survived.
“I think it takes a very special person to perform the job we do,” Walker said, noting that he was proud of his ambulance crews. “We see things the average person wouldn’t be able to handle. On a normal basis, we handle that with grace and skill.”
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